Think about that for a second. If in my industry we had customers we sold to below cost because we new we could charge other customers whatever we needed to to make up for it, what do think happens to cost controls, salaries, and how often do you think my suppliers bare raising prices?
Health Care
- Thread starter Syskatine
- Start date
Please tell me the difference in the US and the Netherlands that creates a 5x difference. I know the EU is famous for a lax regulatory environment but can that really account for a 5x difference?
When all the doctors are working there because of the paycuts that may be the way to go
That comparison question is the challenge in front of the more-socialized-medicine supporters. How do you convince an average guy like me that, that likes his healthcare now, that his level of care won't go down.
To be honest if you think our healthcare system as it stands today is good then it will be hard to convince you to change it.
If you define rock bottom services as the service level in say the Netherlands or France, I think I could learn to live with it.
I just wish someone could ask real and hard questions to these M4A proponents and get straight answers:
1) How with the $3T be funded? Today, that $3T is paid in part by individual payee's, Medicare payments, and Insurance payments which are funded generally tax-free by employees and employers. Can someone actually breakdown where the $3T comes from in the M4A plan? And will that currently untaxed $1T paid by individuals and businesses, suddenly become a tax liability?
2) What happens to the monies in peoples HSA plans? I have nearly 20K in my HSA that is restricted from use outside of healthcare costs but was generated pre-tax. Will that rollover to an IRA? Will that be paid to me in a lump sum and suddenly taxed as income?
3) Will the consumers have skin in the game? If not, what mechanisms will control demand given the finite supply of medical services?
4) How will fraud be managed? Estimates put Medicare fraud today at $60B of a $700B total Medicare spend. That's nearly 10%. When this gets to $3T, we are talking $250B-$300B in fraud and mis-payments.
5) What's the impact to Medicaid? Does Medicaid go away entirely for all states? Does its funding now go to the federal government to pay for M4A?
6) What's the impact to elective services? While everyone languishes the financial impact of emergency and mandatory treatments for people. The costs due to injury for a car wreck or a pregnancy or a cancer diagnosis. And we use these ancedotes when comparing the ease of Canada's or Britain's systems vs. our own. But when it comes to 'elective' care, today's American system is the greatest in the world (without question). A knee replacement in the UK is a 6 month waiting list. Lasix surgery is 3 months.
7) What will be the rules for experimental treatments? Today Medicare does not pay towards non-approved treatments, as there are no fee schedules associated. Do those that require 'new' drugs or treatments have to wait on Congress' annual fee schedule assessment?
8) There a lots of very good hospitals that do not accept Medicare. Many of the BEST cancer treatment centers do not (MD Anderson and Moffit are 2 for example). Are they forced to get in line? What about charity hospitals like St. Jude and Shriner's? Also, does this eliminate the need for the VA, or will it remain separate?
9) Will there still be a private medical market? Look at the education market for example. We have public schools, but the wealthy (who still pay school taxes) choose to send their kids to expensive private schools. Will the same be allowed in medicine? If you are wealthy enough to afford it (while still paying taxes for the public option) can you choose to have non-government paid physicians?
10) What about second opinions? If I get a treatment diagnosis from my local hospital/physician that I don't like, what will be my rules to go elsewhere?
There are probably more questions, but under my current plan, I know most of these answers, yet in all the interviews and discussions about Medicare for All, I never hear any of these questions asked. I'm not a guy who simply trusts the government will get it right, so I'd like to know at at least a high level what Bernie, Warren, or any of the Dems believe is the answer to these questions.
1) How with the $3T be funded? Today, that $3T is paid in part by individual payee's, Medicare payments, and Insurance payments which are funded generally tax-free by employees and employers. Can someone actually breakdown where the $3T comes from in the M4A plan? And will that currently untaxed $1T paid by individuals and businesses, suddenly become a tax liability?
2) What happens to the monies in peoples HSA plans? I have nearly 20K in my HSA that is restricted from use outside of healthcare costs but was generated pre-tax. Will that rollover to an IRA? Will that be paid to me in a lump sum and suddenly taxed as income?
3) Will the consumers have skin in the game? If not, what mechanisms will control demand given the finite supply of medical services?
4) How will fraud be managed? Estimates put Medicare fraud today at $60B of a $700B total Medicare spend. That's nearly 10%. When this gets to $3T, we are talking $250B-$300B in fraud and mis-payments.
5) What's the impact to Medicaid? Does Medicaid go away entirely for all states? Does its funding now go to the federal government to pay for M4A?
6) What's the impact to elective services? While everyone languishes the financial impact of emergency and mandatory treatments for people. The costs due to injury for a car wreck or a pregnancy or a cancer diagnosis. And we use these ancedotes when comparing the ease of Canada's or Britain's systems vs. our own. But when it comes to 'elective' care, today's American system is the greatest in the world (without question). A knee replacement in the UK is a 6 month waiting list. Lasix surgery is 3 months.
7) What will be the rules for experimental treatments? Today Medicare does not pay towards non-approved treatments, as there are no fee schedules associated. Do those that require 'new' drugs or treatments have to wait on Congress' annual fee schedule assessment?
8) There a lots of very good hospitals that do not accept Medicare. Many of the BEST cancer treatment centers do not (MD Anderson and Moffit are 2 for example). Are they forced to get in line? What about charity hospitals like St. Jude and Shriner's? Also, does this eliminate the need for the VA, or will it remain separate?
9) Will there still be a private medical market? Look at the education market for example. We have public schools, but the wealthy (who still pay school taxes) choose to send their kids to expensive private schools. Will the same be allowed in medicine? If you are wealthy enough to afford it (while still paying taxes for the public option) can you choose to have non-government paid physicians?
10) What about second opinions? If I get a treatment diagnosis from my local hospital/physician that I don't like, what will be my rules to go elsewhere?
There are probably more questions, but under my current plan, I know most of these answers, yet in all the interviews and discussions about Medicare for All, I never hear any of these questions asked. I'm not a guy who simply trusts the government will get it right, so I'd like to know at at least a high level what Bernie, Warren, or any of the Dems believe is the answer to these questions.
Really? You are fine with 6 month waiting periods for simple things like knee-replacements and Lasix?
Having never lived there, I have no idea what their level of service is like.
Do their people have generally healthy lifestyles as compared to the average US citizen?
Do they develop a lot of new medical technologies?
Are there any countries other than the Netherlands or France that we should also use in the comparison, or just those two?
1) How with the $3T be funded? Today, that $3T is paid in part by individual payee's, Medicare payments, and Insurance payments which are funded generally tax-free by employees and employers. Can someone actually breakdown where the $3T comes from in the M4A plan? And will that currently untaxed $1T paid by individuals and businesses, suddenly become a tax liability?Payroll tax.
2) What happens to the monies in peoples HSA plans? I have nearly 20K in my HSA that is restricted from use outside of healthcare costs but was generated pre-tax. Will that rollover to an IRA? Will that be paid to me in a lump sum and suddenly taxed as income? Yes those are the two options.
3) Will the consumers have skin in the game? If not, what mechanisms will control demand given the finite supply of medical services? Long waits and triage
4) How will fraud be managed? Estimates put Medicare fraud today at $60B of a $700B total Medicare spend. That's nearly 10%. When this gets to $3T, we are talking $250B-$300B in fraud and mis-payments. Enforce the laws against fraud.
5) What's the impact to Medicaid? Does Medicaid go away entirely for all states? Does its funding now go to the federal government to pay for M4A? goes away
6) What's the impact to elective services? While everyone languishes the financial impact of emergency and mandatory treatments for people. The costs due to injury for a car wreck or a pregnancy or a cancer diagnosis. And we use these ancedotes when comparing the ease of Canada's or Britain's systems vs. our own. But when it comes to 'elective' care, today's American system is the greatest in the world (without question). A knee replacement in the UK is a 6 month waiting list. Lasix surgery is 3 months. I have bad new for you in regards to how long the wait is for knee replacement in the US.
7) What will be the rules for experimental treatments? Today Medicare does not pay towards non-approved treatments, as there are no fee schedules associated. Do those that require 'new' drugs or treatments have to wait on Congress' annual fee schedule assessment? Yeah probably going to have to get that pro bono or via grants.
8) There a lots of very good hospitals that do not accept Medicare. Many of the BEST cancer treatment centers do not (MD Anderson and Moffit are 2 for example). Are they forced to get in line? What about charity hospitals like St. Jude and Shriner's? Also, does this eliminate the need for the VA, or will it remain separate? Those hospitals that don't accept M4A are going to have an even harder time staying open than Deaconess. I imagine that the VA will stay open since it is more of an NHS type system than a single payer system.
9) Will there still be a private medical market? Look at the education market for example. We have public schools, but the wealthy (who still pay school taxes) choose to send their kids to expensive private schools. Will the same be allowed in medicine? If you are wealthy enough to afford it (while still paying taxes for the public option) can you choose to have non-government paid physicians? Not for treatment that is covered by M4A
10) What about second opinions? If I get a treatment diagnosis from my local hospital/physician that I don't like, what will be my rules to go elsewhere? Yes get a second opinion.
2) What happens to the monies in peoples HSA plans? I have nearly 20K in my HSA that is restricted from use outside of healthcare costs but was generated pre-tax. Will that rollover to an IRA? Will that be paid to me in a lump sum and suddenly taxed as income? Yes those are the two options.
3) Will the consumers have skin in the game? If not, what mechanisms will control demand given the finite supply of medical services? Long waits and triage
4) How will fraud be managed? Estimates put Medicare fraud today at $60B of a $700B total Medicare spend. That's nearly 10%. When this gets to $3T, we are talking $250B-$300B in fraud and mis-payments. Enforce the laws against fraud.
5) What's the impact to Medicaid? Does Medicaid go away entirely for all states? Does its funding now go to the federal government to pay for M4A? goes away
6) What's the impact to elective services? While everyone languishes the financial impact of emergency and mandatory treatments for people. The costs due to injury for a car wreck or a pregnancy or a cancer diagnosis. And we use these ancedotes when comparing the ease of Canada's or Britain's systems vs. our own. But when it comes to 'elective' care, today's American system is the greatest in the world (without question). A knee replacement in the UK is a 6 month waiting list. Lasix surgery is 3 months. I have bad new for you in regards to how long the wait is for knee replacement in the US.
7) What will be the rules for experimental treatments? Today Medicare does not pay towards non-approved treatments, as there are no fee schedules associated. Do those that require 'new' drugs or treatments have to wait on Congress' annual fee schedule assessment? Yeah probably going to have to get that pro bono or via grants.
8) There a lots of very good hospitals that do not accept Medicare. Many of the BEST cancer treatment centers do not (MD Anderson and Moffit are 2 for example). Are they forced to get in line? What about charity hospitals like St. Jude and Shriner's? Also, does this eliminate the need for the VA, or will it remain separate? Those hospitals that don't accept M4A are going to have an even harder time staying open than Deaconess. I imagine that the VA will stay open since it is more of an NHS type system than a single payer system.
9) Will there still be a private medical market? Look at the education market for example. We have public schools, but the wealthy (who still pay school taxes) choose to send their kids to expensive private schools. Will the same be allowed in medicine? If you are wealthy enough to afford it (while still paying taxes for the public option) can you choose to have non-government paid physicians? Not for treatment that is covered by M4A
10) What about second opinions? If I get a treatment diagnosis from my local hospital/physician that I don't like, what will be my rules to go elsewhere? Yes get a second opinion.
I wouldn't want to slip below that level of service. I would say France should be the floor.
1) How with the $3T be funded? Today, that $3T is paid in part by individual payee's, Medicare payments, and Insurance payments which are funded generally tax-free by employees and employers. Can someone actually breakdown where the $3T comes from in the M4A plan? And will that currently untaxed $1T paid by individuals and businesses, suddenly become a tax liability?Payroll tax. Yea! More taxes for businesses and individuals.
2) What happens to the monies in peoples HSA plans? I have nearly 20K in my HSA that is restricted from use outside of healthcare costs but was generated pre-tax. Will that rollover to an IRA? Will that be paid to me in a lump sum and suddenly taxed as income? Yes those are the two options. Is this stated somewhere or your hypothesis of how it would work.
3) Will the consumers have skin in the game? If not, what mechanisms will control demand given the finite supply of medical services? Long waits and triage Sign me up please. At least with what I pay today, I can get fast service. That will go away fast.
4) How will fraud be managed? Estimates put Medicare fraud today at $60B of a $700B total Medicare spend. That's nearly 10%. When this gets to $3T, we are talking $250B-$300B in fraud and mis-payments. Enforce the laws against fraud. Like we do today? Insurance companies are motivated by profit to go after and eliminate fraud. The government has no such motivation. Its not its money being stolen.
5) What's the impact to Medicaid? Does Medicaid go away entirely for all states? Does its funding now go to the federal government to pay for M4A? goes away Interesting. So i guess my current state taxes won't go down to offset the reduction of Medicaid expenses, yet my Federal taxes will go up to pay for the new federal program. Wonderful.
6) What's the impact to elective services? While everyone languishes the financial impact of emergency and mandatory treatments for people. The costs due to injury for a car wreck or a pregnancy or a cancer diagnosis. And we use these ancedotes when comparing the ease of Canada's or Britain's systems vs. our own. But when it comes to 'elective' care, today's American system is the greatest in the world (without question). A knee replacement in the UK is a 6 month waiting list. Lasix surgery is 3 months. I have bad new for you in regards to how long the wait is for knee replacement in the US. Not sure what you are talking about? On a Medicare plan, yea its a wait. On good private insurance, my mom's knee replacement surgery was scheduled and performed in less than 2 weeks.
7) What will be the rules for experimental treatments? Today Medicare does not pay towards non-approved treatments, as there are no fee schedules associated. Do those that require 'new' drugs or treatments have to wait on Congress' annual fee schedule assessment? Yeah probably going to have to get that pro bono or via grants. Pro Bono from the medical and drug companies that are being pay restricted to have minimal profit margins? That sounds likely. I guess if you are gonna get sick, you better hope its a well-established condition.
8) There a lots of very good hospitals that do not accept Medicare. Many of the BEST cancer treatment centers do not (MD Anderson and Moffit are 2 for example). Are they forced to get in line? What about charity hospitals like St. Jude and Shriner's? Also, does this eliminate the need for the VA, or will it remain separate? Those hospitals that don't accept M4A are going to have an even harder time staying open than Deaconess. I imagine that the VA will stay open since it is more of an NHS type system than a single payer system. Hooray. Let's run out of business some of the most prestigious institutions in our history, all in the name of ensure some illegal immigrant who managed to cross a river can have their kid for free. Woohoo!
9) Will there still be a private medical market? Look at the education market for example. We have public schools, but the wealthy (who still pay school taxes) choose to send their kids to expensive private schools. Will the same be allowed in medicine? If you are wealthy enough to afford it (while still paying taxes for the public option) can you choose to have non-government paid physicians? Not for treatment that is covered by M4A. Great. So now the super wealthy will use medical tourism to go to countries where the good doctors will go, and the non 1%ers will get long wait times and shit for service medical care. I can't believe this kind of plan doesn't pass Congress 568 to 0.
10) What about second opinions? If I get a treatment diagnosis from my local hospital/physician that I don't like, what will be my rules to go elsewhere? Yes get a second opinion. Do you know what Medicare's rules are for second opinions? They only pay in certain circumstances. But since their no longer is insurance, which will usually cover a second opinion, how will that work?
Pilt, in all honesty, I do appreciate the response and honest attempts at answers to the questions posed. It scares the hell out of me that we think this is a good idea. Having seen how Medicare treated my father while he had Alzheimer's and the crap coverage he received vs. the care he received prior to turning 65 and having his private insurance policy through Aramco, I have no interest in government paid health-care.
2) What happens to the monies in peoples HSA plans? I have nearly 20K in my HSA that is restricted from use outside of healthcare costs but was generated pre-tax. Will that rollover to an IRA? Will that be paid to me in a lump sum and suddenly taxed as income? Yes those are the two options. Is this stated somewhere or your hypothesis of how it would work.
3) Will the consumers have skin in the game? If not, what mechanisms will control demand given the finite supply of medical services? Long waits and triage Sign me up please. At least with what I pay today, I can get fast service. That will go away fast.
4) How will fraud be managed? Estimates put Medicare fraud today at $60B of a $700B total Medicare spend. That's nearly 10%. When this gets to $3T, we are talking $250B-$300B in fraud and mis-payments. Enforce the laws against fraud. Like we do today? Insurance companies are motivated by profit to go after and eliminate fraud. The government has no such motivation. Its not its money being stolen.
5) What's the impact to Medicaid? Does Medicaid go away entirely for all states? Does its funding now go to the federal government to pay for M4A? goes away Interesting. So i guess my current state taxes won't go down to offset the reduction of Medicaid expenses, yet my Federal taxes will go up to pay for the new federal program. Wonderful.
6) What's the impact to elective services? While everyone languishes the financial impact of emergency and mandatory treatments for people. The costs due to injury for a car wreck or a pregnancy or a cancer diagnosis. And we use these ancedotes when comparing the ease of Canada's or Britain's systems vs. our own. But when it comes to 'elective' care, today's American system is the greatest in the world (without question). A knee replacement in the UK is a 6 month waiting list. Lasix surgery is 3 months. I have bad new for you in regards to how long the wait is for knee replacement in the US. Not sure what you are talking about? On a Medicare plan, yea its a wait. On good private insurance, my mom's knee replacement surgery was scheduled and performed in less than 2 weeks.
7) What will be the rules for experimental treatments? Today Medicare does not pay towards non-approved treatments, as there are no fee schedules associated. Do those that require 'new' drugs or treatments have to wait on Congress' annual fee schedule assessment? Yeah probably going to have to get that pro bono or via grants. Pro Bono from the medical and drug companies that are being pay restricted to have minimal profit margins? That sounds likely. I guess if you are gonna get sick, you better hope its a well-established condition.
8) There a lots of very good hospitals that do not accept Medicare. Many of the BEST cancer treatment centers do not (MD Anderson and Moffit are 2 for example). Are they forced to get in line? What about charity hospitals like St. Jude and Shriner's? Also, does this eliminate the need for the VA, or will it remain separate? Those hospitals that don't accept M4A are going to have an even harder time staying open than Deaconess. I imagine that the VA will stay open since it is more of an NHS type system than a single payer system. Hooray. Let's run out of business some of the most prestigious institutions in our history, all in the name of ensure some illegal immigrant who managed to cross a river can have their kid for free. Woohoo!
9) Will there still be a private medical market? Look at the education market for example. We have public schools, but the wealthy (who still pay school taxes) choose to send their kids to expensive private schools. Will the same be allowed in medicine? If you are wealthy enough to afford it (while still paying taxes for the public option) can you choose to have non-government paid physicians? Not for treatment that is covered by M4A. Great. So now the super wealthy will use medical tourism to go to countries where the good doctors will go, and the non 1%ers will get long wait times and shit for service medical care. I can't believe this kind of plan doesn't pass Congress 568 to 0.
10) What about second opinions? If I get a treatment diagnosis from my local hospital/physician that I don't like, what will be my rules to go elsewhere? Yes get a second opinion. Do you know what Medicare's rules are for second opinions? They only pay in certain circumstances. But since their no longer is insurance, which will usually cover a second opinion, how will that work?
Pilt, in all honesty, I do appreciate the response and honest attempts at answers to the questions posed. It scares the hell out of me that we think this is a good idea. Having seen how Medicare treated my father while he had Alzheimer's and the crap coverage he received vs. the care he received prior to turning 65 and having his private insurance policy through Aramco, I have no interest in government paid health-care.
