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kristopher

(29,798 posts)
Sun Nov 1, 2015, 10:53 AM Nov 2015

Too 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?

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 today’s 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 PNHP’s 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 economics, a cartel is an agreement between competing firms to control prices or exclude entry of a new competitor in a market. It is a formal organization of sellers or buyers that agree to fix selling prices, purchase prices, or reduce production using a variety of tactics.


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.
49 replies = new reply since forum marked as read
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Too many DUers don't know why the goal of single payer matters (Original Post) kristopher Nov 2015 OP
We would first need all doctors to agree to be govt employees. JaneyVee Nov 2015 #1
No we don't. kristopher Nov 2015 #2
Even in the UK with the NHS not all doctors are government employees Fumesucker Nov 2015 #3
Because there is also private insurance in the UK. JaneyVee Nov 2015 #4
I guess people can continue to die untreated then Fumesucker Nov 2015 #5
Boosting the number of doctors can't be done without breaking the AMA's cartel. kristopher Nov 2015 #7
The average US state has 1/50th the population of the US cprise Nov 2015 #8
1/15th? Now you are just making things up. nt kristopher Nov 2015 #9
We have states Rosa Luxemburg Nov 2015 #25
Making public college tuition free could go a long way toward increasing the numbers Uncle Joe Nov 2015 #31
Excellent point, Uncle Joe! Enthusiast Nov 2015 #36
I'm not so sure of that kristopher Nov 2015 #38
There are Rosa Luxemburg Nov 2015 #24
Do you always comment on subjects that you know nothing about? jeff47 Nov 2015 #6
That is even made clear in the OP. nt kristopher Nov 2015 #11
JaneyVee always seems ready to defend the status quo - HRC or the AMA erronis Nov 2015 #27
Bullshit. Ed Suspicious Nov 2015 #21
There's some grade-A Republican talking point right there. Scootaloo Nov 2015 #26
That's a big No. polly7 Nov 2015 #30
Straight out of the Republican playbook Janey. And false, false, false. Scuba Nov 2015 #39
If I had written a blatently FALSE OP, bvar22 Nov 2015 #44
Those darned ethics, so pesky for some, no trouble at all for others. Scuba Nov 2015 #45
Still waiting for my $2500 I was promised MichMan Nov 2015 #10
Another confused citizen. kristopher Nov 2015 #12
One I found MichMan Nov 2015 #14
No offense, but I don't follow links or play vids kristopher Nov 2015 #15
His own words MichMan Nov 2015 #16
This message was self-deleted by its author kristopher Nov 2015 #18
OK, here is the "promise" straight from Obama's campaign literature kristopher Nov 2015 #19
Why not? MichMan Nov 2015 #22
Why not? Maybe you trust too much in sound bites? kristopher Nov 2015 #32
Yes and Sanders has proposed a .1% financial transaction tax to pay for it riderinthestorm Nov 2015 #13
+1 with an ! kristopher Nov 2015 #17
ACA was a sellout to the right wingers PowerToThePeople Nov 2015 #20
You can't blame anyone except the Democrats for the ACA NobodyHere Nov 2015 #34
I'd say Hillary's opposition also has a corruptive role stupidicus Nov 2015 #23
Unlike the rest of the developed world Cosmic Dancer Nov 2015 #28
so the insurance industry is our golden savior from the bad old medical industry lol odd way msongs Nov 2015 #29
Not insurance "Industry" or "Companies" kristopher Nov 2015 #33
There is no good argument against adopting single payer in the USA. Enthusiast Nov 2015 #35
I suppose that depends on your perspective and where your self interest lies kristopher Nov 2015 #48
Medicare for all would simplify the paper work. That is quite a headache for the clinic where I go. Enthusiast Nov 2015 #49
The reason for that is that most people will never get expensively sick eridani Nov 2015 #37
The larger the insured pool, the more the risk is spread. Medicare for All would be the largest ... Scuba Nov 2015 #40
Many of us felt the same way, but I didn't blame Obama. kristopher Nov 2015 #41
I don't recall Ned Lamont ever being President, but I do remember BHO capitulating ... Scuba Nov 2015 #42
The sidelining of (D) candidate Lamont in favor of (I) Lieberman kristopher Nov 2015 #43
As a self-proclaimed Moderate Republican from the 80s, bvar22 Nov 2015 #46
I'm in debt... kristopher Nov 2015 #47

Fumesucker

(45,851 posts)
3. Even in the UK with the NHS not all doctors are government employees
Sun Nov 1, 2015, 11:08 AM
Nov 2015

There are private doctors in the UK.

 

JaneyVee

(19,877 posts)
4. Because there is also private insurance in the UK.
Sun Nov 1, 2015, 11:15 AM
Nov 2015

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)
5. I guess people can continue to die untreated then
Sun Nov 1, 2015, 11:33 AM
Nov 2015

Sounds a lot like the Republican health care plan actually.

If you get sick die quickly.

kristopher

(29,798 posts)
7. Boosting the number of doctors can't be done without breaking the AMA's cartel.
Sun Nov 1, 2015, 11:49 AM
Nov 2015

They maintain an artificial shortage.

Uncle Joe

(58,372 posts)
31. Making public college tuition free could go a long way toward increasing the numbers
Sun Nov 1, 2015, 02:29 PM
Nov 2015

of doctors and nurses.

kristopher

(29,798 posts)
38. I'm not so sure of that
Sun Nov 1, 2015, 10:07 PM
Nov 2015

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)
24. There are
Sun Nov 1, 2015, 01:19 PM
Nov 2015

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)
6. Do you always comment on subjects that you know nothing about?
Sun Nov 1, 2015, 11:46 AM
Nov 2015

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.

erronis

(15,306 posts)
27. JaneyVee always seems ready to defend the status quo - HRC or the AMA
Sun Nov 1, 2015, 01:36 PM
Nov 2015

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.

 

Scootaloo

(25,699 posts)
26. There's some grade-A Republican talking point right there.
Sun Nov 1, 2015, 01:24 PM
Nov 2015

Heard the same thing about the affordable care act.

bvar22

(39,909 posts)
44. If I had written a blatently FALSE OP,
Mon Nov 2, 2015, 03:17 PM
Nov 2015

and was properly corrected by a number of trusted DUers......
I would delete the embarrassing OP.

MichMan

(11,940 posts)
10. Still waiting for my $2500 I was promised
Sun Nov 1, 2015, 11:51 AM
Nov 2015

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)
12. Another confused citizen.
Sun Nov 1, 2015, 11:55 AM
Nov 2015

Please quote the promise so we can deal with reality rather than a slipshod characterization put forth out of cynical obstructionism.

kristopher

(29,798 posts)
15. No offense, but I don't follow links or play vids
Sun Nov 1, 2015, 12:28 PM
Nov 2015

from new members quoting known false right wing talking points.

Please provide a text quote.

MichMan

(11,940 posts)
16. His own words
Sun Nov 1, 2015, 12:43 PM
Nov 2015

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

(29,798 posts)
19. OK, here is the "promise" straight from Obama's campaign literature
Sun Nov 1, 2015, 12:58 PM
Nov 2015
"Barack Obama believes we live in the greatest country in the world and that when it comes to health care America can and must do better. Obama has a three part plan to build upon the strengths of the U.S. health care system, including innovative state efforts, and address its glaring weaknesses, such as affordability. The Obama plan will save a typical American family up to $2,500 every year on medical expenditures by:
(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)
22. Why not?
Sun Nov 1, 2015, 01:17 PM
Nov 2015

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)
32. Why not? Maybe you trust too much in sound bites?
Sun Nov 1, 2015, 04:58 PM
Nov 2015

The plan is always far more clear

"The Obama plan will save a typical American family up to $2,500 every year on medical expenditures by..."
http://www.nytimes.com/packages/pdf/politics/factsheet_healthcare.pdf

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)
13. Yes and Sanders has proposed a .1% financial transaction tax to pay for it
Sun Nov 1, 2015, 12:02 PM
Nov 2015

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.
 

PowerToThePeople

(9,610 posts)
20. ACA was a sellout to the right wingers
Sun Nov 1, 2015, 01:07 PM
Nov 2015

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!

 

stupidicus

(2,570 posts)
23. I'd say Hillary's opposition also has a corruptive role
Sun Nov 1, 2015, 01:18 PM
Nov 2015

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)
28. Unlike the rest of the developed world
Sun Nov 1, 2015, 01:54 PM
Nov 2015

Americans are undeserving of of universal health care and our politicians have convinced us that our system is better.

msongs

(67,421 posts)
29. so the insurance industry is our golden savior from the bad old medical industry lol odd way
Sun Nov 1, 2015, 02:22 PM
Nov 2015

to phrase it that the insurance companies are our friend and not concerned about making more money

kristopher

(29,798 posts)
33. Not insurance "Industry" or "Companies"
Sun Nov 1, 2015, 05:04 PM
Nov 2015

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:

What is Single Payer?
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 today’s 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 PNHP’s 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)
35. There is no good argument against adopting single payer in the USA.
Sun Nov 1, 2015, 09:17 PM
Nov 2015

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)
48. I suppose that depends on your perspective and where your self interest lies
Tue Nov 3, 2015, 03:58 PM
Nov 2015

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)
49. Medicare for all would simplify the paper work. That is quite a headache for the clinic where I go.
Tue Nov 3, 2015, 04:01 PM
Nov 2015

[URL=.html][IMG][/IMG][/URL]

eridani

(51,907 posts)
37. The reason for that is that most people will never get expensively sick
Sun Nov 1, 2015, 09:50 PM
Nov 2015

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)
40. The larger the insured pool, the more the risk is spread. Medicare for All would be the largest ...
Mon Nov 2, 2015, 09:12 AM
Nov 2015

... 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.

 

Scuba

(53,475 posts)
42. I don't recall Ned Lamont ever being President, but I do remember BHO capitulating ...
Mon Nov 2, 2015, 01:48 PM
Nov 2015

... 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)
43. The sidelining of (D) candidate Lamont in favor of (I) Lieberman
Mon Nov 2, 2015, 02:02 PM
Nov 2015

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)
46. As a self-proclaimed Moderate Republican from the 80s,
Mon Nov 2, 2015, 06:20 PM
Nov 2015

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.)

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