william wrote:

StarAC17 wrote:

c933103 wrote:

But isn't that a way of exploiting young inexperienced doctors? (Public place salary are lower than private thus cannot attract private doctors - So those with less bargaining power aka in this case those with less experience, are forced to work for it for less than they could otherwise earn - Unless that's considered a return by them to training they received)

When you are new you start at the bottom and that is way for the two tier British system to not fall into a completely private system due to it being more lucrative. You have to do a minimum time in the public system.

I hope someone from the UK can chime in but I remember from the Michael Moore movie Sicko which was released in 2007 (not the greatest example I know) that the NHS doctor earned something like $100,000 pounds a year which is USD $137,000. Keep in mind that this is a GP and in the UK under the NHS the infrastructure is already there and all of the nurses and associated staff are also employed by the NHS so that is a salary. While a US GP would earn far more they would have to pay their staff, malpractice/liability insurance, rent a clinic etc. None of those costs would have to be assumed by the doctor.

Also they get bonuses for positive health outcomes. If they get a patient to quit smoking or lose weight they get paid more.

Even in Canada where the universal system is run provincially dental, optometry, prescription drugs, physiotherapy, therapy aren't covered by the government and you usually get extended health through your employer.

The biggest thing with the wait times coming from Canada is that there is simply not enough funding in the system to fulfill capacity. Covid has exposed this issue but it was always there.

Amid aging population across developed countries, is it realistic for a public health system in such countries to remain properly funded?

I think if its clearly explained to the taxpayers that this is the cost of the system and it isn't mired in in-efficiency and corruption then people will pay the higher taxes for it.
The reason that say the Scandinavian countries accept the tax levels they have is that that money in used very well for the society where in the US and even in Canada the money is often used poorly.

The alternative is that some people are waiting or dying. We are going to the polls in 3 weeks in Canada and this question is very much on the ballot with the conservatives suggesting some kind of two tier system.

Healthcare like private business will face highs and lows of demand on their services but with the system operating near or above capacity and when there is a surge like a pandemic or a bad cold and flu season then the system gets to its limit. For healthcare to work properly you need that capacity which if strictly looking at the books is inefficient because 100% is ideal as there is no wasted capacity. For healthcare to actually work you need 10-25% spare capacity to handle things like Covid or any local outbreak of other infectious diseases. Taxpayers don't like this because higher taxes but they don't like the wait times either.

That's a trade off that need to be made no matter it's public or privately funded

That's fine but when you get an event like Covid then there might not be the ability to get treated if you need it and you will face delays.

Funny, I remember when Obamacare was being argued, why not just full on Universal. One of the sticking points was malpractice. The trial lawyers are a BIG donor to Democrats, and they did not want that gravy train to go away. How does malpractice work under Universal Healthcare? What role do the lawyers have in Universal Healthcare?

Why do so many Canadians and Europeans come to the US for treatment? Its expensive, I go to Mexico for dental because of the quality and price.

How many is 'so many'?

Aaron747 wrote:

william wrote:

StarAC17 wrote:

When you are new you start at the bottom and that is way for the two tier British system to not fall into a completely private system due to it being more lucrative. You have to do a minimum time in the public system.

I hope someone from the UK can chime in but I remember from the Michael Moore movie Sicko which was released in 2007 (not the greatest example I know) that the NHS doctor earned something like $100,000 pounds a year which is USD $137,000. Keep in mind that this is a GP and in the UK under the NHS the infrastructure is already there and all of the nurses and associated staff are also employed by the NHS so that is a salary. While a US GP would earn far more they would have to pay their staff, malpractice/liability insurance, rent a clinic etc. None of those costs would have to be assumed by the doctor.

Also they get bonuses for positive health outcomes. If they get a patient to quit smoking or lose weight they get paid more.



I think if its clearly explained to the taxpayers that this is the cost of the system and it isn't mired in in-efficiency and corruption then people will pay the higher taxes for it.
The reason that say the Scandinavian countries accept the tax levels they have is that that money in used very well for the society where in the US and even in Canada the money is often used poorly.

The alternative is that some people are waiting or dying. We are going to the polls in 3 weeks in Canada and this question is very much on the ballot with the conservatives suggesting some kind of two tier system.



That's fine but when you get an event like Covid then there might not be the ability to get treated if you need it and you will face delays.

Funny, I remember when Obamacare was being argued, why not just full on Universal. One of the sticking points was malpractice. The trial lawyers are a BIG donor to Democrats, and they did not want that gravy train to go away. How does malpractice work under Universal Healthcare? What role do the lawyers have in Universal Healthcare?

Why do so many Canadians and Europeans come to the US for treatment? Its expensive, I go to Mexico for dental because of the quality and price.

How many is 'so many'?

I don't have an exact number, I just going by what my friends say that live in Detroit and Buffalo and Canadian friends. But if you really want to know, from the Toronto Sun-

https://torontosun.com/news/national/ca ... new-report

Again, I ask, how is malpractice handled in a Universal Healthcare system?

william wrote:

Aaron747 wrote:

william wrote:

Funny, I remember when Obamacare was being argued, why not just full on Universal. One of the sticking points was malpractice. The trial lawyers are a BIG donor to Democrats, and they did not want that gravy train to go away. How does malpractice work under Universal Healthcare? What role do the lawyers have in Universal Healthcare?

Why do so many Canadians and Europeans come to the US for treatment? Its expensive, I go to Mexico for dental because of the quality and price.

How many is 'so many'?

I don't have an exact number, I just going by what my friends say that live in Detroit and Buffalo and Canadian friends. But if you really want to know, from the Toronto Sun-

https://torontosun.com/news/national/ca ... new-report

Again, I ask, how is malpractice handled in a Universal Healthcare system?

https://www.usnews.com/news/best-countr ... ealth-care

Canadians can enroll in private insurance to cover the costs of out of country procedures. Why do they leave Canada for their procedures? Wait times. Not quality. Unlike Americans who go to Mexico or Indonesia for procedures because they are cheaper.

william wrote:

Aaron747 wrote:

william wrote:

Funny, I remember when Obamacare was being argued, why not just full on Universal. One of the sticking points was malpractice. The trial lawyers are a BIG donor to Democrats, and they did not want that gravy train to go away. How does malpractice work under Universal Healthcare? What role do the lawyers have in Universal Healthcare?

Why do so many Canadians and Europeans come to the US for treatment? Its expensive, I go to Mexico for dental because of the quality and price.

How many is 'so many'?

I don't have an exact number, I just going by what my friends say that live in Detroit and Buffalo and Canadian friends. But if you really want to know, from the Toronto Sun-

https://torontosun.com/news/national/ca ... new-report

Again, I ask, how is malpractice handled in a Universal Healthcare system?

Based on my understanding: in Germany, most malpractice claims go to arbitration and then court if that fails. Medical negligence is covered under tort law in Australia. Both countries require physicians to have indemnity insurance.

In Japan litigiousness is very low and malpractice claims would first be handled by a local health board before escalating to a court.

Aaron747 wrote:

william wrote:

Aaron747 wrote:

How many is 'so many'?

I don't have an exact number, I just going by what my friends say that live in Detroit and Buffalo and Canadian friends. But if you really want to know, from the Toronto Sun-

https://torontosun.com/news/national/ca ... new-report

Again, I ask, how is malpractice handled in a Universal Healthcare system?

Based on my understanding: in Germany, most malpractice claims go to arbitration and then court if that fails. Medical negligence is covered under tort law in Australia. Both countries require physicians to have indemnity insurance.

In Japan litigiousness is very low and malpractice claims would first be handled by a local health board before escalating to a court.

Thank you, interesting way of litigation and actually preferable. Would explain why the Lawyer Lobbyist was against Universal Healthcare. I remember the topic being discussed back in 2010. Obama had a veto proof congress, and one would think one of the liberal think tanks would have an Universal Healthcare plan ready to hit House Floor, instead of convoluted mess that passed. Oh, and i forgot the Union's were against it too with their "Cadillac" plans, whatever that means.

william wrote:

Again, I ask, how is malpractice handled in a Universal Healthcare system?

The first step is to simply talk to your health provider. Regardless whether that’s a nurse / doctor / dentist / pharmacist / etc.

This can be escalated to the hospital’s or practise’s complaints department. By law they must have one, and it must be independent and impartial.(NL: Klachtenfunctionaris)

If they can’t resolve the problem to your satisfaction you can go for arbitration. Again, independent and impartial. They can award damages up to 25.000 euro. (NL: Geschilleninstantie / Geschillencommissie

Your final recourse is to go to court. There is a specific court for medical matters (NL: Tucht college) so everyone involved knows about medical matters. This court has the power to suspend the doctor’s license, both temporarily or definitively. They can also award damages, but the site does not mention a limit or if there even is one.

Here’s a link to the relevant article on the website of the Dutch government.
https://www.rijksoverheid.nl/onderwerpe ... instelling

Universal healthcare won't be brought up until the 2024 primaries in the Democratic party, assuming Biden doesn't run. Likely, Kamala Harris will take the existing ACA position (and build on it) approach, and some progressive candidates will be for M4A, and there will be a lot of debate hours focused on the topic again.

Some in the right call it fringe left, but they loved Tulsi Gabbard, who was for Medicare for All. Maybe Tulsi just wanted to take the anti Obama position on health care, and that simply made it easier for her health care plan to be Medicare for All.

petertenthije wrote:

william wrote:

Again, I ask, how is malpractice handled in a Universal Healthcare system?

The first step is to simply talk to your health provider. Regardless whether that’s a nurse / doctor / dentist / pharmacist / etc.

This can be escalated to the hospital’s or practise’s complaints department. By law they must have one, and it must be independent and impartial.(NL: Klachtenfunctionaris)

If they can’t resolve the problem to your satisfaction you can go for arbitration. Again, independent and impartial. They can award damages up to 25.000 euro. (NL: Geschilleninstantie / Geschillencommissie

Your final recourse is to go to court. There is a specific court for medical matters (NL: Tucht college) so everyone involved knows about medical matters. This court has the power to suspend the doctor’s license, both temporarily or definitively. They can also award damages, but the site does not mention a limit or if there even is one.

Here’s a link to the relevant article on the website of the Dutch government.
https://www.rijksoverheid.nl/onderwerpe ... instelling

Almost correct. The 'tucht college' isn't about damages, it answers the question if the medical professional (all kinds, not just doctors) is fit to perform its profession. The arbitration is a choice, you might go directly to civil court if the situation calls for it. Arbitration is only for 'small' damages, below the 25kEuro.

william wrote:

Thank you, interesting way of litigation and actually preferable. Would explain why the Lawyer Lobbyist was against Universal Healthcare. I remember the topic being discussed back in 2010. Obama had a veto proof congress, and one would think one of the liberal think tanks would have an Universal Healthcare plan ready to hit House Floor, instead of convoluted mess that passed. Oh, and i forgot the Union's were against it too with their "Cadillac" plans, whatever that means.

Interesting that those two groups (lawyers and unions) lobbied against Universal Healthcare. Given that lawyers are against it, you might argue that it is a good idea.

What argument did the unions make to be against this? I could see that it might strip them from some powers given that healthcare would not be provided through employers, but still. It would be could for employees given it would cost less.

Dutchy wrote:

william wrote:

Thank you, interesting way of litigation and actually preferable. Would explain why the Lawyer Lobbyist was against Universal Healthcare. I remember the topic being discussed back in 2010. Obama had a veto proof congress, and one would think one of the liberal think tanks would have an Universal Healthcare plan ready to hit House Floor, instead of convoluted mess that passed. Oh, and i forgot the Union's were against it too with their "Cadillac" plans, whatever that means.

Interesting that those two groups (lawyers and unions) lobbied against Universal Healthcare. Given that lawyers are against it, you might argue that it is a good idea.

What argument did the unions make to be against this? I could see that it might strip them from some powers given that healthcare would not be provided through employers, but still. It would be could for employees given it would cost less.

From what I could remember, the Union present medical plan would be better than a Universal plan or Medicare for All (really need to change that messaging). I guess that is where the term "Cadillac Plan" came from.

A Universal Healthcare or Medicare for All plan is going to come from the Democratic Party. That Party is made of various lobbies and groups. Simply put, not all the players in the Democratic Party are down with Universal Healthcare.

Dutchy wrote:

william wrote:

Thank you, interesting way of litigation and actually preferable. Would explain why the Lawyer Lobbyist was against Universal Healthcare. I remember the topic being discussed back in 2010. Obama had a veto proof congress, and one would think one of the liberal think tanks would have an Universal Healthcare plan ready to hit House Floor, instead of convoluted mess that passed. Oh, and i forgot the Union's were against it too with their "Cadillac" plans, whatever that means.

Interesting that those two groups (lawyers and unions) lobbied against Universal Healthcare. Given that lawyers are against it, you might argue that it is a good idea.

What argument did the unions make to be against this? I could see that it might strip them from some powers given that healthcare would not be provided through employers, but still. It would be could for employees given it would cost less.

I think the Union's argument is that for many locals, health care is a huge bargaining chip and/or a massive incentive for people to join their membership. Even if it will save the union money, it's a major reason for their existence.

If a country has a decent social safety net lawsuits are not nearly so important nor likely.

LabQuest wrote:

Pi7472000 wrote:

With Democrats controlling the house, senate and White House will they push for universal healthcare before the 2022 midterms? We need universal healthcare in the U.S. I think Democrats will still control all three branches after the midterms due to the rhetoric and policies on the right. Will universal healthcare be proposed or will it be stopped by the conservative Democrats in the senate in WV and AZ?

The democrats are going to get crushed in the midterms. The controlling party always looses seats at the midterms.

The reason universal healthcare isn't more popular is because most people have affordable, comprehensive insurance that covers their medical costs at a reasonable rate.

Not in 2022. People did not like the actions or policies of Trump or conservatives and these midterms will not follow history. Democrats are still popular in polls and it will be hard for Republicans to win. Many Americans face crippling medical debt and do not have affordable, comprehensive insurance. We need a new system that provides free healthcare to any person who needs it. Health care is a human right and people should not have to sacrifice their economic well being to get health care.

Aaron747 wrote:

Based on my understanding: in Germany, most malpractice claims go to arbitration and then court if that fails. Medical negligence is covered under tort law in Australia. Both countries require physicians to have indemnity insurance.

In Japan litigiousness is very low and malpractice claims would first be handled by a local health board before escalating to a court.

Don't other countries also have a national version of our state registries for doctors? In the USA a bad doctor in one state can go practice in another. How many other nations can that happen in?

Tugg

william wrote:

I don't have an exact number, I just going by what my friends say that live in Detroit and Buffalo and Canadian friends. But if you really want to know, from the Toronto Sun-

https://torontosun.com/news/national/ca ... new-report

Bit of a myth.

Statistics show that the number of Canadians using US healthcare services is minuscule, single digits even, even in areas close to the US/Canada border. Most Canadians use US healthcare for emergency care (ie Canadian tourists in the US who had a medical emergency and needed to closest care, not Canadians flocking across the border to get elective surgery as Canadian wait times are too long).

https://www.aarp.org/politics-society/g ... -care.html

This debunks one of the biggest talking points from US universal healthcare opponents

Tugger wrote:

Aaron747 wrote:

Based on my understanding: in Germany, most malpractice claims go to arbitration and then court if that fails. Medical negligence is covered under tort law in Australia. Both countries require physicians to have indemnity insurance.

In Japan litigiousness is very low and malpractice claims would first be handled by a local health board before escalating to a court.

Don't other countries also have a national version of our state registries for doctors? In the USA a bad doctor in one state can go practice in another. How many other nations can that happen in?

Tugg

Australia, with a similar federated system to the USA, has a national register of medical practitioners, even where the regulator may be state based. With the Medicare system, many doctors recieve some payment direct from the Commonwealth government for services.

sierrakilo44 wrote:

william wrote:

I don't have an exact number, I just going by what my friends say that live in Detroit and Buffalo and Canadian friends. But if you really want to know, from the Toronto Sun-

https://torontosun.com/news/national/ca ... new-report

Bit of a myth.

Statistics show that the number of Canadians using US healthcare services is minuscule, single digits even, even in areas close to the US/Canada border. Most Canadians use US healthcare for emergency care (ie Canadian tourists in the US who had a medical emergency and needed to closest care, not Canadians flocking across the border to get elective surgery as Canadian wait times are too long).

https://www.aarp.org/politics-society/g ... -care.html

This debunks one of the biggest talking points from US universal healthcare opponents

There is a lot of medical tourism to the US, though. Elective and experimental treatments for those who can afford them.

For more routine procedures the most part coming from the Caribbean LatAm, Africa, etc. Countries without a solid health system in the first place.

JJJ wrote:

There is a lot of medical tourism to the US, though. Elective and experimental treatments for those who can afford them.

Yes, that is one of the benefits of the capitalistic US system. If you have the money, the US medical system is brilliant for you, if not, then it is sub-par. And that is a choice society makes. A system that delivers for the happy few, or a system that works for the vast majority.

These kinds of statistics baffle me:
US: $10,966
Comparable Country Average: $5,697

(Health consumption expenditures per capita, U.S. dollars, PPP adjusted, 2019)



source

As you can see, the US is quite exceptional with its cost, yet it doesn't deliver the results in a longer lifespan (is shorter) or a more healthy population. This should shock US voters and demand change. Pay more, receive less is. not the American way, or is it?

JJJ wrote:

There is a lot of medical tourism to the US, though. Elective and experimental treatments for those who can afford them.

For more routine procedures the most part coming from the Caribbean LatAm, Africa, etc. Countries without a solid health system in the first place.

That’s for those one in a million type experimental treatments as a last ditch effort when everything else has failed. It’s almost a functions of research science, not healthcare.

When we say healthcare we mean the meat and potatoes stuff that makes up 99.99% of medical services.

Heart disease treatment, Insulin for diabetics, Chemotherapy for cancer, Broken bones, influenza, childbirth, hip replacement, MRI, ambulance calls etc.

It’s that basic stuff the rest of the world does so much better than America. You can access those basic services without potentially going bankrupt.

And even then some of the world leading centres aren’t in America. Remember when one of those most right wing politicians in America, Rand Paul, went to Canada for Hernia surgery as it was a hospital in the Canadian Socialist healthcare centre that was recognised as having the world’s best Hernia centre and can be accessed by Canadians under their universal care system for free?

Pi7472000 wrote:

LabQuest wrote:

Pi7472000 wrote:

With Democrats controlling the house, senate and White House will they push for universal healthcare before the 2022 midterms? We need universal healthcare in the U.S. I think Democrats will still control all three branches after the midterms due to the rhetoric and policies on the right. Will universal healthcare be proposed or will it be stopped by the conservative Democrats in the senate in WV and AZ?

The democrats are going to get crushed in the midterms. The controlling party always looses seats at the midterms.

The reason universal healthcare isn't more popular is because most people have affordable, comprehensive insurance that covers their medical costs at a reasonable rate.

Not in 2022. People did not like the actions or policies of Trump or conservatives and these midterms will not follow history. Democrats are still popular in polls and it will be hard for Republicans to win. Many Americans face crippling medical debt and do not have affordable, comprehensive insurance. We need a new system that provides free healthcare to any person who needs it. Health care is a human right and people should not have to sacrifice their economic well being to get health care.

Like I stated, Democrats could have passed Universal Health care in 2010, no one could stop them. I am sure there are a dozen Liberal Think Tanks on Pennsylvania Avenue that could produce an outline for a bill. Instead they passed some hybrid convoluted mess. I have mentioned two constituencies of the Democratic Party that did not want Universal Healthcare. Are there other constituencies in the Democratic Party against it, maybe. That is Political reality. And change the stupid messaging. "Medicare for All" is not appealing.

Doctors would love not to pay malpractice insurance under Universal Healthcare, would be interesting to compare their income under either plan.

Kent350787 wrote:

Australia, with a similar federated system to the USA, has a national register of medical practitioners, even where the regulator may be state based. With the Medicare system, many doctors recieve some payment direct from the Commonwealth government for services.

It's not unusual for General Practitioners in particular to become virtually unemployable if they lose their Medicare provider number due to fraud.

With the Australian system, GP visits are either heavily subsidised, or are 'bulk billed', meaning there is no cost to the patient, depending on the GP practice. If you do have to pay, it's normally only $20-$30 or so. Most GP practices are now corporate-run, the days of the single Doctor, or small partnership practice are almost over. Medications are also heavily subsidised. The public system also covers the cost of pathology, and medical imaging. Private insurance here only covers hospital visits, and things like dental or physio if you also have 'extras' cover. For major surgery, it's not unusual to be treated in a public hospital, as a private patient. Also, most surgeons operate in both the public & private systems.

The only time you'll see a 'go fund me' situation with medical expenses in Australia, if it's a final-shot situation where the medication might be 'experimental', and not subsidised, experimental-type surgery overseas, or if someone's burnt through their sick leave. Very rare to see these situations here though.

william wrote:

A Universal Healthcare or Medicare for All plan is going to come from the Democratic Party. That Party is made of various lobbies and groups. Simply put, not all the players in the Democratic Party are down with Universal Healthcare.

I can't disagree here. The US in reality is divided into 3 maybe 4 political parties in reality based on ideology. The fact that the democrats have absorbed centre-right, traditional left and progressive isn't a good way to get things done.

frmrCapCadet wrote:

If a country has a decent social safety net lawsuits are not nearly so important nor likely.

How dare you cost lawyers jobs

william wrote:

Pi7472000 wrote:

LabQuest wrote:

The democrats are going to get crushed in the midterms. The controlling party always looses seats at the midterms.

The reason universal healthcare isn't more popular is because most people have affordable, comprehensive insurance that covers their medical costs at a reasonable rate.

Not in 2022. People did not like the actions or policies of Trump or conservatives and these midterms will not follow history. Democrats are still popular in polls and it will be hard for Republicans to win. Many Americans face crippling medical debt and do not have affordable, comprehensive insurance. We need a new system that provides free healthcare to any person who needs it. Health care is a human right and people should not have to sacrifice their economic well being to get health care.

Like I stated, Democrats could have passed Universal Health care in 2010, no one could stop them. I am sure there are a dozen Liberal Think Tanks on Pennsylvania Avenue that could produce an outline for a bill. Instead they passed some hybrid convoluted mess. I have mentioned two constituencies of the Democratic Party that did not want Universal Healthcare. Are there other constituencies in the Democratic Party against it, maybe. That is Political reality. And change the stupid messaging. "Medicare for All" is not appealing.

Doctors would love not to pay malpractice insurance under Universal Healthcare, would be interesting to compare their income under either plan.

I remember in 2009 when the Obama administration was negotiating this. One old lady said "Don't get your government hands on my Medicare"

Medicare along with Social Security remain two government programs that consistently poll well and this just takes will to be expanded to even 50+.
Healthcare needs are exponentially more as you age. If you are generally healthy you cost the system essentially nothing until 50 or 60 then your costs increase exponentially.

It would make sense to have a private marketplace for those who cost the least in the system as long as they aren't bankrupted by a need that can blindsight anyone. Car accident, cancer, catastrophic injury etc.

StarAC17 wrote:

It would make sense to have a private marketplace for those who cost the least in the system as long as they aren't bankrupted by a need that can blindsight anyone. Car accident, cancer, catastrophic injury etc.

No, that would not make sense.

The insurance companies would love your proposal though. They would collect money from those that are least likely to make claims. By the time their customers start making claims, the insurance companies can kick them to government healthcare. The insurance companies would make even more money then now.

Just as with social security and pension plans, you need the young to pay into the healthcare fund to make it affordable. Or the healthcare fund has to be financed through the general budget, which makes future cuts to the healthcare budget more likely.

petertenthije wrote:

StarAC17 wrote:

It would make sense to have a private marketplace for those who cost the least in the system as long as they aren't bankrupted by a need that can blindsight anyone. Car accident, cancer, catastrophic injury etc.

No, that would not make sense.

The insurance companies would love your proposal though. They would collect money from those that are least likely to make claims. By the time their customers start making claims, the insurance companies can kick them to government healthcare. The insurance companies would make even more money then now.

Just as with social security and pension plans, you need the young to pay into the healthcare fund to make it affordable. Or the healthcare fund has to be financed through the general budget, which makes future cuts to the healthcare budget more likely.

In Australia, private healthcare is heavily subsidised by the Commonwealth, with a 30% discount on memberships fees funded to the insurer. People taking out private health insurance in their 30s rather than 20s also pay a sliding scale rate penalty.

Even with these incentives/disincentives, private healthcare in Australia continues to lose coverage.

Funny, I remember when Obamacare was being argued, why not just full on Universal. One of the sticking points was malpractice. The trial lawyers are a BIG donor to Democrats, and they did not want that gravy train to go away. How does malpractice work under Universal Healthcare? What role do the lawyers have in Universal Healthcare?

Why do so many Canadians and Europeans come to the US for treatment? Its expensive, I go to Mexico for dental because of the quality and price.

In the US there will always be attorneys who will work with you on filing a malpractice suit, regardless of the health insurance system. Jurors will also listen with care when presented with gross malpractice. You can go "universal" and keep a decent tort system, you Judy need to ensure that the new laws don't block legitimate legal actions.

For the US, the best initial approach would be Medicaid For All. That absorbs a chunk of there federal costs of health care and folks who want better can add private insurance on top off that. Folks like my Better Half and I can keep our Medicare Insurance as well as our State Farm Plan F Supplemental insurance.

Taking that approach guts the costs of private insurance. In Australia zI had a private policy with MediBank Privaate, which was on top of Public Medibank. My monthly premium was $88. That's; a MONTH. When I needed a root canal on a business trip there it costs just over A$600, which was comparable to US costs. After payng the Dentist (for a very good job) I took my receipt to a MediBank Private store front, walked I, filled out a form and took it, with my receipt, insurance card and ID to s live teller. This very nice lady checked the stuff I gave Cher and immediately pulled out the cash. I got everything back - no co-pays, no deductions, just the exact same amount I paid for the treatment. And this was on the way to my hotel room!

How long will a US insurance company take to pay your claims? How much will be taken out fo your cash for deductible and other crap? And we both know that it will cost a hell of a lot more than $88 a month..

As for why people come here for treatment, you're talking about RICH people. Normal folks get their care at home.

And the quality at home can be pretty good. Ever hear of total hips? Developed in the UK and one of the best local bone docs here went to the UK to learn how to do them. My wife (a Physical Therapist) went in to observe the first scheduled total hip in order to plan the rehab plan. That was in 1971 (IIFC) and they were using British instruments, devices and training. The lucky Brits were able to get their total hips free with their public health. Bit more pricy I the US, eh what?

I am a big supporter of Medicare for all. As much as many on the right would like you to think it takes away freedom I believe just the opposite. Being tied to employer based healthcare has actually taken away some of my freedom, because the insurance companies are telling me who I can and can't see as a doctor...which troubles me in so many ways.

As for the original theme of the thread, as long as the Democratic party from a national level is run by the neo-liberal wing you are never going to see universal healthcare in this country in our lifetime. Richard Neal is the chairman of the House Ways and Means committee, and he is a major recipient of campaign money from the health insurance industry. He singlehandedly quashed a bill that would have paved the way for cheaper drug prices. He is as corrupt as they come. Yet, when he was primaried, somehow it became acceptable for Democrat elites to run homophobic smears in order to defeat his primary challenger. And the big money and the democratic establishment doesnt want it either and fears people who will fight for it. That is why they went all in on defeating Nina Turner in Ohio. That is why they didn't pass it when they had a super majority in the senate and a president who supposedly supported it. Instead they passed a bill that while it did some good things, it actually made a lot of our healthcare problems worse but it gave the illusion that Democrats cared about this issue and that Republicans didn't (Which they actually don't)

Another reason you wont see it is look at where the blue areas of the country are now. Mostly urban areas where most of the big money resides. Massachusetts is one of the Bluest states in the country, but with the hospitals in the Boston area, healthcare is one of their biggest industries. What happens to that industry if M4A were adopted? (Interestingly enough, Stephen Lynch, a democratic congressman from MA, was one of the few DEM no votes on Obamacare). In New York city, much of the money and power lies with Wall Street. Need I say more. New Jersey is just an extension, where many on Wall Street actually live. MD and VA are full of healthcare lobbyists fighting for the status quo. The Democratic politicians cater to these people, and not the people. This is why we don't have a 15 dollar minimum wage. This is why labor unions aren't stronger. This is why bad trade deals were passed. I could go on and on. And the republican politicians in office are even worse, and don't even try to hide it quite frankly.

So the USA are on the way to leave (in part) the Wild Wild West and to reach the date "15-Jun-1883"....cool.

Or will also the dental work been included, so USA will directly jump to the 01-Jan-1914?

( and if you do not know, I am talkin about: Sorry, for the 1914, you will have to go to the German wiki site, I will not link, link is left on the wiki page).
https://en.wikipedia.org/wiki/Healthcare_in_Germany#1883

apodino wrote:

I am a big supporter of Medicare for all. As much as many on the right would like you to think it takes away freedom I believe just the opposite. Being tied to employer based healthcare has actually taken away some of my freedom, because the insurance companies are telling me who I can and can't see as a doctor...which troubles me in so many ways.

I live in a country with Medicare for All. I can see any doctor I want, there’s some private clinics that charge an extra fee but most doctors are in the public system so no charge, and you get a partial rebate at the private clinics anyway.

I have the freedom to never worry about how I will pay for medical bills.

I have the freedom to go to almost any doctor I want (unless they’re already seeing another patient of course!) at any time I want (can usually get a booking for same day or next at the latest).

I have the freedom to know I’ll almost never have to be admitted to hospital because of a gunshot wound.

I have the freedom to be able to quit my job and know I’ll still have full healthcare coverage.

When their leaders tell Americans universal healthcare will take away your freedom they mean it will take away the freedom of the private insurers (who bribe politicians to repeat their talking points) to rob the American public blind.

sierrakilo44 wrote:

apodino wrote:

I am a big supporter of Medicare for all. As much as many on the right would like you to think it takes away freedom I believe just the opposite. Being tied to employer based healthcare has actually taken away some of my freedom, because the insurance companies are telling me who I can and can't see as a doctor...which troubles me in so many ways.

I live in a country with Medicare for All. I can see any doctor I want, there’s some private clinics that charge an extra fee but most doctors are in the public system so no charge, and you get a partial rebate at the private clinics anyway.

I have the freedom to never worry about how I will pay for medical bills.

I have the freedom to go to almost any doctor I want (unless they’re already seeing another patient of course!) at any time I want (can usually get a booking for same day or next at the latest).

I have the freedom to know I’ll almost never have to be admitted to hospital because of a gunshot wound.

I have the freedom to be able to quit my job and know I’ll still have full healthcare coverage.

When their leaders tell Americans universal healthcare will take away your freedom they mean it will take away the freedom of the private insurers (who bribe politicians to repeat their talking points) to rob the American public blind.

I know, seeing these endless discussions is like receiving signals from another planet.
In the 21 years of treatment since being diagnosed with Rheumatoid Arthritis, I take to control it a cocktail of medications, since this is a lifetime, ultimately progressive condition, in my case these are free prescriptions. As are the ones for the moderate Epilepsy since 1988, which made several comebacks in 2015-2018, with different meds, under control since.

Today it's been hot and sunny here in the UK, I walked across Cranford Park, near LHR, across the heaths and the Hillingdon Trial, to Hayes, a bit of shopping and home. Walked about 5 miles. The idea that I could have done this when what turned out to be the Arthritis and early in the treatment, over 20 years later on reflection seems amazing.
But I followed their advice, are very disciplined with taking the meds, the main one Methotrexate, is an anti cancer, immune system suppressor since RA is caused by an over active immune system. But it requires blood tests about every two months, you have to avoid alcohol, so I have been teetotal since taking it. Small price to pay.

But in all of the above, no monetary concerns. No being forced to do things, plenty of accessible advice.
Every LIE told by US political/business interests debunked, not just by me, but millions of others, every day, since July 5th 1948.

Everyone I know takes the advice they are given, they all, aside from Mother who was 18 when the NHS came into being, cannot remember any other way and yet none of us takes it for granted.
Which at indicates another lie, that such systems, however they are organised, makes for feckless people who abuse the services. Sure some here do, however this is outweighed by how much more effective at preventative treatments/services public systems are. By design, for their own smoother running and cost control it's in their interests too.

Lot's of regular consultation, even if only by phone since Covid, (that drug also meant I was early on the vaccine list, 1st in early Feb, 2nd in April).
Speaking of which, unlike the hugely expensive Track and Trace hived off to friends of the Clown Cartel in government, the vaccination program wholly administered by the NHS was the one of great success. As a Private vs Public health system demonstration, it speaks volumes. Not MBA BS, a real world once in a century emergency.

Just over a decade ago, a TV show on a small US network starring a quite successful middle aged actor started to get traction and was becoming more of a hit, worldwide too.
Much comment outside the US of viewers was that 'Breaking Bad could not be set here, viewers that is in other first world western nations since no one would be faced with not being able to afford the needed medical care.

So how will the democrats pull this off at the Federal level, expand Medicare and Medicaid or create a new federal agency?

par13del wrote:

So how will the democrats pull this off at the Federal level, expand Medicare and Medicaid or create a new federal agency?

Medicare or Medicaid program would provide the venue to for core care and my preference is to go with Medicaid because it involves no premiums. Let Medicare stay the "premium" government health insurance. If individuals want something better than Medicaid then they can pay for Medicare (like I do each month) and maybe add a supplemental policy, like Plan F from State Farm that I also have.

While the insurance companies will scream louder than before it does provide them with a very competitive position because universal health care eliminates a lot of expensive costs - like hospitals treating everyone and then adding those costs to paying patients. That override ends up at the insurance companies. Eliminate that huge costa and insurance premiums can be dramatically cut - if they want to.

So moving everyone not covered with Medicare onto Medicaid. Use their heath database to identify patients to send cards and let the individuals sty there, or move most of the Medicaid to private insurance.

Financing that program would be within FICA contributions.

par13del wrote:

So how will the democrats pull this off at the Federal level, expand Medicare and Medicaid or create a new federal agency?

Aside from a very select few democrats, the democrats really have no interest in pulling this off at the federal level and therefore you will never see it unless there are serious changes to party leadership. (Which doesnt seem likely because many democratic primary voters believe what the media tells them that they have to vote for centrists if they want to win.) First of all, Biden specifically kept saying during the Democratic primary that this was not an option. Second of All, behind the scenes Barack Obama sees this as destroying Obamacare, which means that the only accomplishment he can boast is getting Osama Bin Laden. Third of all, the Health Insurance lobby and the health care lobby are in the pockets of some very powerful Democrats in Congress, noteably Richie Neal, Maxine Waters, and Jim Clyburn. There is no way the democrats are going to do anything that rubs these special interests the wrong way. If you watch any progressive talk show or even some of the YouTube outlets that are outside the mainstream (Young Turks, Secular talk, Breaking Points, etc) they repeatedly hammer these issues home.

What you need to do to get this change done is start running candidates in Democratic Primaries who are for this stuff, and don't let the DC establishment hand pick candidates the way they do now. Nina Turner would have been great, except as soon as she started polling well, all the establishment money came in and that was that. Bernie was well on his way to the democratic nomination until Barack Obama behind the scenes coordinated a massive pull out that told everyone to get out on super Tuesday. Alex Morse tried to primary the aforementioned Richie Neal, but if you are outside the establishment, it is perfectly acceptable to run homophobic smears even in a democratic primary. The other thing you can do is start acting like the Tea Party. Make life hell for Nancy Pelosi and company, the way the tea party did for Bohener and Ryan. The sad fact is, the squad talks a good game, but doesnt use their power and just falls in line like good little sheep and does what they are told.

I live in Neal’s district, I’ve dealt with his staff on local military issues. He’s as crooked as a country road, BUT, he won due to his seniority in Congress. Bring home the bacon and brag about it, yes, they slammed Morse, but being gay had nothing to do with his losing. It would have been an advantage here. He lost because he was inexperienced, lacked prestige and seniority. As most challengers do.

I was on BC/BS and several company-sponsored plans before Medicare. I’d go back and pay the premiums for my last High-Deductible HSA plan in a New York minute, if I could. Sadly, making decisions has been taken away if you’re over 65.

Ken777 wrote:

par13del wrote:

So how will the democrats pull this off at the Federal level, expand Medicare and Medicaid or create a new federal agency?

Medicare or Medicaid program would provide the venue to for core care and my preference is to go with Medicaid because it involves no premiums. Let Medicare stay the "premium" government health insurance. If individuals want something better than Medicaid then they can pay for Medicare (like I do each month) and maybe add a supplemental policy, like Plan F from State Farm that I also have.

While the insurance companies will scream louder than before it does provide them with a very competitive position because universal health care eliminates a lot of expensive costs - like hospitals treating everyone and then adding those costs to paying patients. That override ends up at the insurance companies. Eliminate that huge costa and insurance premiums can be dramatically cut - if they want to.

So moving everyone not covered with Medicare onto Medicaid. Use their heath database to identify patients to send cards and let the individuals sty there, or move most of the Medicaid to private insurance.

Financing that program would be within FICA contributions.

The problem is that almost every Medicaid program is ran/administrated by the private health insurance companies.

Same with Medicare, the US government doesn't have the capability, they hire almost everything out to the private insurance companies. This includes enrollment and claims processing. Sure, the federal government has CMS, but really they issue very broad guidelines and leave it up to the insurance companies to interpret.

The unfortunate truth is that the US government does not have the ability to stand up a Medicare for all without having to outsource everything anyways. It's part of why Obama tried the mandate/subsidy route. It pacified the health insurance companies that got to keep their lucrative fully insured business (self insured business is easy money, but less lucrative) but also in theory made it easier for those that couldn't afford it to get insurance through expanded Medicaid and subsidies.

The real crime is HDHPs, they are great when you are young and don't go to the Dr for a few years and can accumulate a large sum in your HSA or if you need a good tax sheltered place to stash some money and have the option to pull out for medical expenses should the need arise. The 35 year old mom with a couple of kids making 60k? That 8k deductible is probably hard to handle if even one kid has a medical need on a regular basis.

In reality, they need to get rid of the HDHP requirements for an HSA and roll the Medical FSA and HSA programs into the HSA program.

This doesn't even begin to get into PBMs including specialty and infusion services.

Tldr, no easy answer and any changes are going to need to happen in stages.

tys777 wrote:

Ken777 wrote:

par13del wrote:

So how will the democrats pull this off at the Federal level, expand Medicare and Medicaid or create a new federal agency?

Medicare or Medicaid program would provide the venue to for core care and my preference is to go with Medicaid because it involves no premiums. Let Medicare stay the "premium" government health insurance. If individuals want something better than Medicaid then they can pay for Medicare (like I do each month) and maybe add a supplemental policy, like Plan F from State Farm that I also have.

While the insurance companies will scream louder than before it does provide them with a very competitive position because universal health care eliminates a lot of expensive costs - like hospitals treating everyone and then adding those costs to paying patients. That override ends up at the insurance companies. Eliminate that huge costa and insurance premiums can be dramatically cut - if they want to.

So moving everyone not covered with Medicare onto Medicaid. Use their heath database to identify patients to send cards and let the individuals sty there, or move most of the Medicaid to private insurance.

Financing that program would be within FICA contributions.

The problem is that almost every Medicaid program is ran/administrated by the private health insurance companies.

Same with Medicare, the US government doesn't have the capability, they hire almost everything out to the private insurance companies. This includes enrollment and claims processing. Sure, the federal government has CMS, but really they issue very broad guidelines and leave it up to the insurance companies to interpret.

The unfortunate truth is that the US government does not have the ability to stand up a Medicare for all without having to outsource everything anyways. It's part of why Obama tried the mandate/subsidy route. It pacified the health insurance companies that got to keep their lucrative fully insured business (self insured business is easy money, but less lucrative) but also in theory made it easier for those that couldn't afford it to get insurance through expanded Medicaid and subsidies.

The real crime is HDHPs, they are great when you are young and don't go to the Dr for a few years and can accumulate a large sum in your HSA or if you need a good tax sheltered place to stash some money and have the option to pull out for medical expenses should the need arise. The 35 year old mom with a couple of kids making 60k? That 8k deductible is probably hard to handle if even one kid has a medical need on a regular basis.

In reality, they need to get rid of the HDHP requirements for an HSA and roll the Medical FSA and HSA programs into the HSA program.

This doesn't even begin to get into PBMs including specialty and infusion services.

Tldr, no easy answer and any changes are going to need to happen in stages.

This, this, this. The devil is in the details and healthcare is very complex as currently structured and administered.

Medicare contracts with private companies, true, but it keeps payouts to medical providers at a very high percentage compared to private companies. This is generally acknowledged by all. Here is a link checking Sanders claims. Finding actual costs in huge systems like Medicare, private insurance, Boeing, or Airbus are complicated. An accountant friend was astounded when I said it was difficult to say how much a plane cost. Anyway, https://www.politifact.com/factchecks/2 ... surance-a/

frmrCapCadet wrote:

Medicare contracts with private companies, true, but it keeps payouts to medical providers at a very high percentage compared to private companies. This is generally acknowledged by all. Here is a link checking Sanders claims. Finding actual costs in huge systems like Medicare, private insurance, Boeing, or Airbus are complicated. An accountant friend was astounded when I said it was difficult to say how much a plane cost. Anyway, https://www.politifact.com/factchecks/2 ... surance-a/

Actually, payouts to providers are higher with private insurance, not medicare/Medicaid. Your link talks about administrative costs, which is completely different than payouts to providers. Administrative cost is based on percentage of premiums collected per the ACA. Also, the administrative cost of Medicare is misleading because it doesn't account for the administrative cost for those contracted private insurance companies. Also, as the article points out, the government is passive with claims and doesn't reaearch/go after FWA quite like private insurance companies.

Again, it's not as black and white as either side in this debate tries to make it out to be.

LabQuest wrote:

Pi7472000 wrote:

With Democrats controlling the house, senate and White House will they push for universal healthcare before the 2022 midterms? We need universal healthcare in the U.S. I think Democrats will still control all three branches after the midterms due to the rhetoric and policies on the right. Will universal healthcare be proposed or will it be stopped by the conservative Democrats in the senate in WV and AZ?

The democrats are going to get crushed in the midterms.

Thanks to the incompetency of Biden, for the most part.

Aaron747 wrote:

This, this, this.

True, but we have to address all the issues anyway. The Aussies have managed to address these issues, have significantly lower costs to the patients AND have far better outcomes than the US. Well, about 15 modern countries deliver better outcomes to patients at a lower cost than the US does.

As far as challenges go, When I was I the Navy in the 60s I sat in Japan and watched the US land on the moon. That was on my second ship - the first one was a nuclear powered cruiser with a 3D radar (just like the Enterprise) and Talos, a long range missile that hit tangos at abt 70 miles. Lots of challenges for the US right there and we were able to address it in those days. We should be able to do this, this and this (and that or that or that) as there is a lot work already done. The question should be Are we so greedy that we done want health care to be available to everyone? Just let them die, but not in your backyard?

Personally, I'm on Medicare and also pay for a Supplemental policy and only make one payment to a Dr (a $25 fee for dilation of my eyes once a year). The rest is covered by one policy or the other. Best example I now of is my two cancer drugs - the daily pills are $30K a month and my infusion every 3 weeks is $50K. (I had that infusion today and the $50K includes tapping my port, running the blood tests, flushing the port and the 30 minuted of the actual infusion. I'm already rescheduled for another infusion in 3 weeks.)

It really doesn't matter if the government pays private companies to process claims as the key is to eliminate health care costs for patients without issuance. Those costs are dumped onto insurance companies and are added to insurance premiums that you or your employer pays.

Hey, I'd like Universal Legal Care too.

I do like like the idea of the Govt. setting the fee that can be charged for a procedure, whether it's done by the corner clinic, or by the Chief Surgeon at the Big Hospital...

Ken777 wrote:

Aaron747 wrote:

This, this, this.

True, but we have to address all the issues anyway. The Aussies have managed to address these issues, have significantly lower costs to the patients AND have far better outcomes than the US. Well, about 15 modern countries deliver better outcomes to patients at a lower cost than the US does. .

Australia also has the novel history of introducing universal health care, ditching universal health care (but keeping the largest insurance provider in public ownership), then reintroducing universal health care, admittedly under a hybrid model. The challenge for successive Australian Conservative governments has been to find novel ways to prop up the private health insurance industry, with most yopung people choosing to go with the Medicare coverage.

Aaron747 wrote:

Australia also has the novel history of introducing universal health care, ditching universal health care (but keeping the largest insurance provider in public ownership), then reintroducing universal health care, admittedly under a hybrid model. The challenge for successive Australian Conservative governments has been to find novel ways to prop up the private health insurance industry, with most young people choosing to go with the Medicare coverage.

The Aussie's went with Medibank paid for with a percentage of individual earnings - like the Yanks paying with FICA "contributions". One important distinction Down Under is that Medibank retained the fees for traditional GP visits as well as the costs of Prescriptions - and they kept those costs very low. That eliminates two significant costs for private health insurance companies, which lets me get a private policy for $88 a month.

In truth, young people can generally do well with only Medibank and no private coverage. If there is a significant health problem the head to one of the many public hospitals and there is no costs. The full hospital bill is covered by Medibank, including prescriptions and Doctor fees. That's it - no BS from private insurance companies.

As you get older the private insurance can be important - and the costs is pretty cheap, especially because MediBank continues to cover basic GP visits and Prescriptions.

In terms of propping up the private insurance companies these days I don't have a clue. When we lived in Perth we went with HBF and they did OK. Traveling on business years letter I went with Medibank Private as it appeared a good deal (it was) . My basic instinct would be for the private copies to look really close at their budgets snd keep expenses sane - especially Executive Compensation.