2016 Postmortem
Related: About this forumToo many DUers don't know why the goal of single payer matters
This thread shows that most of the objections are based on reasons that demonstrate a failure to understand the economics of the medical industry's cartel pricing and the only way it can be dealt with.
Ex: http://www.democraticunderground.com/?com=view_post&forum=1002&pid=7298226
When Obama pushed health care reform, he allowed single payer to be taken off the table before the process even started.
Bernie is bringing it back as an issue. He believes in and will aim for the "Medicare for ALL" law that should have been out there in the first place.
What is Single Payer?
The program would be funded by the savings obtained from replacing todays inefficient, profit-oriented, multiple insurance payers with a single streamlined, nonprofit, public payer, and by modest new taxes based on ability to pay. Premiums would disappear; 95 percent of all households would save money. Patients would no longer face financial barriers to care such as co-pays and deductibles, and would regain free choice of doctor and hospital. Doctors would regain autonomy over patient care.
The Expanded and Improved Medicare for All Act, H.R. 676, based on PNHPs JAMA-published Physicians Proposal, would establish an American single-payer health insurance system.
http://www.pnhp.org/facts/what-is-single-payer
Why?
Because it will dramatically lower the costs of health care for everyone.
How?
It prevents the medical industries from gaming the system.
Single payer (mostly) turns the industry from what are called Price Makers to Price Takers.
What's a cartel?
In this case the medical community has a variety of methods to charge much more profit than a "market' would provide them. They do it with things like cartel members (American Medical Associate or the American Dental Association) restricting the number of provider, or through regulations that their lobbyists have had passed which restrict competition (importing medicine).
Because the medical industry is a cartel, the insurance companies can't counter their price demands effectively. They can only work around the edges to affect pricing via those few willing and able to go against the cartels. Enabling insurance companies, as profit seeking entities, to form their own cartel to price fix on the consumer's behalf would be a legal bucket of worms that would ultimately screw the consumer even more.
That requires us to ask this question:
How does the purchaser who is designated to negotiate on your behalf prevent the cartel-member seller from charging exorbitant costs for their product?
That's where single payer "Medicare for ALL" comes in.
Forming our own cartel via our government sends nearly ALL the money being spent on health care through a single faucet. This breaks the back of the medical cartels with the results reflected in this chart. (The further to the left, the lower the cost per person and the higher on the chart the better overall health care outcomes.)
Everyone gets covered and we all spend less for our own needs.
JaneyVee
(19,877 posts)kristopher
(29,798 posts)Fumesucker
(45,851 posts)There are private doctors in the UK.
JaneyVee
(19,877 posts)And we would also need to dramatically boost the doctor to patient ratio. These other countries have 1/15th of our population.
Fumesucker
(45,851 posts)Sounds a lot like the Republican health care plan actually.
If you get sick die quickly.
kristopher
(29,798 posts)They maintain an artificial shortage.
cprise
(8,445 posts)So what.
kristopher
(29,798 posts)Rosa Luxemburg
(28,627 posts)Uncle Joe
(58,372 posts)of doctors and nurses.
Enthusiast
(50,983 posts)kristopher
(29,798 posts)The AMA is quite capable of increasing the number of doctors anytime they want. There is no shortage of people who could be trained in today's educational pipeline. The AMA that establishes hurdles unrelated to being a qualified physician - it is behavior that has accompanied guilds since they were first conceived. In fact, it is precisely the reason they were conceived. The tradeoff is a higher level of tradecraft, but at the point we are now, the barriers to entry in the field are artificially high.
Rosa Luxemburg
(28,627 posts)I grew up in the UK and I thought it was a fine health system. Health care for all and free at the point of use.
jeff47
(26,549 posts)Single payer does not require all doctors to work for the government. In fact, the vast majority of single-payer systems don't do that.
kristopher
(29,798 posts)erronis
(15,306 posts)And s/he/it seems to be quickly into the conversation. Either a bored partisan or a bot.
Just so I don't get crapped on by the acolytes of the status quo... How is a self-regulating entity a good thing? How is the AMA really going to police its paying members? Same for the DNC, RNC, ADA, NRA, etc.
Ed Suspicious
(8,879 posts)You sound like Rand when you say that.
Scootaloo
(25,699 posts)Heard the same thing about the affordable care act.
polly7
(20,582 posts)Our doctors here are not gov't employees.
Scuba
(53,475 posts)bvar22
(39,909 posts)and was properly corrected by a number of trusted DUers......
I would delete the embarrassing OP.
Scuba
(53,475 posts)MichMan
(11,940 posts)Still somewhat skeptical on the cost savings that are thrown around here. I'm still waiting for the $2500/yr savings that was promised multiple times by the President prior to the passage of the ACA.
kristopher
(29,798 posts)Please quote the promise so we can deal with reality rather than a slipshod characterization put forth out of cynical obstructionism.
MichMan
(11,940 posts)[link:
|kristopher
(29,798 posts)from new members quoting known false right wing talking points.
Please provide a text quote.
MichMan
(11,940 posts)Didn't realize that you tube clips from the President's own words was a false right wing link? Do you believe it was a Barack Obama imposter that said those things?
No matter, if you want to believe statements made by politicians in campaigns always end up being accurate, go ahead. I have been around long enough to have seen many of them say anything that polls well in focus groups, so a little cynical. Single payer may be the best approach for many reasons, but not believing that some of the numbers being thrown turn out to be correct.
Response to MichMan (Reply #16)
kristopher This message was self-deleted by its author.
kristopher
(29,798 posts)(1) Providing affordable, comprehensive and portable health coverage for every American;
(2) Modernizing the U.S. health care system to contain spiraling health care costs and improve the quality of patient care; and
(3) Promoting prevention and strengthening public health to prevent disease and protect against natural and man-made disasters.
Under the Obama plan, the typical family will save up to $2,500 every year through:
Health IT investment, which will reduce unnecessary and wasteful spending in the health care system that results from preventable medical errors and inefficient paper billing systems.
Improving prevention and management of chronic conditions;
Increasing insurance industry competition and reducing underwriting costs and profits,
which will reduce insurance overhead;
Providing reinsurance for catastrophic coverage that will reduce insurance premiums; and
Making health insurance universal, which will reduce spending on uncompensated care."
Do you think your original complaint is justified after reading this?
MichMan
(11,940 posts)Maybe everyone else's premiums were lowered $2500 after the passage of the ACA, all I know is that it didn't happen to us or anyone else I have talked to. Those are the sound bites that resonate with average voters, and even after he said it again and again, it ended up not being true. It doesn't matter why, people who believed it felt deceived. Are you surprised many would be cynical?
Bernie's proposal for a transaction tax may be a good idea, just skeptical that it can finance free single payer health care and college tuition with little to no costs for anyone but Wall Street. Hope I am wrong, but the reality of what gets promised in campaigns usually doesn't match reality, don't have any expectation this will be any different.
kristopher
(29,798 posts)The plan is always far more clear
My premiums are only one part of the picture, and it wasn't what was under discussion. I'd go along with criticism saying the message could have been more clear, but when I heard the speeches, let me point out that it was clear to me at the time what he was saying. Never once did his words cause me to expect the kind of decrease you are talking about. Look at the list on the NYT site and you'll see that these are all things that will happen going forward.
I started with a key piece of knowledge that I'm sure you also had - the price trend for health care was shooting almost straight up. Maybe the difference is that I have enough common sense to know that when discussing future costs the discussion is about future costs. It doesn't much to make the connection between those two points and understand that the savings are only a small part of what we need to actually make health care affordable.
I can see your disillusionment and partially that is why those of us who support "Medicare for All" were so disappointed with the process and the product. It is also why I support "The Goal Bernie Sanders is Setting" so unequivocally. There is no wriggle room or mealy mouthed mumbling - he is going to get make health care a thing we can count on if we can create the revolution he is asking for.
The only thing I can tell you is that there is a price in time and effort that we all have to pay to be informed voters. You have to do your homework and you have to read up on their plans.
riderinthestorm
(23,272 posts)and a .001% transaction tax on derivatives transactions.
Ie: Wall Street pays for free public education and single payer.
http://www.alternet.org/economy/bernie-sanders-bold-idea-make-wall-street-pay
Bernie Sanders' Bold Idea to Make Wall Street Pay
Why a financial transactions tax is good policy.
There are three points people should understand about an FTT. The first is that it can raise an enormous amount of money. An FTT could be imposed at different rates. Sanders proposed following the rate structure in a bill put forward by Minneapolis Congressman Keith Ellison. Eleven countries in the European Union are working to implement a set of FTTs that would tax stock trades at a rate of 0.1 percent and trades of most derivative instruments at the rate of 0.01 percent.
Extrapolating from a recent analysis of the European proposal, a comparable tax in the United States would raise more than $130 billion a year or more than $1.5 trillion over the next decade. This is real money; it dwarfs the sums that have dominated most budget debates in recent years. For example, the Republicans had been trying to push through cuts to the food stamp program of $40 billion over the course of a decade. The sum that can be raised by this FTT proposal is more than 30 times as large. The revenue from an FTT could go far toward rebuilding the infrastructure, improving the health care system, or paying for college tuition, as suggested by Senator Sanders.
The second point is that Wall Street will bear almost the entire cost of the tax. The financial industry is surely already paying for studies showing the tax will wipe out the 401(k)s held by middle income families. This is nonsense. Not only is the size of the tax small for anyone not flipping stock on a daily basis, research indicates that most investors will largely offset the cost of the tax by trading less.
Most research shows that trading volume falls roughly in proportion to the increase in transaction costs. This means that if an FTT doubles the cost of trading then the volume of trading will fall by roughly 50 percent, leaving total trading costs unchanged. Investors will pay twice as much on each trade, but have half as many trades. Since investors don't on average make money on trades (one side might win, but the other loses), this is a wash for the investor.
kristopher
(29,798 posts)PowerToThePeople
(9,610 posts)A plan that originated in a right wing think tank. Single payer was never on the table.
Currently we are a country with two right wing parties, this needs to change.
Bernie 2016!
NobodyHere
(2,810 posts)stupidicus
(2,570 posts)because it far outweighs many/most/all of their objections to Bernie, including the human cost/toll due to his Brady vote.
Cosmic Dancer
(70 posts)Americans are undeserving of of universal health care and our politicians have convinced us that our system is better.
msongs
(67,421 posts)to phrase it that the insurance companies are our friend and not concerned about making more money
kristopher
(29,798 posts)But I think I appreciate the hint of irony in that reading of it.
Anyway, just so no one misunderstand your meaning, here is some important information:
Single-payer national health insurance, also known as Medicare for all, is a system in which a single public or quasi-public agency organizes health care financing, but the delivery of care remains largely in private hands. Under a single-payer system, all residents of the U.S. would be covered for all medically necessary services, including doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs.
The program would be funded by the savings obtained from replacing todays inefficient, profit-oriented, multiple insurance payers with a single streamlined, nonprofit, public payer, and by modest new taxes based on ability to pay. Premiums would disappear; 95 percent of all households would save money. Patients would no longer face financial barriers to care such as co-pays and deductibles, and would regain free choice of doctor and hospital. Doctors would regain autonomy over patient care.
The Expanded and Improved Medicare for All Act, H.R. 676, based on PNHPs JAMA-published Physicians Proposal, would establish an American single-payer health insurance system.
http://www.pnhp.org/facts/what-is-single-payer
Enthusiast
(50,983 posts)But when we discuss single payer we get nice little paid sock puppets in the threads to repeat corporate talking points and muddy the issue.
kristopher
(29,798 posts)The insurance companies, of course, have very valid reasons to want things to remain the same.
As for front line physicians (excluding those in the business of corporate medicine) by and large, I believe they prioritize it 1) wanting to help people, and 2) wanting to make a decent living like anyone else. I think this group would be very happy with a Medicare for All approach.
Enthusiast
(50,983 posts)[URL=.html][IMG][/IMG][/URL]
eridani
(51,907 posts)In every age demographic, 5% of that demographic accounts for 50% of its health care costs, and 15% for 85% of costs. The remaining relatively healthy 85% are free to continue thinking their insurance is pretty good, a belief similar to thinking that their fire extinguishers are pretty good.
Granted, the sum total expenses of 20 somethings are lower than those of 60 somethings, but the percentages still apply.
Scuba
(53,475 posts)... pool possible.
Way back in late 2009 I had a post hidden for calling Obama's not fighting for a public option a "betrayal."
Bet that wouldn't happen today.
kristopher
(29,798 posts)It was, and is, much deeper than him. Remember Ned Lamont?
http://www.dailykos.com/story/2006/08/10/235397/-My-Letter-To-The-DSCC-Regarding-Contributions
https://en.wikipedia.org/wiki/United_States_Senate_election_in_Connecticut,_2006
Scuba
(53,475 posts)... there would be no public option before the negotiations ever began. Then the ACA passed with exactly zero Republican votes.
If only he'd fought as hard for a public option as he has the TPP we'd have one and the for-profit health insurance industry would be in ashes.
kristopher
(29,798 posts)by a sizable portion of (economically right-wing) Senate Dems is why he had to leave single payer out of the picture, IMO.
Maybe you're correct, I don't know, but I tend to think that he gave deference to what the old hands in the senate told him was possible. I think it is what crippled him in the fight, though; he unknowingly gave away his best weapon. If he had not listened to them, and had instead insisted on a Medicare for All direct to the public campaign I too think it would have worked.
bvar22
(39,909 posts)Neither Universal HealthCare NOR a Public Option were on "The Plan" for the ACA.
President Obama started craw-fishing on the Public Option during his first week as president.
(For those not from the South, craw-fish walk backwards.)
kristopher
(29,798 posts)...to you for sharing your unique insight.