Throw-away because I like to keep my financial details personal.
I'm self employed and have been for about 15 years. We purchase health insurance from the state exchange. Prior to this, I'd purchased it as an individual directly from the insurers, or used the plan my wife had through her employer. Those options are no longer available to us, so we use the state exchange.
My family's health insurance rates increased 17% last year. This year, my state has approved an increase of 27% for the provider I use and a 31% increase for one of the other providers in the state.
To insure our family of four, we'll pay around $25,000 for insurance before a dollar is spent on deductibles, co-pays or other associated costs. We're generally all healthy. Have no pre-existing conditions to speak-of. We earn more than the level where you qualify for any subsidy.
It's not just unsustainable, it's absurd! $25,000 USD is most of, if not the entirety, of the TOTAL income taxes many people pay in other OECD nations. How are these other nations providing all of the functions of government, including universal health care, for what Americans are paying just for insurance? This shouldn't be a partisan issue - even the most conservative of Americans should be outraged that we are being ripped off.
I took my child in for a regular 15 minute doctors appointment recently and the cost of seeing the provider (no tests) was $350. Does it really cost $1,400/hour to operate a medical clinic? Google tells me that the average GP salary in the US is $189,000 ($90/hour), average salary for a nurse is $67,000 ($32/hour), and average for a receptionist is $27,000 ($12/hour). Add another nurse for administering shots/drawing blood and the total payroll per hour is about $166/hour. Where is the other $1,234/hour going?
I'm sure there are reasonable explanations for some of it (cost of the building, cost of medical equipment in the clinic, professional insurance, and maintenance on the fish tank) but the ridiculous cost of everything is the elephant in the room that no amount of "cracking down on fraud" or "incentivizing healthy behaviors" will solve.
As an immigrant to the US, it's maddening. It just doesn't have to be this way, there is half a century of evidence showing that alternative systems are cheaper and more effective. I also look at that $9,800/year per capita and wonder what our economy looks like if everyone had an extra $2-4,000/year in their pocket. Or if we eliminated the burden of health care from businesses and individuals trying to start a business.
Very sorry to hear about the burden you and your family are bearing.
I hope we can devise an alternative to the current system, as $25,000 is more costly than just buying everything up front!
I did some research and found that an apendectomy is one of the most important things insurance can pay for, as it is sudden, life threatening, and generally not easily controlled by lifestyle choices.
The quoted cost of an apendectomy from a variety of different countries and hospitals?
"Between $3,000 and $150,000 USD"
It might as well be "blank check", if this price gouging is allowed in the US.
Sometimes I think other nations should be a bit more pragmatic in generating revenue from the huge costs of healthcare in the US.
In the UK we can charge foreigners for use of our NHS. I believe that using this private service, is significantly cheaper than the equivalent in the states. Flight costs are trivial when looking at US healthcare costs. Of course this can only deal with non-urgent and (relatively) well off people.
It's worse than that. With the biologics on their way to market today, and with guidelines changing, we could be treating relatively common diseases with absurdly expensive drugs, and insurance companies will have no choice but to cover these therapies. That will in turn cause premiums to skyrocket.
Something has to be done as status quo is not working. The idea that one could go bankrupt if they don't have health insurance or god forbid are hit with an illness such as Cancer is ridiculous.
Is single payer the answer ? Frankly I don't know. But as Americans, we live in fear when it comes to healthcare. If you have a job where your employer provides great coverage, then you are ok for the time being. But what if you lose that job ? What if you want to start your own business ? What if you want to be self employed ? What if...there are more like this.
Ok lets pay out of pocket then. Fine. If you have a family of 4 or more, be ready to shell out anywhere from $1500-$2000/Month (yes per month) to get a decent enough plan that doesn't have crazy deductibles and out of pocket limits. Can't afford this ? Oops sorry, you are on your own (some exceptions if you can prove you are extremely poor and get medicaid etc)
Fear. That is the issue I have. I don't want to be scared and I am not a dramatic person. But it is scary. Just the thought of getting sick and not having insurance.
Not to mention too many cooks. Don't believe me ? See below:
1. The Patient (so far so good)
2. The doctor/hospital (still good)
3. Insurance Company (things start to get worse. Too much power)
4. Doc's/Hospital Billing Company and their own process (now this is really idiotic). I once ran for a month to get billing errors corrected (not kidding).
Ideally, a system should only have the top 2 mentioned above. Single payer can certainly replace #3 with Govt. but that part is the tricky one. Part 4 should not even exist. But hey, medical billing/coding is an entire Business in the US.
And the ironic thing is, the fear and anxiety caused by healthcare costs (along with the many other things that everyone middleclass and down is anxious over) makes us less healthy.
This is one reason that I am glad to have my own policy (although if the ACA gets repealed, there is no guarantee that I won't get kicked off of it eventually) since my company is too small to have a group plan. I have private health insurance (with a stipend from my employer) and private disability insurance as well. I pay significantly more than I would for a group plan, but I also have some peace of mind knowing that losing my job doesn't directly put that in jeopardy (assuming I can still make my payments that is).
> Something has to be done as status quo is not working [for everyone].
FTFY.
It's working for me in a way that only one other healthcare system would be able to help me (and even that healthcare system can only help me because the US healthcare system developed the medical advances I benefit from). If I moved abroad, I would have to keep a US health insurance plan and return to the US regularly to get the treatment I need here that isn't available in the rest of the World.
I'm still waiting for proponents of single-payer healthcare to take the effort to find out what works about the current system and who it works for. If they don't figure that out, they won't propose a solution that maintains the benefits of the current system.
The single-payer system being proposed will almost certainly reduce efforts to improve medicine that would improve my health issues in the future.
Isn't it in everyone's best interest to revamp healthcare? Who exactly loses here? Rich people in the health industry? I don't get it.
I read somewhere that half a trillion a year[1] would be saved by single-payer. It's probably an exaggeration, but even if its an order of magnitude too high... sounds good to me.
Absolutely, except for the wealthy private interests like pharmaceutical companies and insurance.
Polls show the majority of Americans have favoured a single-payer system now for decades. This was the case under Reagan even, and still is today.
This shows the degree to which the US is not in fact a true democracy, but more of an oligarchy. However things can change if there is enough public pressure. People just need to be organized.
I have read that the US spends 18% of GDP vs. most other countries spending around 10%. That means the health industry is at risk of losing 8% of GDP which at 18 trillion GDP is around 1.5 trillion.
People say this money is being wasted but it's going somewhere and these people will fight for keeping it.
My take is that any kind of fair renegotiation removing the regulatory capture and the anti-competitive behavior allowed (and in some cases, required) by decades of lobbying would improve the situation. Single payer would work, free(er) market would work, but we're currently reaping the fruits of generations of entrenched political class for sale.
There's a lot of people that see the government do an awful job in so many areas (over budget, over time, etc), and worry that the same would happen with healthcare; _"Have you seen how poorly the government handles 'abc'? I don't want them in charge of my health, too"_
I'm somewhat of the mind that the government couldn't possibly do it worse than it's being done now. However, looking at the constant issues with VA healthcare, I'm not sure of my opinion either.
Rich people gain from research, new drugs, new equipment and new procedures. If the system spends more on poor people and common illnesses, it'll spend less on the things that benefit rich people.
Billionaires from around the globe fly to the Mayo Clinic in the USA. Why seek medical care in the USA? It spends more on the things that are good for the rich.
> Who exactly loses here? Rich people in the health industry? I don't get it.
You forget lawmakers reaping various lobbyist benefits, which is one reason why not much changes. Two sides bicker for a while to satisfy their constituencies, then compromise by doing nothing.
I lose here. I don't work in pharma, but I benefit from a drug developed in the US that is only available and approved for my condition in the US and one other country.
Not only will I lose here, but the future you will lose here as will the future everyone on the planet. Healthcare needs don't just exist in the present.
Healthcare is a racket. It takes advantage of our fear of death and suffering. It suggests it has solutions if you are willing to exchange your life savings for a few more weeks in $100k/ day ICUs.
I lean libertarian, but I have given up on the current system. I'd like to see all of the insurance companies and health care bureaucracy burned. This is an idea worth voting for Bernie.
I doubt that any real change is on the horizon as long as people keep confusing affordable health insurance with affordable health care. Obamacare was never the solution to the actual problem, which is unnatural pricing that is extracted under duress.
"The CEO has been under fire for taking the unprecedented step of transferring the patent of one of Allergan’s blockbuster drugs, the eye medication Restasis, to a sovereign Native American tribe as part of a bid to maintain monopoly control of the drug and its revenue."
"The Restasis patent was approved 15 years ago and was set to expire in 2014, but the Allergan deal is part of an attempt to renew the patent and extend the company’s control of the drug through 2024."
I like Sanders as much as anyone else, but can anyone who supports it explain how Single Payer is obviously better than expanding the current system to provide universal healthcare? It seems to me that single payer would require a radical overhaul(more than 100 million people leaving their employer given insurance) and huge tax increases that requires a level of political consensus among the public and Democrat majority in both houses not seen since The New Deal.
That's not even to mention the fact that more vulnerable Blue seats are up for grabs than Red in 2018. I just don't see the current roster of the GOP supporting anything the Democrats put forward, especially something as radical as medicare-for-all.
I don't know if single-payer is the way to go, but I don't think that short-term disruption is a valid argument against almost anything, if there is evidence of mid-to-long-term benefit.
Separation of healthcare benefits from employment seems to have significant improvement in mobility for employees, overall. I think we (US citizens) need to have a serious, substantive discussion about how we get there. Actually doing that has been made incredibly difficult because of the way any government involvement in healthcare has been portrayed in the political arena for nearly 100 years.
>That's not even to mention the fact that more vulnerable Blue seats are up for grabs than Red in 2018. I just don't see the current roster of the GOP supporting anything the Democrats put forward, especially something as radical as medicare-for-all.
The GOP is going to oppose anything the democrats put forward, so it makes political sense for the democrats to aim for the most "left" solution possible so in case of compromise they can still get a lot. They learned from their mistake with Obamacare.
>I like Sanders as much as anyone else, but can anyone who supports it explain how Single Payer is obviously better than expanding the current system to provide universal healthcare?
It's cheaper. Taxes will go up, but bills will go down by more (for most people.) The political difficulties are actually part of the point, it allows the Sanders wing to set a litmus test for more traditional corporate dems. The Hillary-wing of the party is fighting a war on two fronts, single-payer and economic issues are what progressives are flanking them with.
Other countries usually control prices either through... well, price controls, or by establishing a monopsony on basic healthcare (single-payer). If we're not willing to create price controls (doubt it) then that leaves single payer.
Single-payer is the most startup-friendly system available.
It moves variable health care costs entirely out of your HR and payroll systems. You can get more experienced employees when they aren't afraid to risk their family's health care on a job move. By reducing risk exposure there, the risk of salary vs equity becomes more attractive.
For most industries, definitely. It may make it much harder for startups in the medical space (if it becomes more difficult to get that single payer to pay them).
Until I can see the VA work successfully or Doctors being excited about TriCare, I don't think we should entertain this idea. Further, right now all parts of the government are being weaponized by Democrats and Republicans. The last thing I want is my healthcare being used a political leverage, even more than it has been since Obamacare was passed.
I went to a walk in clinic a few months ago to get antibiotics for a severe sinus infection and I have insurance. I had to pay a $50 copay. While I was waiting another customer walked up who did not have insurance and was charged $99. A few weeks later I was billed an additional $97 because my insurance refused some items.
The clinic is allowed to charge some customers more than others, that seems unreasonable. The root issue though is that health care is a for profit business.
While I understand that profits are what drives drug companies to assume the risk of new drug development, people should not be forced to decide between going to the doctor or dentist to get important medical help or paying the rent.
Many high cost procedures could be eliminated if they were caught earlier with affordable preventative care. Health care costs are further driven up by the hospital having to initially eat the cost of treating uninsured people.
Prior to obamacare both of my parents were uninsured due to being self employed and pre-existing medical conditions. In a span of a week my father had a heart attack and my mother shattered her arm (requiring surgery). Total cost was over $80,000. They of course could not pay that and defaulted.
Once Obamacare was introduced they both signed up and had insurance.
Long story short if you provide affordable options for people they will generally take it. Basic human decency states that the cost of medical care should never be prohibitive enough to stop people from seeking the care they need.
If Europe can make it work I see no reason the US cannot.
Want to hear something completely mind-blowing? I'm working on an issue regarding prescription drug benefit scoring. Whenever you fill a prescription, the pharmacy is required to share that information with certain entities, such as your insurance company. However, those entities then share it with data brokers.[0] Ever been turned down for health, or life insurance? Seen a premium spike? It could be because the prescription data brokers have rated you (based on your prescriptions) as a health risk. You cannot opt out of this. The only way to opt out is to never fill a prescription.
Whenever you apply for any type of health or life insurance, these brokers (think credit score for health) report a score based on the medications you take, have been prescribed but not filled, and those you've filled. You have no idea what's in the report, but you can request your report if you've been denied.
There is a sweet spot for businesses who have massive regulatory protection the way pharma does, and who want to maximize rent extraction from society as much as possible.
For big pharma, this peaked in the past few years. The Mylan lawsuit and the outrage about Martin Shkreli are flare-ups that signal that public outrage is on the horizon.
In terms of social benefit, the trade-offs are not optimal at all. We are overly risk-averse to the point where FDA bureaucrats needlessly hold up drug approval, yet once a drug is granted approval we are very slow to sound the alarm if it turns out that additional data shows unanticipated risks. For example, the risks of Vioxx (as with many other NSAIDS) were well known to physicians long before the drug was taken off the market.
There is no such thing as a single wise entity that can appropriately vet all drugs for maximal societal value. Different people have different levels of risk-aversion. Our system exists to maximize the winner-take-all aspect of intellectual property protection for pharma, not to maximize the benefits of innovation to society or maximally incentivize innovation.
Certainly, someone who is 80 might be more willing to try a new drug with unknown 20 year side-effects than the parents of a 10 year old. The single regulator model is deeply flawed and creates massive harm on both ends of this risk spectrum.
But there is no need for big pharma to worry. We have broad bipartisan support of massive, long-term sponsorship of big pharma companies. Unlike Martin Shkreli, these companies play a longer-term game and for the most part avoid embarrassing fiascos such as the one that impacted Mylan.
But yet, in spite of this, they are insulated from competition by regulators and manage to extract sweeter and sweeter deals. Note the way Mylan gradually ramped up the cost of epi-pens following ACA? Mylan was just trying to get its share of the pie. Other firms, like health insurance firms, got their piece of the pie "de-contenting" bronze plans and removing high deductible options from ACA. The government got its share by being able to claim credit for passing a landmark law, etc. Like tigers tearing chunks of flesh from a fallen gazelle, the powerful interests manage to get what they came for, which is why the ACA passed in the first place, they all knew/expected the benefits to occur. The only group who got a bad deal were Americans relying on the ACA who were not poor enough to get a heavily subsidized plan... these people just had a massively regressive additional tax.
I simply cannot understand why the following question is never asked, addressed or even acknowledged to be a valid question:
"What health plan are all senators and government officials on? If congress cares about healthcare "for all Americans" - then put every American on the same health plan they have, or force them to only be allowed to use ObamaCare or whatever plan it is that they offer the people."
> I think we’ve got to do things to bring that trust back
The cynic in me wants to say "like not making indecent amount of profits on the back of miserable people".
There is nothing wrong with turning a profit, which is healthy. But when profit maximization is the prime directive, well... you know what happens.
As other commenters have pointed out, single-payer works well enough in Europe (there are issues, but I doubt they are directly inputable to the single-payer policy). Of course, that's rather hard to understand for the fringe of the population that can't distinguish between socialism and communism, solidarity and reckless selflessness.
[+] [-] singlepayer|8 years ago|reply
I'm self employed and have been for about 15 years. We purchase health insurance from the state exchange. Prior to this, I'd purchased it as an individual directly from the insurers, or used the plan my wife had through her employer. Those options are no longer available to us, so we use the state exchange.
My family's health insurance rates increased 17% last year. This year, my state has approved an increase of 27% for the provider I use and a 31% increase for one of the other providers in the state.
To insure our family of four, we'll pay around $25,000 for insurance before a dollar is spent on deductibles, co-pays or other associated costs. We're generally all healthy. Have no pre-existing conditions to speak-of. We earn more than the level where you qualify for any subsidy.
This is unsustainable.
[+] [-] knz|8 years ago|reply
It's not just unsustainable, it's absurd! $25,000 USD is most of, if not the entirety, of the TOTAL income taxes many people pay in other OECD nations. How are these other nations providing all of the functions of government, including universal health care, for what Americans are paying just for insurance? This shouldn't be a partisan issue - even the most conservative of Americans should be outraged that we are being ripped off.
https://data.oecd.org/healthres/health-spending.htm - the US spends $9,800/year per capita, clearly an outlier, and yet we still can't cover everyone in a reasonable way?!
I took my child in for a regular 15 minute doctors appointment recently and the cost of seeing the provider (no tests) was $350. Does it really cost $1,400/hour to operate a medical clinic? Google tells me that the average GP salary in the US is $189,000 ($90/hour), average salary for a nurse is $67,000 ($32/hour), and average for a receptionist is $27,000 ($12/hour). Add another nurse for administering shots/drawing blood and the total payroll per hour is about $166/hour. Where is the other $1,234/hour going?
I'm sure there are reasonable explanations for some of it (cost of the building, cost of medical equipment in the clinic, professional insurance, and maintenance on the fish tank) but the ridiculous cost of everything is the elephant in the room that no amount of "cracking down on fraud" or "incentivizing healthy behaviors" will solve.
As an immigrant to the US, it's maddening. It just doesn't have to be this way, there is half a century of evidence showing that alternative systems are cheaper and more effective. I also look at that $9,800/year per capita and wonder what our economy looks like if everyone had an extra $2-4,000/year in their pocket. Or if we eliminated the burden of health care from businesses and individuals trying to start a business.
[+] [-] quuquuquu|8 years ago|reply
I hope we can devise an alternative to the current system, as $25,000 is more costly than just buying everything up front!
I did some research and found that an apendectomy is one of the most important things insurance can pay for, as it is sudden, life threatening, and generally not easily controlled by lifestyle choices.
The quoted cost of an apendectomy from a variety of different countries and hospitals?
"Between $3,000 and $150,000 USD"
It might as well be "blank check", if this price gouging is allowed in the US.
[+] [-] alva|8 years ago|reply
In the UK we can charge foreigners for use of our NHS. I believe that using this private service, is significantly cheaper than the equivalent in the states. Flight costs are trivial when looking at US healthcare costs. Of course this can only deal with non-urgent and (relatively) well off people.
[+] [-] frozenport|8 years ago|reply
[+] [-] nugget|8 years ago|reply
[+] [-] epmaybe|8 years ago|reply
[+] [-] Navarr|8 years ago|reply
[+] [-] rabboRubble|8 years ago|reply
[+] [-] codegeek|8 years ago|reply
Is single payer the answer ? Frankly I don't know. But as Americans, we live in fear when it comes to healthcare. If you have a job where your employer provides great coverage, then you are ok for the time being. But what if you lose that job ? What if you want to start your own business ? What if you want to be self employed ? What if...there are more like this.
Ok lets pay out of pocket then. Fine. If you have a family of 4 or more, be ready to shell out anywhere from $1500-$2000/Month (yes per month) to get a decent enough plan that doesn't have crazy deductibles and out of pocket limits. Can't afford this ? Oops sorry, you are on your own (some exceptions if you can prove you are extremely poor and get medicaid etc)
Fear. That is the issue I have. I don't want to be scared and I am not a dramatic person. But it is scary. Just the thought of getting sick and not having insurance.
Not to mention too many cooks. Don't believe me ? See below:
1. The Patient (so far so good)
2. The doctor/hospital (still good)
3. Insurance Company (things start to get worse. Too much power)
4. Doc's/Hospital Billing Company and their own process (now this is really idiotic). I once ran for a month to get billing errors corrected (not kidding).
Ideally, a system should only have the top 2 mentioned above. Single payer can certainly replace #3 with Govt. but that part is the tricky one. Part 4 should not even exist. But hey, medical billing/coding is an entire Business in the US.
[+] [-] semi-extrinsic|8 years ago|reply
E.g. in Norway, people mostly pay around 30% in tax, and 8.2 percentage points out of those 30 go towards free universal healthcare.
The Norwegian state's annual healthcare expenditure per capita is below $8000, for one of the highest quality systems in the world.
[+] [-] okreallywtf|8 years ago|reply
This is one reason that I am glad to have my own policy (although if the ACA gets repealed, there is no guarantee that I won't get kicked off of it eventually) since my company is too small to have a group plan. I have private health insurance (with a stipend from my employer) and private disability insurance as well. I pay significantly more than I would for a group plan, but I also have some peace of mind knowing that losing my job doesn't directly put that in jeopardy (assuming I can still make my payments that is).
[+] [-] Synaesthesia|8 years ago|reply
I think so, it works for European countries, and Canada, which are comparable in wealth to the US. I don’t see why not.
[+] [-] samstave|8 years ago|reply
[+] [-] vermontdevil|8 years ago|reply
[+] [-] malandrew|8 years ago|reply
FTFY.
It's working for me in a way that only one other healthcare system would be able to help me (and even that healthcare system can only help me because the US healthcare system developed the medical advances I benefit from). If I moved abroad, I would have to keep a US health insurance plan and return to the US regularly to get the treatment I need here that isn't available in the rest of the World.
I'm still waiting for proponents of single-payer healthcare to take the effort to find out what works about the current system and who it works for. If they don't figure that out, they won't propose a solution that maintains the benefits of the current system.
The single-payer system being proposed will almost certainly reduce efforts to improve medicine that would improve my health issues in the future.
[+] [-] _m8fo|8 years ago|reply
I read somewhere that half a trillion a year[1] would be saved by single-payer. It's probably an exaggeration, but even if its an order of magnitude too high... sounds good to me.
[1] http://www.pnhp.org/sites/default/files/docs/2012/Dollars%20...
[+] [-] Synaesthesia|8 years ago|reply
Polls show the majority of Americans have favoured a single-payer system now for decades. This was the case under Reagan even, and still is today.
This shows the degree to which the US is not in fact a true democracy, but more of an oligarchy. However things can change if there is enough public pressure. People just need to be organized.
[+] [-] maxxxxx|8 years ago|reply
People say this money is being wasted but it's going somewhere and these people will fight for keeping it.
[+] [-] jerkstate|8 years ago|reply
[+] [-] RHSeeger|8 years ago|reply
I'm somewhat of the mind that the government couldn't possibly do it worse than it's being done now. However, looking at the constant issues with VA healthcare, I'm not sure of my opinion either.
[+] [-] irq-1|8 years ago|reply
Billionaires from around the globe fly to the Mayo Clinic in the USA. Why seek medical care in the USA? It spends more on the things that are good for the rich.
[+] [-] mysterydip|8 years ago|reply
You forget lawmakers reaping various lobbyist benefits, which is one reason why not much changes. Two sides bicker for a while to satisfy their constituencies, then compromise by doing nothing.
[+] [-] malandrew|8 years ago|reply
Not only will I lose here, but the future you will lose here as will the future everyone on the planet. Healthcare needs don't just exist in the present.
https://www.quora.com/Which-country-develops-the-most-effect...
[+] [-] droopybuns|8 years ago|reply
I lean libertarian, but I have given up on the current system. I'd like to see all of the insurance companies and health care bureaucracy burned. This is an idea worth voting for Bernie.
I doubt that any real change is on the horizon as long as people keep confusing affordable health insurance with affordable health care. Obamacare was never the solution to the actual problem, which is unnatural pricing that is extracted under duress.
[+] [-] jakelarkin|8 years ago|reply
"The Restasis patent was approved 15 years ago and was set to expire in 2014, but the Allergan deal is part of an attempt to renew the patent and extend the company’s control of the drug through 2024."
no shit people are fed up
[+] [-] otalp|8 years ago|reply
That's not even to mention the fact that more vulnerable Blue seats are up for grabs than Red in 2018. I just don't see the current roster of the GOP supporting anything the Democrats put forward, especially something as radical as medicare-for-all.
[+] [-] JoBrad|8 years ago|reply
Separation of healthcare benefits from employment seems to have significant improvement in mobility for employees, overall. I think we (US citizens) need to have a serious, substantive discussion about how we get there. Actually doing that has been made incredibly difficult because of the way any government involvement in healthcare has been portrayed in the political arena for nearly 100 years.
[+] [-] pm24601|8 years ago|reply
Your own research might be the best way to go - that way you can get the answer to your exact question.
People: We Americans think we are special - really we are just isolated and not exposed to other ideas directly.
There is a world of difference between reading about an idea, visiting a country's hotels, and really talking to the locals.
I see discussion time and time again:
* Healthcare * High-Speed Rail * Renewable Energy * Cities built for walking/biking instead of driving
All the above are solved problems for a generation in other parts of the world.
At some point, we owe it to ourselves to find out directly from the locals how things work.
[+] [-] frgtpsswrdlame|8 years ago|reply
The GOP is going to oppose anything the democrats put forward, so it makes political sense for the democrats to aim for the most "left" solution possible so in case of compromise they can still get a lot. They learned from their mistake with Obamacare.
>I like Sanders as much as anyone else, but can anyone who supports it explain how Single Payer is obviously better than expanding the current system to provide universal healthcare?
It's cheaper. Taxes will go up, but bills will go down by more (for most people.) The political difficulties are actually part of the point, it allows the Sanders wing to set a litmus test for more traditional corporate dems. The Hillary-wing of the party is fighting a war on two fronts, single-payer and economic issues are what progressives are flanking them with.
[+] [-] ashark|8 years ago|reply
[+] [-] dsr_|8 years ago|reply
It moves variable health care costs entirely out of your HR and payroll systems. You can get more experienced employees when they aren't afraid to risk their family's health care on a job move. By reducing risk exposure there, the risk of salary vs equity becomes more attractive.
[+] [-] jonlucc|8 years ago|reply
[+] [-] maxxxxx|8 years ago|reply
[+] [-] exabrial|8 years ago|reply
[+] [-] wonderwonder|8 years ago|reply
The clinic is allowed to charge some customers more than others, that seems unreasonable. The root issue though is that health care is a for profit business.
While I understand that profits are what drives drug companies to assume the risk of new drug development, people should not be forced to decide between going to the doctor or dentist to get important medical help or paying the rent. Many high cost procedures could be eliminated if they were caught earlier with affordable preventative care. Health care costs are further driven up by the hospital having to initially eat the cost of treating uninsured people.
Prior to obamacare both of my parents were uninsured due to being self employed and pre-existing medical conditions. In a span of a week my father had a heart attack and my mother shattered her arm (requiring surgery). Total cost was over $80,000. They of course could not pay that and defaulted.
Once Obamacare was introduced they both signed up and had insurance.
Long story short if you provide affordable options for people they will generally take it. Basic human decency states that the cost of medical care should never be prohibitive enough to stop people from seeking the care they need.
If Europe can make it work I see no reason the US cannot.
[+] [-] Overtonwindow|8 years ago|reply
Whenever you apply for any type of health or life insurance, these brokers (think credit score for health) report a score based on the medications you take, have been prescribed but not filled, and those you've filled. You have no idea what's in the report, but you can request your report if you've been denied.
[0] https://www.consumerreports.org/drugs/prescriptions-not-secr...
[+] [-] grandalf|8 years ago|reply
For big pharma, this peaked in the past few years. The Mylan lawsuit and the outrage about Martin Shkreli are flare-ups that signal that public outrage is on the horizon.
In terms of social benefit, the trade-offs are not optimal at all. We are overly risk-averse to the point where FDA bureaucrats needlessly hold up drug approval, yet once a drug is granted approval we are very slow to sound the alarm if it turns out that additional data shows unanticipated risks. For example, the risks of Vioxx (as with many other NSAIDS) were well known to physicians long before the drug was taken off the market.
There is no such thing as a single wise entity that can appropriately vet all drugs for maximal societal value. Different people have different levels of risk-aversion. Our system exists to maximize the winner-take-all aspect of intellectual property protection for pharma, not to maximize the benefits of innovation to society or maximally incentivize innovation.
Certainly, someone who is 80 might be more willing to try a new drug with unknown 20 year side-effects than the parents of a 10 year old. The single regulator model is deeply flawed and creates massive harm on both ends of this risk spectrum.
But there is no need for big pharma to worry. We have broad bipartisan support of massive, long-term sponsorship of big pharma companies. Unlike Martin Shkreli, these companies play a longer-term game and for the most part avoid embarrassing fiascos such as the one that impacted Mylan.
But yet, in spite of this, they are insulated from competition by regulators and manage to extract sweeter and sweeter deals. Note the way Mylan gradually ramped up the cost of epi-pens following ACA? Mylan was just trying to get its share of the pie. Other firms, like health insurance firms, got their piece of the pie "de-contenting" bronze plans and removing high deductible options from ACA. The government got its share by being able to claim credit for passing a landmark law, etc. Like tigers tearing chunks of flesh from a fallen gazelle, the powerful interests manage to get what they came for, which is why the ACA passed in the first place, they all knew/expected the benefits to occur. The only group who got a bad deal were Americans relying on the ACA who were not poor enough to get a heavily subsidized plan... these people just had a massively regressive additional tax.
[+] [-] tiggybear|8 years ago|reply
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[+] [-] samstave|8 years ago|reply
"What health plan are all senators and government officials on? If congress cares about healthcare "for all Americans" - then put every American on the same health plan they have, or force them to only be allowed to use ObamaCare or whatever plan it is that they offer the people."
WTF!
[+] [-] maxerickson|8 years ago|reply
At the moment, Congress and staff get subsidies to buy plans from the DC exchange.
All the time: https://www.google.com/search?q=congress+dc+exchange
[+] [-] turk184|8 years ago|reply
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[+] [-] pm24601|8 years ago|reply
TL,DR: CEO of company screwing Americans, says one thing for PR purposes and then continues behavior for the dollars, euros, pounds.
Move along nothing to see here.
[+] [-] norswap|8 years ago|reply
The cynic in me wants to say "like not making indecent amount of profits on the back of miserable people".
There is nothing wrong with turning a profit, which is healthy. But when profit maximization is the prime directive, well... you know what happens.
As other commenters have pointed out, single-payer works well enough in Europe (there are issues, but I doubt they are directly inputable to the single-payer policy). Of course, that's rather hard to understand for the fringe of the population that can't distinguish between socialism and communism, solidarity and reckless selflessness.
[+] [-] alistairSH|8 years ago|reply
[0] https://www.everydayhealth.com/news/real-monthly-cost-arthri...
[+] [-] marze|8 years ago|reply
And are Americans healthier as a result?
[+] [-] turk184|8 years ago|reply
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