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apodino
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Why don't more corporations support Single Payer in the US

Thu May 28, 2020 8:57 pm

I was reading something about how KLM is offering an Early retirement due to COVID-19 and it got me thinking. In the US, Healthcare is largely tied to your employer, meaning you have to work in order to get good coverage or have a lot of money. If the folks who were closer to retirement age could keep their healthcare after the retired, I think corporate America would be able to get a lot more people to retire early and save money as a result. But even without COVID, there are a lot of benefits I think for corporations if the US went to a single payer system.

1. Employers eat about 80 percent of the cost of insurance premiums for their employees. Imagine the savings they would reap if they didn't have this expense.
2. With better coverage, sick people are more likely to seek treatment sooner. This means employees would be healthier, and thus more productive.
3. For groups that have unionized workforces, this is one less thing that they would have to negotiate with the Unions, which I believe would make it easier to come to contracts that benefit both worker and company better in the long term. (The AA mechanics negotiation took 6 years largely because of this one issue)
4. Much of the HR departments at big corporations are dedicated to Benefits. If you simplify the Health Benefit, you can streamline the benefits department and also make it easier for HR to work on other things.

So the question is, given all the benefits to both corporate America and the American People, why is corporate America against this, and more to the point, why in the midst of a pandemic given all the benefits are the nominees of both major political parties campaigning against it? And why have people who have been for single payer in the past changed their tune? (Specifically Elizabeth Warren)
 
flyguy89
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Re: Why don't more corporations support Single Payer in the US

Thu May 28, 2020 9:55 pm

apodino wrote:
So the question is, given all the benefits to both corporate America and the American People, why is corporate America against this

I don't think corporate America is particularly against it. I think they're just not especially for it given that they know it's likely whatever savings they may garner from not having to pay insurance premiums is a wash when paired with the higher taxes they'll pay. Additionally, many companies use healthcare as a recruiting tool, which they'd obviously lose.

apodino wrote:
And why have people who have been for single payer in the past changed their tune? (Specifically Elizabeth Warren)

Because being for single payer healthcare and "Medicare for all" are not one in the same. Elizabeth Warren is smart and knows better than to keep pretending that the idea of just extending Medicare universally was ever realistic. To act like nationalizing healthcare and cutting all compensation to Medicare rates without creating massive shortages in care and overall chaos was always disingenuous for someone as technocratic as her. The Trumpian Sanders Medicare for All plan may play well as a slogan, but as actual policy it's total fantasy that no OECD country with single payer healthcare actually employs. I'm fine to have a discussion on the merits of single payer, so long as it's honest with regard to the type of care that can likely be provided and the cost.
 
frmrCapCadet
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Re: Why don't more corporations support Single Payer in the US

Thu May 28, 2020 10:15 pm

The medical industry has captured about 18% of our national product some 50% more than most modern economies while producing some of the poorer results in the world. They like the system as it is. Employers hold a big stick over workers in the current system. Trump promised a better system as a candidate - he has had over 3 years to come up with a plan. He lied. He, and most Republicans do not want a better medical (payment) system.

A public option based on Medicare, Medicaid, or both would probably be the simplest. Merely dropping the eligibility for to 62 (and then by steps down to 55) would probably be the easiest politically. Except for pregnancy, most of a persons lifetime medical costs occur after 55, so private insurance for younger people would be a lot cheaper.

The CEO of GM some years ago commented while in Canada, at one of the GM plants, that GM would do better with the Canadian system. Within several days the plutocrats forced him to recant.
Buffet: the airline business...has eaten up capital...like..no other (business)
 
rfields5421
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Re: Why don't more corporations support Single Payer in the US

Thu May 28, 2020 10:51 pm

Several years ago I made one of the DUMB A$$ comments I'm know for about the Health Insurance coverage to the CIO of the company where I worked. An international publicly traded company. With over 20,000 US employees on the company health plan.

As my punishment for my sin, I was assigned to a six month 'additional tasking' to represent my geographic location for the annual health care and insurance review and bid process.

Basically I have to review several hundred pages of proposals from various insurance companies - there were seven bids that year. Four national and three for certain regions. Attend a weekly two hour conference call, and develop agendas for three presentations for the conference call. We worked from February to July, and submitted our recommendation for which companies got the contracts, along with ideas for what the company cost would be and the employee cost shares.

Then in early October the new benefits handbook came out for the new year starting on Jan 1.

It was an enlightening, disgusting, detailed process. And in the end, the company the 23 person committee recommended did not get the contract, it went to the second place company for the national employees - about 14,500 employees.

The companies were very vicious in their competition for our company business. Pennies being shaved each week.

The insurance companies want separate systems, separate processes, even separate coding systems and bill submission systems from the medical care provider. The more unique a company can make their system, the greater the cost and inconvenience to the insured employees to change companies.

------------------------------------------------------------------------------

I'll give Trump a pass on promising a better system and not delivering. The people fighting against such a system are numerous and with pockets deeper than Trump can imagine. The most important thing I remember is from March 2017 when Trump told a FoxNews reporter that "Who knew healthcare and insurance were so complicated?"

I'll guarantee you that Donald Trump never filled out an insurance claim, waited on approval of a referral, or fought over a denied coverage in his life. That is not a complaint. He was lucky not to have to mess with it like the rest of us.

In December 1986, I moved with my two children from the US Naval Activity, Yokosuka, Japan to the Dallas Texas area. I had never had to deal with insurance for my children's health care. From ages birth through three, we were stationed at US Navy bases that provided dependent health care. For the next eight years, we were stationed on US Navy bases in other countries.

When I first started having to deal with insurance for my children's care, it was a nightmare for me. A rude introduction to a process move people grow into younger than their late 30's like I did.

Trump was just one of those people who had managed to avoid dealing with details. Then he got hammered by reality, and the special interests when he was elected.

No one in Congress wants to offend the insurance industry. After all the insurance industry wrote the ACA to meet their needs, not the needs of the people.
Not all who wander are lost.
 
rfields5421
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Re: Why don't more corporations support Single Payer in the US

Thu May 28, 2020 10:57 pm

Another thing

I've been covered by two 'government' single source/ payer health care systems during my lifetime, after I retired from the US military.

The first was/ is Champus / Tri-Care - as a retiree not located near a US military medical facility.

The second was/ is Medicare.

Neither system is "single payer"

Both have bill processing done on a regional level by contracted health insurance company payment systems.

My son is a disabled veteran also receiving 'government' healthcare via a contracted health insurance company payment system.

Both of us deal with payment denials, 'coding' errors, etc on a regular basis. Luckily, our referral system for specialists is much better than the commercial system I had under Aetna and United Healthcare while working for a major US company.
Not all who wander are lost.
 
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DL717
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Re: Why don't more corporations support Single Payer in the US

Sat May 30, 2020 4:48 am

apodino wrote:
I was reading something about how KLM is offering an Early retirement due to COVID-19 and it got me thinking. In the US, Healthcare is largely tied to your employer, meaning you have to work in order to get good coverage or have a lot of money. If the folks who were closer to retirement age could keep their healthcare after the retired, I think corporate America would be able to get a lot more people to retire early and save money as a result. But even without COVID, there are a lot of benefits I think for corporations if the US went to a single payer system.

1. Employers eat about 80 percent of the cost of insurance premiums for their employees. Imagine the savings they would reap if they didn't have this expense.
2. With better coverage, sick people are more likely to seek treatment sooner. This means employees would be healthier, and thus more productive.
3. For groups that have unionized workforces, this is one less thing that they would have to negotiate with the Unions, which I believe would make it easier to come to contracts that benefit both worker and company better in the long term. (The AA mechanics negotiation took 6 years largely because of this one issue)
4. Much of the HR departments at big corporations are dedicated to Benefits. If you simplify the Health Benefit, you can streamline the benefits department and also make it easier for HR to work on other things.

So the question is, given all the benefits to both corporate America and the American People, why is corporate America against this, and more to the point, why in the midst of a pandemic given all the benefits are the nominees of both major political parties campaigning against it? And why have people who have been for single payer in the past changed their tune? (Specifically Elizabeth Warren)


Ask the unions. It’s one of their biggest bargaining chips when they are negotiating new contracts.
Welcome to Nothingburgers. May I take your order?
 
JJJ
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Re: Why don't more corporations support Single Payer in the US

Sat May 30, 2020 7:45 am

flyguy89 wrote:
apodino wrote:
Additionally, many companies use healthcare as a recruiting tool, which they'd obviously lose.



That's also the case in single payer systems. Companies often offer private plans on top of their tax obligations.
 
melpax
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Re: Why don't more corporations support Single Payer in the US

Sun May 31, 2020 2:43 pm

JJJ wrote:
flyguy89 wrote:
apodino wrote:
Additionally, many companies use healthcare as a recruiting tool, which they'd obviously lose.



That's also the case in single payer systems. Companies often offer private plans on top of their tax obligations.


In Australia, it's very rare for employers to offer private health insurance to their staff as part of a renumeration package. Though it is common for some large companies to arrange discounted coverage to their staff through one of the insurers as for those who wish to have private cover. While the government system (Medicare) provides full coverage to all, private cover comes into it's own when you add coverage for extras such as physio & dental, and the ability to have elective procedures done as a private patient, which means not having to be put on a waiting list for non-urgent surgery.

If employers here were suddenly told that they had to offer health insurance to their staff US style, there would be a big outcry with the added administrative burden involved.
Essendon - Whatever it takes......
 
LCDFlight
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Re: Why don't more corporations support Single Payer in the US

Sun May 31, 2020 5:18 pm

This question is trickier than it looks.

If Medicare for all were mandated, a sharp increase in its payments would be required. Who would administer those payments? Would hospital administrators, doctors, drug companies get as much as they want?

Single payer has the potential to cost far more than the mess we have today, unless there are clear rules in place. Clear limits on expectations. We can't spend $2-4 million caring for every 85 year old who is sick, giving them endless heart transplant surgeries etc. So who will write those standards of care?

We are wealthy enough to have a good, fair health care system. We are NOT wealthy enough to have an un-managed, feelings-based healthcare program with an open budget. It would crush the country and the world. This would hurt the most vulnerable people in it.

Imprecise thinking does not lead to successful policies and systems. .Overall I favor full public funding, clear standards of care nationally, and private sector bidding on an open market to provide the services at lowest cost. Bu,t this would "devastate" most of the existing system and its workers.
 
frmrCapCadet
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Re: Why don't more corporations support Single Payer in the US

Sun May 31, 2020 6:01 pm

One of the 3rd wire zappers in medical health in the US is the inability to rationally discuss end of life issues. Most people my age want to live healthy to as close to the end as possible, and when that becomes not possible well managed comfort care, preferably at home. So called hospice care is a joke as it has become overtaken by the mafia hospital industry.

What a dying person wants and needs is home care that may include heating something in a microwave, washing the dishes, minor house cleaning, as much as assistance with bathing, checking medications, and monitoring pain and discomfort. Instead hospitals are often charging $100 a visit for an over qualified nurse who is forbidden to do the things first on my list.
Buffet: the airline business...has eaten up capital...like..no other (business)
 
rfields5421
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Re: Why don't more corporations support Single Payer in the US

Sun May 31, 2020 6:11 pm

LCDFlight wrote:
This question is trickier than it looks.

If Medicare for all were mandated, a sharp increase in its payments would be required. Who would administer those payments? Would hospital administrators, doctors, drug companies get as much as they want?


All of the proposals do not change the current Medicare system of having regional contractors handle the processing and payment. Organizations like Aetna, Blue Cross, United Healthcare would only scale up their current contract processing centers for Medicare to handle the increased workload.

Neither do they substantially change the current Medicaid system where each state sets up a system, including a payment processing contractor.

Likely some of the increased staffing would come from lower staffing requirements for private insurance support. Different set of rules, but basically the same process and coding system.

Medicare Advantage Plans are a huge portion of the Medicare system today. My daughter is a supervisor for a company call center which handles Medicare Advantage sign-ups. She is told that over 1/3 of current Medicare beneficiaries have a Part C Medicare Advantage Plan, and the companies are pushing for more and more enrollment each year. Of course, Part C wants the 'healthy' Medicare beneficiaries, hoping to have the really sick patients drop the plans later.

None of the 'Medicare for All' plans will eliminate private insurance for those companies or people who wish to pay additional for that service. Nor do they require ALL doctors to take Medicare/ Medicaid patients.

My best Endocrinologist for my diabetes worked wonderful with my military Tricare insurance. But when I turned 65, he does not work with Medicare. Refuses to deal with it, and has a strong, healthy practice of people with private insurance, or a substantial patient base who are self-pay. He's very good, and I wish I could have afforded $250 per office visit and stayed with him.

In summary - NONE of the current proposals for universal healthcare coverage in the US change to a 'Single Payer' system. They are all just modifications of the current system.

And you can be sure the current big insurance companies will be involved in writing the law, and the regulations to implement the law - with the goal of making the insurance companies bigger and more powerful.
Not all who wander are lost.
 
rfields5421
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Re: Why don't more corporations support Single Payer in the US

Sun May 31, 2020 6:50 pm

frmrCapCadet wrote:
One of the 3rd wire zappers in medical health in the US is the inability to rationally discuss end of life issues. Most people my age want to live healthy to as close to the end as possible, and when that becomes not possible well managed comfort care, preferably at home. So called hospice care is a joke as it has become overtaken by the mafia hospital industry.

What a dying person wants and needs is home care that may include heating something in a microwave, washing the dishes, minor house cleaning, as much as assistance with bathing, checking medications, and monitoring pain and discomfort. Instead hospitals are often charging $100 a visit for an over qualified nurse who is forbidden to do the things first on my list.


My experience with Hospice with my father's end of life care was different. Now his hospice care was funded by the VA and Medicare with a supplement from his old company health insurance.

It was in a small town (400 people or less) in southwest Arkansas just a few miles from the Louisiana state line.

He was visited by a nurse every day at home during his final three months. The nurse checked that he was taking the correct medications, dealt with pain and discomfort. When his leukemia started to cause a lot of pain, the nurse had a 'comfort pack' delivered with some serious pain medications. She trained my brother and sister who lived near Dad when and how to use the pain meds.

That nurse had a 'client' base of about 30 people on 'hospice' but over half were patients in the local nursing home/ rehab center.

Also, six days a week - he was visited by a "Home Health" aide. Who was responsible for bathing him, checking.to make sure he was eating, etc. In the last month of his life, we were not willing to have him live in his home alone any longer. One of us children was there 24/7.

When it came to my turn, I had a 'Come to Jesus' meeting with Dad over his instance that he walk to the toilet without assistance. He did not want to use the potty chair next to his bed. And he went hourly. The home was far from reasonable for a mobility handicapped person, but it was HIS house. I told him that I would not insist upon holding his arm, or using a lift strap. I would be close. And if he fell (1) I was not going to risk injuring myself trying to catch him, (2) if he fell on my watch - he would go to the ER in the county seat in an ambulance, and (3) he would go from the hospital to the nursing home. He would NOT be coming back to his house. If he wanted to die at home, then he danged well better work with us to prevent falls. He learned a few years earlier that I will not argue with him over such things. I will just do what needs to be done.

Dad always had a major fear of nursing homes, and wanted to die in his own bed. Well, he didn't get that. But he was in a hospital bed in his bedroom in the only house he ever owned.

For the final week, we decided to pay to local ladies who were self-employed - to sit with him for 12 hour shifts.

Was hospice perfect? No.

Was it a heck of a lot better than several other people I've seen die at home, or being forced into a nursing home in the past? Yes

Maybe being in a small town helped. It also helped that the three oldest children were retired and could arrange schedules to stay with him. We were expecting several months, and were prepared for that. He always talked about how he took care of his parents when they got old. Well, both of his parents died in the same bedroom that he died in. At ages 60 and 59, 32 days apart when I was less than 18 months old, and my sister less than six months old. Also Dad, worked, it was our mother who did most of the care of his parents.

My father was 90, and two of his children were older than those grandparents none of his children ever knew were when they died, when dad passed away.

Though the day he died, three of us boys were there with him. My two sisters and one other brother had to drive down from the county seat. The funeral home folks arrived. And it was till almost 2 1/2 hours before the Hospice Nurse could make it to his house to pronounce him deceased.

(The nurse had three hospice deaths at the nursing home and one other at another home at near the same time that day.)

(In case anyone wonder's - my mother's family had Alzheimer's. My father kept her at home and took care of her as best he could until age 67 she had to be placed in a nursing home. He visited her almost everyday for over 15 years, tried to feed her at least twice a day. She had lost the ability to swallow, and after the 5th time in a year of her being hospitalized after aspirating water into her lungs because he would NOT stop giving her un-thickened water to drink, we cooperated with the nursing home and prohibited him for feeding her any longer.

She died four days later, but at least it was not him who gave her that last bit or water or food. It was far past time for my mother to go to heaven. When we were all teenagers and her mother died from complications of that horrible disease, she made us promise to not visit her in a nursing home if she got that disease, to not bring our children to see her. Of course we did because it made Dad happy to see us do that. And I'm sure she gave him HECK when he got to heaven seven and a half years later.)
Not all who wander are lost.
 
LMP737
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Re: Why don't more corporations support Single Payer in the US

Sun May 31, 2020 10:34 pm

DL717 wrote:

Ask the unions. It’s one of their biggest bargaining chips when they are negotiating new contracts.


What point are you trying to make? Are you trying to say that unions are the reason hwy we don't have single payer? If so please back that up with some actual facts.
Never take financial advice from co-workers.
 
MaverickM11
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 1:43 am

LMP737 wrote:
DL717 wrote:

Ask the unions. It’s one of their biggest bargaining chips when they are negotiating new contracts.


What point are you trying to make? Are you trying to say that unions are the reason hwy we don't have single payer? If so please back that up with some actual facts.

Did not realize big pharma was a union. Or that republicans would support single payer were it not for those unions! Learn something new every day!
I don't take responsibility at all
 
flyguy89
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 1:59 am

rfields wrote:
None of the 'Medicare for All' plans will eliminate private insurance for those companies or people who wish to pay additional for that service. Nor do they require ALL doctors to take Medicare/ Medicaid patients.

Actually, Bernie's plan, which several of the Dem candidates vaguely backed, specifically called for the elimination of private health insurance. And when directly asked at a debate if they would eliminate private health insurance, several candidates agreed that they would. This, of course, is unlike many other countries with universal healthcare who do in fact have robust private health and insurance systems for those who opt to pay for it.
 
sierrakilo44
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 2:13 am

flyguy89 wrote:
This, of course, is unlike many other countries with universal healthcare who do in fact have robust private health and insurance systems for those who opt to pay for it.


This is a major misconception I hear from Americans who oppose Medicare for All, that “other countries have private insurance and they’re doing great”.

In Australia we have public single payer Healthcare, known as Medicare. Every single Australian citizen and resident is covered by it, hence its “Medicare for All”. In addition to publically funded hospitals and subsidised medications.

In addition there is an option to voluntarily purchase private health insurance, but this does not replace Medicare. It is in addition to it. The main benefits are you can possibly get non-essential surgery earlier, you have some choice of doctor perhaps, you may get a private room in a hospital (but not always). If you’re prepared to pay for an expensive plan you can get more dental and vision cover. Beyond that it’s things like massage therapy, acupuncture, holistic medicine etc.

For the most part Australians under the age of 55 don’t really need any additional cover, so there are tax incentives for younger people to purchase this private insurance. It’s estimated that overall we would save $3 billion if we stopped subsidising private insurance and pumped additional money into Medicare, as well as bring down surgery wait times. But private insurers do hold some power over our government, just not as much as they do in America. A year ago the CEO of a private insurer put forward a proposal to abolish Medicare, he was universally attacked by both sides of politics however.

So the fact is while we have private insurance it can’t exist here without Medicare. No one would support the abolition of the universal government funded single payer system.

You need to have that single payer system as an underlying bedrock first before you worry about allowing private insurers into healthcare.
 
flyguy89
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 2:35 am

sierrakilo44 wrote:
flyguy89 wrote:
This, of course, is unlike many other countries with universal healthcare who do in fact have robust private health and insurance systems for those who opt to pay for it.


This is a major misconception I hear from Americans who oppose Medicare for All, that “other countries have private insurance and they’re doing great”

I don't know who it is that you've spoken to, but that's not at all the misconception I hear from Americans. One of the main points of opposition to it that people usually point to is the idea that they wouldn't have any choice in their healthcare and would be forced into a bureaucratic system of low quality care with "death panels" yadda yadda even if they liked their private insurance...when it should be pointed out by proponents that in other countries you do in fact have options and private insurance does exist to varying degrees. Alas proponents of universal healthcare here are also ignorant in many ways as to how universal healthcare actually functions in other countries, so nuanced discussions are often not possible.
 
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Aaron747
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 3:21 am

flyguy89 wrote:
sierrakilo44 wrote:
flyguy89 wrote:
This, of course, is unlike many other countries with universal healthcare who do in fact have robust private health and insurance systems for those who opt to pay for it.


This is a major misconception I hear from Americans who oppose Medicare for All, that “other countries have private insurance and they’re doing great”

I don't know who it is that you've spoken to, but that's not at all the misconception I hear from Americans. One of the main points of opposition to it that people usually point to is the idea that they wouldn't have any choice in their healthcare and would be forced into a bureaucratic system of low quality care with "death panels" yadda yadda even if they liked their private insurance...when it should be pointed out by proponents that in other countries you do in fact have options and private insurance does exist to varying degrees. Alas proponents of universal healthcare here are also ignorant in many ways as to how universal healthcare actually functions in other countries, so nuanced discussions are often not possible.


This is basically the issue with any complex problem in our country - with only ~35% of the population educated at tertiary level and believing whomever is manipulating them, nuanced discussion is a foregone conclusion. Too many people go uncritically with absolutist statements and misinformation simply because they are untrained to think critically (or don’t care).
If you need someone to blame / throw a rock in the air / you'll hit someone guilty
 
sierrakilo44
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 4:06 am

flyguy89 wrote:
One of the main points of opposition to it that people usually point to is the idea that they wouldn't have any choice in their healthcare and would be forced into a bureaucratic system of low quality care with "death panels" yadda yadda even if they liked their private insurance...when it should be pointed out by proponents that in other countries you do in fact have options and private insurance does exist to varying degrees. Alas proponents of universal healthcare here are also ignorant in many ways as to how universal healthcare actually functions in other countries, so nuanced discussions are often not possible.


Within Australia’s government funded Medicare system I have absolute choice of practicing GP (like a family doctor) I can visit. When they refer me to a specialist or to a surgeon that comes under the public health system and I get whom I’m given, but I don’t see that as a problem. Australia is a first world country with first world standards and I know that all surgeons and specialists are trained well and operate under good procedures. So to me I don’t know why some people find comfort in the ability to “choose” a doctor. No one here would review the resume of a pilot before they stepped on a plane to ensure that pilot met “their” standards. You get whom you’re given, but trust that the system the airline works under trains their pilots well. The same goes for healthcare.

The old “death panels” myth. They exist...... In America. They’re called Private Insurance companies or HMOs, and it’s well documented how they will deny healthcare to sick people as they are too expensive to treat and it will hurt their profits. You don’t find that in a nation with government mandated universal healthcare:

https://m.youtube.com/watch?v=Ns0xrHMN8s8

This is basically the issue with any complex problem in our country - with only ~35% of the population educated at tertiary level and believing whomever is manipulating them, nuanced discussion is a foregone conclusion. Too many people go uncritically with absolutist statements and misinformation simply because they are untrained to think critically (or don’t care).


When borders are reopen and international travel resumes it would be a good idea for Americans (who have such a low rate of international travel for a western country) to explore the rest of the world and see it isn’t the hell hole their media portrays it as. You cannot call yourselves the world’a greatest, most exceptional nation if you can’t provide basic healthcare to 100% of your nation.
 
LCDFlight
Posts: 436
Joined: Wed Jan 01, 2020 9:22 pm

Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 5:46 am

sierrakilo44 wrote:
flyguy89 wrote:
One of the main points of opposition to it that people usually point to is the idea that they wouldn't have any choice in their healthcare and would be forced into a bureaucratic system of low quality care with "death panels" yadda yadda even if they liked their private insurance...when it should be pointed out by proponents that in other countries you do in fact have options and private insurance does exist to varying degrees. Alas proponents of universal healthcare here are also ignorant in many ways as to how universal healthcare actually functions in other countries, so nuanced discussions are often not possible.


Within Australia’s government funded Medicare system I have absolute choice of practicing GP (like a family doctor) I can visit. When they refer me to a specialist or to a surgeon that comes under the public health system and I get whom I’m given, but I don’t see that as a problem. Australia is a first world country with first world standards and I know that all surgeons and specialists are trained well and operate under good procedures. So to me I don’t know why some people find comfort in the ability to “choose” a doctor. No one here would review the resume of a pilot before they stepped on a plane to ensure that pilot met “their” standards. You get whom you’re given, but trust that the system the airline works under trains their pilots well. The same goes for healthcare.

The old “death panels” myth. They exist...... In America. They’re called Private Insurance companies or HMOs, and it’s well documented how they will deny healthcare to sick people as they are too expensive to treat and it will hurt their profits. You don’t find that in a nation with government mandated universal healthcare:

https://m.youtube.com/watch?v=Ns0xrHMN8s8

This is basically the issue with any complex problem in our country - with only ~35% of the population educated at tertiary level and believing whomever is manipulating them, nuanced discussion is a foregone conclusion. Too many people go uncritically with absolutist statements and misinformation simply because they are untrained to think critically (or don’t care).


When borders are reopen and international travel resumes it would be a good idea for Americans (who have such a low rate of international travel for a western country) to explore the rest of the world and see it isn’t the hell hole their media portrays it as. You cannot call yourselves the world’a greatest, most exceptional nation if you can’t provide basic healthcare to 100% of your nation.


There have been some fabulous posts here on this. rfields and you both wrote things that are very meaningful. I am looking here to learn things. The US is looking for an answer to its unsustainable care issues and money issues.

Yes, agree that insurance denials happen all the time. The US system is absolutely terrible other than that it is a good employment source. And it is a pretty good system if you are poor, or very rich. Most people have real difficulty seeing the doctor. My primary care bill is $300 per visit. I have good insurance, not Cadillac insurance but good.

The reality is that insurance is substantially a myth. Most people can't access the care they need. I can, only because my income per person is enough to pay cash and not worry. We don't have enough health issues to go above the deductible yet (this is what keeps Americans with average income totally out of the doctor's office). I surmise that the hope is that people with average income never see the doctor, and die at home at around retirement age.
 
sierrakilo44
Posts: 327
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 7:30 am

LCDFlight wrote:
There have been some fabulous posts here on this. rfields and you both wrote things that are very meaningful. I am looking here to learn things. The US is looking for an answer to its unsustainable care issues and money issues.


Healthcare is 17% of the US GDP. The Health Insurance Industry is one of the biggest lobbyists in government. If the government was truly representative of the people you would have a policy like Medicare for All which enjoys majority public support. Unfortunately in your political system you have only two parties, the Republicans who are 100% against Medicare for All and the Democrats who are 95% against Medicare for All. Any Democrat who mentions it is sidelined by the party leaders and forced away from the leadership (Bernie). So in the long run to get better healthcare industry you need to completely overhaul your political system, change from first past the post voting, ban corporate bribes to politicians, stop wasting money on bombing brown people in the Middle East etc. But that will take a generation.

Yes, agree that insurance denials happen all the time. The US system is absolutely terrible other than that it is a good employment source. And it is a pretty good system if you are poor, or very rich. Most people have real difficulty seeing the doctor. My primary care bill is $300 per visit. I have good insurance, not Cadillac insurance but good.


That's f***ing terrible. In Australia I can book a same day appointment with a well trained General Practitioner and have it fully bulk billed (zero cost to me) by the government under Medicare. All that you hear in the US media about "long waiting lists" in foreign healthcare systems is BS. And then I can get medications supplied under our Pharmaceutical Benefits Scheme (PBS) for bargain basement prices, if you are elderly, disabled or unemployed the price can be as little as $6 per month! And then if I choose to leave my job to pursue a small business or do something else with my life I don't have to worry about not having healthcare coverage. How's that for real freedom!

Australians wouldn't know what "cadillac insurance", "deductables", "co-pays", "HMOs" etc are. It's simply a matter of get sick, go to doctor, get treated, go home. It wouldn't surprise me if the added stress of having to deal with insurance companies decreases the health of Americans.
 
rfields5421
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 1:05 pm

Frankly during my lifetime, insurance has always been a LIMITING factor in obtaining health care.

As a child, my father and mother were very thankful for the union backed company healthcare plan. But I also know with six children, one with major facial deformities - only Shriner's Hospitals made it possible for my younger sister to have a somewhat normal life. She and my youngest brother were also mentally disabled. We had access to our 'choice' of a doctor. Of the three available in my home town area. But cost was always a factor. My father never took home $100 per week straight time until I was 16 years old. I was making close to $30 a week at the time with four part-time jobs, and contributing half of that to my parents. (Who put it in the bank and it financed my first year of college.)

We lost the youngest sister at age 61 because basically she refused to cooperate with her medical doctors on her eating and exercise requirements. Her diminished mental capacity was certainly a contributing factor.

We almost lost my youngest brother, with Downs Syndrome, last summer when aspiration of food put him in the hospital with severe pneumonia. Spent eight weeks staying close to home and with him 8-12 hours most days. His mental capacity is pre-elementary school academically. He needed full-time family support to be able to cooperate with his medical care. His 60th birthday almost a month ago was a miracle, especially since I remember the day my parents brought him home from the hospital, and cautioned us 'older' children that he probably would not live very long.

My brother and sister were basically Medicaid/ SSI disabled their entire lives after the first few years. They have/ had good access to medical care, but they don't have a lot of choice.

I spent 20 years in the US Navy with good medical care, especially for my wife and children while overseas. I never got to pick my doctor. Once I was put on an airplane in Puerto Rico and sent to Bethesda, Maryland with just an hour notice because the Navy doctor decided I needed a CT Scan. Without time to tell my wife that I would be gone for several days.

The 20 years of private insurance between Navy retirement and Medicare was very frustrating. Mostly because where I retired was far from any military base or access to military healthcare.

Ten of those years were with a 'Cadillac' health care plan from a major corporation. I got to choose my doctors, but frankly the limitations on referrals, co-pays and such were a nightmare. I had one major illness, and only survived financially because the supplemental coverage from military Tricare helped. Even so, I still ended up paying over $30,000 out of pocket while the insurance paid close to $75,000. Even so, the total billed was over $300,000, but negotiated prices by the insurance companies greatly lowered the actual amounts due.

My daughter and her children have suffered from lack of insurance, and lack of access. We have spent a lot of money helping them. They are 'working poor' making enough money to live well in the US, but working for companies without healthcare and no near enough money to purchase insurance privately.

That is the biggest problem with the US system in my opinion.

Not "I won't be able to see my doctor" or "death panels" or anything like that.

The working people with some, usually, poor healthcare insurance coverage, are taught that these other plans will give something FREE to people who don't earn it.

There is a great push by the conservatives to convince the working poor that universal healthcare coverage is going to give greater benefits to the poor (read LAZY) who do not want to work. That the 'bums' are going to have much better healthcare than the people who work.

Rather than fight for better coverage and access for EVERYONE, the working poor/ middle class of America is trained to fight against having to 'pay' for coverage of people who do not want to work.

And they believe that BS.
Not all who wander are lost.
 
sierrakilo44
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 2:43 pm

rfields5421 wrote:

There is a great push by the conservatives to convince the working poor that universal healthcare coverage is going to give greater benefits to the poor (read LAZY) who do not want to work. That the 'bums' are going to have much better healthcare than the people who work.

Rather than fight for better coverage and access for EVERYONE, the working poor/ middle class of America is trained to fight against having to 'pay' for coverage of people who do not want to work.

And they believe that BS.


Australians pay $4500 per year for healthcare, mostly through taxes. Americans pay about $10,000 per year. Australians have better outcomes, higher life expectancy, lower infant mortality, lower wait times, a healthier populace, less dependence on prescription drugs. Most western countries are the same.

I spent 20 years in the US Navy with good medical care, especially for my wife and children while overseas.


You shouldn't be forced to sign up to the military to get healthcare. Making healthcare and education access hard to get for civilians is probably a good recruiting tool for the US military though.
 
AA747123
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 3:41 pm

For the most part it is the American citizens that do not want socialized health care. It would result in significantly higher taxes, less choice in health care, long waits for care. Single Payer is viewed as socialism which is not what the American people want, thats why Trump ended Obama Care
 
flyguy89
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 3:53 pm

sierrakilo44 wrote:
rfields5421 wrote:

There is a great push by the conservatives to convince the working poor that universal healthcare coverage is going to give greater benefits to the poor (read LAZY) who do not want to work. That the 'bums' are going to have much better healthcare than the people who work.

Rather than fight for better coverage and access for EVERYONE, the working poor/ middle class of America is trained to fight against having to 'pay' for coverage of people who do not want to work.

And they believe that BS.


Australians pay $4500 per year for healthcare, mostly through taxes. Americans pay about $10,000 per year.

It's not $10,000 I'll tell you that. Your per annum healthcare expenditures here are highly dependent on the type of plan you have and your health. I have a high-deductible plan and my out of pocket expenses are usually a lot less than $4500 per year. $10,000 would probably be the most I would pay before hitting my max out-of-pocket cost if ever I have a major medical event.
 
JJJ
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 4:21 pm

AA747123 wrote:
For the most part it is the American citizens that do not want socialized health care. It would result in significantly higher taxes, less choice in health care, long waits for care. Single Payer is viewed as socialism which is not what the American people want, thats why Trump ended Obama Care


The armed forces are socialism, the police is socialism, the road network is for the most part socialism.

Socialism for "anything state-owned and operated that I don't agree with" is a very curious US phenomenon.
 
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EstherLouise
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 5:02 pm

The primary reason a lot of Americans are against Medicare For All or primary provider is due to a simple fear of the unknown. They know their private insurance sucks, but are afraid anything else would be worse. And if you try to talk sense to them, they clam up and/or defend their crappy private insurance.
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PPVRA
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 5:49 pm

Early retirement reduces revenues for social security and health systems through lower income/payroll taxes. This adds strains to these programs who are already on unsustainable financial legs.

The problem is healthcare costs. Single payer won’t do much of anything towards this, seeing as healthcare costs are rising globally.

All single payer does is disconnect people from healthcare costs. This is a very populist idea, but will eventually lead to problems—and everywhere we see problems with costs rising every year, leading to cuts in service levels, capacity, etc.

The US has a highly regulated health insurance market, and it’s been this way for several decades. There’s far too much reliance on the concept of insurance because this is mandated by government regulation. This has distorted health care markets, leading to higher costs.

Healthcare costs in Europe also rise because of distortions in health care markets. Remember, markets REGULATE pricing levels through supply and demand and competition. What we see is an unregulated price increase, year after year, globally.

Single payer is not immune to cost increases although it can, temporarily, shield people from cost fluctuations.

Like a pandemic, some countries will run into bigger problems before others do, so basic comparisons without this temporal consideration will be misleading. Ultimately, what dictates accessibility is cost and no country or continent in this planet has the example solution for this cost rising problem. Just because some places look worse than others, doesn’t mean they’re really doing something that much worse.
"If goods do not cross borders, soldiers will" - Frederic Bastiat
 
rfields5421
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 5:53 pm

flyguy89 wrote:
$10,000 would probably be the most I would pay before hitting my max out-of-pocket cost if ever I have a major medical event.


I thought I had that type coverage through my company. What I found out with a major medical issue was that a LOT of expenses are not covered by insurance, or if you are placed in an emergency hospitalization - many of the people who provide care/ tests/ etc - are NOT in network.

Say you have a major accident, and the police call for an air ambulance to take you to a critical care facility. Surprise, you are going to be hit with a bill for between 5,000 and 10,000 if it was a short flight within a metropolitan area. Because NO insurance company for standard health care includes air ambulance costs - only paying the surface transport equivalent. You get stuck with the rest.

We had a maximum out of pocket of $5,500 with our company insurance plan. I thought having to only pay $30,000 was great because it took TWO YEARS of work, challenging bills and charges and such to get it that LOW. And I ended up with dealing with two years of BAD credit reports for not paying faster - that was still impacting my credit report six years later when we bought a new house.

Does your insurance policy have a maximum on prescriptions?

I was placed on TPN feeding in the hospital. That was NOT covered as either a prescription or a routine costs. Friggin' hospital billed me $39.74 per day for food, and I could not take anything by mouth.

Also, the drugs prescribed for my care in the hospital for 29 days came under my prescription coverage with Humana Health - not under my hospitalization coverage.

The reality in the US is that high deductible insurance policies never provide the coverage the person expected to have for a major event. And often lead to the taxpayers or other patients having to eventually pay the costs of the hospitalization because the person either never pays the fees, or files for bankruptcy.
Not all who wander are lost.
 
bhill
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 6:27 pm

sierrakilo44 wrote:
LCDFlight wrote:
There have been some fabulous posts here on this. rfields and you both wrote things that are very meaningful. I am looking here to learn things. The US is looking for an answer to its unsustainable care issues and money issues.


Healthcare is 17% of the US GDP. The Health Insurance Industry is one of the biggest lobbyists in government. If the government was truly representative of the people you would have a policy like Medicare for All which enjoys majority public support. Unfortunately in your political system you have only two parties, the Republicans who are 100% against Medicare for All and the Democrats who are 95% against Medicare for All. Any Democrat who mentions it is sidelined by the party leaders and forced away from the leadership (Bernie). So in the long run to get better healthcare industry you need to completely overhaul your political system, change from first past the post voting, ban corporate bribes to politicians, stop wasting money on bombing brown people in the Middle East etc. But that will take a generation.

Yes, agree that insurance denials happen all the time. The US system is absolutely terrible other than that it is a good employment source. And it is a pretty good system if you are poor, or very rich. Most people have real difficulty seeing the doctor. My primary care bill is $300 per visit. I have good insurance, not Cadillac insurance but good.


THIS!!!!! One would be AMAZED at the cash Big Pharma and the Private Health Insurance industry is pouring into lobbying. As for Doc's refusing to accept Medicare, as soon as all the tens of billions flowing into what we pay for premiums and deductibles were pooled to pay for a single payor system, the re-imbursements to these docs would increase, that and holding Big Pharma to the same pricing standards that other countries that have single payor systems would save a chunk of that GDP being pissed away. As for "coding errors" most of those are human errors, either Doc's entering the wrong Dx or the coder doing the same as soon as a single, standardized input system is accepted..we already have the ICD codes. Single payor MUST happen, or we will be in a pickle shortly...we cannot sustain the current silliness.

That's f***ing terrible. In Australia I can book a same day appointment with a well trained General Practitioner and have it fully bulk billed (zero cost to me) by the government under Medicare. All that you hear in the US media about "long waiting lists" in foreign healthcare systems is BS. And then I can get medications supplied under our Pharmaceutical Benefits Scheme (PBS) for bargain basement prices, if you are elderly, disabled or unemployed the price can be as little as $6 per month! And then if I choose to leave my job to pursue a small business or do something else with my life I don't have to worry about not having healthcare coverage. How's that for real freedom!

Australians wouldn't know what "cadillac insurance", "deductables", "co-pays", "HMOs" etc are. It's simply a matter of get sick, go to doctor, get treated, go home. It wouldn't surprise me if the added stress of having to deal with insurance companies decreases the health of Americans.
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Tugger
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 6:35 pm

JJJ wrote:
AA747123 wrote:
For the most part it is the American citizens that do not want socialized health care. It would result in significantly higher taxes, less choice in health care, long waits for care. Single Payer is viewed as socialism which is not what the American people want, thats why Trump ended Obama Care


The armed forces are socialism, the police is socialism, the road network is for the most part socialism.

Socialism for "anything state-owned and operated that I don't agree with" is a very curious US phenomenon.

INSURANCE is a form of socialism.....

It is spreading risk across a large group of people who will not all benefit the same nor contribute the same.
:roll:
Tugg
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There are many kinds of sentences that we think state facts about the world but that are really just expressions of our attitudes. - F. Ramsey
 
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Tugger
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 6:52 pm

flyguy89 wrote:
sierrakilo44 wrote:
Australians pay $4500 per year for healthcare, mostly through taxes. Americans pay about $10,000 per year.

It's not $10,000 I'll tell you that. Your per annum healthcare expenditures here are highly dependent on the type of plan you have and your health. I have a high-deductible plan and my out of pocket expenses are usually a lot less than $4500 per year. $10,000 would probably be the most I would pay before hitting my max out-of-pocket cost if ever I have a major medical event.

No, he's basically right, in fact for this year per capita medical spending in the USA is actually ~$11,000.

https://www.cms.gov/Research-Statistics ... Historical
https://www.brookings.edu/research/a-do ... re-system/
https://www.statista.com/statistics/184 ... ince-1960/
https://www.healthsystemtracker.org/cha ... nged-time/
https://www.pgpf.org/blog/2020/04/why-a ... healthcare
https://www.kff.org/other/state-indicat ... er-capita/

Tugg
I don’t know that I am unafraid to be myself, but it is hard to be somebody else. - W. Shatner
There are many kinds of sentences that we think state facts about the world but that are really just expressions of our attitudes. - F. Ramsey
 
frmrCapCadet
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 6:53 pm

Medicare is a single payer program. Administered along the Social Security. With standard Medicare you do not need a referral to go to a specialist - you can go to anyone who accepts Medicare - and most do. Many think this would result in much higher costs. Oddly, it does not. Likely if congress adds younger people to the program they need to raise reimbursements by 25-50%. The big kicker right now is medications - congress and the president forbade Medicare from negotiating drugs - just pay whatever they want to charge. And then congress acts surprised that some greedy companies do (including just about all insulin* providers).

Insulin, all GMOs, probably has manufacturing costs around $5 per 1000 unit vial. Prices in Canada and Mexico are about $15-35 a vial. In the USA - some approaching $400. Walmart carries 2 kinds for about $25 a vial. They deserve a lot of credit for keeping many of us diabetics alive.
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flyguy89
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 7:02 pm

rfields5421 wrote:
flyguy89 wrote:
$10,000 would probably be the most I would pay before hitting my max out-of-pocket cost if ever I have a major medical event.


I thought I had that type coverage through my company. What I found out with a major medical issue was that a LOT of expenses are not covered by insurance, or if you are placed in an emergency hospitalization - many of the people who provide care/ tests/ etc - are NOT in network.

Say you have a major accident, and the police call for an air ambulance to take you to a critical care facility. Surprise, you are going to be hit with a bill for between 5,000 and 10,000 if it was a short flight within a metropolitan area. Because NO insurance company for standard health care includes air ambulance costs - only paying the surface transport equivalent. You get stuck with the rest.

We had a maximum out of pocket of $5,500 with our company insurance plan. I thought having to only pay $30,000 was great because it took TWO YEARS of work, challenging bills and charges and such to get it that LOW. And I ended up with dealing with two years of BAD credit reports for not paying faster - that was still impacting my credit report six years later when we bought a new house.

Does your insurance policy have a maximum on prescriptions?

I was placed on TPN feeding in the hospital. That was NOT covered as either a prescription or a routine costs. Friggin' hospital billed me $39.74 per day for food, and I could not take anything by mouth.

Also, the drugs prescribed for my care in the hospital for 29 days came under my prescription coverage with Humana Health - not under my hospitalization coverage.

The reality in the US is that high deductible insurance policies never provide the coverage the person expected to have for a major event. And often lead to the taxpayers or other patients having to eventually pay the costs of the hospitalization because the person either never pays the fees, or files for bankruptcy.

That's very unfortunate. I have a separate catastrophic plan that I pay about $90/month for, still a pretty small price for the extra peace of mind. Doesn't cover helicopter transport, but does include Ambulance transport. Regardless, $10,000 yearly is not a typical cost most Americans pay for routine healthcare unless they have a major medical event or pre-existing condition. Not a defense of our current system, but that reality is important in these discussions because it's a pretty big factor in why single payer has been a difficult debate in the US: a majority are healthy and don't incur huge medical bills, so it can therefore be difficult for them to see the benefit in paying more for a service they don't really use.
 
flyguy89
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 7:14 pm

Tugger wrote:
flyguy89 wrote:
sierrakilo44 wrote:
Australians pay $4500 per year for healthcare, mostly through taxes. Americans pay about $10,000 per year.

It's not $10,000 I'll tell you that. Your per annum healthcare expenditures here are highly dependent on the type of plan you have and your health. I have a high-deductible plan and my out of pocket expenses are usually a lot less than $4500 per year. $10,000 would probably be the most I would pay before hitting my max out-of-pocket cost if ever I have a major medical event.

No, he's basically right, in fact for this year per capita medical spending in the USA is actually ~$11,000.

https://www.cms.gov/Research-Statistics ... Historical
https://www.brookings.edu/research/a-do ... re-system/
https://www.statista.com/statistics/184 ... ince-1960/
https://www.healthsystemtracker.org/cha ... nged-time/
https://www.pgpf.org/blog/2020/04/why-a ... healthcare
https://www.kff.org/other/state-indicat ... er-capita/

Tugg

That is not an accurate picture of the on-the-ground experience for most Americans however. That's just averaging the total spending across the entire population which of course doesn't reflect a typical yearly cost burden for an individual.
 
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Tugger
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 7:19 pm

flyguy89 wrote:
Tugger wrote:
flyguy89 wrote:
It's not $10,000 I'll tell you that. Your per annum healthcare expenditures here are highly dependent on the type of plan you have and your health. I have a high-deductible plan and my out of pocket expenses are usually a lot less than $4500 per year. $10,000 would probably be the most I would pay before hitting my max out-of-pocket cost if ever I have a major medical event.

No, he's basically right, in fact for this year per capita medical spending in the USA is actually ~$11,000.

https://www.cms.gov/Research-Statistics ... Historical
https://www.brookings.edu/research/a-do ... re-system/
https://www.statista.com/statistics/184 ... ince-1960/
https://www.healthsystemtracker.org/cha ... nged-time/
https://www.pgpf.org/blog/2020/04/why-a ... healthcare
https://www.kff.org/other/state-indicat ... er-capita/

Tugg

That is not an accurate picture of the on-the-ground experience for most Americans however. That's just averaging the total spending across the entire population which of course doesn't reflect a typical yearly cost burden for an individual.

Yes, it does. I believe the error you are making is that you are not considering a lifetime. At any particular time in our lives we will all have different annual costs. But the big issue is the fact that medicine in the USA is for profit (not a bad thing per se) and that we all very badly want to live. Why do you think diabetics are willing ot pay up to $400 for insulin as noted above?

And that when you get cancer your medical bills for a two odd year period of time can exceed $100,000/yr.

Or if you have heart bypass surgery you can be spending upwards of $200,000 for that one year (and multi-thousands for years after with followup and additionally surgery).

Or god forbid, be blessed with a child with a congenital issue that requires multiple operations or doctors visits as a newborn and baby and then a lifetime of medical needs.

Tugg
Last edited by Tugger on Mon Jun 01, 2020 7:33 pm, edited 1 time in total.
I don’t know that I am unafraid to be myself, but it is hard to be somebody else. - W. Shatner
There are many kinds of sentences that we think state facts about the world but that are really just expressions of our attitudes. - F. Ramsey
 
flyguy89
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 7:33 pm

Tugger wrote:
flyguy89 wrote:
Tugger wrote:

That is not an accurate picture of the on-the-ground experience for most Americans however. That's just averaging the total spending across the entire population which of course doesn't reflect a typical yearly cost burden for an individual.

Yes, it does. I believe the error you are making is that you are not considering a lifetime. At any particular time in our lives we will all have different annual costs. But the big issue is the fact that medicine in the USA is for profit (not a bad thing per se) and that we all very badly want to live. Why do you think diabetics are willing ot pay up to $400 for insulin as noted above?

And that when you get cancer your medical bills for a two odd year period of time can exceed $100,000/yr.

Or if you have heart bypass surgery yuo can be spending upwards of $200,000 for that one year (and multi-thousands for years after with followup and additionally surgery)

Tugg

I understand what you're trying to say, but those are all still uncommon health events that a majority fortunately don't experience. The links you posted also don't contain any figures averaging a typical individual's lifetime healthcare spend per year. Simply averaging healthcare spend by total population is not going to be representative of typical cost burdens per year for health expenses.
 
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Tugger
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 7:40 pm

flyguy89 wrote:
I understand what you're trying to say, but those are all still uncommon health events that a majority fortunately don't experience. The links you posted also don't contain any figures averaging a typical individual's lifetime healthcare spend per year. Simply averaging healthcare spend by total population is not going to be representative of typical cost burdens per year for health expenses.

And I was just going to add to my post, that I think maybe you are right, that the real problem is that the majority of Americans think "it won't happen to me" so all they think about is what they think they spend in a certain year. And if they are healthy then they are fine but if they are like so many people and at some point in their life have a significant medical issue, then they are screwed if they don't have a way to spread costs across a larger population of people.

So you are probably right that to most people who don't think past what they see right now, the fact that the USA has an average cost of over $11,000/person/year is "not accurate" and lost on them.

Tugg
I don’t know that I am unafraid to be myself, but it is hard to be somebody else. - W. Shatner
There are many kinds of sentences that we think state facts about the world but that are really just expressions of our attitudes. - F. Ramsey
 
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Tugger
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Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 7:59 pm

Here's a quick example:
On average there are ~500,000 open heart surgeries per year in the USA.
And the average cost of one open heart surgery is ~$325,000.00
https://www.lifespan.org/lifespan-livin ... rt-surgery
https://www.healthcarebusinesstech.com/ ... rocedures/

And that is not the most expensive procedure, that honor belongs to transplants, of which the US averages over 30,000 per year currently. And some of those top $1M per.

Then throw in an average annual cost of $300B-$400B for prescription drugs (yes folks, that does not include the cost of OTC drugs), and you start talking some real money!
https://www.ncsl.org/research/health/ph ... icing.aspx

Tugg
I don’t know that I am unafraid to be myself, but it is hard to be somebody else. - W. Shatner
There are many kinds of sentences that we think state facts about the world but that are really just expressions of our attitudes. - F. Ramsey
 
rfields5421
Posts: 6264
Joined: Thu Jul 19, 2007 12:45 am

Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 9:18 pm

flyguy89 wrote:
a majority are healthy and don't incur huge medical bills, so it can therefore be difficult for them to see the benefit in paying more for a service they don't really use.


The people in the United States, and I suspect a large part of the world, have a mis-understanding of what insurance is.

In the most basic terms insurance is a bet a person makes against themselves, that the hope to lose.

I went decades without a car insurance claim. Then a hail storm caused over 10,000 damage to my primary vehicle. Frankly, the company paying the damage was almost as much trouble as having the damage in the first place.

We do not view health insurance in the US as a protection against catastrophic loss, the costs of a major illness or accident.

We view it as a general savings feature to offset the unreasonable, uneconomic costs of dealing with ROUTINE health costs. Health insurance prevents us from having to price shop for medical care. From making a cost vs value decision on a doctor, or other health care professional.

The very concept that "I don't need health insurance, I don't get sick" is so fundamentally against the economic basis of insurance as to be laughable.

But that is how we have been trained to look at it. My father's generation in the 50's and 60's had a big part in perpetuating that myth.

Before wide health insurance coverage, doctors and other medical professionals had to price their services for the local market place. Starting in the 50's they started to transition to pricing their services to match the conditions that health insurance was willing to pay for. Their 'customer' was no longer the person needing medical care - it was the insurance company.

That is very much so today - the customer is the insurance company, not the patient.

For years my dental work, and my wife's dental, has been done in Mexico. A community which focuses on providing cost effective medical and dental care to largely retiree's who can walk across the border to get work done, and be back home that afternoon. "Home" being anything from a winter long mobile home to someone like us who live full-time in a travel trailer RV.

I visited four dentists and interviewed them. Paid $25 each for a bit of time to discuss my needs. Then picked one to do 23 extractions, two implants and two sets of full dentures. Price was a major consideration, cash a bit under $4,000. But I also preferred someone who was very fluent in English, had done some of their training in the US.

I can't even start 'shopping' for a medical doctor in the Dallas area that way.

If my children/ grandchildren would move, I'd never come back here. I would not leave the US, but I'd spend more time in warmer winter weather.
Not all who wander are lost.
 
frmrCapCadet
Posts: 4090
Joined: Thu May 29, 2008 8:24 pm

Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 10:45 pm

Medical insurance may be better understood as a combination of a utility and of insurance. I am not sure these two components can be separated out.
Buffet: the airline business...has eaten up capital...like..no other (business)
 
GalaxyFlyer
Posts: 5578
Joined: Fri Jan 01, 2016 4:44 am

Re: Why don't more corporations support Single Payer in the US

Mon Jun 01, 2020 11:18 pm

rfields5421 wrote:
flyguy89 wrote:
a majority are healthy and don't incur huge medical bills, so it can therefore be difficult for them to see the benefit in paying more for a service they don't really use.


The people in the United States, and I suspect a large part of the world, have a mis-understanding of what insurance is.

In the most basic terms insurance is a bet a person makes against themselves, that the hope to lose.

I went decades without a car insurance claim. Then a hail storm caused over 10,000 damage to my primary vehicle. Frankly, the company paying the damage was almost as much trouble as having the damage in the first place.

We do not view health insurance in the US as a protection against catastrophic loss, the costs of a major illness or accident.

We view it as a general savings feature to offset the unreasonable, uneconomic costs of dealing with ROUTINE health costs. Health insurance prevents us from having to price shop for medical care. From making a cost vs value decision on a doctor, or other health care professional.

The very concept that "I don't need health insurance, I don't get sick" is so fundamentally against the economic basis of insurance as to be laughable.

But that is how we have been trained to look at it. My father's generation in the 50's and 60's had a big part in perpetuating that myth.

Before wide health insurance coverage, doctors and other medical professionals had to price their services for the local market place. Starting in the 50's they started to transition to pricing their services to match the conditions that health insurance was willing to pay for. Their 'customer' was no longer the person needing medical care - it was the insurance company.

That is very much so today - the customer is thhe insurance company, not the patient.

For years my dental work, and my wife's dental, has been done in Mexico. A community which focuses on providing cost effective medical and dental care to largely retiree's who can walk across the border to get work done, and be back home that afternoon. "Home" being anything from a winter long mobile home to someone like us who live full-time in a travel trailer RV.

I visited four dentists and interviewed them. Paid $25 each for a bit of time to discuss my needs. Then picked one to do 23 extractions, two implants and two sets of full dentures. Price was a major consideration, cash a bit under $4,000. But I also preferred someone who was very fluent in English, had done some of their training in the US.

I can't even start 'shopping' for a medical doctor in the Dallas area that way.

If my children/ grandchildren would move, I'd never come back here. I would not leave the US, but I'd spend more time in warmer winter weather.


True in spades. The happiness medical sectors are vision and dental care—its a patient-doctor relationship, not a doctor-insurer vs. patient relationship. Third party payer is a huge part of the US problem all brought in because of WW II wage controls made medical benefits a thing.

The Swiss plan makes a lot of sense, but being Swiss, it isn’t cheap. And, having spent most of afternoon in a hot, un-air conditioned travel clinic in best hospital in Geneva, I’m doubtful it’s as good as some say. My home clinic did over 2500 appointments a year with one NP and I never waited.
 
User avatar
Dutchy
Posts: 11614
Joined: Sat Nov 03, 2007 1:25 am

Re: Why don't more corporations support Single Payer in the US

Tue Jun 02, 2020 6:34 pm

apodino wrote:
So the question is, given all the benefits to both corporate America and the American People, why is corporate America against this, and more to the point, why in the midst of a pandemic given all the benefits are the nominees of both major political parties campaigning against it? And why have people who have been for single-payer in the past changed their tune? (Specifically Elizabeth Warren)


America has a poor system for health care, very expensive, poor performance for the society at large. If you've got money, everything is possible, if not, too bad for you. Because it is tied to your employer, it makes the job market less flexible and employees far more dependent on their employer.
Many happy landings, greetings from The Netherlands!
 
apodino
Topic Author
Posts: 3869
Joined: Mon Apr 04, 2005 2:11 am

Re: Why don't more corporations support Single Payer in the US

Wed Jun 03, 2020 6:59 pm

Dutchy wrote:
apodino wrote:
So the question is, given all the benefits to both corporate America and the American People, why is corporate America against this, and more to the point, why in the midst of a pandemic given all the benefits are the nominees of both major political parties campaigning against it? And why have people who have been for single-payer in the past changed their tune? (Specifically Elizabeth Warren)


America has a poor system for health care, very expensive, poor performance for the society at large. If you've got money, everything is possible, if not, too bad for you. Because it is tied to your employer, it makes the job market less flexible and employees far more dependent on their employer.


Its not just Health Care but every part of American society that has gone in this direction...which is a large part of the root of what is going on in the US the past week.

This discussion has been great. I wish we had more civil discussions like this instead of people shouting their points and not listening.
 
frmrCapCadet
Posts: 4090
Joined: Thu May 29, 2008 8:24 pm

Re: Why don't more corporations support Single Payer in the US

Wed Jun 03, 2020 8:30 pm

Running a modern industrial-high tech economy is expensive. To do it right progressive income taxes need to top out, on average, 5-10% over what they are in the US on higher and high incomes. Higher earning people do not want to pay that much. They have a lot of power. But no more sense than the rest of us.
Buffet: the airline business...has eaten up capital...like..no other (business)
 
Ken777
Posts: 10045
Joined: Thu Mar 11, 2004 5:39 am

Re: Why don't more corporations support Single Payer in the US

Wed Jun 03, 2020 9:57 pm

My favorite was the Aussie system where Medibank hit you up for 3% of your pay, or 2% if you had private insurance. While that wold get some liberals screaming the reality is the 1% reduction is because Medibank is relieved of significant costs. The private insurance does not cover regular doctor visits, or your normal prescriptions. It does cover "treatments" ilk a root canal treatment.

This takes care of two issues - without the basic Dr. Visits and Rx my "Private insurance" was on.y $88 a month. The public sector also gains as private care lots a significant burden of of the pubic programs costs. Insurance companies also benefit - they are so profitable that the government started a private company (Medibank Private) to compete. And the business sector gains as the private insurance is paid by individuals health insurance never its the P&L.
 
GalaxyFlyer
Posts: 5578
Joined: Fri Jan 01, 2016 4:44 am

Re: Why don't more corporations support Single Payer in the US

Wed Jun 03, 2020 9:59 pm

frmrCapCadet wrote:
Running a modern industrial-high tech economy is expensive. To do it right progressive income taxes need to top out, on average, 5-10% over what they are in the US on higher and high incomes. Higher earning people do not want to pay that much. They have a lot of power. But no more sense than the rest of us.


Read up on US tax distribution by income levels. If the top 25% of the income tax payers paid 10% more, as you posted, it would add a measly $137 billion to the tax revenue, nowhere near enough. The top 50% of the income distribution pays 97% of the income tax. The bottom 50% pays 3% plus they’re paying into FICA which is really an a flat tax for people with an income below about $135,000 gross.

https://taxfoundation.org/summary-of-th ... 20-update/
 
GalaxyFlyer
Posts: 5578
Joined: Fri Jan 01, 2016 4:44 am

Re: Why don't more corporations support Single Payer in the US

Wed Jun 03, 2020 10:20 pm

Ken777 wrote:
My favorite was the Aussie system where Medibank hit you up for 3% of your pay, or 2% if you had private insurance. While that wold get some liberals screaming the reality is the 1% reduction is because Medibank is relieved of significant costs. The private insurance does not cover regular doctor visits, or your normal prescriptions. It does cover "treatments" ilk a root canal treatment.

This takes care of two issues - without the basic Dr. Visits and Rx my "Private insurance" was on.y $88 a month. The public sector also gains as private care lots a significant burden of of the pubic programs costs. Insurance companies also benefit - they are so profitable that the government started a private company (Medibank Private) to compete. And the business sector gains as the private insurance is paid by individuals health insurance never its the P&L.


Sounds cheap until I looked at Australian tax rates, computed my taxes on my US income before retirement. Me effective rate would have been double my US rate, paid about twice as much even adding my insurance premiums and what we paid out of our HSA.
 
B777LRF
Posts: 2682
Joined: Sun Nov 02, 2008 4:23 am

Re: Why don't more corporations support Single Payer in the US

Thu Jun 04, 2020 5:39 am

AA747123 wrote:
For the most part it is the American citizens that do not want socialized health care. It would result in significantly higher taxes, less choice in health care, long waits for care. Single Payer is viewed as socialism which is not what the American people want, thats why Trump ended Obama Care


BS, BS, BS and, again, BS.

Higher taxes: Yes, but more than compensated through not having to pay insurance (see Australian example; 4500 vs 10000 a year). But if you stopped bombing brown people and invading their countries, it would more than pay for it
Less choice: Incorrect. I have a choice of doctor and hospital, should I ever need either
Long waits: Only correct for elective surgery; having to wait for a gastro bypass because you're a fat slob is really not a good example
Viewed as socialism: The vast majority of Americans couldn't tell you what socialism is, or distinguish between it, communism and social democracy

By the way, Trump only won because a) Hillary was the opponent and b) too many democrats were certain of victory and therefore refrained from casting a vote. He did lose the popular vote by a considerable margin, but due your gerrymandered districts, the electoral college system and first-past-the-goalpost, that didn't matter. That's not the hallmarks of a democracy, rather a system that has utterly failed its citizens to enrich the top 1% of society.

Reality is that your politicians are bought and paid for by interest groups, with the health care industry being just one of them. They do not have the best interest of the US population at the top of their agenda, or even anywhere near their agenda. They're in it to make money, as much money as possible, and nothing else matters. That is not going to change unless you embark on a complete overhaul of your political system.

What you really need is for a lot, and I mean a whole lot, of different parties to have a shot of winning seats in your congresses around the country. How a nation so diverse can only be represented by 2 parties is, quite frankly, flabbergasting. My small nation of not even 6 million people have 9 parties in a parliament of 179 seats. The trick is being able to count to 90, which require cooperation and compromises to be made across party lines, resulting in legislation backed by a wide spectrum of parliament and thus the electorate.

That's what the US needs, but the chances of that happening are somewhere between zero and non-existent. You'll therefore be locked in a perpetual infight between two non-compromising parties, more often that not guided and governed by the fringes of those two parties, resulting in having fact resistent, incompetent, corrupted, ignorant and uncompromising idiots in parliaments, who are unable and unwilling to cooperate. Multiply that a few times whilst adding "narcissistic", "non-empathic", "psychopathic", "compulsory liar" and "corporate failure", and you'll have an accurate portrayal of the current occupant of the White House.
Signature. You just read one.
 
sierrakilo44
Posts: 327
Joined: Tue Dec 13, 2011 1:38 am

Re: Why don't more corporations support Single Payer in the US

Thu Jun 04, 2020 12:45 pm

B777LRF wrote:
AA747123 wrote:
For the most part it is the American citizens that do not want socialized health care. It would result in significantly higher taxes, less choice in health care, long waits for care. Single Payer is viewed as socialism which is not what the American people want, thats why Trump ended Obama Care


BS, BS, BS and, again, BS.

Higher taxes: Yes, but more than compensated through not having to pay insurance (see Australian example; 4500 vs 10000 a year). But if you stopped bombing brown people and invading their countries, it would more than pay for it
Less choice: Incorrect. I have a choice of doctor and hospital, should I ever need either
Long waits: Only correct for elective surgery; having to wait for a gastro bypass because you're a fat slob is really not a good example
Viewed as socialism: The vast majority of Americans couldn't tell you what socialism is, or distinguish between it, communism and social democracy



First off Trump never ended Obamacare, he failed to repeal it despite it being a major campaign promise of his (something for the "Trump followed up on his promises" crowd).

Secondly, agree with you. The first poster doesn't know what they're talking about. I live in a country with Universal/Socialised/Single Payer Healthcare (Australia). As I've explained there is no issue with it. The many times I've used it it has been effective, prompt, no long waits. You pay more tax but save on premiums/deductables/co-pays etc. To the point your overall spend on healthcare is lower - USA $9892 per year vs Australia $4708 per year, evidence of that fact here:
https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita

Everytime I've been overseas and needed healthcare in any developed country that has universal healthcare it has been quick, effective, and barely any cost. The only country I heard of people having problems in and been told to be careful navigating that country's health system if travelling there is the USA.

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