Re-Thinking Single Payer

#1

I am starting to rethink single payer and am wondering what you have heard mentioned and your opinion on how you see this whole thing playing out.

A friend has a really good job as a tug boat captain. He came down with a type of blood cancer that is treatable, but will have him out of work for 6 months. At three months out of work, he will be fired. Then, if at some point he is able to work again, he will be re-hired by the same company. Since he was fired though, his healthcare stops at that point. He can get COBRA, but that is 700 a month and his family just lost all of his income so that 700 will be hard to come up with.

My employer has 8 employees. Every year workmans comp takes about 50k from him for coverage. Then at the end of the period, they demand to see his gross receipts and if his earnings are above what they estimated, he gets a bill for even more money for past coverage of that previous year that is already over.

Next thing is auto insurance. It seems like the biggest part of auto insurance is the medical coverage incase of accident.

Finally another guy I know had a bad gall bladder that went bad. He didnt have insurance, but the VA took care of it. He was still out of work for two weeks and had no pay check coming in. It seems to be like the state should provide some type of short term disability insurance for people that will be out of work for a short period, less than 90 days or so. They can come up with funds to provide care for someone for 20 years, you would think that they could help a family out that is in the hospital for a couple of weeks.

So if Single Payer is introduced, Do you see auto insurance going down? How about workmans comp for small businesses?

It is starting to look to me, that maybe taxes would go up for individuals, but a lot of other stuff would go down. I know workmans comp for my employer runs him a minimum of 45k per year. That is the price of an employee for a year. And it never goes away.

What would you think of a system where the fed covers basic healthcare on an as needed system, and then a private system where one can get private insurance and the private insurance would be similar to fed-ex or ups? One could elect to deal with the govt, or one could pay money to get a private plan that would have shorter wait times with the same provider?

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#2

Sounds better than Obamacare.

Trump should support this plan.

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#3

Two words, disability insurance, if he had it, he would be able to afford his COBRA.

#5

Would you expect to see Auto Insurance go down if there was single payer? Would you expect to see your wages go up if businesses were no longer providing healthcare?

#6

Would you expect big ticket items to go down if employers were not providing healthcare? I read somewhere that some crazy amount of every car sold by gm goes to pay the healthcare of their current and retired employees. The number I read was 1525 dollars of every new vehicle sold goes directly to healthcare. So if they are no longer paying for the healthcare of current and retired employees, would the cost of the vehicle go down and would they be more competitive with other automobile mfrs?

#7

No.

For those who are currently getting healthcare benefits from their employers, yes.

For those who are not, they would not. At least not immediately. I think there would be some market adjustments as employers who previously were not providing health benefits would now be competing for employees with other companies that are now offering higher wages.

But for the guy who was not previously getting healthcare, his cash flow situation would not change if he switches from his current out-of-pocket payments for health insurance to single-payer out-of-pocket premiums. (Assuming the cost of the two plans were relatively comparable.)

What concerns me about single-payer is giving that much of the economy to the government to screw up. They can’t run a small segment of it well as it is (the VA), and there is nothing to support a hope that they would suddenly be able to run it all.

#8

That was my thought as I read the anecdote.

#9

Regarding auto insurance, probably not. We already force people to buy it and auto costs dont come close to medical costs in the catastrophic sense and in terms of how often catastrophic occurrences take place

#11

The data on single payer make it clear that it would be a lower cost means of providing healthcare than our current system and it would be means of achieving universal coverage.

That said, it has two major downsides.

  1. If the Democrats push it through (the Republicans obviously would not), the implementation would be a political disaster… especially if all the people on private’s insurance were forced to accept some version of Medicare

  2. We have a hierarchical health care system today with very different outcomes as a function of how much money a person has and where they live. In wealthier parts of the country most of the best rated doctors “don’t take insurance” at all, which means they charge what they find the market will bear and leave the patient to get what they can (if anything) from their insurance company. This system is why we see African American and Native American women dying from childbirth at such greater rates than Caucasian women. I would imagine elites would struggle mightily, and put up a lot of money, to retain their superior access and outcomes.

So we face a dilemma: do we want to provide universal, more affordable care or do we want to protect a hierarchical system in which costs are higher but the interests of those with greater power are well protected? What kind of country are we – and can anyone see a way to thread between these polls.

If I were a cynical Republican (and I think that’s just about all R’s today) I would hope the D’s implement single payer and then I can reap the political benefits for years to come.

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#12

Life and health do not come with guarantees.

There will be people covered and unable to wait in the long line of single payer. No health care panacea exists. Good issue to jerk voters around with…

:face_with_head_bandage:

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#13

Single payer doesnt mean a person will not be treated in an emergency.

A few years ago, I desperately needed to see a dermatologist, and the nearest appointment was nearly 3 months away. I was lucky to get into another office earlier, but they were basically useless and didn’t solve my problem. After 4 weeks, about 500 in copays, and another few hundred in ineffective meds, I finally solved the problem with a local clinic and 12 dollars worth of meds.

If conservatives are going to claim they are pro LIFE then they should start act like pro lifers instead of just pro birth.

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#14

Single payer, such as Medicare for all, comes with a hefty price tag. But overall, its less than what we are currently spending for less coverage than what Medicare for all would provide.

I don’t think businesses would get off Scott free though, they would still have to contribute just to a different place. But if you are getting more and paying less for it, that makes sense and it would help in a lot of ways we don’t appreciate, like the examples you stated.

The question is, how do we collect the funds needed to implement it? We wouldn’t need to collect any more than we already spend, we would need less. Standardization of billing alone would provide some monetary benefit.

Private insurers would still be able to sell supplemental insurance to everyone, which is always their best profit products. So they will be fine.

A transaction tax of 0.2 percent should handle it, and that way everyone puts into the kitty. If we have extra money we can use that to shore up SS or pay off some debt.

A sales tax of 10 percent would probably come close to paying for it. But this would benefit the very wealthy over the poorer classes as it would not affect stock transactions and a host of other transactions not subject to sales taxes.

#15

Everyone is now treated for emergency care. You cannot expect to cut staff and reimbursements to medical professionals and get a BETTER quality of care. We will all wait longer.

Single payer is equivalent to asking for field care quality in place of hospital quality care.

Some people do want this. I guess if it works in China and Russia…it should be fine everywhere.

:face_with_head_bandage:

#16

I was more looking to see how it works in every Western Democracy.

#17

I’m wondering why some people think companies are going to increase wages as a result of not having to purchase insurance for their employees. I mean most companies didn’t increase wages after getting a huge tax cut. Sure, some of them gave out a one time bonus, but hey, how much profit have they made since that one time bonus? Businesses are solely in business to make money. Why would they increase wages? That just costs them money.

#18

The ACA is the Republican answer to Single Payer, and even they hate it.

Why are we using a system nobody wants? (Because the insurance industry loves it.)

Medicare for all is the only answer that makes sense to me. I would support eliminating insurance entirely before supporting Obamacare. It’s not a good system.

#19

The one vehicle I could see that would raise wages is through the restructuring of benefit packages. Most companies use health insurance as a draw for potential hires to work for them, as they have competitive plans with competitive costs. Taking that out of the equation, employers would be forced to re-imagine their benefit structure which includes salary/compensation to attract the talent they are looking for. One less bargaining chip in the benefit package will increase the weight of salary/compensation when a candidate is determining whether to accept an offer or not.

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#20

It works in Korea where my wife is from. They have a population of 50m in an area about the size of Indiana. In the US, we have 330m and over 50 times the land.

There though, you do have a user access fee and it is paid immediately upon service. If I remember right, it was less than 30 dollars but could go up depending on tests and meds.

#21

You are correct, but from a different perspective, if a company figures they will spend 20% of their revenue on “Labor”, You would have to include the percs thrown in to the employees as part of that 20%. In this case the perc is healthcare.

So now you drop the healthcare and say the labor pot now drops to 12%. That same company may opt to give raises to their employees to keep the original 20% figure. This would help them to retain quality employees that are already trained to do the required tasks. No company that I can think of likes employee turnover.

#22

It does not matter what we think, It matters what dems or republicans are willing to propose…

I think Obama care was the best the dems could come up with. Because the insurance companies paid for it. Reps are to chicken to propose anything.

The left should be supporting non-govt free clinics. The rest should be free market. I’m for outlawing employers picking health insurance providers. Let the employee do that.

The left says they like Norway,and I have yet to meet a leftist who actually knows how that system runs…