Saves money for patients and for doctors.

. . .they and their staff have to deal with

since that won't allow people to pay out of pocket to unfairly get better care. I worked for a medical billing software company for almost five years, and it was sad how the majority of money made was from the wealthy paying out of pocket.

Plus allow extra insurance for extra.

It seems to me that would satisfy all reasonable people. Nobody would not be taken care of. If people wanted to pay for extra insurance, why not? If people want to pay for high end treatment, why not? Let them test out expensive treatments and prove them and bring the cost down so that the masses can get it incorporated in their care too.

There can be a tax surcharge on extra care that would subsidize the standard care. The 1% would scream, but they can afford to scream. Let them scream, but make them pay extra for extra.

Single-payer-plus.

`We need real single payer.

The whole intent of single-payer is to get the lowest costs (to society) for the standard level of care and to ensure that everyone gets it.

It is more freedom to allow extra options rather than shut them out. There has to be a super-strong case for reducing freedoms.

then it is no longer *single* payer. Single means one.

That doesn't preclude additional levels of service being available optionally. If someone wants to pay more out of their pocket for medical care that goes over and above what is automatically available to everyone, there's no reason to say they can't.

Whatever gets the most people the most care most affordably will probably be fine with me.

"...single-payer... won't allow people to pay out of pocket to ... get better care."

I don't think it's true.

It means one.

ETA: The advantage of single payer is that the health care providers and associated industries can't game the system by excluding insurance companies that don't play along with them. In economic language, it changes the medical establishment from price setters to price takers.

And, then single isn't single. It's multiple.

Look at Michael Jackson, Prince, Joan Rivers, Steve Jobs... (I don't know what the hell it is about Dick Cheney, maybe it's some kind of voodoo magic, maybe he's a vampire or some other sort of were-creature.)

Appropriate and mostly preventative medical care is surprisingly inexpensive compared to the mess we have now where most everybody has inadequate preventive care and very expensive and frequently inappropriate care whenever things go seriously wrong.

And then there's all the people who still have limited or no access to appropriate medical care and are frequent visitors to very expensive emergency rooms.

A single payer system could cost less and provide better care for everyone, rich or poor. And the wealthy would still pay extra for care as they please, care that is slightly better, or much, much worse.

Judged by outcomes, the wealthy are just as likely to get inappropriate care as anyone else.

and a standardized system with no bean counters interfering with his care of his patients.

think of it: one set of codes. One billing and payment app with direct payment and no worries about rejection for commonly used treatments. No need for insurance approval, which varies from company to company. No dealing with multiple insurance companies who have different rules for what is approved. A patient walks in, and they get treated, with no need to fill out insurance forms, mess with co pays, etc.

He made a comment that his office costs him more than what he takes home, just to manage the billing. And it take him months to get paid and the insurance companies try to pay part of the bill to try to chisel him out of the balance. He said he cut his billing staffing in half, and billing staff is one third of his office head count.

It's not socialized medicine. it's cutting the people out of the loop who profit from illness and misery.

It doesn't take an MBA to figure out that universal/single payer would also create bigger profits.

because the European employees had state funded health insurance. It was far too expensive, said GM, to provide health insurance for employees and retirees, so they had to hold the line on raises. Hmmmmmm...... seems like GM would have been fighting tooth and nail for Universal health insurance when the Affordable Care Act was being debated. But NOOOO, total silence from them and other corporations and Joe Lie-berman and his gang gutted our chances.

member benefit.

NT

some time ago that unions were upset about parts of the ACA. Generally, in my experience anyway, union health insurance is better than what one gets through the ACA, but then it falls in the "Cadillac plans" which are taxed.

Health insurance companies = death panels.

"Sorry Mrs. Robinson but you have reached the limit of your plan and we (health ins co) will not cover anymore chemotherapy treatments"...half way thru the planned number of treatments.

I remember that day well.

...if she was still alive...... I remember it.

An insurance company killed her because it determined she had reached her lifetime maximum benefit, so they weren't going to pay for any more chemotherapy for her cancer. She died trying to claim bankruptcy so she could get MedicAid. Clearly that insurance company was far more interested in its precious profits than in a patient's life.

I say, FUCK THE INSURANCE COMPANIES, and the horses they rode in on. Single Payer. NOW. Today. Burn 'em to the ground and bury the ashes in a deeep hole.

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And I agree 100% with you. For profit healthcare is truly diabolical.

As I said I will never forget that day in November or the look of defeat under her tears (not the first battle with the insurance co about coverage...but it was the last) as my mom repeated to me what the insurance told her...6 months later she died. 12 yrs later it is still as infuriating today as it was then...

Last edited Sun Aug 7, 2016, 10:14 AM - Edit history (1)

...that no one else will ever suffer a similar fate in America. We're NOT going back. EVER. The GOP threat to repeal ACA must be fought tooth and nail, hammer and tong.

There are no words. Very sorry.

That is absolutely horrible and should be illegal. I despise insurance companies - how they can to that to someone is simply unforgivable.

and more yes.
Esp. drugs are an unaffordable scam.

as opposed to being unnecessary middlemen. Healthcare should be a right, not a privilege. Why does the RW only care about people dying if they're killed by a "terrorist."

which is something we need to change.

Profiting at the expense of patients is the American way.

and be prepared for ever emerging global markets coming to a neighborhood near them. Tech training is, we hear, critical.

This one wins the thread

UnitedHealthcare will operate only in a “handful” of health insurance exchanges in 2017, down from 34 states this year, company officials said Tuesday.

The company did not provide the anticipated details in its first-quarter earnings announcement released Tuesday morning or in a subsequent teleconference with securities analysts. But a spokesman confirmed Nevada and Virginia would be among the states where it will retain a presence. In the past week, UnitedHealthcare said it would leave Georgia, Michigan, and Arkansas.
...

is providing medical care for some, on the backs of others who get none. They chose not to cover them and subsidized health ins cos to cover those that were left, to keep the costs down.

We need everyone covered.

I use. I wonder if this will matter??

I've always wondered.... why doesn't the state just operate Medicaid itself? Before I started using it, I thought that's what Medicaid was - I didn't think the private insurers had anything to do with it.. but in Arizona you get to select from a list of providers. I just picked UnitedHealthcare because that's what I had when I had "real" insurance.

nt

Too many people employed in that industry.

like that. The rationale being it cost more to get them to and from work than they actually produced (i.e. nothing).

It's easy for a physicist to come up with ideas like that. They don't have to get people to vote for them. I have my doubts that any politician anywhere would survive proposing such a thing

The AMA fought Medicare, Medicaid and every proposal for universal medical care from the Roosevelt administration on. It was "communism!", they yelled. And they were a lot more powerful than they are now.

And on a personal level, every doctor I knew up through the early "90 was against it. Maybe new generation has finally had enough.

hoops, that some have finally had to address the problem. I think some are genuinely concerned that some of their patients cannot afford care because costs, especially prescription drugs, have escalated so rapidly and are so much higher than is the cost of comparable care in other western democracies than in the early '90s. But I think that it had to hit some of them directly in their own pockets/pocketbooks before they saw the problem.

wanting insurance companies to be their patients' doctor.

My GP told me about a very ill poor patient of hers who was taking a med that was working. The insurance company insisted the patient must switch to a drug on formulary and fail that one and two other substitute drugs before they would cover the one currently working. The substitutions had completely different actions from the working one.

We fought my insurance for a drug they didn't want to cover, wanted to substitute for something I didn't want to take, and in my case we won, but I have cancer and we were able to make a different sort of appeal. My GP said only about 20% of her medication appeals were successful.

...determine what hospitals get paid for psychiatric length of stay. I can't tell you how many times I've been on the phone defending our care of patients only to be turned down for payment from insurance companies with extremely strict (read: impossible to meet) criteria for hospital stay.

To compound that usurping of power from the people actually providing the care (i.e., determining if a psychiatric patient is safe for discharge), if your patient returns within 30 days you get a reduced rate of reimbursement. They get you going and coming.

It's almost like what those dirty fucking hippies were on about back in 2009 when the details of the Affordable Care Act were being worked out.

It makes clear that the AMA still opposes universal health care.

Other groups of doctors, both formal and informal, have disagreed with that stance all along, particularly in the last several years in the run up to the ACA and since. This includes groups like the PNHP: http://www.pnhp.org/.

NT

A lot are still against it.

This is a relatively small group of physicians.

Single payer means more work for less money for doctors, so most aren't jumping for joy about it

People like Stupak and other so called DINOs who have a vested interest in never seeing the end of for profit health care in this country. Our insurance system in this country is a fucking joke, even with the ACA in place. It would be at least 1324234234323243243249823429492389432 times worse without the ACA or if the ACA was repealed by some Republican fuck stick.

If I sound pissed off it's because I'm having to deal with this horseshit right now.

Or their corporate/business overlords?

I think I know the answer.

EDIT:

I listened to NPR a few years ago and the focus was on healthcare in Germany. If I recall correctly, everyone paid about 8% of their income for universal healthcare. If you earned nothing, you obviously paid nothing. If you earned a lot, you paid a lot. However, let's not forget the fact that high earners still bring home hefty pay, so it's not like an incentive for people to not earn more!

My company-based health insurance plans have cost me well over 8% of my income for many years. That's just for the premiums and doesn't include deductibles and other costs if I actually use it.

Germany still has doctors who do house calls! Well, they did when that NPR piece was aired, so I assume it still happens.

Their universal health care plans lasted through WARS!

Then you will see real change... I'm not talking about working for nothing, a good salary is fine but really? Obscene salaries for "working" the system..
After working in the health care industry for over 40 years I've seen quite a bit.. The classic was when I was in the radiologist office a surgeon walks in with a ultrasound image and says " Hey find something, I have to cut this week to make a boat payment" ..... I almost puked... Lots of new MD's have great aspirations to help people and they get seduced by the easy money.. They find out that if they turn more patients, they make more money.. And don't get me started on medicare fraud.... Down here in South Florida it's rampant..

Just remember, preventative medicine is bad for business...
m

went to Self-Insured. Horrible. They went into this Wellness Program where your premiums went up if you did not follow their "Preventive" program for you, and your spouse and children if they were insured through the district.

Corrupt? They hired four RN's as "Health Coaches". who came up with your own personal health plan, to the tune of $2M for their salaries!!!!!! What??? Do the math there. My first thought on hearing this was who do did these nurses personally know? The Skeletor? After all, Naples is his "hometown", and he knows all about fraud.

for a while. Rehab would fix it up, but that is $50 a visit. I burned through the $2k on my FSA already due to my wife's knee surgery and rehab. And you know what- I am one of the lucky ones. I can't imagine not having the insurance I do have. This country is ass backwards.

Insurance companies, with the help of large corporations (especially the defense industry) and the GOP majority in the congress, shake down Americans every day for health care.

... but I'm so thankful to ophthalmologists around the country who stood up to Genentech a few years ago.

It's a long story, but I'll try to keep it short.

1. Genentech scientists developed a drug to slow down colon cancer.
2. The drug is administered by IV to cancer patients.
3. It doesn't work as well compared to other treatments, so many IV bags in hospitals go unused.
4. Ophthalmologists in Florida used the drug experimentally on people with macular degeneration by injecting small doses of it into their eyeballs.
5. It worked phenomenally well to treat that eye condition!
6. Word spread, and soon many ophthalmologists around the country were saving eyesight by purchasing those IV bags of and dividing them into smaller doses.
7. Genentech management claimed that they were "concerned" that the drug would be contaminated during the division process, and they initially pushed for government to outlaw it.
8. Genentech instead wanted to control these small eye injection doses.
9. If they had their way, my payment for these injections would have risen from about $300 per injection to about $2500 per injection! My insurance would not pay for it because Genetech didn't get FDA approval for people with my rare condition... which causes blindness from macular degeneration far sooner than for people with age-related macular degeneration.
10. Genentech backed off when ophthalmologists raised a major stink, but they're still bilking the government and insurance companies with their their higher dosage prices (for people with AMD who choose that route). At least they backed off and allowed people like me to still AFFORD TO SEE!

Sudden loss of most vision in on eye due to the wet version of MD. Luckily the treatment she received the first day worked well, and within a week she is nearly back to normal. Has to do the shots, though. And her first read on it was that it would be very expensive.

Sorry that you're dealing with it too.

The shots indeed help with the "wet form" of MD.

There's tiny blood vessels behind the retina that get stimulated to grow there by a chemical called VEGF. VEGF exists throughout the body, and blood vessels are stimulated by it like roots of a tree drawn to water.

When the blood vessels that naturally reside in the retina (through the optic nerve) no longer provide sufficient oxygen and nutrients to the retina, those cells release VEGF to stimulate blood vessel growth.

In my case (and for AMD in a different way), the VEGF leaks through cracks in a membrane behind the retina and that causes blood vessels from the choroid to grow into the retina and leak. That's when visual distortions are noticed, like someone pushing on a flat movie screen to distort the image.

If the leaking persists for very long, the body will naturally create scar tissue to stop it. It's the scar tissue that causes permanent vision loss, partly by blocking the ability of photoreceptors to eliminate metabolic waste. The photoreceptors essentially "suffocate" in their own waste.

The shots, which contain anti-VEGF, counteracts the VEGF stimulation and the invasive blood vessels stop leaking and wither away.

I'll eventually go blind from the "dry form" of it, according to my eye doctor, but it's hard to know how quickly that will happen. The "dry form" is basically the loss of the cells known as RPE that help remove waste from the photoreceptors.

By the way, although it probably sounds awful to get injections in your eyeballs, it's really not too bad. Numbing is done, and the injection is pretty quick into the side of the eye.

Fund it by a tax on before tax total payroll of an employer...about 6-7 pct.

fastest way to Medicare for all. But it will cost more than $3000 to $3500 a year per person.

That is how Ontario, Canada does it.

unemployed, etc. I do not believe $3000 per person will be anywhere near enough.

insurance companies are the true death panels.

to do during the 70's when the mergers flew fast and furious. Learn something else. No one gave two hoots about us at that time, I have no sympathy this time.

Reducing jobs for which Alan Greenspan apologized -- big whoop... an apology!

Obama had 42 days in which to bring back jobs and effect workable health care from a health care system that ran a 1.5 trillion (with a T) dollar health care denial industry coupled with a 1 trillion dollar health care industry. All while the economy was in a tailspin crashing into a whirlpool. And that during two wrong headed wars.

Near 8 years of Republican congress not allowing anything Obama to pass, not even funding against Zika virus, has not helped.

70's had our loss in Vietnam. Not good for our economy. Then Reagan who borrowed our way out of our problems from that loss. Then Bush, HW, who escalated that borrowing. You're right. All we got was a couple TRA (Trade Readjustment Act) attempts. maybe that did not amount to a hoot.

Now we have some jobs -- some. Maybe now we could jump to drop that larger health care denial industry.

I'm for single payer. We can do it now.

Medicare-for-all universal coverage single payer health care - not health insurance.

but all the for profit hospitals, care centers, laboratories, drug companies, pharmacies. The U.S. health care system is all for profit even the portion covered by taxes is paid to for profit providers and Medicare is not single payer, unless you have must have a private for profit supplemental policy and a Plan D drug policy, also private and for profit.

Medicaid supplements the for retirees unable to purchase a policy and they also have to pay for profit providers for the care.

Dumping the insurance companies might help some but not enough.

In most other developed nations, healthcare is seen as a basic human right, a belief shared by both the left and right wing in those nations. Yet in the "greatest nation on earth", we are stuck with a bloated, inefficient, and unequal healthcare system where only the well-off can get proper treatment, and thousands are left to suffer.

The elite in this country would rather send young men off to wars in the Middle East, instead of helping out their fellow man. When will this madness end?

It's so disgusting we allow this to go on. Medicare should also include dental and eye care. As if teeth and eyes are not part of our bodies. Never understood that one.

Noam Chomsky sometimes speaks about seeing publicly funded R&D at MIT being "given away" to various corporations. They enjoy the profits from it.

Just do what every nation from, France to Australia to Japan does, make a REAL public option that has teeth and force the insurance companies to REALLY compete.

... beaten into a puddle of blood and bone, and reviled as the diseased socio-economic spawn of fascism that it indisputably is, the brazen bribery of the conservative hyenas in Congress will ensure the continuation of an exploitive and destructive system that benefits a few insulated from need at the expense of the many purposely mired in need and persecuted because they are in need.

No fate is too gruesome for the evil monsters that force American patients to bear prescription costs that are often thousands of times higher than what patients in civilized countries pay for the exact same drug.

Insurance company administrative staff can easily transition to administrating a single-payer system; the over-paid executives can roast in hell. I'm sure Ayn Rand will save them a seat.

Here I am, forth week in, waiting to hear if my insurance is going to pay for some kidney tests my doctor feels I need. He isn't making the decision, some insurance clerk sitting in a cubicle is looking in a computer file to see if they should cover a test that may or may not decide if they are going to remove a kidney.

and whether treating you or letting you die is going to be cheaper.

The scenes about the real insurance company death panels in Michael Moore's SICKO were truly disturbing.

There are insurance execs who should be in prison, and only kept alive so we can learn more about spotting and limiting the damage of sociopaths in the future.