"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).
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1 – 200 of 360 Newer› Newest»Y'all know Vermont tired this already, right? I don't think Bernie does...
Those tax hikes will have to be marginal rates in the 175% range for this to work.
You think it's expensive now wait until it's free.
It's only expensive if you pay doctors, nurses, and hospital staff.
What's the true cost then, Bernie?
$32 Trillion, though, will get us a lot of free stuff.
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,
But they don't. They ration and even refuse care all the time. The three reasons healthcare is so expensive in the US are:
1) Government regulations and policies
2) The fact that most people don't actually pay for their healthcare, insurance companies do.
3) 20 million illegal immigrants consuming healthcare without paying for it.
I oppose any such plan on small government / individual liberty grounds.
However, when you talk about the increase in government spending, and the corresponding increase in taxes, you have to balance that against the decrease in individual ( and/or employer ) spending. I'm not saying they balance out evenly, but it is not like the additional taxes would be the only change to your household budget.
Socialism requires, first, that everyone put their common sense away before considering it. Does no one know what the expression "Land Office Business" means?
If that's the initial projection, you can be sure it will cost more than 3X that amount.
"it is not like the additional taxes would be the only change to your household budget."
The dirty secret of the European welfare state is that everyone pays. The poor pay taxes and VAT and premiums.
In the U.S., the left plays games, favoring representation without taxation, something for nothing.
Unless and until the American left is minimally honest about what the bottom half of the income distribution will pay, I call for #Resistance.
HEY! if we Just get THE RICH to PAY THEIR FAIR SHARE this takes care of itself!!!
{of course, that all depends on How we define The Rich, and Fair Share; i'm thinking 100% and 100% should do nicely}
...but it's FREE! and run by the government. What could be better?
He wants to expand a broke program?
Well his wife did make the college she ran go broke and close.
The poor pay taxes and VAT and premiums.
Serious question (since i've NEVER been overseas)
In countries with VATs, do people buying things with their EBT cards have to pay VAT too?
I suppose that their SNAP allotments are just adjusted to compensate?
It will come out as no doctors accepting medicare and everybody running a cash business.
Gahrie said...
But they don't. They ration and even refuse care all the time. The three reasons healthcare is so expensive in the US are:
Your ration and refuse point is true. Your three reasons are ... ideological.
The three reasons healthcare is so expensive in the US are:
1. We spend more on facilities and offer more expensive treatments, especially for chronic conditions
2. We pay healthcare providers a lot more than in other countries. A lot lot more.
3. We have a more diverse and more distributed population.
Inefficiencies is also part of it. But efficiency is not necessarily something you can legislate into being.
We could have open markets with the prices listed on all medical procedures and opt to pay for our own healthcare and be inspired to place savings aside for rainy day and use insurance as it was meant to be used - the big stuff. But that would make us responsible adults. We can't have that. The left need Americans as sheep and dependent children. We can buy beyonce albums and jets skis, and vacations and silly time shares, but there is no money left over for health care. You must pay for my health care. After decades of manipulated leftwing slide towards a government controlled system, it's a tangled mess. By design. But come on now, lets sing in unison the lefty hivemind group think song...
"WE MUST DO SOMETHING!" "SOMETHING MUST BE DONE!" "Insert Bullshit about Emergency Rooms here..."
"However, when you talk about the increase in government spending, and the corresponding increase in taxes, you have to balance that against the decrease in individual ( and/or employer ) spending. I'm not saying they balance out evenly, but it is not like the additional taxes would be the only change to your household budget."
Well, it depends. If BernieCare requires that everyone pay a premium, then my employer quits taking my health insurance premium out of my paycheck and instead deducts the BernieCare premium instead.
Even if there is no premium to be paid, right now healthcare usage is constrained by people deciding to not spend their money on that office visit. There are many non-severe maladies that are not viewed as "worth it" to make the appointment, take time off work, pay the copay to get seen. Once it's "free" all of those barriers go away.
Bernie Sanders could help pay for this, if he would sell off 2 of his 3 houses, and deposit the money into the Medicare account.
The Millionaires and Billionaires song.. Sing it, Bernie.
I bet that taking all of those employees who administer payments to doctors and hospitals and making them government union employees with sweet retirements and higher wages than most Americans, and impossible to fire, will save a bundle!
Gahrie, you forgot that we pay for the innovations that foreign price controls and poverty won't.
It will come out as no doctors accepting medicare and everybody running a cash business.
I once sat next to a Canadian on a flight and she said that waitlists were no problem as long as you made a “donation,” a.k.a. bribe, at the front desk.
https://twitter.com/ernietedeschi/status/1023927465956335617
but but but... Evil Insurance companies.... make evil profits! Kill them... Or better yet, offer them government payouts with tax pay dollars .. shhh media will keep it a secret.
It's Obama's secret.
How The Obama Administration Raided The Treasury To Pay Off Insurers
Good thing most Americans are economic illiterates who watch Colbert and buy into Michael Moore's crazy.
In a world where more people have jobs and are paying taxes, this seems like a poorly timed proposal. Bernie proposes to inflict financial pain on a growing group of working taxpayers.
I suppose the idea that everyone will have equally crappy health care does appeal to the Democrat voting base, as does the idea of using taxation to destroy incentives to work. Removing incentives to work makes that $32T even harder to find.
The Pension Hole for U.S. Cities and States Is the Size of Japan’s Economy
Like Green and Insty says. Do you really want them to run your health care?
R me do you really want it to be run like Chicago or Illinois?
Sanders believes he can repeal economic laws, such as the law of supply and demand (which is actually, two laws, the law of price and supply and price and demand). Or, in this case, the law that says that when something is subsidized (healthcare), more of it will be consumed. Which, brings us back to the law of price and demand -- as demand increases so does the price. The rising price is the signal that brings additional supply to the market. However, with a single payer, the signal of rising prices falls on deaf ears and all we get are shortages -- long lines, denied coverage, lower quality.
This HAS to be the result of Sanders' proposal, unless he can repeal natural law.
In countries with VATs, do people buying things with their EBT cards have to pay VAT too?
Most VAT exempts food (which includes beer and wine in Germany)
Sanders is not entirely wrong, in the sense of pointing to the absurdity of the cost of medical care. But his solution is a fantasy.
Our problem is that any real solution to metastasizing health care costs will require cutting a Gordian knot, and that ain't gonna happen, since any "reform" is going to be written by the current "shareholders" in our current byzantine system with its layers of entrenched middlemen. (See: Obamacare.) No way they're going to write themselves out of access to the trough, so the necessary fundamental structural reform will always be a non-starter.
Henry,
It is not ideological to note people's tendency to over-consume when they do not directly pay for the goods and services they consume. That tendency exhibits itself across industries and customer populations, regardless of the good or service.
Your pretension that you can call somebody else's assertion of an observable fact "ideological" is an exhibit of your own ideology.
What is hidden in the report is that without Medicare for all healthcare spending will be 34 trillion so Medicare for all saves 2 trillion.
"We pay healthcare providers a lot more than in other countries. A lot lot more."
This is an inescapable fact. Look up average nurses' salaries in France, or a pediatrician's pay in Germany. Then ask your socialist congressperson: Do you have a plan to reduce health care providers' pay? Then listen to the obfuscation, mumbling, lies and bullshit. "Nobody's pay is gonna be reduced except the evil insurance executive's. And if we need more money we'll take it from the evil Koch brothers."
Why are lasik treatments and plastic surgery getting cheaper all of the time while other forms of treatment are getting more expensive? Because neither the government or most insurance companies pay for them.
let's be careful to define what we mean by "single payer," which has become a mantra and litmus test on the left. There is a huge difference between "there is a single payer that everyone can use," and "there is a single payer that everyone must use."
Most on the left promise the former and mean the latter. Not only is there some sort of single easy to access health care and insurance scheme for poor or unfortunate people, but you and I are forbidden to escape it, to have private doctors, private hospitals, or private insurance outside the scheme. Doctors are forbidden to have private cash paying customers. That truly is a nightmare, and it will mean the allocation of good medical care by connections and bribes.
But a single provider or payer than anyone in trouble can use, supported by taxes, not cross-subsidized by restrictions on your and my health care -- not underpaying in a private system and forcing that system to overcharge others -- while allowing a vibrant completely competitive free market in private health care on top of that, is not such a terrible idea...
-Source
Gahrie and Henry:
I could be wrong, but don’t we also pay a large share of the sunk costs for innovation, both technological and pharmaceutical, that others then adapt / employ more cheaply? I remember hearing a lot about cheap generic drugs back in the day, compared to our rapacious Big Pharma; OK, but who worked out the syntheses, and paid to try all those drugs hat failed?
@JPS:
Yes.
We could have open markets with the prices listed on all medical procedures...
I always like to post this when it comes up- there's a hospital that's actually posting prices!
Hospital Cash Pricing
National Health Insurance will be the disaster here that it has been everywhere else. We saw it doing its thing in the Veterans Administration that was as bad as medicine gets for over 100 years. So by all means let's do it right this time, by magic.
When you’re heading toward an iceberg, the smartest thing is to go faster.
I say since Bernie wants it... Bernie pays of it!!!!
"We pay healthcare providers a lot more than in other countries. A lot lot more."
A big chunk of this is cross subsidies the system establishes in order to hide the crazy.
I am not against single-payer, in principle. A lot of people would be put out of work at insurance companies, and a lot of private businesses would be harmed. I guess that they are all officially hated people by the left, anyways, so no harm there.
Also, countries that do this tax EVERYBODY, as Sebastian said. They use a VAT which is a way to bring in oceans of money because everybody pays, even low income people. That’s how Canada does it. The left here has made an emotional argument against “taxing the poor” so they will not even consider that that is the only way to get this done. The rich will pay too, but the left is so bent on progressive taxation that they have made single payer very difficult to finance. The US has the most progressive taxation of any western economy. So they are going to go after the 32 trillion from the same 50% of workers who actually pay taxes. That’s why Freder’s simple math is bullshit.
A fascinating tidbit: "Surgery Center of Oklahoma does accept private insurance, but the center does not accept Medicaid or Medicare. Dr. Smith said federal Medicare regulation would not allow for their online price menu. They have avoided government regulation and control in that area by choosing not to accept Medicaid or Medicare payments." Well, so much for the idea that regulations encourage competition and lower prices.
-Source
The assumption behind Medicare For All is that physicians, hospitals, and other providers of medical services can and will accept Medicare rates from all patients, even though these are significantly lower than those provided by private insurers.
As a high-level overview, Medicare gets away with paying less because it mostly pays more than providers' marginal costs, even if it doesn't fully cover proportional costs. And economic theory says both (1) a business is always better off selling something at more than its marginal cost than refusing the sale at that price, and (2) a business must recover proportional costs if it is to stay in business.
The hokus-pokus in Bernie accounting is assuming everyone can just pay less (on average and in aggregate) without affecting the quantity or quality of medical services available. A more probable outcome is a decline in quantity as private investment moves to more profitable sectors combined with an increase in demand due to lower out-of-pocket prices. Thus leading either to long queues for service, or rationing (i.e., if you don't have enough quality-adjusted life expectancy left then you get only palliative care.).
Most on the left promise the former and mean the latter.
Yeah, that was the way it went in Canada. They didn’t want a “two tier” health system. But their Supreme Court found that their was a right to healthcare and forcing people to wait months and months for treatment was violating that right. No shit.
Trump doesn't seem so hostile to single-payer health care. He has a long history with talking about it:
https://www.vanityfair.com/news/2017/05/donald-trump-single-payer-australia-bernie-sanders
I'm looking forward to long wait times for government approved procedures.
Just take a pain pill. Then listen to the chorus sing about opioid addiction.
RE: Henry
It's only expensive if you pay doctors, nurses, and hospital staff.
I was going to reply that part of our problem is that we pay doctors more than other countries do, but the gap isn't actually as severe as I had thought. Average doctor's income in Japan, for example, is apparently about $136,000/year (although other sources say only about $101,000), whereas in the US it's apparently $178,000/year, or almost as much as a first year associate in a big law firm, straight out of school. So if we wanted to bring our cost structure down, we'd be looking at a ~25% cut in doctors' incomes (note: my father is a doctor, as was his father before him, so this is a traitorous argument against mine own blood). There's other areas for possible savings, in terms of patent medications or just barring expensive treatments, but I have serious doubts that a public healthcare program in the US would be able to resist political pressure to expand coverage. The military is apparently paying for transgender reassignment surgery now, so there's really no limit to what our government can be pressured into paying for.
More broadly, though, medical care delivery in the US is extremely inefficient -- you go in for a checkup, and the actual "checkup" work is about 10 minutes, but you spend 50 minutes sitting around waiting for doctors and nurses to show up. That's space you're taking up that they're paying for! Some of my relatives just get their health checkups done when they return to Korea every year, because it's cheaper than health insurance in the US, easier to schedule, and much more efficient.
We already have a regulated insurance industry, which is effectively a single-payer system. The problem is not in payments but costs. So, what do we gain by ignoring causes and forcing a massive and progressive anthropogenic misalignment?
The three reasons healthcare is so expensive in the US are:
Forget the immigrants. A bigger problem is perfectly healthy people going to the doctor all the time when they really do not need to, as well as the over-medication problem we have. And part of the reason they go is that having paid so much into the system, they want to get their money's worth.
There’s a show my hubby and I watch I think on Britbox.
It was filmed about 5 years ago called Escape to the Continent. It’s about Brits moving off the island.
Damn. Europe—even Estonia was expensive to retire or relocate to.
The minimum Abode we saw so far was $250k US.
"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,"
This was debunked way back in 2008. See Megan Mcardle's many articles on the topic. First, they do not achieve better health outcomes. If you correct for things like inner city violence, and more strenuous attempts to save neonatal babies, the US has some of the best health care in the world. It has as good outcomes as anyone if you start with a given condition and see the results - instead of counting a murder as bad health care.
Second, health care costs largely depend on the baseline. The US's costs are not growing faster than Europe's, they are growing at exactly the same rate. The difference is that we pay a lot more. Doctors, nurses, OTs, lab techs - everyone in health care gets paid half again as much as they would make in Europe. We also have physically bigger hospitals, which increases the upkeep. You gonna fix that?
If the government takes over health care does it impact malpractice suits and the need for tort reform?
I think that right now nobody knows what a medical procedure should cost. The medical industry does not care since it works on the assumption that everybody is "insured," and the insurance industry does not care since it is part of Obamacare that the Gov't will reimburse the companies for any losses they may incur, and of course the Gov't bureaucrats do not care since it is not their money either, and they are just following "the Law" as directed by Congress.
And Congress does not care since if everybody would just work as Congress intended they should - even if contrary to human nature - everything would have worked out just fine.
Y'all know Vermont tired this already, right? I don't think Bernie does...
Tennessee TennCare crashed and burned
Oregon is still trying to make theirs work
And accepting the “FREE” federal Obamacare money to sign up Medicaid patients is beginning to bite state’s bottom lines like it was supposed to. Trump’ll have to fix that stupidity, too.
Russia, Russia, Russia, Russia, Koch, Koch, Koch, Russia, Russia, Russia.
Very few people understand that few countries use "single payer" like Britain. Most are variations like France. I have a number of blog posts that explain the French system which I like. Among other things, medical school is free and does not require a college degree. A lot of those high prices going to doctors that Henry doesn't like are paying student loans. USC, where I taught for 40 years is $57,000 a year.
And do not forget that these systems need administrators!
Lots of administrators and quite well paid to say the least!
Blogger gilbar said...
HEY! if we Just get THE RICH to PAY THEIR FAIR SHARE this takes care of itself!!!
You mean like Jeff Bezos? Currently heading for $200,000,000,000 and beyond, pays about $1mm per year in taxes. Jack his rate up. Make him pay 90% tax rate. No deductions
Yeah, that'll do it.
(At 90% Bezos will pay about 2.7 million per year)
Gilbar, I suspect that you know the difference between rich and high income. It is sad that so many people, including most politicians, don't.
I suspect that if you asked AOC, who paid a quarter million $ for an economics degree to define "rich" she would do so in terms of income.
Actually, I doubt that she paid for the degree.
John Henry
Nobody responsible for nothing is a sure recipe for disaster.
Blogger Seeing Red said...
He wants to expand a broke program?
Broke?
Broken I understand but broke? Do you mean out of money?
Sad how few people fall for the story that SS and Medicare are, or even can be, broke.
They can be no more broke than the US Army or Food Stamps. All three are funded out of general tax revenue. Congress could decide not to fund it any longer but it can't go broke in any meaningful sense of the word.
The pretense that they are some sort of insurance is bullshit. The govt has power to tax and it has the power to provide welfare funds. It does NOT have the power to mandate insurance.
That is why Obamacare was found constitutional. It was the whole, constitutional, for basis for Social Security.
John Henry
What people forget us that Europe could afford to spend more on health care since they didn’t spend as much on their military. Now some have to spend more on their military.
Read the English papers, NHS isn’t healthy.
My daughter has lived in England for 18 years now--along the way she married and has two children. Her opinion of the NHS is not high.
Sanders--the Senator in charge of making stuff up.
And it’ll take a generation here to start seeing the decline. Which, just like global warming, they’ll hide.
If you think you’re going to get bright and shiny on a limited pocketbook, think again.
Using logic, reason, and math doesn't seem to penetrate some people's dense emotional bubble. Oh, they may actually accept the notion that somebody somehwere has to pay for "free" healthcare. But in their imaginations, that someone is a villainous ultra-rich person whose personal wealth exists in some static state that has no postive effect on anything else. They imagine some horde of wealth that's just sitting their waiting to used for good if it weren't in the hands of such amoral, self serving rich people who've never paid their "fair share".
They can imagine these things because they've never had a good reason to critically think about things such as the differences between the concepts of money and wealth, how wealth is generated, and why the people of the United States have been able to generate so much wealth. And what's more, they're even discouraged from thinking too critically about such things by their peers and their teachers and professors (who may or may not know better themselves).
Nothing changes, nobody ever seems to learn. It's depressing.
3.3 trillion annually. Cut defense to zero, and there is still a 2.7 trillion dollar deficit. He will need to either force massive misalignments in the economy, scrape the bones of the middle class, shred the wealth of the on-paper rich, or establish a gross wealth tax to cannabilize real property holders. We already tried borrowed 100 billion from granny and all we got was Obamacare. They're getting either the diagnosis or treatment wrong.
Read Canadian papers from the early 2000s on the state of their single payor.
There was a time dogs and cats were getting MRIs faster than humans. Canada had very few MRI machines for a population of over 20 million.
It’ll NEVER happen here! Why not? Sux to need a knee replacement if you’re #5801 and they only allow 5800 a year.
You can go online now and check wait times for procedures in the various territories. Read it yourself.
"They can be no more broke than the US Army or Food Stamps. All three are funded out of general tax revenue. Congress could decide not to fund it any longer but it can't go broke in any meaningful sense of the word." Have you heard that many state and municipal pension funds are broke? They also can be funded by general tax revenue. Unfortunately, there isn't enough tax revenue to pay for them and for police and fixing the roads as well.
Unlike the US Army, these are not discretionary funds, where Congress can decide to fund a little less this year. Their expenditures, like state pension funds, are fixed by the obligations already taken on. And the plan for how much of the tax revenue would pay for them isn't nearly enough any more.
@Birkel -- The cost factors are really not that hard to track down. Cost of providers, cost of hospitals, more aggressive care for more high risk patients, costs of drug and medical equipment innovation, infrastructure problems due to the size of the country and diversity of the population.
The argument that overconsumption drives up medical costs is an ideological argument. There's nothing wrong with ideological arguments, but it is a second order argument that is causal, not descriptive. And you then have to establish the truth of the argument.
Once you are arguing causes you open up the field to all manner of responses. One common argument in favor of single payer is that it would prevent overconsumption of some of the most expensive services -- emergency room care, for example.
Take a look at this Harvard Business Review article. The authors note a study that establishes overconsumption as 10% of the cost of health care. Get rid of that and the U.S. is still the most expensive in the world, but that's just an aside. The real point is that the answer to overconsumption is to limit patient access to unnecessary tests and procedures. A fee-for-service model does not do that because patients don't know which tests and procedures are necessary and which are not. The people providing the services have a completely different set of incentives than the patient -- and if an insurance company is involved, their incentives are also suspect.
The answer to overconsumption is, in short, death panels.
hawkeyedjb: This is an inescapable fact. Look up average nurses' salaries in France, or a pediatrician's pay in Germany. Then ask your socialist congressperson: Do you have a plan to reduce health care providers' pay? Then listen to the obfuscation, mumbling, lies and bullshit. "Nobody's pay is gonna be reduced except the evil insurance executive's. And if we need more money we'll take it from the evil Koch brothers."
The pay of both doctors and "insurance executives" contribute to the cost of health care. If doctors can make "too much money", then insurance executives can make "too much money" vis à vis that cost. Doctors and nurses get much less compensation in Europe? Guess what, so do CEOs.
Note, this is not an argument for socialized medicine. I just get tired of cartoon arguments demonizing one side or the other. Evil insurance companies! Greedy doctors! Socialists! Koch brothers! Fix those bastards and all will be well! Looks to me that we have a deeper structural problem here. So we somehow manage to lower the pay of doctors and nurses (by government regulation?) without touching any of the other nodes in the system. Crazy cost escalation contained? I doubt it.
Maybe doctors and nurses "make too much" compared to what they make in other, different, systems. (Or an ideal system, socialist or free market.) Note, "other, different". Their pay isn't an isolated variable.
As an aside, I don't think most doctors entering the field these days make the kind of money doctors used to make (and they have greater debt burdens). Nor do I think removing financial incentives for pursuing a career in medicine is a great idea. If "too much money" becomes "not enough money", you're not going to attract the sort of people you want practicing medicine on *you* into the field. It's funny how people can think that CEOs making millions annually are being properly rewarded by the market, and get highly indignant that anyone should suggest otherwise, but think there's something wrong with a good physician making good money.
Leftists are typically very greedy and cheap. They are happy to force YOU to pay for their healthcare. They will be damned if they will contribute to YOUR healthcare.
One of the cheapest people I know lives across the street from me. She is cheap in every way and one of the most uncharitable souls I know. She is gross. She is also a Hillary supporting democrat.
Blogger traditionalguy said...
National Health Insurance will be the disaster here that it has been everywhere else. We saw it doing its thing in the Veterans Administration that was as bad as medicine gets for over 100 years. So by all means let's do it right this time, by magic.
Have you ever been to the VA for healthcare, Tradguy? That's a serious question and I would be interested in how you were treated since it seems to vary. Any other vets with experience?
We hear a lot of stories about the VA and my experience is limited to the San Juan VA hospital and the Ceiba PR satellite clinic. I have gotten all my medical care from them for the past 10 years and could not be happier.
I have a routine doctors visit at the clinic twice a year. The doctor always spends at least 20 minutes with me even though I never have any health issues. The one time I needed non-scheduled visit, I had no trouble seeing a doctor.
I was there for my regular visit a couple weeks ago and mentioned that, although I have been riding a stationary bike 45-60 minutes daily for the past 10 years, and don't get short of breath on it, I have always gotten short of breath goin gup stairs and have for as long as I remember. I was basically making conversation to fill the 20 minutes.
BANG! Now I have an appointment next week for a bone density scan and a cardio stress test. No indications I need them, the doc just thought it would be a good idea. Then, the week after, I have a pulmonary test.
I also get free eyeglasses every year. I don't take them because it will involve 2 trips to San Juan and the lost time is more expensive than just paying for the glasses.
In other words, service here in PR is fanstastic!
My brother in law was had his knee rebuilt by the VA. Very happy with the experience.
Another brother in law had a stroke 12-15 years back and was treated and rehabbed by the VA. Again, very happy with the treatment.
None of us are retired or have service related injuries.
Sometimes I wonder if all the badmouthing of VA is to keep vets from using the service. I certainly never even thought about using it until my son did a rotation there and convinced me to sign up.
John Henry
Many western European countries provide the butter, while the US provides the guns. If they are to reach 2% GDP on defense, they will have to raise taxes or cut spending elsewhere.
They’ll pay for part of this by forcing US to hand over our 401ks so they can manage it for us. Because they do so well managing our other programs.
$7 TRILLION sitting there and they’ve been bitching since the 90s they can’t get their hands on it.
He reminds me of someone else with good intentions.
Mr. Chairman, we do not have a crisis at Freddie Mac, and in particular at Fannie Mae
She has since taken her message to the streets, in people's faces. That said, maybe bubble economics is inevitable and we just have to evolve to love it.
Among all the other valid arguments against mandatory and universal government-provided health services, one factor that I've not seen addressed is the level of waste, fraud and abuse ALREADY seen in the Medicare/Medicaid system, and the potential for even more extraordinary returns to the criminal element should the feds take over the health care system. People complain about the private health insurance industry refusing claims and the like, but that's at least in part because they're trying to identify fraud BEFORE they send payment, while CMS sends the money first and then tries to identify "improper payments." ...and then tries to collect. Any business run like CMS runs its programs would be out of business in a flash -- but, it's "government" so no-to-little accountability for "improper payments."
For example:
"As mentioned previously, we designated Medicare and Medicaid as highrisk programs starting in 1990 and 2003, respectively, because their size, scope, and complexity make them vulnerable to fraud, waste, and abuse.15 Similarly, the Office of Management and Budget (OMB) designated all parts of Medicare as well as Medicaid “high-priority” programs because these programs report $750 million or more in estimated improper payments in a given year. We also highlighted challenges associated with improper payments in Medicare and Medicaid in our annual report on duplication and opportunities for cost savings in
federal programs.16
"Improper payments are a significant risk to the Medicare and Medicaid programs and can include payments made as a result of fraud. Improper payments are payments that are either made in an incorrect amount (overpayments and underpayments) or those that should not be made at all.17 For example, CMS estimated in fiscal year 2016 that the Medicare fee-for-service (FFS) improper payment rate was 11 percent (approximately $41 billion) and the Medicaid improper payment rate was 10.5 percent (approximately $36 billion).18 Improper payment measurement does not specifically identify or estimate improper payments due to fraud."
https://www.gao.gov/assets/690/688748.pdf
Medicare: Too big to fail.
Lololololol
Re: PuertoRicoSpaceport.com:
The San Juan VA operation has also had some bad whistleblower reports, although not with any of the services you mentioned:
In San Juan, PR, the VA’s Office of Geriatrics and Extended Care Operations substantiated a whistleblower’s allegations that nursing staff neglected elderly residents by failing to assist with essential daily activities, such as bathing, eating, and drinking. OSC sought clarification after the VA’s initial report denied that the confirmed conduct constituted a substantial and specific danger to public health. In response, the VA relented and revised the report to state that the substantiated allegations posed significant and serious health issues for the residents.
Not nearly as much as the other VA facilities that have been the center of the misconduct investigations, though.
This grossly misleading and biased report is the Koch brothers' response ...
Why are the Koch brothers being blamed?
The report was written by the Mercatus Center at George Mason University.
Millions of Americans can save loads of money on healthcare by not going to the ER for none emergent problems. If you have the flu, go to a local clinic for your Doctor's note. Ask a medical professional the busiest day for an ER (they'll correct you and call it an Emergency Department, it is more than one room); it's Monday, because all the people who partied too hard on the weekend what a note to miss work. That's $100+ a visit to miss a couple of days of work.
You get those people out of the ED, and then the Doctors and Nurses can focus on the people who really need their assistance.
It also helps when you don't have the cast of "The View" acting like nursing is some menial work akin to housekeeping or being a stay at home mom. Of course, it would be good if "The View" recognized great women from all walks of life in whatever endeavor they choose, but when you bad mouth a profession like nursing, you convince people not to go into a field in which there is currently a great demand. Telling people that services should be free, thus associating Doctors and Nurses to slaves; then you'll get even fewer of the professionals we need.
Yeah, we pay our medical providers a lot. But it turns out that 4 years pre-med + 4 years med school is something like $300k, so they gotta pay that down. Sure, we could offer "free" medical school like France, but as with all things, somebody somewhere has to pay for that too. And at the end of the day, any time you have some program to subsidize a thing, whether its an education or medical treatment or whatever, you're just shifting the costs around and also adding to the costs with administration and interest and such.
My insurance company tried to get me to sue myself to recover costs. It was very entertaining. It wasn’t at the time.
I never said that! Yes you did.
My bad: I should have included (bold added) after the quoted material.
The cost-control reforms that would make "single payer" viable in the US would make the current system, or any other system, viable as well.
The payment system is irrelevant. Your real problem is the unique American case of extremely costly medical services delivery. Nobody else in the world, regardless of their (many, varied) payment systems has such costly medical services.
Here's the tell: “Koch brothers”.
"The assumption behind Medicare For All is that physicians, hospitals, and other providers of medical services can and will accept Medicare rates from all patients, even though these are significantly lower than those provided by private insurers."
At the moment many, many doctors will not accept Medicare patients because Medicare won't pay what the doctor charges private patients. Leftys just ignore this fact which tells me that their plan won't deal with the fact either. Then trouble. Remember the rollout of Obamacare? Remember, "If you like your doctor, you can keep your doctor"? Remember how premiums were going to drop? Like that but ten times worse. "If you like living, you can keep on living." Then disaster and expensive confusion. Then the final solution to our medical problems. Euthanasia for the sick older people and the chronically ill (packaged as peace for quality-of-life-challenged incompetent, expensive non-persons. "Her last Twitter said: 'At last I will be at peace' as all Last Twitters say); rationing for the rest.
As I've said if you're healthy, you will get to be insured and treated. Before single-payer you had no coverage but you got treatment, after single-payer you'll have coverage but no treatment.
Mark: Forget the immigrants. A bigger problem is perfectly healthy people going to the doctor all the time when they really do not need to, as well as the over-medication problem we have. And part of the reason they go is that having paid so much into the system, they want to get their money's worth.
Got some numbers on whether poor immigrants not paying for medical care is a "bigger problem" than people visiting doctors for the sniffles?
Could be; I don't know. Unlike lots of other people who seem pretty damned sure they know that Isolated Factor X is the major cause of our health care woes. (Though I do kinda doubt that overconsumption of the sniffle-variety is a bigger drain than uncompensated care.)
$32.6 Trillion/decade is $3.26T a year, or almost $9bn a day. Only $100K every second. Can you print money that fast?
What if the Govt forbade your employer from paying for Health Insurance? Stop the practice that started in WWI (or was it II?). Make it incumbent upon a person to be responsible and to find insurance, and to pay for it.
I said:
As I've said if you're healthy, you will get to be insured and treated. Before single-payer you had no coverage but you got treatment, after single-payer you'll have coverage but no treatment.
What I was trying to say was:
if you're healthy and wealthy, you will get to be insured and treated as you are now.. If you're sick and poor it will be different. Before single-payer you had no coverage but you got treatment, after single-payer you'll have coverage but no treatment
The payment system is irrelevant. Your real problem is the unique American case of extremely costly medical services delivery. Nobody else in the world, regardless of their (many, varied) payment systems has such costly medical services.
THIS.
Medical payments are hidden behind the web of insurance/government control. By design.
The first time I saw the article, I thought it was $32T per year, but now I see it is over 10 years. Thats about right at $3T per year. Of course it doesn't have to be that high nor would it. That is the fallacy of the report. It assumes, correctly, that if services are free, then consumption of services will increase. In reality that won't happen. The opposite will happen because $3T per year is too much. As with all single payer systems, the $ value of supply is set and fixed and if demand exceeds supply, it is then rationed. It's fairly simple. Everyone gets coverage, less services, and lower average quality. Healthcare professionals will have incomes limited by legislation and the brightest minds will pick some other field.
If single-payer socialized medicine is all you've ever known, you are OK with it. I think Americans will not like the change.
BTW, the math is fairly simple, $1000 per month per person. Somebody has to pay it.
Self-Described Smear Merchant Chuck: "Trump doesn't seem so hostile to single-payer health care."
Well, I guess that explains Trump's support as President for single-payer......er...oh.
Never mind.
Nice try "Brian Stelter republican" Chuck. Better luck next time.
tim in vermont said...Also, countries that do this tax EVERYBODY, as Sebastian said. They use a VAT which is a way to bring in oceans of money because everybody pays, even low income people.
Yes, but that's just step 1. Step 2 is hollering about how unfair it is that the poor have to pay this tax so then you'll get added subsidies and an expansion of the welfare state. These measures will be targeted first at the "very poor" but then the next-poorest group will complain and you'll have more subsidies, then the next, etc. Then, you know, the people actually paying will be paying so much they'll demand to get SOMETHING back for their contribution so you'll see acceptance of other social welfare measures, other programs, nationalization of other industries...and each step moves us closer to full socialism.
But hey, don't listen to me: I'm a crazy free market capitalist pig.
Something tells me that the President (Trump) who has delivered the most conservative 18 months of governance since Coolidge will not be the one advancing any single-payer dream bill of LLR Chuck's dem allies.
Go ahead Chuck, say it: Trump is the most conservative President since Coolidge.
Go ahead, say it......
LOL
I do kinda doubt that overconsumption of the sniffle-variety is a bigger drain than uncompensated care
For example, let's use this hypothetical -- Doctor's visits twice a year even though the person never has any health issues, with the doctor spending at least 20 minutes with them, and the person even basically making conversation to fill the 20 minutes; tests and scans with no indications the person needs them, the doctor just thinks it would be a good idea; etc. All of that adds up.
Aren't current Medicare costs partially subsidized at the provider level by the charges for non-Medicare patients?
I read a couple of articles several months ago about two doctors who operated a cash-only family practice. Since they didn't deal with insurance, they had significantly less admin overhead, which resulted in cheaper, and quicker services. They contracted out with local hospitals for tests they didn't have the equipment for.
Get rid of the bureaucracy, in any organization/business, and services will be better, cheaper, and faster. "Medicare for all" would do the exact opposite.
Sanders and the rest of LLR Chuck's democrat/lefty allies care not one bit about system performance, health care delivery outcomes, cost effectiveness, etc.
It is literally pointless to even bother addressing such points.
There is, as always, only 1 question that matters and determines what the position of LLR Chuck's democrat allies will be:
Does it increase government control over the lives of Americans?
If the answer is yes, you already know where LLR Chuck's democrat allies will be on the issue.
Power of the govt over the citizen is the ONLY consideration for the dem/left.
Nice group of allies you joined up with there Chuck.
All estimates are low, but, but they'd cap spending and rationing would occur as happens in all countries with socialized medicine. The political elite would not face rationing, though.
wwww: "If Americans want a good system, like Germany, then make it happen"
Step one: Get the US to pay for all relevant defense expenditures.
Step two: Make sure the minimal amount of money spent on defense goes to decidedly non-military preparedness activities: road building, facility building, pipeline building, etc., but is counted as "defense expenditures" anyway.
Step three: Create Trade Agreements which guarantees the US has a permanent losing Trade imbalance which transfers hundreds of billions of dollars over the years from the US to your country.
Complete these steps and you will free up billions of your own money to spend on whatever you want.
The most efficient health care system was the one we had before 1965 and LBJ.
Patients paid cash and insurance covered major illness.
Doctors had low overhead and fees were low. A family friend had his wife working in the office as his only nurse. He was one of the top orthopedist in Chicago. He was The White Sox team doctor.
Go to a cash primary care system and overhead drops 50%
The poor got better care at LA County hospital than they did from docs who took Medicaid, and often cheated.
Too long a story for the iPad.
Mark: For example, let's use this hypothetical --
I didn't ask for a hypothetical, I asked for some numbers. You know, stats. Somebody must be doing the slicing and dicing on what factors are driving ballooning health care costs, and by how much. Lots of things "add up". Everybody has their pet health care cost bête noire.
wwww: "T. A. R. R. I. F. F. S.
A. R. E.
G. R. E. A. T."
I'm sorry you are so upset that Trump is demanding the US no longer permanently accept a losing trade position via massive European/Asian tariffs on US goods with no reciprocal protections for US industries.
You passionate defense of the US accepting trade agreements which structurally advantage every nation on Earth over the US is duly noted.
Keep up the good work, because the desire to reward the world at the expense of US citizens is one of the key reasons you got Trump.
So in a very real way, you are why Trump is elected.
Congratulations to you and LLR Chuck!
wwww: "I got no patience for Hoover isolationists."
Thank you for your continued support of the Trump policies to get NATO to strengthen their capabilities.
It is heartwarming that you have come around.
Or did you think your hilariously moronic lefty bumper sticker comments would win the day?
LOL
Too funny.
Inga level posting by wwww. I can't wait to see what comes next!
Why don't the people in New England try out "Medicare for all". They're a bunch of socialists, and keep electing Senators who want to impose it on the rest of us, along with Open Borders.
My only thought on socialized medicine. Places like England end up with two health care systems. One for the Well-to-do, the Top 5%, who use a private system - and a large mediocre system for everyone else. Needless to say the best doctors, go into the private system. If we had "Medicare for all" the same thing would happen in the USA.
wwww is in favor of World Government. Good to know.
Michael K: "wwww is in favor of World Government.
Oh, I'm sure wwww would settle for the standard democrat tactic of simply replacing the US electorate with a socialist-minded 3rd world wave of democrat voters.
Most working people pay quite a bit in private medical insurance. That would be replaced by higher takes under "Medicare for All".
BTW, the insanity of open borders + "free" Medical care for all, is beyond belief.
Every time, I see Bernie Sanders, Blumethal, or Warren, I wish we could kick New England out of the country.
Freder Frederson said...
What is hidden in the report is that without Medicare for all healthcare spending will be 34 trillion so Medicare for all saves 2 trillion.
Apparently we're to believe 32 trillion is completely different than 34 trillion. Unserious people will always find a pretext to dismiss inconvenient realities
I'm in the VA system. Even if you are healthy, you still have to see a VA doctor once a year to stay in the system. That's when they draw blood, and within the week, I'll get the results. It's a good way for me to address any high readings for any of the tests that are performed. I also look at it as an early warning system.
wwwww: "Some of us like the post WWII world order that promotes free markets and democracy."
We do not have free markets and democracy.
The European and Asian nations have, with US globalist support, permanent US trade disadvantages and still treats China as an "emerging nation", with even more advantages.
On top of currency manipulation, national subsidies to its companies, massive intellectual property theft, etc.
Which wwww is now on record as being in support of, but only completely.
"free markets", LOL
Tariffs on US cars going to China: 20%
Tariffs on US cars going to Europe: 10%
Tariffs on foreign cars coming to the US: 2.5%
wwww thinks this is a "free market" relationship!
Again, remarkably stupid.
Remarkably.
Field Marshall Freder: "What is hidden in the report is that without Medicare for all healthcare spending will be 34 trillion so Medicare for all saves 2 trillion."
LOL
I wonder what Freder's estimate for completion of the California Choo-choo To No-Where is?
Whenever you see something like "32 Trillion over the next decade" don't break it down to 3.2 trillion per year. A per decade figure may mean that something will cost 1 trillion the first year and will ramp up to 4 or 5 trillion for year ten. I suspect that ramping up of costs is something the study shows.
Personally, I'd expect Medicare-for-all to get out of hand quickly. You'll run into the vocal minority/passive majority problem when it comes to determining what sort of treatments get covered. If we aren't spending 100 million a year on Reiki massage by year ten of Medicare4All, I'll eat my shoes.
Dr. K: Go to a cash primary care system and overhead drops 50%
Yup. Chance in hell of cutting that Gordian knot? (Can't really even buy old-school "catastrophic insurance" any more. Or rather, you can, but you pay "cadillac" rates for what is effectively "catastrophic" coverage.)
I often think that the things started going south when health insurance became tied to employment. What do you think would happen if employers were not allowed to offer health insurance as part of compensation, and people had to buy it directly?
wwww: "Just your usual promoter of western allies and the post WWII promotion of free markets, democracy, and the rights of man."
Gee, that explains the complete trade capitulation to the Chinese, noted purveyors of "the rights of man".
LOL
wwww goes full Tom Friedman (not that we didn't already know that).
wwww: "Maybe the US goes go back to Hoover isolationism and a 16th century mercantilism."
wwww will fight to the death for unfair trade practices which rewards all US trading partners at the expense of US citizens.
The LAST thing the Europeans and the Asians and the dems and the left want is actual Free Trade, free of structural barriers and currency manipulation and intellectual property theft.
That is literally the LAST thing the dems/left want.
The dems/left and globalist GOPe want what we have now: structural arrangements which guarantees America is a trade loser transferring hundreds of billions of dollars to other nations while asking nothing of those other trading partners.
"And tomorrow, a sex offender registry for dogs."
"It's about time."
tag for news show, Veep Season 6
Still waiting for wwww to express some concern that Germany is moving to have 70% of all their energy needs controlled by Putin, including the energy that powers US bases in Germany!
Not to mention the billions that will flow from Germany to Putin for Putin's use in developing weapons that can be used on the US personnel who are doing the job that the Germans long ago decided wasn't something they were interested in.
"rights of man"
LOL
Isolationist indeed.
The "best" part of the complete energy capitulation/collusion between Germany and Russia which completely empowers the Russians?
The fact that it is the former Chancellor of Germany who is being paid by the Russians to lead and lobby for that very effort.
It's almost exactly as if a former US President and/or a US Presidential candidate were being paid by Russian oligarchs to hand over US strategic assets like uranium.......er....oh. Right.
"rights of man".
LOL
The Koch Brothers live rent free in Bernie's head.
In the Czech Republic, doctors make around $40,000 a year.
Try that in America, Bernie. NURSES make close to $60k in America and that is conservative.
Mike Smith: "The Koch Brothers live rent free in Bernie's head."
Bernie better watch out. He's likely to run into the Koch's these days at democrat fundraisers.....
All you need to know to realize Bernie is an idiot and not a serious person is this: he doesn't explain why the analysis is wrong or the methodology that produced it erroneous. No, he attacks the people that, he supposes, funded it. No facts to refute the study, just a boogeyman to vilify.
-sw
For the last 10 years of my career, I worked as a clinical psychologist for a large hospital system. Three things struck me after comparing that experience to 20+ previous years working in a private pay system.
1). The system offered a 40% discount if you paid cash at time of service. That was essentially the cost of dealing with insurance although many of the paperwork requirements remained. The hidden costs of managing potential lawsuits also remained.
2). Private insurers, Medicaid and Medicare set their reimbursements to clinicians based on what they thought we should be earning. Coming from a free market value added system, this was a shock.
3). Hospital administration makes a lot more money than practitioners although we are the talent that draws in patients.
Overall, the bureaucrats and the lawyers win. The providers get screwed unless they go into private, cash only practice.
So Bernie's degree wasn't in math, was it.
Um no, Schroeder is just on the board, the CEO Markus warnig is a fmr?? Stasi agent and chairman of Dresdner bank who has long standing ties to putin.
FIDO: "So Bernie's degree wasn't in math, was it."
Bernie's only "job" ever was working on a commie commune where the other commies literally kicked him out for being too lazy.
Literally.
If every major country on earth can guarantee health care to all, and achieve better health outcomes ...
Both assertions are wrong. Most major countries have a national health service supplemented by private health insurance plans. And the outcomes are not better, not even in the average much less in comparing best to best.
Note to Bernie. SHOW US THAT THE GOVERNMENT CAN FIX THE TWO SINGLE-PAYER HEALTHCARE PROGRAMS WE ALREADY HAVE and then maybe we can listen. That would be the VA and the Indian Health Service. Fix them first.
HoodlumDoodlum said...What's the true cost then, Bernie?
--
"Next question!"
My favorite part of the Medicare for all crowd is the high proportion of believers that have never looked at (or comprehended) a CMS visit statement.
Vs "Free", it's difficult to engage them on issues like provider reimbursements and coverage vs access. Once you spread the teetering Medicare system far and wide, those will likely be more at the lesser Medicaid rates.
Somewhere in the costs of health care is malpractice/liability insurance.
And..of course..our legislators sit squarely in the moral hazard of gettin' their own, dammit.
@wwww, yup. See you there.
Asshole.
acting like nursing is some menial work akin to housekeeping or being a stay at home mom
... or dad.
menial (adj.)
late 14c., "pertaining to a household," from Anglo-French meignial, from Old French mesnie "household," earlier mesnede, from Vulgar Latin *mansionata, from Latin mansionem "dwelling" (see mansion). Sense of "lowly, humble, suited to a servant" is recorded by 1670s.
Semantic progression.
Menial or not, it is fully half the economy in a two-person household, work that must be done for quality and quantity of life, and for duck dynasties. I would split taxable income in half after necessary expenses.
Dresdner also has toes to hsbc,
https://www.occrp.org/en/investigations/6785-firm-linked-to-putin-friend-smoothed-path-for-bp-in-russia
You might think it possible to tax people enough to fund Medicare for all, but you won't be able to. We haven't even been able to tax them enough through the entire course of their working lives to fund Medicare for just the old people. What reason do we have to believe it will be fund-able if it is extended to everyone?
I will consider Medicare for all after Democrats propose free legal representation for all. When lawyers get treated like doctors (e.g., with essentially fixed wages) then we will have a more level playing field.
Likelihood that Democrats and their trial lawyer allies support that move = 0%.
We're going broke over the amassed army of state run government employees. The administrative state will drive/is driving us into a bankrupt hole. What do the D's want? More. It's all about control.
We will know the libruls have won this battle when a doctor makes only $75K per year and a college diversity bureaucrat is paid $125K. Let's face it, that is the librul goal and they see nothing wrong with it.
Single payer will become single employer. Unionized striking doctors and nurses. Yeah, that will solve our health care expenditure problems. Thats the British way. Our Canadian friends used to have a system where doctors were allowed a maximum annual compensation. Once the doctor reached the compensation limit, the doctor would receive no further compensation and hence no reason to work for the balance of the year. Hence Canadians crossing the border.
4-dub: "Some of us like the post WWII world order that promotes free markets and democracy."
Yeah, we know, 4-dub. That's a currently popular talking-point among the twitter/facebook cat-lady brigades who've recently become experts on trade relations.
If they actually knew anything about the origin and evolution of the "post WWII order", they would understand that it's been under serious strain since long before Trump showed up. Still, it's entertaining to watch them natter on pompously using the phrases they just learned yesterday. ("Hoover isolationism". "16th century mercantilism". Lol.)
Drago: wwww thinks this is a "free market" relationship!
Again, remarkably stupid.
4-dub went off the deep-end into talking-point dementia sometime around the beginning of the "kids in cages" and the first volleys of tariff re-negotiations. At the time, judging from the hysterical barrage of lame CoC-type propaganda she pumped out in response to the latter, I hypothesized some personal skin in the game re Canada and tariffs.
MikeR said...
"They can be no more broke than the US Army or Food Stamps. All three are funded out of general tax revenue. Congress could decide not to fund it any longer but it can't go broke in any meaningful sense of the word." Have you heard that many state and municipal pension funds are broke? They also can be funded by general tax revenue. Unfortunately, there isn't enough tax revenue to pay for them and for police and fixing the roads as well.
Unlike the US Army, these are not discretionary funds, where Congress can decide to fund a little less this year. Their expenditures, like state pension funds, are fixed by the obligations already taken on. And the plan for how much of the tax revenue would pay for them isn't nearly enough any more."
No. Pensions are contractual obligations hence legal liabilities. Food stamps, Social Security, Medicare and Medicaid are political obligations and are only as good as Congress deems them to be. Look up the Nestor decision.
The administrative state will drive/is driving us into a bankrupt hole. What do the D's want? More. It's all about control.
Follow the logic: our system is bad because we pay too much. This implies the resulting system will save money. But Democrats have never advocated reducing the pay of government employees even when they are vastly overpaid as in Jamie Gorelick or Lois Lerner. In fact Democrats believe it perfectly acceptable that government employment lead to becoming rich (like Bernie, Obama, Clinton, etc) . In this they emulate the ancien regime where the aristocracy used political / social power to extract wealth from the population.
This entire movement is a scam.
I wish we could go back to catastrophic coverage for major medical - that seemed to work before so many people got spoiled by free office visits for a cold and no co-pays. And the welfare crowd in this country thinks everything should be free to them because they are victims of the man!
What has been the fastest growing occupation in America since the 1960's?
Social worker
College administrator
Community activist
Lobbyist
Non-profit employee
Lawyer
I don't know the answer but I would bet on social worker which includes govt Medicare, Medicaid, Social Security System employees, social service agency employees, etc.
see the usual dumbshits are talking about "Free Trade".
We don't have "Free Trade". We have Trade deals that allow everyone to more or less export to the USA, without any barriers - while many USA goods are subject to Trade quotas and tariffs. Result $800 billion trade deficits - year after year.
Any attempt to get better trade deals for the USA, is met with screeching about "Tariffs are Taxes" and "Free Trade is good".
Morons.
Bernie has turned himself into the "Baghdad Bob" of the Left. The Iraqi Bob was famous for saying that he got his information from "authentic sources—many authentic sources" Seems to me that Bernie is doing mainly the same thing.
Follow the Money in Florida: 34,873 Public Employees with $100,000+ Salaries Cost Taxpayers $5.5B
And that's just Florida.
Follow the money in every state. The bureaucratic administrative State will sink us. *but it's for your own good*
THE TWO SINGLE-PAYER HEALTHCARE PROGRAMS
You forgot military medicine.
Our system is working just fine as long as your not having a baby as our infant mortality rate is higher then 27 other countries -- many with single payer plus premium plans.
Drago,
Fred was referring to this Koch-funded document, not his own estimates.
https://twitter.com/ernietedeschi/status/1023927465956335617
rcocean: Any attempt to get better trade deals for the USA, is met with screeching about "Tariffs are Taxes" and "Free Trade is good".
Morons.
Some of the screechers are morons while others aren't morons at all but merely serenely self-interested. And of course some of them are self-interested morons.
Herbert Hoover was no isolationist. On the contrary, he was most famous for organizing the Belgian rescue mission during WWI and the general European aid mission - and especially Russia! - after the The Great War to end all wars.
(Actually, Hoover was sort of a compulsive manager - whatever the problem of the day was, he wanted to manage the effort to resolve it.)
wwww just displays his ignorance of history - again.
Henry said...
The answer to overconsumption is, in short, death panels.
Death panels are a solution to both overconsumption and appropriate consumption.
The far better solution, if you only want to target overconsumption, is a cost-benefit analysis. However, a cost-benefit analysis only works if the person doing it cares about both the costs and the benefits. Death panels only care about costs. Patients covered by insurance or single payer ( and their doctors ) only care about benefits.
Individuals paying out-of-pocket for the care of themselves or their loved ones care about both.
roesch/voltaire: "Our system is working just fine as long as your not having a baby as our infant mortality rate is higher then 27 other countries -- many with single payer plus premium plans"
A long ago utterly debunked and stupid lefty talking point, which makes it par for the course for r/v.
This argument goes way back with the lefties lies stacked up to provide a basis for socialized medicine.
No one is fooled by such nonsensical claims.
https://www.nationalreview.com/2011/09/infant-mortality-deceptive-statistic-scott-w-atlas/
- Underreporting and unreliability of infant-mortality data from other countries undermine any comparisons with the United States.
- Gross differences in the fundamental definition of “live birth” invalidate comparisons of early neonatal death rates.
- An additional major reason for the high infant-mortality rate of the United States is its high percentage of preterm births, relative to the other developed countries.
- Throughout the developed world, and regardless of the health-care system, infant-mortality rates are far worse among minority populations, and the U.S. has much more diversity of race and ethnicity than any other developed nation.
"The fact is that for decades, the U.S. has shown superior infant-mortality rates using official National Center for Health Statistics and European Perinatal Health Report data — in fact, the best in the world outside of Sweden and Norway, even without correcting for any of the population and risk-factor differences deleterious to the U.S. — for premature and low-birth-weight babies, the newborns who actually need medical care and who are at highest risk of dying."
Sorry lefty. Just another socialist lie.
Next up for r/v: Venezuelans eat better than US citizens......
"Our system is working just fine as long as your not having a baby as our infant mortality rate is higher then 27 other countries -- many with single payer plus premium plans."
This is such a stupid canard, one that has been debunked so many times, it's embarrassing to see it dragged out as a serious argument. No other society - none - undertakes such heroic efforts to save underweight and premature babies. There is such a vast difference in what counts as "infant mortality" that the comparison is difficult, but suffice it to say that many instances of infant death in the United States would not be counted as such in other systems.
There are ways in which the American medical system underperforms and costs too much. Why not address them, rather than rely on nonsense?
anti-de Sitter space: "Drago, Fred was referring to this Koch-funded document, not his own estimates."
LOL
Yes, by all means lets go with that! It's Koch funded, unlike the back of the napkin over cocktails loose discussion of estimated costs made by some economist in about 5 minutes and never analyzed by Bernie and his lazy commie pals!
Too funny.
Re: Free Trade
In the abstract, I am for it. It clearly makes a lot of sense mathematically. In practice, it is a bit a prisoner's dilemma scenario (game theory). Were all sides to act free, it would be to the greatest benefit. HOWEVER, for a cheater or two, it can be better to be 'Do as I say, not as I do'. The only solution is punitive altruism. 'Yeah it'll hurt us to hurt you. As soon as you are done acting like an ass, so will we.'
What the free trader's are claiming / demanding is a unilateral disarmament will *eventually* win, due to the many mathematical benefits we will accrue. However, I wonder what the cost of bitterness, resentment and dislocation will be, and how could that be captured in the balancing equation.
"Burlington Bern" vs. "Baghdad Bob"! Peas in a pod except Bob was better educated and likely knew that he was spouting garbage.
The left on Q: If you don't accept our bogus Michael Moore economic arguments, you hate babies.
R/V, I've seen that regarding infant mortality rates. Apples to oranges. The data points included are different for other countries. When you use the same causes of death data the US fares far better.
A son of one of my former bosses as the head of ER at a major local hospital was paid ca. $200,000/yr, but also paid ca. $100,000 for his personal malpractice coverage.
Drago,
That link goes shows the actual text from the Koch-funded document.
No napkins.
KH: "What the free trader's are claiming / demanding is a unilateral disarmament will *eventually* win...."
Unfortunately, what the leftists actually want is a permanent weakening of the US through continued and permanent massive transfers of capital, intellectual property and jobs to other nations via structured trade deals which guarantee our losing.
Because we are guilty and deserve it.
All of wwww's faked support for "fair trade" is really just a call for structured unfair trade designed to punish the US.
Should read the comments first. Better addressed above.
adSs: I think we are talking past each other.
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!"
The folks pushing this the hardest are Bernie and Occassional Cortex who have failed to deliver any analysis for their planned health care lunacy.
Perfect example of how government involvement ALWAYS makes things more expensive
https://www.vox.com/policy-and-politics/2018/7/31/17629526/mri-cost-certificate-of-need-north-carolina-lawsuit
I'm not analyzing it. Just reading it.
If I was analyzing it, I'd say that granting the assumption of greater than 40% cuts in provider payments seems problematic. Likewise, what happens when healthcare workers are forced to deal w/ lower reimbursements (salaries).
I dunno.
As is the case with "free college" in Europe is not the same as paid college in the US, "free healthcare" in Europe is not the same as "paid healthcare" in the US.
For college in Spain, for example, there is no tuition for most pubic universities, but there are also no dorms, no student centers, no athletics, limited office hours, fewer small class sizes, very limited social events, no fraternities, no sororities, no diversity administrators, no Title 9 administrators, and no safe spaces. There are also entrance exams that are generally designed to limit the overall freshman class to about 17% of the population, limited choices for majors (sometimes no choices depending on the school where one gains admission,) and essentially no professional placement services for graduates. Oh, and SJW antics like try shouting down a professor or driving a speaker off results in termination. In other words, the U of Seville bears no resemblance to the U of Wisconsin.
Hospital care is also "free", but unlike in the US you don't get what you want when you want it - you go on a waiting list for most procedures unless you have separate insurance and can thus go to a private hospital as I do. A British expat friend who uses the Spanish national system waited 18 months for a knee replacement despite being in constant pain, my American friend's wife waited only a week for a hip replacement in the private hospital. BTW, "free medical" involves a monthly deduction from one's paycheck and care does not include food, assistance getting up to the bathroom, help bathing or even frequent monitoring. In fact, when someone goes into the hospital a family member is required to go with the patient, sit with them and do all that non-medical stuff. Clinical services are also sometimes so difficult to get that most people who can afford it pay a monthly fee to a private clinic (about 75 euros/month) for access to walk in treatment. Interestingly, the average doctor here makes about $40,000 euros per year.
Comparing supposed European freebees to their paid US counterparts is like comparing beans to steak. You can argue that our students and our patients do not need to receive steak like service, but neither are many snowflakes or seriously ill Americans going to put up with beans when they've got used to eating steak. Young Americans are being conned on socialism (surprise, surprise!) and it's going to be a painful lesson to learn if they don't wise up.
hawkeye: There are ways in which the American medical system underperforms and costs too much. Why not address them, rather than rely on nonsense?
Oh, don't mind dotty old r/V. Let him continue to enjoy himself composing the silly comments that he apparently thinks are trenchant witticisms à la the latter half of his username. He's just here to drop those totally killer mic-drop mots, you know, not to engage.
If they're admitting to $32.6 trillion, then we know when all is said and done the real cost will be 3 times that.
That number, $36 trillion over 10 years is not too far off from from how much the US as a whole will spend on health care over the next 10 years. In 2016 the U.S. spent $3.3 trillion on healthcare.
Ignorance is bliss said...
The far better solution, if you only want to target overconsumption, is a cost-benefit analysis. However, a cost-benefit analysis only works if the person doing it cares about both the costs and the benefits. Death panels only care about costs. Patients covered by insurance or single payer ( and their doctors ) only care about benefits.
Individuals paying out-of-pocket for the care of themselves or their loved ones care about both.
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%.
Individuals paying out-of-pocket for themselves or loved ones care very much about not dying.
With respect to our soon-to-be glamourous new Congresswoman, Alexandria Ocasio-Cortez, I like "Occasional Cortex." That is good. Very good. Hat tip to Doc Michael K.
I have also offered "Socialist waitress of color" into the mix for group consideration.
Freder Frederson said...
Most VAT exempts food (which includes beer and wine in Germany)
Thanx Freder, like i said; i seriously have NEVER been overseas, and didn't know
roesch/voltaire said...
Our system is working just fine as long as your not having a baby as our infant mortality rate is higher then 27 other countries -- many with single payer plus premium plans.
I see R/V is eager to prove he has no understanding of what a medical system is. Our child mortality rate is higher largely because we have a larger drug problem than pretty much any other country. Focusing on specific criteria like this is intentionally misleading just as when the left cites life expectancy statistics. In the latter's case our numbers are lower because we live both riskier and less healthy lifestyles neither of which is controlled by the healthcare system.
As a physician I have seen the effects a tortious environment, so-called patient advocacy, and medical algorithms have had on daily practice. EMTALA mandates a good faith exam for every ER visit that may include batteries of extensive tests ordered by docs in CYA mode. Physicians will routinely perform, and charge for, unnecessary procedures for non-medical conditions (e.g. benign mole removal) that would otherwise be dismissed as trivial rather than risk a downgrade on Yelp from a disgruntled patient. If these are problems now in the current healthcare system they will only be magnified under any Federal single payer plan.
Our system is working just fine as long as your not having a baby as our infant mortality rate is higher then 27 other countries -- many with single payer plus premium plans.
Lefties just LOVE this hideous lie. Because places like Cuba don’t record a “live birth” unless the baby survives the first 48 hours, it kinda skews that “infant mortality” talking point. We are the only country that expends so much energy and capital to save preemies, correct birth defects and go to extraordinary lengths to try and save unhealthy newborns. It is only our extraordinary efforts coupled with our belief that every living baby at birth is worthy of being counted as a “live birth” that warps the comparison. Other countries don’t count the babies that never make it out of the hospital alive. I hope it is RV’s ignorance of how medicine works in the USA that drives his need to post drivel and not the case that we would adopt barbaric medical practices just so our stats look better like “the rest of the world.”
gilbar,
Norway VATs food.
A lower rate than other stuff (w/ an extra low rate for raw fish (gotta make lutefisk)), but taxed.
Kristian Holvoet: What the free trader's are claiming / demanding is a unilateral disarmament will *eventually* win, due to the many mathematical benefits we will accrue. However, I wonder what the cost of bitterness, resentment and dislocation will be, and how could that be captured in the balancing equation.
But trying to capture all the real-world variables would destroy a beautiful model, which has "proved" that all's for the best in the best of all possible worlds in the practice of unilateral free trade. (You know, just like with open-borders and mass immigration.)
$10,000 per capita / $40,000 family of four
easier to grasp and think about what that can buy in private decision making.
his was debunked way back in 2008. See Megan Mcardle's many articles on the topic.
I believe it was also Mcardle who pointed out that just in general the idea that "if other countries can do it, so can the US" is wrong. Other countries tend to be smaller and centrally governed. The US is sprawling and decentralized. Huge projects assigned to the Federal Government tend to be run inefficiently and turn out badly.
Jaydub said :
For college in Spain, for example, there is no tuition for most pubic universities, but there are also no dorms, no student centers, no athletics, limited office hours, fewer small class sizes, very limited social events, no fraternities, no sororities, no diversity administrators, no Title 9 administrators, and no safe spaces.
No safe spaces? I gotta get me to Spain.
Americans want it all free, and they want the soft floatie-chair goodies, too.
Jaydub - excellent post.
?that should be in addition to current spending? over 10 years??
Jaydub is right about Spain.
Their costs are exceptionally low vs “developed” Europe, however, for both education and medical care.
Even their private insurance is very cheap.
My relatives are amazed at what our employer coverage costs.
Germany and France are better comparisons vs the US, and they suffice to make the case.
US education and medical services are two areas where the US can very profitably copy others.
The US is stuck in an extremely inefficient situation in both areas.
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?
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