What would be the potential negatives of a so-called Medicare for all system?

dantes · 2018-08-27T18:19:21.693Z

Multiple. The main driver behind slowing health care cost expansion was increasing share of patient responsibility. The higher the deductible, the more choosy individuals will be on deciding what services they should obtain. Combine that with the way the subsidies were enacted. The subsidies encouraged people to chose higher deductible and smaller networks.

There’s one more big component, which were ACOs. Organizations could take responsibility for an entire patient’s care. If they were able to provide care at a lower cost than Medicare expected, they’d get to keep a portion of the difference, which incentivized better outcomes as opposed to just collecting fee for service. This is being expanded and it seems likely that alternative payment models will become the standard rather than the exception.

adroit · 2018-08-27T18:20:58.617Z

Piper:

Washington (AP) – Sen. Bernie Sanders’ “Medicare for all” plan would boost government health spending by $32.6 trillion over 10 years, requiring historic tax hikes, says a study released Monday by a university-based libertarian policy center.

That’s trillion with a “T.”

Bloomberg - Are you a robot?

You forgot to include the part that explains that it would be less expensive than the status quo on top of the benefit of covering everyone.

Eagle-Keeper · 2018-08-27T19:33:29.117Z

Look I spent the last couple of hours going through different articles on this - you can find both positive and negative. Here is my conclusion. The cost of almost anything is mostly impacted by competition, supply and demand. I really had a hard time seeing how the ACA impacted those market forces. By and large what it did at the personal level was help one group - the poor who had not been previously covered while hurting many in the middle-class who had private health insurance. Here is a coupe of article’s on that:

Washington Examiner – 9 Apr 18

Obamacare is now so expensive it keeps patients away from their doctors

In December 2009, three months before the Affordable Care Act was passed, former President Barack Obama met with Democrat leaders from the Senate to help them put the final touches on what would soon become his administration’s signature piece of...

CNNMoney

Is Obamacare actually affordable?

High deductibles have some middle class Obamacare enrollees questioning how affordable it is.

dantes · 2018-08-27T19:53:58.496Z

Middle class were receiving enormous subsidies for their premiums. Subsidies were based in silver level plans. Choosing a bronze level plan meant those individuals would pay little if anything in premiums. The thousands upon thousands of dollars they save in premiums more than offsets the deductibles they paid as a result of their choice in the market.

Eagle-Keeper · 2018-08-28T20:25:26.885Z

Personally I fall somewhere in the middle on this debate. I do favor a safety net for those who don’t have and cannot afford health insurance, but I would encourage free market solutions as well. For example does one really need health insurance to see a GP doctor/nurse/PA for things like physicals, the flu, a cold, etc? We don’t buy comprehensive insurance for cars for example. The free market would be much better suited for things like routine care and would be able to do it a much more effectively economically.

gwhit · 2018-08-28T20:59:38.586Z

VA health care is fine and would improves if everyone else in America where on it, but since it is only vets most people just don’t care that it is under funded. Plus you can’t discount the fact that as a community Vets at VA are at VA because of issues related to war. Most of Vets I see when I go for my yearly are old nam vets who are one foot in the grave.

FloridaYankee · 2018-08-28T21:53:39.047Z

Hellsbane:

Medicare is a system based upon people paying in for many, many years before they can start actually using it, like Social Security. Although what people who paid in, most current recipients having paid in for decades, ended up with is even after they start receiving it, they still have to continue paying for it. In some cases, it ends being detrimental to their standard of living.

Now, this Medicare for all, in order for it to be like current Medicare, would imply that everyone who gets it, must pay into for many, many years even decades, before they can start getting it. I seriously dont think this is what they really have in mind. I think they want something more along the lines of a Medicaid for all where a lot of people never pay in but can use anytime.

Everybody with a job pays FICA taxes now, there is no reason for that to change, except they would obviously pay more.

FloridaYankee · 2018-08-28T21:58:52.563Z

tnt:

I don’t know anyone who is suggesting government run healthcare.

Medicare is not government run healthcare. It is government funded healthcare. The healthcare is provided by private concerns.

The govt. does however refuse to pay what many doctors think is a fair price for different procedures. They are clearly exerting some control.

Roxiebelle · 2018-08-28T22:07:12.689Z

Seniors over 65 paid into Medicare for 50 years of their working life and that’s just for the very basic hospitalization, they continue to have to pay an additional $100 a month for extended office and doctors care, which doesn’t include expensive medication. There would be plenty of $$$ in Medicare & Social Security funds to care for the senior population if Congress hadn’t been raiding those funds for decades. IOU’s don’t cut it with an aging population who have paid their dues or as the hero to liberals Obama said have “skin in the game”! Throwing everybody into Medicare including illegals is nothing more then fraud, in addition to theft, by the Government.

dantes · 2018-08-28T22:16:20.513Z

The people you claim “paid their dues” are exactly the one who are responsible for the existence of those IOUs.

Eagle-Keeper · 2018-08-28T22:22:09.529Z

I’ve been spending some time reading different articles pertaining to Canada’s system, here are a few conclusions: For routine care there arguably no difference, although if you needed more extensive type surgery your better off here. also if you have cancer your better off here as well. I also found yhis statement regarding Canada’s system:

“The part nobody ever talks about when they mention Canada’s health care system is how intertwined it is with their 100-point merit-based immigration system. People with chronic illnesses are not allowed to immigrate to Canada, period. That includes children with asthma. That includes spouses of actual Canadian citizens if they have an expensive chronic condition like MS. All potential newcomers are subjected to rigorous medical and psychological testing beforehand and even intellectual deficiencies in a family member are a deal-breaker for the entire family. American leftists are completely clueless. They point to countries like Canada and lament the fact that we can’t provide universal health coverage like they do, yet scream like wild banshees when you start talking about bringing even the tiniest degree of common sense into the equation as it relates to our massive immigration problem.”

SottoVoce · 2018-08-28T22:25:41.937Z

Eagle-Keeper:

I’ve been spending some time reading different articles pertaining to Canada’s system, here are a few conclusions: For routine care there arguably no difference, although if you needed more extensive type surgery your better off here. also if you have cancer your better off here as well. I also found yhis statement regarding Canada’s system:

“The part nobody ever talks about when they mention Canada’s health care system is how intertwined it is with their 100-point merit-based immigration system. People with chronic illnesses are not allowed to immigrate to Canada, period. That includes children with asthma. That includes spouses of actual Canadian citizens if they have an expensive chronic condition like MS. All potential newcomers are subjected to rigorous medical and psychological testing beforehand and even intellectual deficiencies in a family member are a deal-breaker for the entire family. American leftists are completely clueless. They point to countries like Canada and lament the fact that we can’t provide universal health coverage like they do, yet scream like wild banshees when you start talking about bringing even the tiniest degree of common sense into the equation as it relates to our massive immigration problem.”

I don’t know about Canadian immigration policies as it pertains to health care. I’ll do a search and read up on it. Do you have any good links?

Eagle-Keeper · 2018-08-28T22:29:14.082Z

You being a NJ resident like myself may have personal experience with the long wait periods. I have found it much more pronounced with my children. With certain doctors especially in areas where there is high immigrant populations it may take 4 to six months to get an appointment.

Eagle-Keeper · 2018-08-28T22:32:28.273Z

Not off the top of my head. I googled statements like “how good is Canada’s healthcare system” and read through a number of articles from those searches. Typically what I like to do as well is read through responses from others on the articles I find to get different perspectives on what I read.

Toll_Collector · 2018-08-28T22:36:25.501Z

Eagle-Keeper:

You being a NJ resident like myself may have personal experience with the long wait periods. I have found it much more pronounced with my children. With certain doctors especially in areas where there is high immigrant populations it may take 4 to six months to get an appointment.

That is not an acceptable wait period. I have not waited anywhere near that period of time for an appointment. I have not seen anything remotely close to 4-6 months for myself or any of my extended family.

Eagle-Keeper · 2018-08-28T22:55:06.045Z

I have only experienced this with certain specialists who are located in certain areas with high immigrant populations. Thus far I have not experienced for myself. For example I recently had to get shoulder surgery. I was able to get an MRI in under a week and the surgery done in less than a month after that. I’m willing to bet that the typical Canadian would not be able to say that. In fat I have heard a number of anecdotal accounts of Canadians having to wait months just to get the MRI.

Eagle-Keeper · 2018-08-28T23:01:11.435Z

Here is something I found:

immigrationcanada.pro

This domain may be for sale!

Although it looks like they are going to reform those policies:

Canadim – 16 Apr 18

Canada relaxes restrictions for immigrants with medical conditions

Canada will be loosening medical inadmissibility restrictions for immigration applicants living with certain disabilities and medical conditions.

Toll_Collector · 2018-08-29T01:02:43.203Z

Eagle-Keeper:

I have only experienced this with certain specialists who are located in certain areas with high immigrant populations. Thus far I have not experienced for myself. For example I recently had to get shoulder surgery. I was able to get an MRI in under a week and the surgery done in less than a month after that. I’m willing to bet that the typical Canadian would not be able to say that. In fat I have heard a number of anecdotal accounts of Canadians having to wait months just to get the MRI.

I’m in a union. These guys would love to sit around for weeks or months before surgery being paid 80%. But when it’s workmans comp, they’re under the knife within 2 weeks. When it’s not workmans comp it takes a little longer, but not by much. Maybe a month because that is insurance already paid for.

Janet_Miller · 2018-08-29T17:28:52.629Z

It’s fine?

That really does depend on which V A facility is being reviewed. There are vets who’ve been on this board who wouldn’t refer their worst enemy to the V A near them for a minor procedure.

And what is “just vets”? An argument that in the U S, veterans aren’t valued? I would argue again that really does depend on what part of the U S.

And funding, hmm. Having worked for one, there was a union.

Members paid dues to see absolutely no benefits to it & drop out, so I cannot agree more funding is the answer.

Hellsbane · 2018-08-29T17:42:41.561Z

SottoVoce:

It wouldn’t be like current medicare. It would be like current medicare plus current private insurance plans. You don’t have to wait until you’re 65 to use benefits from your current healthcare insurance provider. You’d continue to pay for the elderly/retired, but instead of paying for private insurance you’d pay the government to act as an insurer.

OK, but that is NOT a system for ALL. That is where they are being deceptive. There are 10,s of millions of people who can not pay a dime into medical insurance without losing a chunk of their survival needs. That is why i say, Medicare for all is not what they want and is not what most of supporters believe it to be. Ignorance is bliss till you get the bill.