"If every major country on earth can guarantee health care to all, and achieve better health outcomes, while spending substantially less per capita than we do, it is absurd for anyone to suggest that the United States cannot do the same," Sanders said in a statement. "This grossly misleading and biased report is the Koch brothers response to the growing support in our country for a 'Medicare for all' program."
July 31, 2018
"Sen. Bernie Sanders' 'Medicare for all' plan would boost government health spending by $32.6 trillion over 10 years, requiring historic tax hikes..."
"... according to the analysis by the Mercatus Center at George Mason University in Virginia. Doubling federal individual and corporate income tax receipts would not cover the full cost, the study said" (Bloomberg).
Subscribe to:
Post Comments (Atom)
Posts
360 comments:
«Oldest ‹Older 201 – 360 of 360The European attitude towards universities (and to a large degree high schools, or their equivalent, is that students are adults.
There is no American in loco parentis. The idea is absurd.
Just sell a wide variety of health care plans on Amazon - from high deductible to Cadillac plans and any other creative ideas providers come up with. Doctor's groups and hospitals could all have their own plans and compete. Then they publish their prices, and people will get what they want, and what they can afford, and they will lower costs like you won't believe, becuase those who don't compete will be looking for other work. The market would fix most problems with health care costs. Health care is the only thing you buy where you don't know the cost until after you commit to buy. It's impossible for that system to not have wildly inflated pricing and waste. Are we stupid or what?
Apparently elementary mathematics is just another Koch Brothers conspiracy.
“The Koch brothers provided funding for an academic study which can be rigorously analyzed to your hearts content.
The left is complaining that this study is all wrong wrong wrong because "Koch!!!11!1!!111!eleventy!"”
Donald J. Trump
Donald J. Trump
@realDonaldTrump
The globalist Koch Brothers, who have become a total joke in real Republican circles, are against Strong Borders and Powerful Trade. I never sought their support because I don’t need their money or bad ideas. They love my Tax & Regulation Cuts, Judicial picks & more. I made.....
5:14 AM · Jul 31, 2018
Donald J. Trump
Donald J. Trump
@realDonaldTrump
....them richer. Their network is highly overrated, I have beaten them at every turn. They want to protect their companies outside the U.S. from being taxed, I’m for America First & the American Worker - a puppet for no one. Two nice guys with bad ideas. Make America Great Again!
5:23 AM · Jul 31, 2018
I don't want "free" healthcare, just like I don't want government cheese or a government provided car. Imagine that piece of shit. I want to pick and choose my providers and my treatments and pay for them like an adult who cares about the health of his body and his bank account and is not willing to trust bureaucrats with either. They fuck up everything they touch, because they don't care. Who thinks they do?
@bagoh20. well said. Let the market have a shot at this. Innovation, technology, and faith in our ability to solve tough problems. Who really thinks that anyone in congress is capable of 'providing' health care. Bernie is a joke. So are most congress people. The job of government should be to stay out of the way of innovation. Looking to government to solve this problem is stupid. Stop trying to solve the current problems with ideas that didn't work in the past century.
Amazon, Walmart, and cash only clinics are going to change the debate. It is happening now, at small startups and large companies. Trying to impose a one size fits all model on America is a non starter. except for those who think government is the answer to all problems.
Inga provides Koch brother bona fides!
I have sincerely wondered if the infant mortality statistic comparison is as broken as it once was. I have been reading about the problems with that comparison for at least a decade or more and it could well have been revisited.
Good news - the left just fell in love with the dreaded Koch Brothers.
woot!
“Let the market have a shot at this.”
The market had a shot at healthcare for decades before the ACA.
Henry: "Inga provides Koch brother bona fides!"
Indeed.
The Parrot is feverishly posting pro-Koch/Hannity/etc links left and right.
Of course, there is never any comment from her about what precisely the import is of what she is posting, but that is to be expected.
I've never actually seen a real Parrot explain its thinking on a particular issue either.
@ Bagoh I don't want "free" healthcare, just like I don't want government cheese or a government provided car. Imagine that piece of shit.
LOL. You don't want the Pelosi-go?
Everyone pays more under ACA, with less choice. Score one for the left!
Earnest Prole: "Apparently elementary mathematics is just another Koch Brothers conspiracy."
It's worse than that for our lefties!
"Teaching maths perpetuates white privilege, says university professor"
https://www.independent.co.uk/news/world/americas/teaching-maths-white-privilege-illinois-university-professor-rochelle-gutierrez-a8018521.html
Mathematics is literally White Supremacy now for the left.
Letting the market flourish and naturally lower costs and increase access and choice will never work because there's no room for Deep State graft.
Inga would probably be able to fully explain her thinking if it wasn't for that "b**** Althouse" and Johnson and that damn war!!!
“Inga provides Koch brother bona fides!”
Drago mustn’t have gotten the directive from Trump yet, the Kochs are personas non grata now.
Inga lives in the past. like most leftists. The system that existed when I was a child was far superior to what we have now. But technology and innovation have changed everything. It will change health care, if government gets out of the way.
Hey Drago, Facebook knows what you’ve been doing...
Not sure what the problem is. Tax everybody fifteen percent of gross income, let VA run the program.
gilbar said...In countries with VATs, do people buying things with their EBT cards have to pay VAT too?7/31/18, 8:28 AM
If you buy anything in countries with a VAT system, you pay! Think of it as the ultimate (con) in hidden taxes - you never see it! This is in addition to local, state, Federal Sales taxes which have been creeping up ever more aggressively the last 20 + years.
“Inga lives in the past. like most leftists.”
Then he goes on to say this...
“The system that existed when I was a child was far superior to what we have now”.
Who longs for the past? Not me. I’m a progressive, progress, get it?
Yes, and my no-deductible cadillac plan cost half of what my current $2000 deductible plan costs. That's with the old system only being nominally free market. Consumers still didn't know the costs. If they did have pricing input, costs would be a fraction of today.
I just paid $2000 to have a large thorn removed from my toe the other day. On my old plan I had a cancer cured twice with expensive chemo and very extensive surgery that costs well over $500,000. Before the ACA this cost me zero above my premiums which were half of now. Only the government could make a bad system much much worse.
The market had a shot at healthcare for decades before the ACA.
And as a result we have open heart surgery, organ transplants, chemo, cholesterol drugs, MRI machines, portable xRays, eye surgery, joint replacements, laparoscopic surgery, and AIDS/HIV control drugs. Dishonest people try to hide these advances by grouping everything together under "healthcare" but the truth is we pay more because we get more.
Henry said...
I think this is is a case where oversimplification completely misses reality.
Any group decided coverage (Death Panels) cares very much about cost-benefit analysis. If you can get effective medical treatment for 95% of patients where the final 5% costs 50% more, it's cost-effect to target the service to the 95%.
Targeting 90% is even more cost-effective. Targeting 50% much more so.
Individuals paying out-of-pocket for themselves or loved ones care very much about not dying.
How dare they! They might even go on to spend their own money on that, even if they are not in the 95% that you deem worthy of life. We certainly can't allow that.
We allow people to buy a fancy sports car when it would be more practical for them to buy a modest sedan. They can get a big screen TV when a middle-of-the-road model would be more practical. But God forbid we let the avid outdoorsman get the high-end knee replacement (spending his own money) when the middle-of-the-road model is sufficient for the couch-potato bureaucrats on the approval board.
if it wasn't for that "b**** Althouse" and Johnson and that damn war!!!
Why wouldn't she just show up like nothing ever happened? It's not like it's the first time.
What would you rather have?
Nuclear weapons, or free health care?
Plutonium should only be used for medical purposes.
We should get rid of all plutonium based energy, or force the owners to pay for it themselves.
I believe we should keep about 100 nukes, submarine only, the rest should be destroyed.
“And as a result we have open heart surgery, organ transplants, chemo, cholesterol drugs, MRI machines, portable xRays, eye surgery, joint replacements, laparoscopic surgery, and AIDS/HIV control drugs. Dishonest people try to hide these advances by grouping everything together under "healthcare" but the truth is we pay more because we get more.”
Oh poor Canada, Australia, Germany, Great Britain, France, etc etc etc. I bet they wish they would have our technology and medical advancements, instead of using barbers as surgeons, hey?
US medical care and medical insurance was highly regulated prior to ACA.
And even then 80% of medical expenditures were paid by government systems or through mandated employer medical insurance.
So you were and are 80% socialist already.
Yet another fact that seems to need a pickaxe into the skull to drive home.
Let's remember that the current system sucks by design. Obama openly said it was the path to single payer, and the effort to punish us into accepting that continues.
After seeing the IRS weaponized against political foes, imagine giving them control of your very life. What could go wrong?
"perhaps you should travel more to learn about other countries?"
r/v - Perhaps you should investigate the data rather than rely on word of mouth and individual experiences.
The U.S. infant mortality rate is influenced by far greater attempts to save preemies in the US than the rest of the world. Another commenter brought up the issue of higher drug addiction rates here. I do not doubt that a dive into the data will turn up even more factors that account for a higher infant mortality rate here than your implication that our "system" is failing.
Things are often far more complicated than lefties would like them to be.
As a retired military veteran, I get free Prescriptions (I have to pay shipping).
I pay less than $600 a year for coverage (two payments of almost $300).
Why can't Americans have the same thing their useless retired military have?
20 years service for lifetime benefits. Only Congress gives themselves a sweeter deal.
The market was killed slowly and purposefully by the faux good intentions of decades and decades of Teddy Kennedy government gas-lighting. Each new shining promise soon became a terrible threat that needed a new government solution. The road to a socialized system is all by design. Incrementalism. The time for Universal Government Run Health Care is now. It's broken again, you see. the real solution is just around the corner.
All Inga has to do is explain why nurses will be thrilled to take a huge cut in pay for the greater glory of the Democrat party.
"Oh poor Canada, Australia, Germany, Great Britain, France, etc etc etc. I bet they wish they would have our technology and medical advancements, instead of using barbers as surgeons, hey?
Or idiots as nurses, eh?
I bet they wish they would have our technology and medical advancements, instead of using barbers as surgeons, hey?
In fact they do have our technology and medical advances. Apparently Inga's preferences rely on the idiotic belief medical advances are developed independently in each country.
We knew there had to be some stupid rationalizations to support such obviously wrong conclusions but it's stunning to see just how stupid they really are.
“Why wouldn't she just show up like nothing ever happened? It's not like it's the first time.”
She’s been called worse by some of her regular conservative/ Trumpist commenters. I recall a few weeks ago she was called a “cunt” on the post on Sarah Palin and Sasha Baron Cohen, in which she said Palin sounded dumb. That sure made so many of you mad. How dare she call Palin dumb? Those who called her a “cunt” are still commenting here, btw.
I recall a few weeks ago she was called a “cunt” on the post on Sarah Palin and Sasha Baron Cohen,
I don't remember that but I don't read the comments on every post. I do remember you calling another commenter the same thing though.
"What would you rather have?
Nuclear weapons, or free health care?"
Nuclear weapons. I can handle my own healthcare, but defending the whole country is asking a bit much of me. Besides, defense is the constitutional duty of the government, and health care is not.
“In fact they do have our technology and medical advances. Apparently Inga's preferences rely on the idiotic belief medical advances are developed independently in each country.”
The passive agressive little pussy man Rick seems to think no other countries besides the US developed any medical advances.
The market had a shot at healthcare for decades before the ACA
Actually ....no.
The Medical Insurance industry is one of the most highly regulated. By the States who tell them what they must and must not offer. By the Federal Government. Forbidden from being able to offer products over state lines. Told how much they must charge and many many other restrictions.
A free market would allow each individual to pick and choose from plans from all over the Country and to choose what he/she wanted to cover and what NOT to cover.
We have not had a free market in Medical Insurance. Probably not ever.
@ignorance -- The point is that cost-benefit analysis is incompatible with the reality that most people will beg-borrow-or-steal to avoid death.
You can have two systems, which many countries do.
But you can't ascribe cost efficiency to the latter.
Inga: "Those who called her a “cunt” are still commenting here, btw."
And now you join their illustrious ranks.
Congratulations.
If you talk to sick people in nations with government run systems, they are not happy. Ever.
As a first step, I would provide all health insured Americans Americans free prescriptions.
Then I would regulate the drug manufacturers, so that there can be no monopoly.
If you are a foreigner, here legally (vacation or work), then you should be covered the same as Americans.
All IV's should be free, and administered freely.
Blogger Freder Frederson said...Most VAT exempts food (which includes beer and wine in Germany) 7/31/18, 8:41 AM
The problem with such a generalized observation it misses the point. Firstly, statement is only partially correct. Food definition is the key - ingredients going into making food (similar to Cost of Goods Sold) are all taxed by VAT. In your example, barrels, warehouses, vines, water, wires, etc., are all taxes by VAT. At the end of the day, the tax is quite large and pernicious.
Dickin'Bimbos@Home said...If you talk to sick people in nations with government run systems, they are not happy.
The reason is, there is no limit on who can participate.
If only citizens,legal immigrants, and work visa people were covered, the butter could be spread thicker.
RV, the WHO provides the stats you used and they do NOT count every live-born infant as a live birth. You are wrong. And England’s NHS was just in the news for forbidding parents to take their very sick infant to USA for treatment, and “rationed” the child’s care per usual causing much pain and suffering. Maybe you need to travel more. I’ve worked in UK, Sweden, Canada, Spain extensively since 2000 and have seen how different standards of care are. Yes we spend a lot in the USA but the level of care is unmatched by any other system. And most of them have switched to a combo of socialized plus insurance and private hybrid. You can’t give everything away “for free” and have open borders. One if the other. Not both. I still have a factory in France and second Mike K’s appreciation for that system.
"If it wasn't for those meddling Democrats and that dog we would have gotten away with much better health care, at a cheaper price!"
Inga says....The passive agressive little pussy man Rick seems to think no other countries besides the US developed any medical advances.
"The United States remains the world leader in medical innovation, having produced more than half of the world’s new medicines over the last decade." - Forbes
But I am circumspect, being what we have to measure outcomes are produced by governments, I question whether governments are honest in this reporting. Yes, there is a gap favoring OECD countries vs. USA, but the GAP is not an apples to apples comparison and not that large.
bagoh20 said...Nuclear weapons
100 ?
1000 ?
10000 ?
I think I read where the USA has over 4000 nukes, and enough plutonium for thousands more.
P.S. plutonium is what is used in nuclear reactors because of the investment from WW2. It consumes research dollars that would allow low pressure nuclear plants.
It will come out as no doctors accepting medicare and everybody running a cash business.
Remember Hillary Care? She addressed the issue. Docs/hospitals would be forced to accept medicare. IIRC it was to begin a fixed percent of patients. Of course as that coverage filled the percentage would have to rise until all doctors would have to accept medicare for anyone.
Somehow, some way the elites will slither through loopholes. But for us plebes...
The passive agressive little pussy man Rick seems to think no other countries besides the US developed any medical advances.
It's no secret America leads the world in medical advances and has for the last century. Insisting "no" other countries develop "any" advances is just you realizing you can't make your point reasonably and must invent a strawman to even form a response. You unintentionally concede the point by insisting it is only false if other countries develop anything on their own.
This is why the left commenters are so boring. They have nothing intelligent to say and all the comments become clarifications of their various stupidities. Imagine having second graders in a college stats class. Teaching basic addition during stats is like explaining to Inga that America disproportionately drove medical advances when the topic is healthcare policy.
Plus you should probably learn what passive-aggressive means if you're going to keep writing it.
Blogger Inga said...“Let the market have a shot at this.”The market had a shot at healthcare for decades before the ACA.7/31/18, 12:37 PM
I always give Bloggers the benefit of the doubt! But can't let this ignorant comment go unaddressed. You do know that the healthcare market is the most regulated market in the USA by both the Feds and States. There is no "market" - that's like saying there is a K - 12 school market in the USA. If you believe that, then call me I'll sell you a bridge.
Rick: "Plus you should probably learn what passive-aggressive means if you're going to keep writing it"
Inga Cut and Paste Powers Activate!!.....
@Inga, answer my question from 12:58. “Medicare for All” means nothing if not that healthcare provider salaries are capped at Medicare reimbursement rates.
Via Insty:
So the Sanders “Plan” is going to save money. And all we need to do to get to that happy state of affairs is:
• Force every doctor and hospital in America to accept Medicare reimbursement rates for all patients — these are 40 percent lower than the rates paid by private insurance — while assuming that this would have absolutely no effect on their capacity or willingness to provide services
• Raise taxes by 10 percent of GDP — overnight
• Explain to the 150 million people with private insurance that the rules have been changed so dramatically that (a) they can no longer keep their plans, and (b) henceforth, tens of millions among them will be paying more in taxes than they were previously paying in both premiums and out-of-pocket costs
Easy!
" I bet they wish they would have our technology and medical advancements, instead of using barbers as surgeons, hey?"
They have that, and they have it much cheaper.
Because for the most part their governments don't add the mass of bureaucracy and litigation and cost++ regulation on even their own state-owned systems, if they have them.
The US is far more "socialist" than the socialists in fact, in terms of placing burdens not only on the private sector but on the state itself. It costs the state (feds, states, localities) more to do anything than it costs the Euros. You cannot have an American socialism because of its tendency to consume itself.
Rick said...
“And as a result we have open heart surgery, organ transplants, chemo, cholesterol drugs, MRI machines, portable xRays, eye surgery, joint replacements, laparoscopic surgery, and AIDS/HIV control drugs. Dishonest people try to hide these advances by grouping everything together under "healthcare" but the truth is we pay more because we get more.”
Maybe you should try to make less generalizations. You made no mention or gave no credit to countries that have some form of universal health care when it comes to medical advancements. You did do purposefully and when I called you on your dishonesty, you try to slither away from your own remarks. Ha, Rick this is why I call you a little pussy every chance I get. Maybe I should call you a slug.
Blogger Inga said...“Let the market have a shot at this.”The market had a shot at healthcare for decades before the ACA.7/31/18, 12:37 PM
Facepalm
50 states 50 sets of rules and coverages because each state has its own set of coverages then overlay federal rules.
It’s FREE MARKET!
Noooo. The beginnings of a Free Market would be a few basic plans available across the country that all 50 states can agree to. If they all agreed not to cover toupees, that sort of thing.
Illegal immigrants cost us more than nukes do, and the nukes aren't killing anyone.
Build the wall...
out of Plutonium!
Perhaps Inga, if they didn’t have universal insurance, they’d have more money for breakthrus and not rely on us?
Henry said...
@ignorance -- The point is that cost-benefit analysis is incompatible with the reality that most people will beg-borrow-or-steal to avoid death.
Where is the incompatibility? The government outlaws stealing, and lenders would be wise to avoid those on death's door. They can beg, if they wish ( assuming it is not illegal in their locale. ) Or they can spend their own money as they see fit. The experts can tell them how much benefit they can expect to gain from each additional dollar spent. The experts cannot say whether or not that gain is worth that dollar for that individual.
But also keep in mind that not everyone is the greedy, selfish S.O.B. that you make yourself out to be. There are plenty of people who, facing the end of a well-lived life, would be willing to say their goodbyes rather than bankrupting their families. But that decision depends on them spending their own money, not the government's.
You can have two systems, which many countries do.
But you can't ascribe cost efficiency to the latter.
My example shows one area of greater efficiency, but my argument is not based on efficiency, it is based on Get off my lawn. Also Get your hand out of my pocket, and, more generally, Fuck off, asshole.
A NEW STUDY from the Mercatus Center at George Mason University is making headlines for projecting that Independent Vermont Sen. Bernie Sanders’s “Medicare for All” bill is estimated to cost $32.6 trillion — a number that’s entirely in line with 2016 projections, and is literally old news. But what the Associated Press headline fails to announce is a much more sanguine update: The report, by Senior Research Strategist Charles Blahous, found that under Sanders’s plan, overall health costs would go down, and wages would go up .
The study, which came out of the Koch-funded research center, was initially provided to the AP with a cost estimate that exceeded previous ones by an incredible $3 trillion — a massive error that was found and corrected by Sanders’s staff when approached by AP for comment.
But despite that correction, the report actually yields a wealth of good news for advocates of Sanders’s plan — a remarkable conclusion, given that Blahous is a former Bush administration economist working at a prominent conservative think tank.
Blahous’s paper, titled “The Costs of a National Single-Payer Healthcare System,” estimates total national health expenditures. Even though his cost-saving estimates are more conservative than others, he acknowledges that Sanders’s “Medicare for All” plan would yield a $482 billion reduction in health care spending, and over $1.5 trillion in administrative savings, for a total of $2 trillion less in overall health care expenditures between 2022 and 2031, compared to current spending.“
https://theintercept.com/2018/07/30/medicare-for-all-cost-health-care-wages/
bagoh20 said...Illegal immigrants cost us more than nukes do
Nope. All the home building and yard work in Oklahoma is being performed by Central Americans.
You can't find locals willing to work in the sun.
It's too bad people who promise to leave this blog - over and over and over again - never actually, you know, fucking leave.
You made no mention or gave no credit to countries that have some form of universal health care when it comes to medical advancements.
Here's the comment so you can note there is no mention of any country. Only your desire to denigrate America brought country into the discussion.
The market had a shot at healthcare for decades before the ACA.
And as a result we have open heart surgery, organ transplants, chemo, cholesterol drugs, MRI machines, portable xRays, eye surgery, joint replacements, laparoscopic surgery, and AIDS/HIV control drugs. Dishonest people try to hide these advances by grouping everything together under "healthcare" but the truth is we pay more because we get more.
Rick this is why I call you a little pussy every chance I get.
No, you do this because you're small minded, have nothing intelligent to contribute, and hope this will prevent me from pointing out your stupidity.
Oh yay! Another massive disruption for a few billion.
Somebody correct me if I'm wrong, but it's my understanding that France has the world's best healthcare system in terms of quality, cost, and coverage for the great number of people; and that French people belonging to their equivalent of the Baby Boom generation have, all things considered, the world's best standard of living overall. But also that neither the healthcare system nor the standard of living enjoyed by the 55+ cohort will be sustainable for too much longer. That, and the Muslim problem ...
“It's too bad people who promise to leave this blog - over and over and over again - never actually, you know, fucking leave.”
Yes! Like Michael K.
Unknown said...There's a reason for the Triad.
The morale is so low in Minuteman and Bomber squadrons, that giving them nuclear weapons, is like giving them a sex toy and licorice.
At least in nuclear submarines they have high morale, and fantastic food.
What are the odds with some changes we could find those savings without another massive disruption?
That Intercept report is worth following up, but I have to laugh at this:
"The study, which came out of the Koch-funded research center, was initially provided to the AP with a cost estimate that exceeded previous ones by an incredible $3 trillion — a massive error that was found and corrected by Sanders’s staff when approached by AP for comment."
So how did this work? Sanders staff were asked why the Mercatus estimate was $3 trillion higher than previous estimates and they just said, "ignore that $3 trillion"?
And there were learned studies that “proved” that ACA would “bend the cost curve down.” In reality it bent the cost curve UP. Because of ridiculously high deductibles Obamacare amounts to little more than extremely expensive catastrophic coverage. But for sure the new studies will be on the money this time. Uh huh.
But one thing really is for certain. Under Bernie’s plan nurses will take s serious cut in takehome pay.
“So how did this work? Sanders staff were asked why the Mercatus estimate was $3 trillion higher than previous estimates and they just said, "ignore that $3 trillion"?”
—————————————
“Blahous explained the $3 trillion error in an email to The Intercept.
As you might imagine, any draft study like this is shown to many people along the way (at least 20 in this case) and goes through multiple rounds of re-estimation, editing and redrafting. Estimates in prior drafts were revised in both directions (higher and lower) in subsequent drafts on the way to final publication. One of the more recent drafts before final publication was shown to the Sanders office,” he said. “That draft contained an estimate of long-term care costs reproduced from another study, which was cited because this study had no long-term care model to draw upon. That previously-published study predated the introduction of the Sanders bill, the language of which the Sanders office asserted was not intended to increase federal financing of long-term care service utilization. In reality there probably would be some increase in long-term care utilization under M4A because its broader coverage expansion would enable more people to make use of long-term care benefits already authorized under current law through Medicaid. But rather than attempt to estimate that, I concluded the right thing to do was to reflect the language’s intended effect as represented by the primary sponsor, as was done throughout the study with the other provisions of M4A. I was very pleased to receive and incorporate their input.”
$32 Trillion only costs $32 billion to print.
So there is that...
"Rick this is why I call you a little pussy every chance I get. Maybe I should call you a slug."
Yep..you think on that. Easier than admitting his generalization is generally accurate.
I thought after calling Althouse a dumb bitch (after holding it in so long), you announced your departure.
Ah well..back again to call names.
Ah. There's more detail. The $3 Trillion is based on the assumption that Medicaid for all would include more utilization of long-term health care. Sanders' staff, says nope. Our bill won't fund more utilization of long-term health care.
Cut off grandma. Save $3 trillion.
I’m cutting and pasting so much of the article because it’s apparent that Big Mike hasn’t bothered to read it.
“But despite the explicit benefits acknowledged by the Blahous study, health policy experts and single-payer advocates David U. Himmelstein and Steffie Woolhandler, who reviewed the Mercatus study, argue that Blahous actually significantly undercounts savings that could result from “Medicare for All.”
“The Mercatus Center’s estimate of the cost of implementing Sen. Bernie Sanders’ Medicare for All Act (M4A) projects outlandish increases in the utilization of medical care, ignores vast savings under single-payer reform, and fails to even mention the extensive and well-documented evidence on single-payer systems in other nations – which all spend far less per person on health care than we do,” Himmelstein and Woolhandler explain.
In a written analysis shared with The Intercept, Himmelstein and Woolhandler write that Blahous’s report undercounts administrative savings by more than $8.3 trillion over 10 years. Taking those savings into account would lower Blahous’s estimate from $32.6 trillion to $24.3 trillion.
Additionally, the policy experts believe that Blahous underestimates savings from drug prices; for example, ignoring the success the U.S. Veterans Administration, the Canadian government, and certain European governments have had in negotiating for lower drug prices. If the United States paid European prices, they conclude, another $1.7 trillion would be trimmed from Blahous’s total cost estimate, bringing it down to $22.6 trillion over 10 years.
Himmelstein and Woolhandler also claim that Blahous grossly overestimates how much extra care would be utilized as a result of expanding insurance coverage. Using Blahous’s projections, they note that he is essentially arguing that once every American is covered, there will be 100 million additional doctor visits and several million more hospitalizations each year. But Himmelstein and Woolhandler say that’s wildly off the mark.”
Inga, I see you and I were reading and typing at the same time.
"Using Blahous’s projections, they note that he is essentially arguing that once every American is covered, there will be 100 million additional doctor visits and several million more hospitalizations each year."
From what I have read in the past (don't have any links), visits to the doctor's office decrease significantly once a copay, even just a minimal one, is involved. So it seems realistic to expect a significant increase in doctor visits and hospitalizations, a lot of them unnecessary, if Medicare for All happens.
I was wondering if even one of the far left commenters would show their faces to try and defend numbskull Bernie Sanders. Looks like one did. She is Bernie's kindred spirit and just as dumb.
Big Mike, half the article is sheer fantasy, but it's worth a read.
Blauhaus seems to have honestly assessed Sanders' bill based on Sanders' own parameters and come up with a fairly conservative cost estimate. The Intercept reporters then call upon some single-payer enthusiasts who say, "No way man, the savings will be crazy huge better!"
I think I posted this many times before -
On a per-capita basis adjusted for purchasing power (PPP), the US already collects enough money through Medicare alone to buy an entire Canadian-type medical care system.
If you add to that all the various other medical insurance and employer mandated payments according to US law, you could have a Canadian system, or a German system, or any other damned system you like. Any system, and that would still be the most well-funded system on earth.
Many of you are wandering about barking at each other mindlessly about nothing, and the higher up the argument the more mindless it is.
It's my understanding, and please do correct me if I'm wrong, that many non-U.S. countries have agencies that not only grant or withhold approvals for sales of, say, pharmaceuticals (and medical devices, too?) in their countries, but also set the prices at which they will be sold. And, if a drug manufacturer does not agree to the price limit, ... then it cannot sell at all into that market. Any drug manufacturer who desires to sell product internationally will agree to price limits in order to access new markets.
The U.S. does not set the sale prices of pharmaceuticals; the FDA's authority is limited to a determination of safety and efficacy.
If that information is correct, then any comparison of drug/medical spending by the U.S. and other countries is invalid. Instead, it underlines the "free rider" status of any country that enjoys the benefits of foreign medical innovations, but refuses to bear its pro rata share of the costs (costs that include all the product failures as well as the successes.)
I have question that perhaps someone here might answer? When calculating the cost of medical care in non-U.S. countries, does that always include spending from the general treasury fund when targeted revenues (required individual payments in, or general tax allocations) don't meet annual expenses? In other words, are we sure that comparisons of spending is apples-to-apples and includes the whole bushelful?
Just went to the actual paper. Here's a key graf from the abstract:
. It is likely that
the actual cost of M4A would be substantially greater than these estimates, which assume
significant administrative and drug cost savings under the plan, and also assume that healthcare
providers operating under M4A will be reimbursed at rates more than 40 percent lower than
those currently paid by private health insurance.
Inga, this returns us to the question earlier. Are doctors and nurses willing to take a 40% pay cut to achieve single payer?
* * *
Since we already have an answer for that (no), the Sanders parameters are fantasy.
Using Blahous’s projections, they note that he is essentially arguing that once every American is covered, there will be 100 million additional doctor visits and several million more hospitalizations each year. But Himmelstein and Woolhandler say that’s wildly off the mark.”
Understand what this means:
There won't be more utilization because people are accessing what they need / want already. These two are claiming the left's assertion that large percentages of Americans don't have access to healthcare is a lie.
This undercuts the entire (public) rationale for healthcare reform and reveals the movement is ideological / political and desires only control of healthcare for the ancillary employment / voting / contribution benefits to Democrats just as critics have asserted all along.
https://www.youtube.com/watch?v=8DO0kxKMHIA
" If the United States paid European prices, they conclude, "
The US could do that without changing a thing about the financing structure of medical care.
"well-documented evidence on single-payer systems in other nations "
Most other nations don't have a single payer system. They have lots of diverse systems. "Single payer" is a typical bark from the mindless dogs.
It is more meaningful when we try and distill these YUGE numbers down to factoids we can actually grasp a bit better.
If there were 100 million additional doctor visits, and all things being equal, that suggests there would be about 4 million more in Pennsylvania since PA has 4% of the country's population. There are about 12.6 million residents in the state so 4 million more visits equates to about 1 additional visit for every three residents. That does not sound like it would be "wildly off the mark". In fact, I suspect the number of additional doctor visits would be far higher.
Gives new relevance to Will Rogers' statement, "I remember when 'liberal' meant being generous with your own money."
The morale is so low in Minuteman and Bomber squadrons, that giving them nuclear weapons, is like giving them a sex toy and licorice.
Low morale is a problem in the silos but not in the bomber squadrons,
In any case that's an argument for taking steps to rais morale not for eliminating the Triad.
But low morale is not an issue. The Triad continues to be workable in all three of its legs and that's what counts in terms of its effectiveness in providing a convincing and viable second- and third-strike capability. The doctrine of massive assured retaliation, to which the Triad's existence is foundational, is similar to that of the "fleet in being" concept of an earlier age: if it exists it is serving its purpose. In the event you can provide no evident concerning whether low morale will prevent the missile silos from launching and the strategic bombers from flying in the event of a nuclear war.
That is an excellent point Rick. They are trying to have it both ways.
Differences of RN pay in USA and Canada
"Are doctors and nurses willing to take a 40% pay cut to achieve single payer?"
I don't think they need to, under any reformed system. Most of the excess costs in the US system are in various sorts of overhead, process costs, bureaucracy, legal risk, mandates, etc. There are too many people being paid out of medical funds that don't actually provide medical services.
Just like your universities pay a vast army of people who don't teach.
"Using Blahous’s projections, they note that he is essentially arguing that once every American is covered, there will be 100 million additional doctor visits and several million more hospitalizations each year."
Most of that is due to (a) covering the previously uninsured, which is entirely rational to estimate and (b) expanding basic coverage for dental and vision.
@Inga, of course I didn’t read it. I’m a mathematician and nearly all of these phony studies make me angry. You’d laugh hysterically at someone trying to do a nurse’s job without training but I’m supposed to read a bullshit study and treat it seriously? I predicted that the study presumes steep reductions in salary for healthcare providers. Henry confirms it. No doubt it assumes a lot more than that.
Inga has posted a useful article. There is little difference in RN pay, Canada-US.
I don't expect that there should be. Note that Canada does this, and moreover provides a similar population/nurse ratio, while spending per capita about as much as the US spends on Medicare alone - which is truly "single payer".
Its not about how you pay. Its that in the US a great number of non-medical people pile enormous additional expense on the system.
Does the plan assume the barring of malpractice suits? Then given the preponderance of lawyers in the government Bernie’s plan is DBA — dead before arrival.
I have no complaints over the general quality of U.S. healthcare. In fact am thankful for it. I been at death's door on several occasions and was saved each time by the excellent care I received. I am talking about emergency care for physical traumas and the like. I don't know about long term care which I acknowledge is highly problematic and variable in terms of quality and cost.
As for Canada: I've never met a Canadian who had anything good to say about their healthcare system. And I've met a lot of Canadians who disparaged their system in the strongest terms. Many if not most have told me that when the situation is dire they go to the lower 48 for treatment.
Just like your universities pay a vast army of people who don't teach.
The most expensive public education system in the world, that produces a product that is not even in the top ten.
Most of the excess costs in the US system are in various sorts of overhead
Also redistributed (i.e. shifted) costs, in some cases global, for research and development, unhealthy/liberal lifestyles and Choices, poor education and health care (not medical care), excessive immigration (after Planned Parenthood/selective-child), and market dislocations forced by regulatory, legal, and single-payer (i.e. monopoly) disparities.
Asset inflation schemes (e.g. Fannie/Freddie, Obamacare, Net Neutrality) only aggravate the effects. It's a cumulative problem that persists with a complex and progressive ball of yarns.
Blogger buwaya said...
Inga has posted a useful article. There is little difference in RN pay, Canada-US.
Sorry, I didn't see anything in the article that indicated whether the relative compensation info was in CAD or USD. If each is in home-country dollars, then we have no idea of the exchange rate at the time of writing. Perhaps I missed it?
If the compensation (and is that total compensation or only cash wages?) is not expressed in similar terms, then the information is useless for comparison, is it not?
Progressive costs and redistributive schemes can only be sustained in the short-term through capital and labor debasement, Planned Parenthood/immigration reform, and labor and environmental arbitrage in developing nations that are willing to bear the burden of our social progress and environmentalism. Eventually, inevitably, the market will self-correct (typically with a decadal period), catastrophically, despite the heavy hand of socialist monopolies and practices.
"Its not about how you pay. Its that in the US a great number of non-medical people pile enormous additional expense on the system."
Such as malpractice lawyers who use junk science to sue competent doctors a la John Edwards.
Such as administrators with two-bit degrees making millions while MDs and PhDs with far greater credentials making a fraction of their pay.
Such as government bureaucrats ... why go on?
Once you reform these aspect of the healthcare system, I will seriously consider universal Medicare. Until then, I suspect any proposals for "reform" will be biased in favor of the connected rather than the competent.
Some googling suggests that doctors in the U.S. are paid as much as double as Canadian doctors. They are also far more likely to be specialists.
50% pay cut for Doctors should fly.
Experts have said! Single payer health care experts... have said.
What a pantload.
The people are smothered by bullshit artists and so-called experts.
"Its not about how you pay. Its that in the US a great number of non-medical people pile enormous additional expense on the system."
Such as malpractice lawyers who use junk science to sue competent doctors a la John Edwards.
Such as insurance administers. Such as compliance officers. It is the same as schools and big business. Government (and their captured lackey the insurance company) wants to micromanage outcomes, so they need data, so they require a lot of data to be presented to them, in their format.
Most of the better Canadian specialists left 25 years ago. Canada froze medical and nursing schools for years . I was at a medical quality meeting a few years ago and met the architect who was building the first new hospital in Canada since the 1950s.
The leftists, like the bedpan commando, think all foreign systems are alike. Much of that is lack of any experience.
I have for years believed we could adopt the French system and save money with no loss of quality.
"On my old plan I had a cancer cured twice with expensive chemo and very extensive surgery that costs well over $500,000. Before the ACA this cost me zero above my premiums which were half of now."
This is why healthcare insurance costs must go up. In the olden days (decades ago) when I was a wee one we had a saying re money not growing on trees. Bag et. al. missed that.
Imagine if Bag could borrow dough to buy a half million dollar car such that the amount of his old premiums were a high enough of a payment such that his Ferrari was paid off in a few years.
Premiums are expensive because the underlying thing that is being purchased is expensive. Americans, on average, are getting big dough health care. Gotta be paid by someone.
Math is tricky.
We already effectively have single-payer (i.e. regulated market). As with the very expensive education system, the problem is not in payment (we can double the national debt, inflate assets to the moon, and redistribute the consequences) but in costs and inefficiency forced by monopolies and practices. Expert systems (e.g. single-payer) are simply inefficient and unviable for long-term governance in diverse (i.e. numerical, not color), complex environments with finitely available and accessible resources. That said, a commitment to life and rejection of Choice would go along way to address the uncertainty of ethics, morality, and motives of the Twilight fringe.
Re: Murph:
It's my understanding, and please do correct me if I'm wrong, that many non-U.S. countries have agencies that not only grant or withhold approvals for sales of, say, pharmaceuticals (and medical devices, too?) in their countries, but also set the prices at which they will be sold. And, if a drug manufacturer does not agree to the price limit, ... then it cannot sell at all into that market. Any drug manufacturer who desires to sell product internationally will agree to price limits in order to access new markets.
I think that's basically correct as to Japan and Korea. In Japan, health insurance reimbursement rates are set by the Ministry of Health and Welfare, on the advice of the Central Social Insurance Medical Counsel (中央社会保険医療協議会, popularly known in English as a "Death Panel" (haha)). Basically, there's a patchwork of different insurance programs that charge different amounts, both private employer-provided insurance and public insurance (which I think is run by prefecture), but they all reimburse at the same rates (with a 30% copay born by the patient), and don't cover the latest, most expensive medicines or procedures, although patients can pay for certain approved "advanced" procedures individually alongside normal insurance coverage for covered elements of the overall program of treatment. And for unapproved "advanced" treatments, patients just pay everything themselves. This is an issue with cancer treatments, which can be expensive, but there is still a market in Japan. So it's not that you're necessarily totally excluded from the market, but there's strong incentives to price in such a fashion that you get on the approved list.
The dimwit left will never adopt the French, or a similar system because it uses market mechanisms and the left considers markets the way vampires think of garlic.
adopt the French system and save money with no loss of quality
It's a first-payer, single-refund, non-contributory (i.e. welfare) allowance system with expert adjudication, right? So, it has the necessary market function to mitigate progressive risk and corruption, while assuring quality, sustainable products and services. I wonder how the system and people are faring under the pressure of progressive, catastrophic immigration reform.
Just like your universities pay a vast army of people who don’t teach.
Somebody has to monitor compliance with all of those regulations! And too bad to the kids who have decades of debt to pay for it! I would love to see a true accounting of the compliance expense for Title IX?
Sanders' staff, says nope. Our bill won’t fund more utilization of long-term health care.
Death panels!
Re: Kristian Holvoet:
Such as insurance administers. Such as compliance officers. It is the same as schools and big business. Government (and their captured lackey the insurance company) wants to micromanage outcomes, so they need data, so they require a lot of data to be presented to them, in their format.
I think part of that is a natural reaction to people trying to game the system all the time.
If you analogise it to, say, a public park, the park can be either expensive to maintain or cheap to maintain depending on the behaviour of the people who use it and are responsible for maintaining it. If the people who use the park are clean and pick up after themselves and don't throw trash everywhere, and the maintenance people do their job efficiently, you can have a nice park that doesn't cost a lot. But if you have park users tossing trash on the field, and defecating and dropping used needles in the sandbox, then maybe you'll want a a security guard watching the park to scare people off of doing that. And of course, your maintenance costs will increase, because now the maintenance crew have to dispose of biological waste and clean up a lot more. And if the maintenance people don't do their job efficiently, then you'll need to put in some kind of monitoring system to check on their progress, and a layer of administration to review their reports and analyse their statistics to see if they're working appropriately, and your costs will multiply. These are two different equilibria, and it's hard to get from used-needle park back to clean park.
It's all very well to complain of all the extra costs larded onto the American health care system -- I certainly don't like them myself. And some of them are probably pure examples of lawyerly nonsense. But I think a lot of that is a reaction to the reality that there's a lot of medical insurance fraud -- so much that you can waste a lot of money policing it and still, theoretically, come out ahead. This is an extreme analogy, but, well, we're kind of stuck in that park full of human waste and used needles and paying through to nose to try and clean it up. A lot of people just don't have a sense of guilt about cheating their countrymen by defrauding Medicare or large insurers, or you wouldn't have $140 billion dollars of fraud every year.
Bag's already well past a half million dollars of health care, over just a handful of years. I.e., this amount excludes the rest of his life to date, and the typically expensive years that have yet to come, at the end. IOW, it seems safe to assume he's gonna use up a million dollars of healthcare, from adulthood to grave.
So, using a gross simplification (e.g. no time value of dough considerations), if Bag has fifty years of paying around $1,700 dollars a month, he'll net out as having no net mooch impact.
You may say that that's the point of insurance. Some get more than they put in.
I agree, but it'd be nice if the moochers could say thanks instead of crying because they got charged a measly two grand which pales in comparison to their moochiness re what they're getting re what they've payed.
Just sayin'
For ACA to fly rich became around $110-$120k/yr.
Nn , it's a payroll deduction system but has been badly stressed by unemployment and now France is getting a lot of British retirees who have never paid in.
They will not go back to the NHS for treatment and register for the welfare part of the system. Immigration must also be a stress. The concept should work well here,though.
Did I see "forget the immigrants" in here. Millions of uncared for medical timebombs. furgetaboutit? Another great financial tragedy to bestow upon your children and their children. However I do favor a "free Lexus" platform. Free stuff you know...
The dimwit left will never adopt the French, or a similar system because it uses market mechanisms and the left considers markets the way vampires think of garlic.
What on earth do you think "Medicare for all" is you moron? It is a publicly funded utilizing private providers.
You are just full of shit and are deliberately mis-characterizing what the "dimwit left" wants. Or maybe you are just a dimwit yourself.
When a friend was being prepped for bariatric surgery, the nurse asked where she was from. When my friend said "right here", the nurse was surprised, as her operating rooms that day were all people from Canada.
The passive agressive little pussy man Rick seems to think no other countries besides the US developed any medical advances.
Which is not true, of course. For example, a German company developed Thalidomide.
@Freder Frederson:What on earth do you think "Medicare for all" is you moron?
The French model is not "Medicare for all". It's "managed care health insurance for all".
"If every major country on earth can guarantee health care to all, and achieve better health outcomes, while spending substantially less per capita than we do, it is absurd for anyone to suggest that the United States cannot do the same,"
uh...no...
https://www.cato.org/publications/briefing-paper/whos-fooling-who-world-health-organizations-problematic-ranking-health-care-systems
Freder Frederson said...
[The dimwit left will never adopt the French, or a similar system because it uses market mechanisms and the left considers markets the way vampires think of garlic.]
What on earth do you think "Medicare for all" is you moron? It is a publicly funded utilizing private providers.
Medicare does not pay market prices. Their fee schedule is based on costs they deem appropriate. Everything is broken down into procedures which are priced by the (Medicare determined) appropriate equipment and labor using time per procedure estimates. These are reviewed and adjusted periodically. These amounts are then subjected to fiat reductions to make the budget numbers work.
The process works very much like the left would implement widely if they could outright control pricing (which is the point behind ACA and "universal healthcare" generally.
You can reach the fee schedules through here:
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/FeeScheduleGenInfo/index.html
Or the process description is here:
https://en.wikipedia.org/wiki/Resource-based_relative_value_scale
So when someone claims Medicare is market based they must mean something other than market based. The only part of Medicare which pays market rates is pharma but that's exactly what the left wants to change. So it's quite odd to see them claim the existence of something they want to change proves someone's criticism of their preferences is wrong.
I'm sure you could keep your doctor though.
If Trump responded to a report on his programs the same way Bernie has responded to *multiple* studies showing how expensive his plan is, he'd be pilloried in the media for his attack on facts.
335 or so comments. Well- Bernie Sanders is a moron. There's nothing more to it than that. This is not the person you want to guide your future economic system. I wouldn't hire him to run a shoe store. Nice Senator, Vermont.
What on earth do you think "Medicare for all" is you moron? It is a publicly funded utilizing private providers.
Speaking of morons, this might be the stupidest comment ever by Field Marshall Freder.
There is NO market mechanism in Medicare. I assume that, like most of life, he knows absolutely nothing about it.
Jesus the left is stupid about Economics.
If I offer a Medicare patient a discount price, I am committing a crime. You idiot.
The French model is not "Medicare for all". It's "managed care health insurance for all".
It's really not managed care but don't tell the field marshal.
Managed care is when I was fined $500 for sending a patient to the "wrong" lab for a $16 wound culture.
In France, you are given an order for something r a prescription and you take it to an independent lab or pharmacy of your choice.
Doctors can charge what they want but they have to advertise the prices in the office. All they have to do is find enough patients willing to pay that.
Freder is as ignorant as Inga.
And calling people who know than he does, names.
If you read Megan McArdle's WaPo article on this report, she points out that its authors were very generous in their estimates. For example, it assumes all providers will be reimbursed at current Medicare rates. Not sure what Bernie is bitching about, as it sounds like a more realistic estimate is much much higher.
A friend of mine just retired in England, and has been moving his stuff to a small town in central rural France. He doesn't want to be around after the Brexit, so he moved to a European Union country.
He doesn't want to be around after the Brexit, so he moved to a European Union country.
I hope he doesn't let the door slam him in the butt. Gee, why would he want to live in a small town in rural France, much more to do in the Paris suburbs! What could be making him not want to live there?
Excuse me, "arse."
I can’t believe we’re debating Socialism again. I guess the promises are just too compelling for some.
Blogger Etienne said...
A friend of mine just retired in England, and has been moving his stuff to a small town in central rural France. He doesn't want to be around after the Brexit, so he moved to a European Union country.
Come on Etienne. Lots of middle class Britons have been moving to rural France for 40 years.
Ever hear of "A Year in Provence?"
Or see the TV series ? Britons who can afford the million pound homes in southeast England are moving there and away from London except for work. The middle class can't afford those prices and move to France.
It has nothing to do with BREXIT and if your friend is really telling you that, he is bullshitting you like all the left wingers that were going to move to Canada if Trump was elected.
"Lots of middle class Britons have been moving to rural France for 40 years."
Lots of Britons have been moving to France and elsewhere in the continent since the 18th century, if strapped for cash. It was always cheaper to maintain a certain lifestyle there.
Lots of Britons have been moving to France and elsewhere in the continent since the 18th century, if strapped for cash.
This has been a real surge the past 40 years. There are now villages in southeast France that are 100% English speaking.
There are web sites that tell British expats how to sign up for services.
https://about-france.com/living-in-france.htm
http://www.creme-de-languedoc.com/languedoc-property/relocating-to-france.php
https://www.frenchentree.com/french-property/regional-property-guides/french-and-expat-communities-in-dordogne/
Michael K:
it's a payroll deduction system
It seems to be both, a compulsory earned income deduction, and reimbursement for qualified medical payments.
Like so many progressive ideas, single payer isn't so much about providing benefits as it is about the accrual of power to the state. The provision of benefits (or withholding of them) is as much a means of control as taxation, fines forfeiture, and so on.
While a payment system is a significant aspect of service entitlements, it is a marginal aspect of providing actual medical or, generously, health care. The World "Health" Organization, Sanders et al are prone to conflation, which is not limited to abortion rites where only one life is officially recognized when it serves their politically structured myth of "progress."
There is evidence (e.g. Surgery Center of Oklahoma) that a market-based mechanism, free of monopolies (e.g. government-regulated insurance, progressive taxation schemes) and practices, legal excess (e.g. tort reform), education reform, and a fully empowered population, can optimize price determination, service availability, service quality, and mitigate progressive corruption through competitive feedback in a capitalist (i.e. retained earnings, organic price determination and resource distribution) economy.
roesch/voltaire said...
Mike live births are recored in England, France, Japan, where I have relatives who have had a number of babies ,and all those countries have better infant mortality rates than ours and are not practicing barbaric medical practices you claim they are-- perhaps you should travel more to learn about other countries?
********************
Perhaps you should PROVE IT with apples-to-apples statistics, instead of offering unsupported assertions? You have relatives in ALL those countries, dickweed?
Oh and btw: I've lived in most of the countries you cite, so no bullshit about me being provincial.
Finally, can you tell us what superior intelligence you possess that allows you to know that Mike hasn't traveled to other countries, and would change his opinion if he had?
What unadulterated bullshit.
Blogger n.n said...
Michael K:
it's a payroll deduction system
It seems to be both, a compulsory earned income deduction, and reimbursement for qualified medical payments.
Yes and I like that. What it does is provide a baseline for the poor, while allowing those who want more to do so without the Medicare abuse. Doctors, in France get free medical school and no need for college degrees. That is good for primary care. If doctors chose to accept the base payment, they can get vacations and pension funds.
France has the highest patient satisfaction in Europe last time I checked. That is very different from surveys about the NHS which asks people who have never used the service what they think. Of course they like it. It is free.
The other thing I like about the French system is that you pay FIRST.
Then you get the reimbursement check a week or two later.
For big hospital admissions there is a program called (in French) "One Third to Pay" so you don't have to pay the whole thing up front.
Dust Bunny Queen said...
The market had a shot at healthcare for decades before the ACA
Actually ....no.
For example, in NY health insurance must cover the chiropractic quacks. Which means that a share of every dollar in health care insurance I pay is going to quackery. Insurance must cover a 30 day inpatient treatment for substance abuse. Despite the mere fact that such programs have a total success rate of curing any kind of addiction approaching zero percent. I'm willing to take my chances I'll never need it. But I can't, so I have to pay so that others may go. Insurance must cover psychiatric care. IMHO, almost equal to chiropractors on the quack scale.
But when you're talking health care reform there's a whole lot of things you could be considering.
For example- why do you have to see a doctor for routine and common sicknesses? Someone mentioned military healthcare up above. For most of my 21 year Navy career if I was sick, I saw an independent duty Hospital Corpsman. He could order up routine blood tests and other diagnostics like a strep throat test. And prescribe from a basic list of pharmaceuticals. Even administer morphine if needed. Like to my one shipmate who passed a kidney stone mid-patrol. He was also trained to recognize WHEN whoever he was diagnosing needed a higher level of healthcare, and send us to a doctor. If we suspected we had a "routine" illness we should be able to choose a HM type healthcare provider for a treatment visit.
And speaking of diagnostic tests, why do I have to visit a doctor to get routine diagnostic tests done? I am perfectly capable of walking into a pharmacy and asking for a CBC, total cholesterol, and A1C level and determining what they mean. And I'm about to have serious talk with my new primary care practitioner about that. She decided I didn't have pre-diabetes because my latest A1C was perfect, so I should discontinue my Metformin. 3 years ago, it wasn't, which shows she didn't review my record. My A1C is low becasue I'm (a) taking Metformin and (b) have severely reduced my sugar intake and (c) taking enormous amounts of fiber supplements which slow down sugar absorption in the digestive system. I discussed all this with my previous doctor who was a good doctor who listened to his patients, but a bad person who is now in jail... I hate it when things like that happen.
For the informed medical consumer, being able to order up diagnostic tests on our own would be huge boon. Not all treatments or supplements or medicine work equally on all people. Lot's of supplement pushers say "May reduce cholesterol in as little as 30 days!" Well, I'd like to be able to test that, but I can't. I have to wait until my next doctor visit. I now know massive doses of psyllium reduces my total cholesterol. Took me year to verify it.
There are all kinds of ways total healthcare costs could be reduced. Some of them require major revisions as to how routine medical care is provided. Which sets the government and consumers up against the all powerful doctor's union, the AMA. Emergency healthcare in the US is really far better than anywhere else. There are even more ways health insurance costs could be reduced. Which sets the healthcare consumer up against the lobbyists- and each other. I know people who absolutely insist their visits to quack chiropractors need to be covered by insurance. I'm perfectly willing to let them buy insurance that covers quack visits, but I don't want to pay for it. Nor do I want my insurance to cover touch therapy, acupuncture, or other quack treatments, which it currently foes. I'm also wiling to forgo inpatient substance abuse treatment programs and psych visits. Ala carte health insurance pricing would be a big plus. Across state lines. And once you have it- it can't be cancelled for reasons like you use it too much.
tim in vermont said......much more to do in the Paris suburbs! What could be making him not want to live there?
Cost of living. Noise, crime. No place to park :-)
He's southeast of Tours about 20 miles. It's easy to drive anywhere in France. It's a small country. Hell, he's been driving to England and back through the chunnel like it was nothing.
Perhaps you should PROVE IT with apples-to-apples statistics, instead of offering unsupported assertions?
R/V don’t gotta prove nuthin. He just says stuff and you better believe it on account of he’s way smarter than youse.
Although data are not widely available for cross-national comparison of posteneonatal mortality, NVSS data indicate that within the U.S., postneonatal mortality rates among non-Hispanic Blacks, American Indian, and Alaska Natives are nearly twice as high as the average of all other races. The NBER working paper concludes that high postneonatal mortality rates among disadvantaged groups is almost entirely the reason these rates are higher in the U.S. than in Austria and Finland.
So basically the high infant mortality is due to a population that is largely on Medicaid? That’s weird!
buwaya said...
Jaydub is right about Spain.
Their costs are exceptionally low vs “developed” Europe, however, for both education and medical care.
Maybe so, bit William S. Burroughs said the Spanish hospital orderlies will steal your morphine.
NVSS data indicate that within the U.S., postneonatal mortality rates among non-Hispanic Blacks, American Indian, and Alaska Natives are nearly twice as high as the average of all other races.
There was a study a few years ago comparing birth weight and neonatal mortality in US Army medical facilities.
They found that birth weight was lower and mortality was higher among blacks and lowest (highest birth weight) among Hispanics. The treatment was exactly the same. Low birthweight babies are much more common in black mothers for reason that have nothing to do with prenatal care.
I wonder if the study could even be done these days?
Which sets the government and consumers up against the all powerful doctor's union, the AMA.
The only part of your comment I disagreed with. The AMA is a scam these days. I get a bill for dues from the AMA EVERY WEEK ! I have not been a member since the middle 1980s. Their membership is about 25% of docs and mostly HMO members whose dues are paid by the HMO so they can dominate policy like union teachers dominate school boards.
The majority of doctors are now on salary since Obamacare. Hospitals bought up medical groups and the freedom of doctors whose practice requires hospital care is gone.
The administrators were the biggest fans of Obamacare because it allowed them to win their war on doctors that had gone on since the 1965 Medicare Act. We were far too independent. Not any more.
The AMA sold out to the Feds years ago. It;s a long story and you probably aren't interested but the AMA is a scam.
Post a Comment