Author Topic: Universal Health Care Practicalities  (Read 8702 times)

FIPurpose

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Re: Universal Health Care Practicalities
« Reply #50 on: February 01, 2019, 05:33:10 AM »
If we wanted to move to socialized medicine, we could just use the VA as a model and slowly offer service to Medicare patients, and then as the system builds lower the age for Medicare overtime. Everyone that isn't in range of a Medicare hospital could continue to use the insurance, and the system could have the proper time to on board doctors and such.

CindyBS

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Re: Universal Health Care Practicalities
« Reply #51 on: February 01, 2019, 08:04:55 AM »
If we are on the fat shaming bandwagon how would a fat tax work?

1) Person 1 is obese but regularly exercises.  Cholesterol, diabetes, blood pressure numbers are good.

2) Person 2 has a normal BMI but never exercises, eats like crap, and has numbers that are all in the danger zone.

So, the fat person gets taxed in this case?  I am overweight but have had 2 different doctors tell me they wish they had my low numbers in terms of cholesterol, sugar, blood pressure, kidney function, etc.  Not all overweight people are unhealthy, and not all thin people are healthy. 


I worry much less about hypochondriacs and repeat admissions to rehab sucking a universal health care system dry than I would the massive grift and price gouging that happens in the current system in the United States.   Many medical supplies, pharmaceutical companies, device makers, etc. literally charge as much as they can get away with and reap massive profits.  Since there often is really is no choice in buying most of these products, it is price gouging people at their most vulnerable.   Case in point - my son takes a drug that costs $11,000 per month.  The bulk of the research for this drug was funded by the US taxpayer.  The CEO of the company that makes this drug got $18 Million in compensation for just the year 2017.  Strict price caps would have to be in place for any universal system to work.  Just like we have a public utilities commission that makes sure the utility companies don't rob you blind for electricity, a government panel should do the same to make sure you don't get robbed blind for chemo or surgery or other health care needs.

Hula Hoop

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Re: Universal Health Care Practicalities
« Reply #52 on: February 01, 2019, 08:08:51 AM »
Cindy - it's amazing to me how much less the same exact pharmaceuticals cost here in Italy than in the US.  I had to take a drug during pregnancy that cost less than 10 euros a month full sticker price here (and only a couple of Euros after the national health care system paid its share of the cost) but in the US it costs hundreds.  I've been told that drugs are so expensive in the US as individuals and individual health insurance companies have a lot less bargaining power than, say, the national healthcare system of Italy or Canada.

FIRE@50

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Re: Universal Health Care Practicalities
« Reply #53 on: February 01, 2019, 08:15:02 AM »
I support treating everyone equally and would not support a fat tax. I would support better education of the population regarding what healthy food actually is. I would also support getting the cattle/dairy and chicken industry out of making government policy decisions so that they aren't being subsidized by tax payers. Subsidies on things like corn and soybeans have probably done more to ruin the health of America than anything else.

Poundwise

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Re: Universal Health Care Practicalities
« Reply #54 on: February 01, 2019, 08:42:42 AM »
Read this interesting op-ed:
https://www.washingtonpost.com/opinions/2019/01/30/media-is-badly-botching-medicare-all-debate

" You have to compare what a universal system would cost to what weíre paying now.

It isnít easy to be perfectly precise about this, because there are multiple forms a universal system might take. But there have been some recent attempts to estimate what it would cost to implement, for instance, the single-payer system that Sen. Bernie Sanders (I-Vt.) advocates; one widely cited study, from a source not favorably inclined toward government solutions to complex problems, came up with a figure of $32.6 trillion over 10 years.

Thatís a lot of money. But you canít understand what it means until you realize that last year we spent about $3.5 trillion on health care, and under current projections, if we keep the system as it is now, weíll spend $50 trillion over the next decade." [bolds mine]

ketchup

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Re: Universal Health Care Practicalities
« Reply #55 on: February 01, 2019, 08:44:18 AM »
Read this interesting op-ed:
https://www.washingtonpost.com/opinions/2019/01/30/media-is-badly-botching-medicare-all-debate

" You have to compare what a universal system would cost to what weíre paying now.

It isnít easy to be perfectly precise about this, because there are multiple forms a universal system might take. But there have been some recent attempts to estimate what it would cost to implement, for instance, the single-payer system that Sen. Bernie Sanders (I-Vt.) advocates; one widely cited study, from a source not favorably inclined toward government solutions to complex problems, came up with a figure of $32.6 trillion over 10 years.

Thatís a lot of money. But you canít understand what it means until you realize that last year we spent about $3.5 trillion on health care, and under current projections, if we keep the system as it is now, weíll spend $50 trillion over the next decade." [bolds mine]
This is the part so many seem to miss.  It's the worst, most expensive option, except for all the others.

Mississippi Mudstache

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Re: Universal Health Care Practicalities
« Reply #56 on: February 01, 2019, 09:52:10 AM »
Read this interesting op-ed:
https://www.washingtonpost.com/opinions/2019/01/30/media-is-badly-botching-medicare-all-debate

" You have to compare what a universal system would cost to what weíre paying now.

It isnít easy to be perfectly precise about this, because there are multiple forms a universal system might take. But there have been some recent attempts to estimate what it would cost to implement, for instance, the single-payer system that Sen. Bernie Sanders (I-Vt.) advocates; one widely cited study, from a source not favorably inclined toward government solutions to complex problems, came up with a figure of $32.6 trillion over 10 years.

Thatís a lot of money. But you canít understand what it means until you realize that last year we spent about $3.5 trillion on health care, and under current projections, if we keep the system as it is now, weíll spend $50 trillion over the next decade." [bolds mine]
This is the part so many seem to miss.  It's the worst, most expensive option, except for all the others.

Exactly. People get all up in arms about how "They'll have to raise taxes!!!1! OMG F-NO!!!" Well, last year my health insurance premiums cost $14,000 (that's how much it costs to insure my family of 6 with zero actual spending) and I spent $10,000 in out-of-pocket costs (because we have a special needs child who requires expensive care). That's more than a quarter of my annual income right there. The federal government could literally triple my effective tax rate and I'd still pay half as much for health care as I do right now. Oh, and don't even get me started on the numbers of hours my wife and I spend sorting, paying, and fighting for corrections to our medical bills. If the government actually tallied lost productivity due to our byzantine healthcare system, publicly-funded healthcare would look like a steal.

RetiredAt63

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Re: Universal Health Care Practicalities
« Reply #57 on: February 01, 2019, 11:41:06 AM »

Exactly. People get all up in arms about how "They'll have to raise taxes!!!1! OMG F-NO!!!" Well, last year my health insurance premiums cost $14,000 (that's how much it costs to insure my family of 6 with zero actual spending) and I spent $10,000 in out-of-pocket costs (because we have a special needs child who requires expensive care). That's more than a quarter of my annual income right there. The federal government could literally triple my effective tax rate and I'd still pay half as much for health care as I do right now. Oh, and don't even get me started on the numbers of hours my wife and I spend sorting, paying, and fighting for corrections to our medical bills. If the government actually tallied lost productivity due to our byzantine healthcare system, publicly-funded healthcare would look like a steal.

We still have to do the paperwork for some of the costs incurred out of system* that are covered by private insurance, but it is nothing like this. 

*My pharmacy has my insurance information and I only do co-pay on prescriptions, I don't have to submit the bill to my insurance, they do.  I have to handle my physiotherapy bills.

gaja

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Re: Universal Health Care Practicalities
« Reply #58 on: February 01, 2019, 11:50:58 AM »

Exactly. People get all up in arms about how "They'll have to raise taxes!!!1! OMG F-NO!!!" Well, last year my health insurance premiums cost $14,000 (that's how much it costs to insure my family of 6 with zero actual spending) and I spent $10,000 in out-of-pocket costs (because we have a special needs child who requires expensive care). That's more than a quarter of my annual income right there. The federal government could literally triple my effective tax rate and I'd still pay half as much for health care as I do right now. Oh, and don't even get me started on the numbers of hours my wife and I spend sorting, paying, and fighting for corrections to our medical bills. If the government actually tallied lost productivity due to our byzantine healthcare system, publicly-funded healthcare would look like a steal.

We still have to do the paperwork for some of the costs incurred out of system* that are covered by private insurance, but it is nothing like this. 

*My pharmacy has my insurance information and I only do co-pay on prescriptions, I don't have to submit the bill to my insurance, they do.  I have to handle my physiotherapy bills.

I don't have any paperwork for the medical part. Some of the welfare system runs on forms, but not the medical one. We have an annual maximal co-pay of about $200, and when we hit the limit, they automatically stop charging us at the doctors', physical therapists' and pharmacies. Even the transport refunds have been automated now. If I have to take the kids to a hospital in a different city, the state will cover the travel costs. It used to be a form to fill out, and you had to send in the receipts. Now we can choose to let them calculate everything automatically, and you only click one box that says "please send the money to my bank account #XXXX". There is no co-pay for the kids, so doctors visits are very easy with them.

Mississippi Mudstache

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Re: Universal Health Care Practicalities
« Reply #59 on: February 01, 2019, 11:58:59 AM »

Exactly. People get all up in arms about how "They'll have to raise taxes!!!1! OMG F-NO!!!" Well, last year my health insurance premiums cost $14,000 (that's how much it costs to insure my family of 6 with zero actual spending) and I spent $10,000 in out-of-pocket costs (because we have a special needs child who requires expensive care). That's more than a quarter of my annual income right there. The federal government could literally triple my effective tax rate and I'd still pay half as much for health care as I do right now. Oh, and don't even get me started on the numbers of hours my wife and I spend sorting, paying, and fighting for corrections to our medical bills. If the government actually tallied lost productivity due to our byzantine healthcare system, publicly-funded healthcare would look like a steal.

We still have to do the paperwork for some of the costs incurred out of system* that are covered by private insurance, but it is nothing like this. 

*My pharmacy has my insurance information and I only do co-pay on prescriptions, I don't have to submit the bill to my insurance, they do.  I have to handle my physiotherapy bills.

I don't have any paperwork for the medical part. Some of the welfare system runs on forms, but not the medical one. We have an annual maximal co-pay of about $200, and when we hit the limit, they automatically stop charging us at the doctors', physical therapists' and pharmacies. Even the transport refunds have been automated now. If I have to take the kids to a hospital in a different city, the state will cover the travel costs. It used to be a form to fill out, and you had to send in the receipts. Now we can choose to let them calculate everything automatically, and you only click one box that says "please send the money to my bank account #XXXX". There is no co-pay for the kids, so doctors visits are very easy with them.

I am seething with jealousy right now. I know you pay higher taxes than we do, but dammit, that's what taxes are for.

gaja

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Re: Universal Health Care Practicalities
« Reply #60 on: February 01, 2019, 12:56:30 PM »

Exactly. People get all up in arms about how "They'll have to raise taxes!!!1! OMG F-NO!!!" Well, last year my health insurance premiums cost $14,000 (that's how much it costs to insure my family of 6 with zero actual spending) and I spent $10,000 in out-of-pocket costs (because we have a special needs child who requires expensive care). That's more than a quarter of my annual income right there. The federal government could literally triple my effective tax rate and I'd still pay half as much for health care as I do right now. Oh, and don't even get me started on the numbers of hours my wife and I spend sorting, paying, and fighting for corrections to our medical bills. If the government actually tallied lost productivity due to our byzantine healthcare system, publicly-funded healthcare would look like a steal.

We still have to do the paperwork for some of the costs incurred out of system* that are covered by private insurance, but it is nothing like this. 

*My pharmacy has my insurance information and I only do co-pay on prescriptions, I don't have to submit the bill to my insurance, they do.  I have to handle my physiotherapy bills.

I don't have any paperwork for the medical part. Some of the welfare system runs on forms, but not the medical one. We have an annual maximal co-pay of about $200, and when we hit the limit, they automatically stop charging us at the doctors', physical therapists' and pharmacies. Even the transport refunds have been automated now. If I have to take the kids to a hospital in a different city, the state will cover the travel costs. It used to be a form to fill out, and you had to send in the receipts. Now we can choose to let them calculate everything automatically, and you only click one box that says "please send the money to my bank account #XXXX". There is no co-pay for the kids, so doctors visits are very easy with them.

I am seething with jealousy right now. I know you pay higher taxes than we do, but dammit, that's what taxes are for.

Do we? If you include the cost of the stuff that is covered by the taxes? Our total taxes ([all tax paid]/[all income]) have the last years been between 20 and 25 %. That is not the theoretical tax bracket, but the amount of our money we paid to the government. It includes state tax, municipal tax, property tax, social security (state pension + medical + "disability insurance"), etc. The only thing that comes in addition is taxes on stuff we buy, like 12 % on food, 25 % on stuff, 100% on petrol and alcohol, etc. Those are difficult to calculate, But based on last years consumption, a rough calculation is that we paid an additional 6 % in taxes that way. People who spend more than us will of course pay more purchase tax.

BeanCounter

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Re: Universal Health Care Practicalities
« Reply #61 on: February 01, 2019, 01:07:20 PM »
The US has a "universal healthcare" system. It's called Medicare. How often do you year someone say "I just got to get to 65 so that I can be Medicare eligible."
I'm sure the system could use some improvements, but the above statement is a pretty good indicator that it works as well if not better than commercial insurance.
Just open Medicare up for everyone and we're done.

Poundwise

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Re: Universal Health Care Practicalities
« Reply #62 on: February 01, 2019, 03:39:48 PM »
The US has a "universal healthcare" system. It's called Medicare. How often do you year someone say "I just got to get to 65 so that I can be Medicare eligible."
I'm sure the system could use some improvements, but the above statement is a pretty good indicator that it works as well if not better than commercial insurance.
Just open Medicare up for everyone and we're done.

We could even just start phasing it in.  Open up Medicare for people 60 and older, and up to age 18.  Then to age 55 and up, and up to age 26. Etc.

BeanCounter

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Re: Universal Health Care Practicalities
« Reply #63 on: February 01, 2019, 03:44:33 PM »
The US has a "universal healthcare" system. It's called Medicare. How often do you year someone say "I just got to get to 65 so that I can be Medicare eligible."
I'm sure the system could use some improvements, but the above statement is a pretty good indicator that it works as well if not better than commercial insurance.
Just open Medicare up for everyone and we're done.

We could even just start phasing it in.  Open up Medicare for people 60 and older, and up to age 18.  Then to age 55 and up, and up to age 26. Etc.
I think the math would support opening it up to everyone all at once. Working people are the lowest utilizers in any plan. The more employed young(ish) people you have in the risk pool the easier it is to fund the sicker members.
The answer is so completely obvious, but the there are too many lobbyists working against it.

RetiredAt63

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Re: Universal Health Care Practicalities
« Reply #64 on: February 01, 2019, 03:57:34 PM »
I think the math would support opening it up to everyone all at once. Working people are the lowest utilizers in any plan. The more employed young(ish) people you have in the risk pool the easier it is to fund the sicker members.
The answer is so completely obvious, but the there are too many lobbyists working against it.

This is partly why it works, everyone is covered, healthy and sick, so the costs in any one year are spread out.  There are years when I have used it a lot, and years when I haven't used it at all, and most of us could say that.

US insurance companies would be huge losers if there were Medicare for everyone.  We still have insurance companies that have health policies, but they cover the things that OHIP (in my case) doesn't cover.

pecunia

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Re: Universal Health Care Practicalities
« Reply #65 on: February 01, 2019, 05:42:42 PM »
What tools are at the disposal of the insurance companies to maintain the status quo?  I can think of a couple.

1) Have their bought politicians promise a big change down the road.  Give the story that the big change will be introduced incrementally so that the economy doesn't get "shocked."  Then throw the public some sort of very small bone to demonstrate progress.  Continually kick the can down the road for the rest of the promised changes.  They've started that already.

2)  Lie to the public.  Show pictures of dying Canadians and give the illusion that they wouldn't be dying with US health care.  They wouldn't even have to be real Canadians.  Just hire some emaciated third world actors to play the part.  Investigative journalists would not be able to do further interviews with the dying people because, well, they died.

3) Obfuscate the facts.  It is a complex issue and good looking people could be hired to sit around tables on news talk shows to give little pieces of the US health care story to make people feel good.  One such BS thing they could bring up over and over would be to say that US pill prices are higher due to the research it is paying for.  Not all BS, just mostly.

4) Link patriotism to the US health care system.  We have a little more pain with our system and perhaps a little more sorrow, but it's our health care system.  It's an American system.  It's a system that was passed down along with the rest of our freedoms from our  founding fathers.  Then show pictures of gulags or something and note that we don't want the systems that they have in other countries.  When Joseph Stalin ran Russia, a universal health care system was introduced.  Than state Millions of people died after that.  The fact that they died due to oppression, World War 2 and other horrible things need not be noted.  Pictures of injured soldiers could be shown, followed by stern faced doctors proclaiming, "We want to help."

5) Use fear - If the health care system of this country is changed, are you sure it will be best for "your" children?


Poundwise

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Re: Universal Health Care Practicalities
« Reply #66 on: February 01, 2019, 06:47:28 PM »
The US has a "universal healthcare" system. It's called Medicare. How often do you year someone say "I just got to get to 65 so that I can be Medicare eligible."
I'm sure the system could use some improvements, but the above statement is a pretty good indicator that it works as well if not better than commercial insurance.
Just open Medicare up for everyone and we're done.

We could even just start phasing it in.  Open up Medicare for people 60 and older, and up to age 18.  Then to age 55 and up, and up to age 26. Etc.
I think the math would support opening it up to everyone all at once. Working people are the lowest utilizers in any plan. The more employed young(ish) people you have in the risk pool the easier it is to fund the sicker members.

I am aware, but I thought that politically it might be easier to phase it in.  People get terrified by the thought of a huge change, but lowering the age for Medicare doesn't seem so radical.

MikeBT

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Re: Universal Health Care Practicalities
« Reply #67 on: February 01, 2019, 07:16:54 PM »
I do think we need to discourage people from crappy medical decisions so I would support a tax on unhealthy foods (e.g. junk food and fast food) as well as higher taxes on smoking and gambling and alcohol. Anything that encourages healthy lifestyles while punishing those who fail to improve their lifestyle choices. (I occasionally eat unhealthy food and I'd be happy for that consumption to be taxed, if it meant my overall income tax didn't go up to pay for people with no sense of their own health).

gentmach

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Re: Universal Health Care Practicalities
« Reply #68 on: February 02, 2019, 06:50:53 AM »
If we are on the fat shaming bandwagon how would a fat tax work?

Actually my father inspired that. He developed a "two Whopper a day" habit while he worked as a farmer. And his diet hasn't improved much since he quit 20 years ago.

He had one knee replaced about 10 years ago. He was placed on social security disability while waiting to get the other knee replaced.

He will never get that other knee replaced though. He has good insurance through my mother. And my mother buys the groceries. Disability pays him and he can work small jobs though he has some paranoia regarding that.

This arrangement worked out decently because my grandmother started needing help at the same time. (She is a 103 now.)

So I see a man who won't get healthy for his family or to be an effective worker. The only leverage left on him is his wallet. The only way I figure someone can get through to him is if his accountant says "you're losing money because you are fat."

And, as things stand right now, it will fall on me to pay for his nursing home care when the time comes. (Alzheimer's runs in the family.)

Yes, I understand my situation is unique. Large bureaucracies are not know for handling uniqueness well. And it did color my previous opinions of healthcare.

BeanCounter

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Re: Universal Health Care Practicalities
« Reply #69 on: February 02, 2019, 07:15:25 AM »
The easiest way we can reduce healthcare expenses is to get rid of commercial insurance. The insurers have layers of network teams to negotiate prices with providers which is passed on to you in your premium. And the providers (hospitals and physician groups) have teams of people that negotiate with the insurance companies and layers upon layers of people that work through all the precertification processes and billing with the insurance companies. And those costs are passed on to the patient through the providers rates. So we as members and patients are getting wacked on both sides by this ridiculous system.
And that's just one piece of it. There is layers and layers of administrative costs which could be done away with. Plus all the expense that's passed on to us for all the people who have NO insurance and their expense gets written off at ridiculous rates by the providers.
Oh, and lets not forget all the "non-profit" hospital systems that make $5B in revenue. THAT THEY DON'T PAY TAX ON. Start taxing them on a small portion of their net income and put that toward the Medicare system. Stop allowing them to build all kinds of capital investments as a way to not pay tax.
I could go on and on.

Poundwise

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Re: Universal Health Care Practicalities
« Reply #70 on: February 02, 2019, 07:29:30 AM »
Was chatting to my husband this morning about just this issue.  You know who's going to suffer if single payer happens? 

The dean of his medical center makes a $7 million salary plus perks you couldn't even know how to dream about, and has an entire building of well paid staff whose job it is to extract the most money from insurers and the government, including a dean whose sole function is to exhort university faculty to write more grants. 

It reminds me of the following:
http://www.geoffwilkins.net/fragments/Adams.htm

RetiredAt63

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Re: Universal Health Care Practicalities
« Reply #71 on: February 02, 2019, 08:34:52 AM »
Was chatting to my husband this morning about just this issue.  You know who's going to suffer if single payer happens? 

The dean of his medical center makes a $7 million salary plus perks you couldn't even know how to dream about, and has an entire building of well paid staff whose job it is to extract the most money from insurers and the government, including a dean whose sole function is to exhort university faculty to write more grants. 

It reminds me of the following:
http://www.geoffwilkins.net/fragments/Adams.htm

It is clear that the US cannot afford universal health care - your whole economy would collapse with all the jobs lost.        ;-)

WhiteTrashCash

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Re: Universal Health Care Practicalities
« Reply #72 on: February 02, 2019, 08:40:50 AM »
You know how people on Facebook are constantly having GoFundMe campaigns due to medical bills and then their friends and relatives and other people they may not know donate to it? Universal Healthcare is basically that system except it's for the entire country and everybody has to give. By having a massive amount of people giving small amounts, the people who get sick can receive treatment. And that's pretty much it. It's not a perfect system but it's way better than losing your house because you get cancer.

pecunia

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Re: Universal Health Care Practicalities
« Reply #73 on: February 02, 2019, 08:49:34 AM »

0000000000----------SNIP----------0000000000 


It is clear that the US cannot afford universal health care - your whole economy would collapse with all the jobs lost.        ;-)

Not sure if you you were joking or not.  What repercussions were felt to those other countries that have done it?

OR

Maybe you are a billionaire.  Even if you are a Canadian, I'll bet your taxes would go up if the US instituted Universal Health Care.  Being a billionaire, health care costs are a tiny increment of what you spend.  Heck, its less than the maintenance cost on one of your yachts.  It may be time to get together with your billionaire friends, go to the media outlets that you own and to start promulgating your message of how the US economy would collapse.  Fear will work to sway people's minds.

gentmach

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Re: Universal Health Care Practicalities
« Reply #74 on: February 02, 2019, 09:15:47 AM »

0000000000----------SNIP----------0000000000 


It is clear that the US cannot afford universal health care - your whole economy would collapse with all the jobs lost.        ;-)

Not sure if you you were joking or not.  What repercussions were felt to those other countries that have done it?


It was a joke. With universal healthcare all the "paper pushers" would be freed up to do meaningful work.

CindyBS

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Re: Universal Health Care Practicalities
« Reply #75 on: February 02, 2019, 12:02:52 PM »
If we are on the fat shaming bandwagon how would a fat tax work?

Actually my father inspired that. He developed a "two Whopper a day" habit while he worked as a farmer. And his diet hasn't improved much since he quit 20 years ago.

He had one knee replaced about 10 years ago. He was placed on social security disability while waiting to get the other knee replaced.

He will never get that other knee replaced though. He has good insurance through my mother. And my mother buys the groceries. Disability pays him and he can work small jobs though he has some paranoia regarding that.

This arrangement worked out decently because my grandmother started needing help at the same time. (She is a 103 now.)

So I see a man who won't get healthy for his family or to be an effective worker. The only leverage left on him is his wallet. The only way I figure someone can get through to him is if his accountant says "you're losing money because you are fat."

And, as things stand right now, it will fall on me to pay for his nursing home care when the time comes. (Alzheimer's runs in the family.)

Yes, I understand my situation is unique. Large bureaucracies are not know for handling uniqueness well. And it did color my previous opinions of healthcare.

So, tax the whoppers but that is not the same as taxing someone extra because they are overweight with no regard to how physically fit they are and what they eat.  There are some slim people who eat total crap and have the high cholesterol, high blood pressure and heart disease to go along with it.   Even if we as a country just stopped subsidizing corn for high fructose corn syrup and instead use that money to make veggies cheaper, that would go a long way. 

FIPurpose

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Re: Universal Health Care Practicalities
« Reply #76 on: February 02, 2019, 12:14:11 PM »

0000000000----------SNIP----------0000000000 


It is clear that the US cannot afford universal health care - your whole economy would collapse with all the jobs lost.        ;-)

Not sure if you you were joking or not.  What repercussions were felt to those other countries that have done it?


It was a joke. With universal healthcare all the "paper pushers" would be freed up to do meaningful work.

Actually this was an actual concern of Obama's when he was president and why he shied away from single payer in the Obamacare implementation. There are literally thousands upon thousands working in the insurance industry. It acts as a de facto wealth redistribution chain. Causing that many people to be unemployed overnight could have some pretty severe consequences.

Maybe providing those employees an expedited path to working on the gov. implementation would help ease that. But there would still be a lot of redundancies.

austin944

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Re: Universal Health Care Practicalities
« Reply #77 on: February 02, 2019, 02:01:39 PM »

Universal health care is an income redistribution scheme.  It takes money away from people who make healthy lifestyle choices, and who live within their means and don't have a horde of children they can't afford, and gives that money over to people who often make unhealthy choices for themselves and the many children they pump out.  It punishes the former and rewards the latter.

RetiredAt63

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Re: Universal Health Care Practicalities
« Reply #78 on: February 02, 2019, 02:12:26 PM »

Universal health care is an income redistribution scheme.  It takes money away from people who make healthy lifestyle choices, and who live within their means and don't have a horde of children they can't afford, and gives that money over to people who often make unhealthy choices for themselves and the many children they pump out.  It punishes the former and rewards the latter.

So many things to say here - but basically the most relevant is that per capita health costs are much lower in countries that have universal health care.   We pay more taxes but we get more benefits from them.  American health insurance premiums are incredibly high.

I know lots of people who live healthy lives and have still needed health care.  Athletes often need health care, since they injure themselves a lot more than the general population.  People get into car accidents.  Those children you seem so concerned about  - why?  Giving birth is not expensive with universal systems.  Pre-natal care, birth, post-natal care, all covered - when my DD was a few days old a public health nurse came to the house to see that we were doing OK, and do a urine test for PKU.  All her vaccinations were covered, so she never got seriously ill as a child.

Do you also worry about the other costs of people making poor choices?  About supporting public education so everyone gets a good start in life?  About people working in poor health environments because they need the jobs?  A lot of the manual labourers in my area (roofers, general constitutions) look 10-20 years older than they are because their jobs are physically hard on their bodies.  Should they be denied health care?

FIPurpose

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Re: Universal Health Care Practicalities
« Reply #79 on: February 02, 2019, 02:16:46 PM »

Universal health care is an income redistribution scheme.  It takes money away from people who make healthy lifestyle choices, and who live within their means and don't have a horde of children they can't afford, and gives that money over to people who often make unhealthy choices for themselves and the many children they pump out.  It punishes the former and rewards the latter.

No. It's not. Either make a real contribution to this thread or stop trolling.

RetiredAt63

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Re: Universal Health Care Practicalities
« Reply #80 on: February 02, 2019, 02:22:19 PM »

Universal health care is an income redistribution scheme.  It takes money away from people who make healthy lifestyle choices, and who live within their means and don't have a horde of children they can't afford, and gives that money over to people who often make unhealthy choices for themselves and the many children they pump out.  It punishes the former and rewards the latter.

No. It's not. Either make a real contribution to this thread or stop trolling.
Good repl;y, you were much calmer than I was.    ;-)

But Canadians feel strongly about Universal Health Care, you will pry it from our cold dead clenched fists. 

gerardc

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Re: Universal Health Care Practicalities
« Reply #81 on: February 02, 2019, 02:35:12 PM »
What I've always seen as a huge short-coming of health care in general, whether it's my 'free' provincial health care, or employer offered health care, they will spend thousands on the disease, but little to nothing on prevention.  ie $1000s on bypass surgery or prescription drugs, but nothing on cease smoking or heart healthy eating or exercise plans.

Maybe because prevention methods we have today (e.g. healthy eating courses, exercise plans) are not really effective?

RetiredAt63

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Re: Universal Health Care Practicalities
« Reply #82 on: February 02, 2019, 04:05:29 PM »
What I've always seen as a huge short-coming of health care in general, whether it's my 'free' provincial health care, or employer offered health care, they will spend thousands on the disease, but little to nothing on prevention.  ie $1000s on bypass surgery or prescription drugs, but nothing on cease smoking or heart healthy eating or exercise plans.
Maybe because prevention methods we have today (e.g. healthy eating courses, exercise plans) are not really effective?


Our idea of healthy eating keeps changing.  And sometimes I wonder.  I look at my local sample of 5 friends (women my age, including me) and I am the only one who still has her gall bladder.  And I have the highest fat consumption of us 5, which is against a lot of modern concepts of healthy eating.

We already have "sin" taxes on alcohol and tobacco, which makes the most obviously unhealthy habits harder to overdo.

I also look at our life styles, and physical activity (as opposed to formal exercise) has been planned out.  When I was in elementary school we went home for lunch (because that was the 50's, and mothers were home, not pushing that part) and I walked 3.6 km every day, since the school was 0.9 km from my house.  We had morning and afternoon recess, and gym at lest 3 days/week.  Now most kids get bused for distances I think are ridiculous, because the streets are not designed for pedestrians and it is not safe.  Adults walk less as well, because the walks are not as pleasant and there is TV.  Everyone circles parking lots looking for a spot close to the entrance.  We pay people to do our gardening and other activities that we used to do ourselves.

I know, I sound like Mr. MM (an older crankier Mr. MM), because yes, we have put too much time into our jobs and commutes and not enough time into our physical lives.

gentmach

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Re: Universal Health Care Practicalities
« Reply #83 on: February 02, 2019, 04:17:37 PM »
If we are on the fat shaming bandwagon how would a fat tax work?

Actually my father inspired that. He developed a "two Whopper a day" habit while he worked as a farmer. And his diet hasn't improved much since he quit 20 years ago.

He had one knee replaced about 10 years ago. He was placed on social security disability while waiting to get the other knee replaced.

He will never get that other knee replaced though. He has good insurance through my mother. And my mother buys the groceries. Disability pays him and he can work small jobs though he has some paranoia regarding that.

This arrangement worked out decently because my grandmother started needing help at the same time. (She is a 103 now.)

So I see a man who won't get healthy for his family or to be an effective worker. The only leverage left on him is his wallet. The only way I figure someone can get through to him is if his accountant says "you're losing money because you are fat."

And, as things stand right now, it will fall on me to pay for his nursing home care when the time comes. (Alzheimer's runs in the family.)

Yes, I understand my situation is unique. Large bureaucracies are not know for handling uniqueness well. And it did color my previous opinions of healthcare.

So, tax the whoppers but that is not the same as taxing someone extra because they are overweight with no regard to how physically fit they are and what they eat.  There are some slim people who eat total crap and have the high cholesterol, high blood pressure and heart disease to go along with it.   Even if we as a country just stopped subsidizing corn for high fructose corn syrup and instead use that money to make veggies cheaper, that would go a long way.

I concede that taxing the food is a better idea.

My point had been that if are goal is to help the sickest among us, then everyone else needs to be striving towards healthy. But if some people are stubborn or insulated from punishment, society would have to consider a more direct intervention.

Fat or thin wouldn't have mattered. If you persist in an unhealthy lifestyle and have nothing seriously wrong with you, you would have a fine imposed upon you.

gentmach

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Re: Universal Health Care Practicalities
« Reply #84 on: February 02, 2019, 04:22:15 PM »
What I've always seen as a huge short-coming of health care in general, whether it's my 'free' provincial health care, or employer offered health care, they will spend thousands on the disease, but little to nothing on prevention.  ie $1000s on bypass surgery or prescription drugs, but nothing on cease smoking or heart healthy eating or exercise plans.
Maybe because prevention methods we have today (e.g. healthy eating courses, exercise plans) are not really effective?


Our idea of healthy eating keeps changing.  And sometimes I wonder.  I look at my local sample of 5 friends (women my age, including me) and I am the only one who still has her gall bladder.  And I have the highest fat consumption of us 5, which is against a lot of modern concepts of healthy eating.

We already have "sin" taxes on alcohol and tobacco, which makes the most obviously unhealthy habits harder to overdo.

I also look at our life styles, and physical activity (as opposed to formal exercise) has been planned out.  When I was in elementary school we went home for lunch (because that was the 50's, and mothers were home, not pushing that part) and I walked 3.6 km every day, since the school was 0.9 km from my house.  We had morning and afternoon recess, and gym at lest 3 days/week.  Now most kids get bused for distances I think are ridiculous, because the streets are not designed for pedestrians and it is not safe.  Adults walk less as well, because the walks are not as pleasant and there is TV.  Everyone circles parking lots looking for a spot close to the entrance.  We pay people to do our gardening and other activities that we used to do ourselves.

I know, I sound like Mr. MM (an older crankier Mr. MM), because yes, we have put too much time into our jobs and commutes and not enough time into our physical lives.

This is why I would have liked to try "New Urbanism" because if we are physically and mentally unhealthy due to our isolation, then we are treating the symptoms of the disease, not the cause.

FIPurpose

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Re: Universal Health Care Practicalities
« Reply #85 on: February 02, 2019, 04:52:43 PM »
Also visceral fat is actually a terrible measure of health. There is some connection between obesity and poor health outcomes, but actually ectopic fat is the actual predictor of bad health. Ectopic fat can be in both thin and fat patients. So a fat tax would be nothing more than a pointless punitive tax that wouldn't actually solve anything.

RetiredAt63

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Re: Universal Health Care Practicalities
« Reply #86 on: February 02, 2019, 05:09:02 PM »
People can be thin and not healthy.  A fat tax is a nasty idea.  Will we tax people who drink and smoke and take all sorts of drugs?  Or don't floss and see a dentist regularly?  Seriously, you should hear the stories my dental technician tells - and bad oral health can lead to all sorts of health problems.

Right now I would not want to go for a walk, Ottawa has had some snow and the streets are slippery and the sidewalks are a mess.  Time for the plows!  If municipalities put priority on designing for an active lifestyle (i.e. safe places to walk that actually go somewhere, so you are not just out for a stroll) and the same for bike paths, and realize that people will use them in winter if they are properly maintained, and basically quit giving cars massive consideration in design, then urban/suburban areas will invite more activity.  Unfortunately we are so out of the habit of walking/biking that it will take a lot to reverse peoples' habits.


Poundwise

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Re: Universal Health Care Practicalities
« Reply #87 on: February 02, 2019, 05:25:26 PM »

0000000000----------SNIP----------0000000000 


It is clear that the US cannot afford universal health care - your whole economy would collapse with all the jobs lost.        ;-)

Not sure if you you were joking or not.  What repercussions were felt to those other countries that have done it?


It was a joke. With universal healthcare all the "paper pushers" would be freed up to do meaningful work.

Actually this was an actual concern of Obama's when he was president and why he shied away from single payer in the Obamacare implementation. There are literally thousands upon thousands working in the insurance industry. It acts as a de facto wealth redistribution chain. Causing that many people to be unemployed overnight could have some pretty severe consequences.

Maybe providing those employees an expedited path to working on the gov. implementation would help ease that. But there would still be a lot of redundancies.

What kinds of meaningful work require a lot of bureaucrats?  We could invest more in the IRS and hire lots of people to catch tax evaders. We could hire caseworkers to look at immigration cases, to expedite asylum cases.  The courts could hire more staff to expedite cases.  We could hire more social workers.   These ideas all involve government investment, but it seems like they might pay for themselves in some way. For instance, think about all the poor people in jail or detention waiting for their cases to come up, instead of doing meaningful work.

A little off topic I know, just some random thoughts.

Doubleh

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Re: Universal Health Care Practicalities
« Reply #88 on: February 02, 2019, 05:30:02 PM »
I come from a country with Ēsocialised medicineĒ and now live in another; but Iím married to a US citizen so have some experience of both sides of this. One thing that I find strange in all of these healthcare discussions is that Americans seem to spend a lot of time and mental energy worrying about the possibility of people getting health care that they donít deserve - either because they donít earn enough, or because they arenít morally upstanding, or because they made lifestyle choices that we donít agree with.

In countries with socliased healthcare systems (we just call it healthcare by the way) we donít tend to worry too much about these things. Sure, the system isnít entirely efficient, and some users cost more than others. But the overall cost of treatment is so much lower than it is in USA - and these edge cases people in the USA seem to worry about so much probably make up a tiny percentage of overall expenditure on health care. If we worry about avoidable health care costs at all it would be to worry about what we can do to avoid the cost of things like gunshot wounds and violence.

But rather than stress over the risk that someone somewhere is getting healthcare they ďdonít deserveĒ we are far more worried by cases where someone was denied treatment they needed becuase they didnít have cover. This seems to happen a lot in the states, and doesnít seem to elicit nearly the level of concern that I would expect it to. To be honest though the reality is that we just donít think about healthcare nearly as much as you guys do - for the most part its there when we need it, and its not something we have to stress about too much.

Sure there are some things that arenít covered, but youíd probably be surprised as to how little. Where there are issues it tends to be longish waiting lists for elective surgery, or limited availability of extremely expensive experimental treatments. But under the current system in USA lots of people donít get those anyway. One mistake people often seem to make is to compare a system like NHS that treats everyone, to the best possible healthcare in USA that very few people have.

This overlooks the fact that if I want to top up my NHS cover with insurance that will plug those gaps like waiting lists for non urgent surgery, I can buy very high quality insurance for something like £20 a month for an individual. Why so low? It doesnít have to cover the cost of treating a road accident, or cancer, or any of the really expensive stuff, as the NHS deals with all of that. Heck, if I didnít have private cover and really didnít want to wait a year for say a joint surgery, I could pay out of pocket for private treatment and it would still cost a fraction of the cost it would in USA and would never get to the level of needing to sell my house to cover it, as I have known people in US have to do just to cover co-pays on a serious illness. That to me is unfathomable.

On the question of cost its worth pointing out that the US government alone currently spends more on healthcare than the UK government does - both per capita and as a percentage of gdp. Again, that is ignoring all expenditure on private healthcare, just the amount spent by govt - and we get universal cover for that price. That fact alone boggles my mind (see link below if you donít believe this!) Of course there is so much inefficiency in the current system that you cant just remove all private spending at once without increasing govt spending, but it certainly shows what is possible and what you can aim for. FYI anecdotally Iíd guess the three largest differences making up this gap are: 1. We donít have all the bureaucracy of billing and insurance companies to cover; 2. Hospitals are usually a few years old and clean but slightly faded, no marble in sight but neither do we feel the need for it; and 3. Doctors are paid like middle class professionals, not rock stars. Think if all Drs got a salary in line with say a teacher or a CPA, instead of a hedge fund manager. But at the same time they donít have to go into $500k of debt either.

Lastly as to the question of how do you judge the success of a healthcare system this is a problem thatís been pretty much solved. You guys go on about universal healthcare like its a really tough problem with no existing answer, like the Apollo landings. Thatís just not true - pretty much every civilised country in the world already has some variation of it. Sure there will be particular difficulties in deciding the best approach for a country as large and diverse as USA, and in implementing it given the existing system and vested interests. But you could start by looking at WHO rankings, which try exactly to gauge the effectiveness of each countryís system and compare them. So there is an existing methodology there you can use to see how well the system works.

Honestly, I think it will be hard to do but once you have made the change you will look back and wonder how you could ever have coped without it, let alone why it seemed so controversial!

https://www.bbc.com/news/uk-42950587

https://en.m.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000

RetiredAt63

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Re: Universal Health Care Practicalities
« Reply #89 on: February 02, 2019, 05:55:47 PM »
^^^ This is the point of universal health care.  Thank you, Doubleh for articulating it so clearly.

WhiteTrashCash

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Re: Universal Health Care Practicalities
« Reply #90 on: February 02, 2019, 07:02:26 PM »

Universal health care is an income redistribution scheme.  It takes money away from people who make healthy lifestyle choices, and who live within their means and don't have a horde of children they can't afford, and gives that money over to people who often make unhealthy choices for themselves and the many children they pump out.  It punishes the former and rewards the latter.

So... what you are saying is that you are in favor of infanticide, because it sounds like you want a whole bunch of helpless innocent children to die due to other people's choices.

Johnez

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Re: Universal Health Care Practicalities
« Reply #91 on: February 02, 2019, 07:16:34 PM »
Interesting perspective Doubleh. US citizens are regularly exposed to the outrages of our health care system's inadequacies. People regularly die here as a result of financially unfortunate circumstances, and then we move on like it was a car crash on the freeway, doing 80 again after a mile. It's sad. Australia figured out banning guns was a good idea after Port Arthur. Canada figured out how to put together a universal health care system against major interests and strikes. How come America can't do the same? I figure it has to do with ego and fear. Fear that  America as a country actually needs this thing, and what that amounts to is admitting we aren't all that great independent strong stand out that we make ourselves out to be. Like very poor people refusing assistance, we are too proud. It's sad, and it's costly in dollars, life expectancy, and lives.

pecunia

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Re: Universal Health Care Practicalities
« Reply #92 on: February 02, 2019, 07:41:09 PM »
Interesting perspective Doubleh. US citizens are regularly exposed to the outrages of our health care system's inadequacies. People regularly die here as a result of financially unfortunate circumstances, and then we move on like it was a car crash on the freeway, doing 80 again after a mile. It's sad. Australia figured out banning guns was a good idea after Port Arthur. Canada figured out how to put together a universal health care system against major interests and strikes. How come America can't do the same? I figure it has to do with ego and fear. Fear that  America as a country actually needs this thing, and what that amounts to is admitting we aren't all that great independent strong stand out that we make ourselves out to be. Like very poor people refusing assistance, we are too proud. It's sad, and it's costly in dollars, life expectancy, and lives.

Wow!  Port Arthur disappeared and became a part of Thunder Bay, Ont about 1970.  They must have had universal health care up there for a long time.

Doubleh - Those were good points backed up with financial facts.

Now - A lot of people are worried about overweight people getting health care and the rest of us paying the bill.  A lot of people are worried about footing the bill for poor people.  Well folks, I don't know how to break it to you but you are already paying for a lot of poor people's health care.  They are on some form of government assistance already

Now - Here is how Universal Health Care would make it better for these people.  I'll use a personal anecdote.  I used to work with this very smart girl we'll call Sally.  Sally and I had this discussion one day and she told me that she had a sister.  I said that if your sister is half as smart as you she is probably doing well in this world.  I was promptly informed that Sally's sister was a "welfare bitch."  I was further informed that as her sister did not have any kind of specialized training that the best jobs she would be able to get would be minimum wage.  She further offered that minimum wage jobs were not enough to pay for her and her two kids, did not offer the health benefits that she had and she would not be able to afford child care.

If we had universal health care, it may not be enough to enable or prompt Sally's sister to work, but it would be added incentive for many people.  I am quite certain that there are many people who do not work because they will lose their taxpayer provided welfare health care.  This is even somewhat true of Obamacare.  If you have insurance with ACA (Obamacare) subsidies, you will lose said subsidies if you earn too much money.  It is a disincentive to work.

Do we want to provide disincentives to work in the USA or do we want to provide added opportunities for people who want to work to be able to work?

gentmach

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Re: Universal Health Care Practicalities
« Reply #93 on: February 03, 2019, 07:29:38 AM »
Interesting perspective Doubleh. US citizens are regularly exposed to the outrages of our health care system's inadequacies. People regularly die here as a result of financially unfortunate circumstances, and then we move on like it was a car crash on the freeway, doing 80 again after a mile. It's sad. Australia figured out banning guns was a good idea after Port Arthur. Canada figured out how to put together a universal health care system against major interests and strikes. How come America can't do the same? I figure it has to do with ego and fear. Fear that  America as a country actually needs this thing, and what that amounts to is admitting we aren't all that great independent strong stand out that we make ourselves out to be. Like very poor people refusing assistance, we are too proud. It's sad, and it's costly in dollars, life expectancy, and lives.

Ego plays a part.

1. Americans don't trust each other. (http://freakonomics.com/podcast/trust-me/) Trust being a basic component of any social program.

I think this has something to do with the "Cult of Individuality" that runs through all economic strata but manifests in different ways.

Upper classes: "I built this business by myself."

Lower classes: "My individual actions won't effect the greater part of society."

The problem is niether is true. Upper classes had help from the government, lower classes create a culture of moral relativity. (I.e. "My friends are all liars, cheaters and thieves, why should I be surprised politicians are?"

2. Americans cannot communicate with each other due to over specialization. A friend of mine left customer service at an insurance company to work in a repair shop. He is finding difficulty explaining his job to his "white collar" friends because they can't imagine .001" of an inch, let alone why it is extremely important.

So when we are talking about healthcare, people may "understand" it, but not really have a frame of reference to actually understand it.

austin944

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Re: Universal Health Care Practicalities
« Reply #94 on: February 03, 2019, 08:57:04 AM »

So many things to say here - but basically the most relevant is that per capita health costs are much lower in countries that have universal health care.   We pay more taxes but we get more benefits from them.  American health insurance premiums are incredibly high.

Obamacare was passed with a mountain of lies, and I expect the same will be true of universal health care.  We were told that we could keep our plans, that health care premiums would decline, and that it was not a tax,  All lies.   The architect of Obamacare admitted that it was written in a "tortured way" to prevent CBO from scoring it as a tax.

Many individuals will pay more, get less, and once again get screwed by our politicians with their empty broken promises.  No more.

Indexer

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Re: Universal Health Care Practicalities
« Reply #95 on: February 03, 2019, 09:04:12 AM »
I came into this thread really questioning Universal healthcare in the US. I'm moderate, socially liberal, but fiscally conservative so I occasionally agree with both major parties, but most of the time I think they are both extreme. Given that, I was hesitant to embrace universal healthcare, but this threat has opened my eyes to the benefits. Thank you fellow mustachians!


Thank you @Doubleh!

You answered a few questions I was going to ask. In order for the US to cost so much more than other countries while getting worse results, there are inefficiencies somewhere. An obvious inefficiency is the health insurance industry acting as middle men.

It appears the amounts we pay doctors is a big part of this. I've always wondered what the difference in pay was. On that note, our for profit health industry creates an incentive to do extra, often unnecessary procedures. I can't remember the poster now, but someone was talking about how in their country they used physical therapy first and surgery as a last resort for physical disabilities.


A few ideas to make this work in the US:

A fat 'product' tax:  Instead of taxing people why don't we change how we tax products. For those of you who don't know, the US has a tax subsidy on corn, wheat, sugar, and meats. However it has very little incentive to farm fruits and vegetables. Let's switch that around! We also already tax tobacco and alcohol quite a bit. Let's extend that to soft drinks, and set it up so the tax revenue from all three has to go to medicare. Americans don't like extra taxes, especially if they consider the results to be waste, but I think a tax on unhealthy habits used to pay for future health expenses is something you could get acceptance for.

On the thought of not trusting people:  The poor in the US already have free healthcare. It's called medicaid. Between that and medicaid the poor and the elderly are covered. It's just the young to middle age middle and upper class who are paying for their own healthcare.

In addition, the poor also get free food in the form of food stamps. Let's change how food stamps can be used and accomplish a few goals. Instead of X dollars and you can spend it however you want, let's set it up so the recipient gets a free allotment of healthy foods. What I'm getting at is that the recipient gets a lot of fruits, vegetables, rice, beans, lean meats, etc. but no processed chips and sodas. If they want to buy those things they can use their own money. This would in effect make our poor population much healthier, clear up some food deserts since there would be automatic added demand for these goods, and save a lot of money on public healthcare be it universal healthcare or medicaid. It would also create greater demand for these goods, which combined with fixing food subsidies, would give farmers incentive to farm a lot more healthy foods.

Thoughts?

gentmach

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Re: Universal Health Care Practicalities
« Reply #96 on: February 03, 2019, 09:11:52 AM »

Right now I would not want to go for a walk, Ottawa has had some snow and the streets are slippery and the sidewalks are a mess.  Time for the plows!  If municipalities put priority on designing for an active lifestyle (i.e. safe places to walk that actually go somewhere, so you are not just out for a stroll) and the same for bike paths, and realize that people will use them in winter if they are properly maintained, and basically quit giving cars massive consideration in design, then urban/suburban areas will invite more activity.  Unfortunately we are so out of the habit of walking/biking that it will take a lot to reverse peoples' habits.

It took decades for our current culture to form, it will take decades to change again(short some huge catastrophe.) So you have to start small, almost guerilla like.

1. Form a corporation with some fellow Mustachians.

2. Find a blighted neighborhood.

3. Buy houses at a "tax sale". (Homes that the county took for not paying taxes.

4. Restore the houses to original condition. (So people in the neighborhood can't say "They're going to change the neighborhood!")

5. Rent the houses. Thoroughly vet tenants, keep the yards neat, hire private snow plows to clean and salt the streets and sidewalks, possibly the bike trails too.

6. A few years down the line, buy more houses, convert them into two apartments.

7. Some years after that, try to build 4 unit apartment buildings.

That's my plan at least. Persuading people is more "a gentle curve" then a sudden 90 degree turn.

gentmach

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Re: Universal Health Care Practicalities
« Reply #97 on: February 03, 2019, 09:25:34 AM »

So many things to say here - but basically the most relevant is that per capita health costs are much lower in countries that have universal health care.   We pay more taxes but we get more benefits from them.  American health insurance premiums are incredibly high.

Obamacare was passed with a mountain of lies, and I expect the same will be true of universal health care.  We were told that we could keep our plans, that health care premiums would decline, and that it was not a tax,  All lies.   The architect of Obamacare admitted that it was written in a "tortured way" to prevent CBO from scoring it as a tax.

Many individuals will pay more, get less, and once again get screwed by our politicians with their empty broken promises.  No more.

While I share your concerns about the government, I believe that we have to allow the experiment to proceed simply to move on to other issues.

Allow the people to try it. If it works, then we move on with our lives. If it fails, we repeal it. If we can't repeal it, people have the right to start putting heads on pikes.

I came into this thread really questioning Universal healthcare in the US. I'm moderate, socially liberal, but fiscally conservative so I occasionally agree with both major parties, but most of the time I think they are both extreme. Given that, I was hesitant to embrace universal healthcare, but this threat has opened my eyes to the benefits. Thank you fellow mustachians!


Thank you @Doubleh!

You answered a few questions I was going to ask. In order for the US to cost so much more than other countries while getting worse results, there are inefficiencies somewhere. An obvious inefficiency is the health insurance industry acting as middle men.

It appears the amounts we pay doctors is a big part of this. I've always wondered what the difference in pay was. On that note, our for profit health industry creates an incentive to do extra, often unnecessary procedures. I can't remember the poster now, but someone was talking about how in their country they used physical therapy first and surgery as a last resort for physical disabilities.


A few ideas to make this work in the US:

A fat 'product' tax:  Instead of taxing people why don't we change how we tax products. For those of you who don't know, the US has a tax subsidy on corn, wheat, sugar, and meats. However it has very little incentive to farm fruits and vegetables. Let's switch that around! We also already tax tobacco and alcohol quite a bit. Let's extend that to soft drinks, and set it up so the tax revenue from all three has to go to medicare. Americans don't like extra taxes, especially if they consider the results to be waste, but I think a tax on unhealthy habits used to pay for future health expenses is something you could get acceptance for.

On the thought of not trusting people:  The poor in the US already have free healthcare. It's called medicaid. Between that and medicaid the poor and the elderly are covered. It's just the young to middle age middle and upper class who are paying for their own healthcare.

In addition, the poor also get free food in the form of food stamps. Let's change how food stamps can be used and accomplish a few goals. Instead of X dollars and you can spend it however you want, let's set it up so the recipient gets a free allotment of healthy foods. What I'm getting at is that the recipient gets a lot of fruits, vegetables, rice, beans, lean meats, etc. but no processed chips and sodas. If they want to buy those things they can use their own money. This would in effect make our poor population much healthier, clear up some food deserts since there would be automatic added demand for these goods, and save a lot of money on public healthcare be it universal healthcare or medicaid. It would also create greater demand for these goods, which combined with fixing food subsidies, would give farmers incentive to farm a lot more healthy foods.

Thoughts?

I withdraw my suggestion of a fat tax. The thought was that some people will be too dense to realize they are being punished in a roundabout way.

I think people on food stamps can only buy "cold" food instead of "hot" food. My point is that there are restrictions in place on food stamps, we can take a better look at it.

wenchsenior

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  • Posts: 1922
Re: Universal Health Care Practicalities
« Reply #98 on: February 03, 2019, 09:26:00 AM »
I came into this thread really questioning Universal healthcare in the US. I'm moderate, socially liberal, but fiscally conservative so I occasionally agree with both major parties, but most of the time I think they are both extreme. Given that, I was hesitant to embrace universal healthcare, but this threat has opened my eyes to the benefits. Thank you fellow mustachians!


Thank you @Doubleh!

You answered a few questions I was going to ask. In order for the US to cost so much more than other countries while getting worse results, there are inefficiencies somewhere. An obvious inefficiency is the health insurance industry acting as middle men.

It appears the amounts we pay doctors is a big part of this. I've always wondered what the difference in pay was. On that note, our for profit health industry creates an incentive to do extra, often unnecessary procedures. I can't remember the poster now, but someone was talking about how in their country they used physical therapy first and surgery as a last resort for physical disabilities.


A few ideas to make this work in the US:

A fat 'product' tax:  Instead of taxing people why don't we change how we tax products. For those of you who don't know, the US has a tax subsidy on corn, wheat, sugar, and meats. However it has very little incentive to farm fruits and vegetables. Let's switch that around! We also already tax tobacco and alcohol quite a bit. Let's extend that to soft drinks, and set it up so the tax revenue from all three has to go to medicare. Americans don't like extra taxes, especially if they consider the results to be waste, but I think a tax on unhealthy habits used to pay for future health expenses is something you could get acceptance for.

On the thought of not trusting people:  The poor in the US already have free healthcare. It's called medicaid. Between that and medicaid the poor and the elderly are covered. It's just the young to middle age middle and upper class who are paying for their own healthcare.

In addition, the poor also get free food in the form of food stamps. Let's change how food stamps can be used and accomplish a few goals. Instead of X dollars and you can spend it however you want, let's set it up so the recipient gets a free allotment of healthy foods. What I'm getting at is that the recipient gets a lot of fruits, vegetables, rice, beans, lean meats, etc. but no processed chips and sodas. If they want to buy those things they can use their own money. This would in effect make our poor population much healthier, clear up some food deserts since there would be automatic added demand for these goods, and save a lot of money on public healthcare be it universal healthcare or medicaid. It would also create greater demand for these goods, which combined with fixing food subsidies, would give farmers incentive to farm a lot more healthy foods.

Thoughts?

You have to be incredibly poor to qualify for Medicaid as a non-disabled adult in many states.  My mother didn't qualify with zero assets and almost exactly $1200/month in income.  In a state that expanded Medicaid under the ACA, I believe she would now qualify, but under our state's current rules she still would not.  If all states would expand Medicaid, that would be a huge boost to the poor and a huge psychological burden lifted from them. 

pecunia

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Re: Universal Health Care Practicalities
« Reply #99 on: February 03, 2019, 10:24:30 AM »
Folks - It's not just you that is paying the high cost of insurance premiums.  It's your employer.

How does your employer get the money to pay for their contribution to your expensive healthcare?  It has to be derived from the income of the goods and services they provide.  These goods and services may have to cost more than competitors.  Some of which are domestic and some are abroad.  Many of the competitors who are abroad do not have to buy health insurance for their employees.  Health is done in a different way.  These competitors can then pass the cost savings on to the consumer and thus increase their market share.

Universal Health Care costs the country less and may allow our businesses to be more competitive.  Americas goods and services will prosper and the overall pie will be bigger.  As right wing politicians are fond of saying, "A rising tide lifts all boats."

Think about Universal Health Care when you vote.  It could give us better than the old cliche, "two chickens in every pot and a car in every garage."