Okay, I'm going to say the same thing I've been saying for years, but for some reason, I always get ignored: maybe they won't have to raise taxes IF THEY WOULD STOP WASTING THE MONEY WE ALREADY GIVE THEM. Maybe if government agencies would stop throwing around tax dollars like confetti, we could afford M4A. Any of you smart people have anything to say about this?
The United States spends $3-4 Trillion per year on healthcare. If we redirected every single dollar the federal government spends to that purpose, it would just barely cover it.
(Grumbles and rolls eyes) Once again, DON'T YOU THINK WE'RE BEING OVERCHARGED FOR HEALTHCARE? This is the real issue, but all I ever hear about it from either side is either: "we're going to have to raise taxes," and "hOw ArE wE gOinG tO pAy FoR aLL oF tHiS?!"
WOW, no smart people except for 'Kahn want to comment on my statement. Let me give y'all a scenario: a husband and wife take their car to a mechanic to have their brake pads replaced* (Aetius,I know you don't have a car, and you never leave your apartment , but just play along). The mechanic says that the job will be $10,000. The husband says that they need to take out a bank loan to pay for it. The wife argues that they should buy an extended warranty for their car for $120 a month for the next five years. BUT NEITHER THE HUSBAND OR WIFE COMPLAIN ABOUT THE PRICE OF THE REPAIR, WHICH IS A FUCKING HOSE-JOB. I know that most of y'all think I'm just a stupid ex-con, but can anyone except the Canadians recognize that our healthcare system is overpriced? All I hear is about how it's going to get paid for. Goddamn, these companies (and their executives, and their paper shufflers) make more than I do, and I bust my ass every day. But they sit behind desks, go to meetings, and they don't need to worry if they get sick or injured. *In my area, you can get a brake-job for a little under $200 per axle. The $10,000 number I mentioned would be excessive.
The biggest problem you have is that your health care system is there to make money, not provide health care. Nobody in a position of authority wants to change it because it makes them too much money.
We pay too much for just about everything that other countries subsidize: healthcare, education, housing, etc. The drivers for the healthcare costs tend to be malpractice insurance (which exploded in the 80's & 90's), and management and overhead. Someone is paying all the insurance people to create chicanery to get out of paying claims. It's not the machinery, it's not the doctors and nurses salaries, it's the middlemen who contribute NOTHING to actual care, who are causing the costs to skyrocket. It's something retail fully embraces: the fewer hands that touch the transaction, the cheaper and easier the transaction becomes. Healthcare, driven by private insurance, becomes almost the opposite: numerous stages of review and approval before a claim is paid, resulting in stupidly complex transactions....that means the overhead is astronomical. Hell, you ever get a prescription from a doctor that needs pre-authorization? It's the most fuck-tarded process you can think of: my doctor writes me a prescription. My insurance company, for reasons known but to God, has to ask my doctor "are you sure? Are you REALLY sure?" as if my doctor is filling the cart with Skinny Girl Popcorn or some shit, and the entire process includes me, my doctor, and the front desk staff over 3 days to untangle....3 days that I'm waiting on a medication for, so I hope it takes longer than that to die from whatever the fuck it is. Our system is indefensible, it truly is.
If you use 3.5 trillion, that's over $10k per person every year. Knock on wood, I've never had a $10k year, but my wife probably exceeds $10k by a lot every year since her injuries. That's over $833 per month, per person. Not per taxpayer, per person. Where the hell does that come from now?
I didn't comment because it's such a bad situation all around there are no easy answers, and also I'm not sure I'm a smart person. I think there are two massive issues with universal healthcare, as it stands (I still want it, I just think these issues need to be fixed first): 1) medical is for-profit, and it needs to not be. 2) the government has proven time and time again that presented with multiple ways of accomplishing something, it will choose that way which wastes the most money Fix those two things, and it's off to the races boys! Easier said than done though. But it needs to be done. Immediately.
My understanding of the high costs of health care is because of reimbursement for the hospital. Let's say a splint costs $20.00. But the insurance company only covers 70% of the charges ( I forget what the actual is. ) In order for the hospital to make any money off that splint ( and go towards the pay for the people who took care of the patient ) they will bill for an inflated price, maybe $80, knowing they won't get it, but they WILL make something more than they paid. Having been the person at the doctor's office dealing with that shit show first hand, I can attest to what 'Dirty says. It is the most convoluted and frustrating process you can go through, and I had to do it day in and day out. And even when you do, it's a 50/50 shot they'll pay for it. I got to where I knew without calling whether the patient's insurance would pay for it or not. Your doctor is not in charge of your health care, your insurance company is. However, here's a tidbit many people don't know: It's sometimes cheaper to pay cash than to have your insurance pay for it, and certainly easier than waiting for the pre-auth to clear, if it does. But a lot of people would rather wait, let the insurance pay $80 for the meds than shell $20 out of their own pocket. And don't get me started on the abuses to Medicaid.
Every country that has implemented some form of socialized healthcare has had to raise taxes to pay for it. I think it's silly to believe we won't have to do so. I mean... yes, you're right? You're presenting this like it's some unknown issue that nobody is talking about. It's well-known that the US has some of the most expensive healthcare in the world. There have been news articles and extensive studies around healthcare costs relative to outcomes, and the US comes out poorly in these assessments. I'm just not sure what your suggestion is here other than, "we're paying too much we need to lower costs." That's true. It's a well-known issue: https://www.pgpf.org/blog/2020/07/how-does-the-us-healthcare-system-compare-to-other-countries Of course we're being overcharged for healthcare across the board. A single payer system helps with this because they have much more leverage in negotiating rates, and better efficiency throughout the system will help lower the costs. But priority #1 is making sure that citizens are not going bankrupt paying for medical care. To your average consumer, it doesn't matter if their healthcare costs are 40% over-priced; they can't afford it anyway.
Something that has always driven me absolutely crazy about healthcare... My mechanic is required by law to give me a price quote for any work done prior to touching anything. Those guys can pretty much nail cost down to a few bucks when just talking about what they are going to do off the cuff because they have done it 1,000 times before and know what pricing is. Ever ask your doctor what something is going to cost before they do it? They have no idea. Can't even give a general ballpark. I got a prescription from my doctor, went to the pharmacy and was told the prescription was going to be $795. I just kind of stumbled and said well I guess I have to do it. The pharmacist then suggests a generic for less than $100 that he tells me will handle things just fine and off I went. It's insane to me that the doctor didn't even discuss the option before writing the script. I went to get a biopsy last year and asked to skip the numbing agent. The doc balked at the idea. I told him when I was there last year I got pinged more for the damn numbing agent than the biopsy and being that money was tight with my divorce I could just tough it out. I broke three fingers in my hand last year and tried setting them myself to avoid medical bills. Eventually, I had to give in and go get things checked out and while the bones had healed properly I apparently screwed up some tendons or ligaments because I still can't close two of my fingers. I asked the hand surgeon what I was looking at cost wise to get things fixed, like more than 8K or less? He couldn't even begin to narrow down the possibilities. He seemed to have no idea why I might need to know if I was going to need to plop down 8 grand or not prior to letting him get to work but if I mechanic can't get me on the phone to let me know my brakes are going to cost $237 he has to wait to start the job.
I agree that taxes will have to go up to pay for a universal system. But if you no longer have any deductions for premiums coming out pretax to pay for your insurance and instead some of that went to the Medicare withholding, would that be worth it? I kinda think it would.
Oh, absolutely. In fact, the assessment of Bernie's plan suggested that a majority of Americans would actually end up paying less out of pocket under M4A (if I'm recalling the details correctly). I mean, who knows how that would have played out, but certainly some of the tax increase will be offset by most of the premiums, deductibles and coinsurance going away. I was just answering the question, which is that taxes will go up; this wasn't going to just be magically eliminated by managing healthcare costs. I am fully in support of socialized healthcare, though, and will happily pay some increased amount of taxes to accomplish that. Despite the fact that my particular combination of health, current coverage and income will likely result in my paying a little more than I am today. The flip side is that I can stop worrying about what my retiree medical costs would be, can stop wondering what would happen if I quit my job to travel, can stop speculating on how much of my income would go towards healthcare costs if I ever transitioned to doing contract work again.
There are several reasons why healthcare is so expensive in this nation. Looking at the cost of pharmaceuticals as an example- as individuals we have very little bargaining power. Contrast this with other nations that have centralized healthcare, where they can debate the value of a medication and use it as a baseline of cost, often significantly cheaper than what we will pay. Essentially, what this means is that between what we fund for R&D as taxpayers, which then gets spun out and acquired by larger pharma / biotech organizations, which then pay well over a billion dollars on average for a drug to reach market, only a third of which will be financially successful enough to pay for other drugs (a blockbuster). Blockbuster drugs need to drive enough revenue to pay for the R&D and clinical trials for other products before they become generic, as when most drugs are off patent they lose a significant portion of their value. Looping back to the first point - that we don't have centralized bargaining - we are essentially subsidizing pharma R&D and sales, as we pay more for drugs than other nations. Change could happen here, but it would mean that their structure would have to shift (not necessarily a bad thing). I'm personally in favor of removing direct to consumer marketing, which has a higher dollar amount allocated to it than I think is appropriate. This is all not even getting into some problems with clinical trial and R&D structure, which sometimes reward incremental movements forward to extend patent life rather than breakthroughs in treatment. That being said, lots of the low hanging fruit for simple drug discovery was knocked out a while ago- new technology is unlocking new usages, and I'm pretty excited for what's to come with precision (personalized) medicine. Happy to drone on about this topic in greater detail if desired. TL;DR: Drugs are more expensive in the US, but that doesn't mean that drug companies are sinister. Shit is expensive to produce. There are definitely examples of companies that take advantage, however, an example being a medical device startup that was basically drooling over a 98% profit margin it was able to earn over a product it produced that really didn't produce any value. Hospital administration is another problem, but an area I know a bit less about.
https://www.wric.com/news/virginia-...avirus-vaccinations-once-available-to-public/ Virginia gives the commissioner of health the power to mandate immunization during a public health crisis, and he plans to use that power. Any other states planning to do this, take away a freedom of choice to not receive a hastily produced, vaccine, or is it just mine?
MA is mandating that all students get the flu shot this year. Just regular flu, not covid. So at least it's not a rushed, profit-motived, experimental vaccine. For whatever that's worth.
Uggh. Next fucking wildly retarded political divide. Without an immensely successful therapeutic a vaccine is the only thing that will get us back to normal. Like full crowd college football normal. Can we just not? Please.
Seeing the reports on the "long haulers" is scaring the fuck out of me....and we have more of them than any country on earth, with the most expensive healthcare on earth. I dunno if I want to line up for a vaccine when we still have really poor understanding of it, and theres immense pressure to produce it for political reasons. I never get a flu shot, and I am no anti vax fucktard, but....they have no idea what the long term effects of this are, so how would they know what the impacts of a vaccine are?