7 ms·

Cost of universal health care in California bigger than state's budget

30 points by mudil 9y ago

chipperyman573 9y ago
Isn't that a given? I mean, do people not realize that the money has to come from somewhere? Of course it's going to be insanely expensive to insure everybody. Edit: I'm not arguing against Single Payer, I'm just surprised that this is something so shocking an article was written (and then upvoted) about.
- flukus 9y ago
  > Of course it's going to be insanely expensive to insure everybody. The entire rest of the western world would indicate that it's cheaper than the current system, better too.
  - threeseed 9y ago
    Actually let's be clear here. The rest of the Western world does not have a pure single payer system. In fact almost all of them don't. What we have e.g. in Australia is a mixed system closer to Obamacare. If you don't pay for private health insurance you get public coverage (but you have to pay an increased tax).
    - flukus 9y ago
      The increased tax is our governments attempt to copy the American system.
- ncallaway 9y ago
  Right, it adds an insane cost. You then need to raise that same amount of money. However, when you consider that people are no longer paying for health insurance there's a large pool of money available. CA needs somewhere between $50-100B to fund this project. The population of CA is around 39M (https://www.google.com/publicdata/explore?ds=kf7tgg1uo9ude_&met_y=population&idim=state:06000:48000&hl=en&dl=en https://www.google.com/publicdata/explore?ds=kf7tgg1uo9ude_&...). That means, you need about $2,564/person/year. Or about $214/person/month. If you compare that figure to the average health insurance cost for people in CA everything starts to look possible or reasonable. Of course, there's still some massive political hurdles to get over. But the money is out there.
  - csuwldcat 9y ago
    You forgot to account for two significant factors: that 40% of Californians pay no state income tax, and that California dramatically skews toward higher brackets paying for the state's expenditures - the top 1% already pay an absurdly massive 48% of state income tax. Per person numbers like the ones you included are basically meaningless, given they bear almost no reflection of the actual fiscal implementation and unique issues it would create. Alexander Tyler nailed the broader issue of 'democracy' long ago: “A democracy cannot exist as a permanent form of government. It can only exist until the voters discover that they can vote themselves money from the public treasure. From that moment on the majority always votes for the candidates promising the most money from the public treasury, with the result that a democracy always collapses over loose fiscal policy followed by a dictatorship."
- smileysteve 9y ago
  > I mean, do people not realize that the money has to come from somewhere? If You read some of the above comments, you'll see that the money is already coming from "somewhere", that Medicare and Medicaid already cost more than what Japan spend per capita, or that $400bln may be half of what is currently being collectively. https://news.ycombinator.com/item?id=14398948 https://news.ycombinator.com/item?id=14398948 https://news.ycombinator.com/item?id=14398974 https://news.ycombinator.com/item?id=14398974
- jernfrost 9y ago
  If you pay 200 dollars today per month for health insurance but instead have to pay 200 dollars in extra taxes tomorrow for health insurance, what difference does it make?
  - dragonwriter 9y ago
    Quite a lot to people who are ideologically opposed to taxes and/or government spending irrespective of the cost-effectiveness of the programs they find compared to alternatives. Which California—Democratic majority notwithstanding—is hardly short on. And those are exactly the people this Sac Bee headline is aimed at.
  - DrScump 9y ago
    Can you name an Obamacare-compliant plan (even just bronze) with a total (unsubsidized) $200 premium for the median or mean adult? One?
stmfreak 9y ago
It will also provide excellent cover for California's pension shortfalls.
aphextron 9y ago
This headline is really misleading and clickbaity. It makes it seem as if the state is facing a budget shortfall. The cost they are referring to is a hypothetical number crunching of possible future healthcare systems.
- gzuki 9y ago
  And even further, they are misrepresenting that somewhat. They admit further down the article that after offsetting from the existing employer based tax that "total new spending to implement the system would be between $50 billion and $100 billion per year". They make it sound like it's $400b more, rather than total. There is also no discussion of the kind of external savings this might create. Usually that kind of thing is included in budget office analysis.
  - tanderson92 9y ago
    More good analysis here too: http://mattbruenig.com/2017/05/22/californias-surprisingly-cheap-single-payer-plan/ http://mattbruenig.com/2017/05/22/californias-surprisingly-c...
- DrScump 9y ago
  The state is facing a budget shortfall, per Brown administration estimates.
sologoub 9y ago
TLDR; $400 billion total, $200 billion is currently spent on subsidies and medi-cal, $150 billion is already spent by employers. The state would need to "find" ~$50 billion or ~$1,300 per resident more to fully fund this. Personally, this seems like a relative bargain and some modest extra taxes should offset the difference. Article reads pretty poorly and sensationalist. Not to mention that the missing amount is less than most people have in various deductables and co-pays already. EDIT: Turns out in 2015, per capita health spending was $9,990 already, which translates to ~$390 billion for 39 million Californians. So $400 Billion is cheaper than what we already spend in 2017, assuming modest growth since 2015. Further, if we assume that this money already gets spent, just not very evenly, we'll end up with a much fairer system and a lot smaller downside for people if/when they get sick. Personally, I'll gladly trade some immediate savings for long term protection from not having insurance when I need it most. The data seems to imply that I won't even have to pay all that much more.
- jlarocco 9y ago
  Yeah, the headline is sensationalist. With the current spending factored in, it's really not that bad. A big enough tax on fast food could probably cover it, with the added bonus of decreasing the amount needed. If that doesn't work, then there are a lot of programs they can cut that are less important than healthcare.
  - tuxracer 9y ago
    > A big enough tax on fast food could probably cover it Exactly this kind of statement is what worries some about universal healthcare. I highly support single payer, universal healthcare. But statements like this undermine the cause by feeding fuel to the idea universal healthcare will inherently lead to more government intrusion into your personal decisions.
    - jlarocco 9y ago
      Like it or not, it's already done with cigarettes, alcohol, marijuana, gasoline, and a ton of other stuff. These type of taxes are the only way I'm in favor of government healthcare programs. Cigarettes, alcohol, and junk food directly increase medical costs, and people who indulge (and over indulge) in those things should be partly responsible for those increased costs.
carsongross 9y ago
Few know this: The United States currently spends more money per capita on socialized medicine than any other country except Norway: https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita#/media/File:OECD_health_expenditure_per_capita_by_country.svg https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... In fact, the US spends more on socialized medicine than Japan, the UK and Finland spend in total, private and public spending. The US healthcare system is totally out of control. Nothing will fix it until there is a collapse.
- therealmarv 9y ago
  Wow, I'm surprised. So doctors/hospitals are extremely expensive in USA? What is spend monthly very roughly on health care in USA (if you're have one)? I'm originally from Germany and I always assumed we pay more for health care generally.
  - curun1r 9y ago
    One aspect that makes care in the US cost more is our culture of being highly litigious. We seem to believe that if doctors make honest mistakes, it entitles the patient or their heirs to a large settlement. So doctors/hospitals need expensive malpractice insurance and that cost gets bundled in with the cost of care. To add to that, settlements encompass both medical costs and compensation for pain and suffering, which is usually a multiple of the medical costs. So the cost of lawsuits increases the cost of care which, in turn, increases the size of settlements which, in turn, increases the cost of malpractice insurance which increases the cost of care. It's a feedback loop. It's not the only reason why our health care costs are spiraling out of control, but it is a reason that will naturally continue to increase over time unless we cap malpractice claims.
    - brownbat 9y ago
      Allow me to play devil's advocate... Medical negligence is the third leading cause of death in the United States. We have an epidemic of "honest mistakes" like scalpels left in patients after surgeries,[0] often leading to deaths, or amputations of the wrong limb[1] leading to enormous harms to the patient. Something as innocent as 'forgetting to wash your hands' has outsized consequences in this industry, forgiving 'honest mistakes' is not a safe standard. It's also not generally true that plaintiffs in tort cases receive exorbitant damages, this is a popular myth because there are a few outlandish examples. The most popular examples, such as the "Stella awards," are completely made up.[1][2] States that have capped medical malpractice have seen no difference in medical costs, and it has not been found to be a significant contribution to costs in the industry.[3] Meanwhile, capping costs hurts patients - some mistakes end up costing millions in additional medical costs throughout an injured patient's life, and most importantly for getting improved care over time, it lightens incentives for billion dollar hospitals to actually correct underlying procedures that make harms more likely. [0] https://en.wikipedia.org/wiki/Retained_surgical_instruments https://en.wikipedia.org/wiki/Retained_surgical_instruments [1] http://www.hotcoffeethemovie.com/default.asp?pg=mcdonalds_case http://www.hotcoffeethemovie.com/default.asp?pg=mcdonalds_ca... [2] http://www.snopes.com/legal/lawsuits.asp http://www.snopes.com/legal/lawsuits.asp [3] http://www.decof.com/decof/wp-content/uploads/2015/12/five-myths-about-medical-negligence.pdf http://www.decof.com/decof/wp-content/uploads/2015/12/five-m... [4] More on handwashing as a challenge to health in hospitals: http://annals.org/aim/article/712481/compliance-handwashing-teaching-hospital http://annals.org/aim/article/712481/compliance-handwashing-...
a3n 9y ago
Separate from the cost debate, the bill is labeled a "job killer," I assume because of all the insurance and related jobs lost. Which would be bad for the people losing their jobs, but they're only employed because they work for an arguably unnecessary middle-man industry. There's no "right" to those jobs, and if we can find a way to deliver health care, as opposed to health insurance, to close to everyone, we should figure that out, regardless of insurance jobs.
- Frondo 9y ago
  Yep, health care administrators--this century's buggy whip makers, telephone sanitizers, ...
- flukus 9y ago
  How many are in state anyway? I'd of thought most of the middle men would be parts of large companies located in cheaper states.
- tuxracer 9y ago
  Both the military and the private health insurance industry are Keynesian jobs programs first, their stated purposes second.
- jernfrost 9y ago
  How is this supposed to kill jobs? Total money spent should be no different. It just shifts from out of pocket to taxes.
  - adt2bt 9y ago
    If you read the other parent comment in this thread, total expenditures on health care would actually drop by close to 50% overall (with a few fraught assumptions, of course). In the best/worst case, that's a $350B economic blow to those who rely on insurers for their employment. Given the complexity of the health care system around the US, I'm sure any move to universal health care will be extremely economically disruptive and render quite a few people jobless without competitive skills.
  - 9y ago
ChuckMcM 9y ago
These discussions rarely include a discussion about existing extortionate pricing models do to distort the discussion.
curtis 9y ago
If your universal health care system is some variant of "single payer", which is what I think is proposed here, then the fact that it is really expensive is largely irrelevant, and for a really obvious reason: You may be paying a lot of money for government funded health insurance, but you are not paying all that money to a private health insurer like you are now. Essentially you are just writing a check to the government rather than a private company.
jernfrost 9y ago
Really weird talking about how expensive this is. Whether you pay through it out of pocket or through taxes what difference does it make? Why do Americans think there is somethink inherently more difficult with paying taxes than paying other expenses. Weird how these people talk about health care as unaffordable but somehow there are always money for wasting trillions in wars like Iraq and Vietnam.
- adt2bt 9y ago
  Yea, nobody seems to talk about it that way for some reason. If we 'save' on health care, it's either from making the system more efficient, or not providing care to people who need it. Maybe it's too complicated for a sound byte, I'm not sure.
- ryanx435 9y ago
  You should look into how much the federal and state governments pay to Medicare and Medicaid and other medical programs than compare it to the budget for the various military expenditures. Also, although iraq and Vietnam were failures on the surface, I challenge you to put a dollar value on the pax Americana that American military spending has enabled in the last 70 years, a dollar value on the various technologies developed through military funding over the years, and a dollar value on a thriving capitalistic economy that was saved from fascist and communist takeovers by military spending. Than maybe it won't be so strange to you why the us spends so much on the military.
  - threeseed 9y ago
    No one is disputing that the US needs a military. What everyone is questioning (and rightly so) is whether the levels of investment are warranted. Especially when the US has such a pitiful social safety net compared to other Western countries. And let's be serious here. The rest of the world has done more to save the world from fascism and communism than the US has. And entrepreneurship has done far more for innovation than military spending has.
    - ryanx435 9y ago
eecc 9y ago
Well, signle player, universal health care provider also means one powerful actor with the weight and leverage to aggressively pursue economies of scale and optimizations and preventive care. As an individual you're just a sucker, a sitting duck to be plucked one feather at a time
anovikov 9y ago
Why all discussions about healthcare reform revolve around money to pay for it? I am sure this is the wrong side of it. Whatever money you pay, you have a limited supply of doctors. So in the end, more money just raises prices, redistributing who gets which care, anyway. Why not start with supply side? Automatically recognize diploma of doctors from all developed countries (you may start with a limited list - very rich countries with life expectancy higher than U.S. - start with UK, France and Germany, add a few more if it's not enough - no one can say that their doctors are not 'good enough') - and make them instant immigration papers - literally, hand out green cards right at the airport on arrival. Millions will flock and quickly saturate the market. Then you will not have a problem with either new single-payer, or old system.
teekert 9y ago
Perhaps they should not accept healthcare cost as is? Wages of physicians are insane in the US (because the price of the education is insane?), as are the prices of medcine. Just think of what Pharma has to spend on commercials in the US. All that money is a big waste.
GiorgioG 9y ago
As much as I'm a proponent for free markets & lower taxes, I want universal healthcare in the US. When big pharma companies & hospital systems are forced to negotiate with the government for rates, costs will go down. My 5 year old's type 1 diabetes quarterly supplies are billed at $6,000 per shipment. Looking at what's in the box, I'm hard pressed to guess there's more than $100 of material costs. The technology has been around forever, and yet these companies continue to extort these exorbitant prices because nobody had said 'Enough!' Same story with a friend's Gleevec. $14,000 per month. It's time to put cost controls in place. If universal care is how that's achieved, then so be it.

30 points by mudil 9y ago

Isn't that a given? I mean, do people not realize that the money has to come from somewhere? Of course it's going to be insanely expensive to insure everybody. Edit: I'm not arguing against Single Payer, I'm just surprised that this is something so shocking an article was written (and then upvoted) about.

flukus 9y ago
> Of course it's going to be insanely expensive to insure everybody. The entire rest of the western world would indicate that it's cheaper than the current system, better too.
- threeseed 9y ago
  Actually let's be clear here. The rest of the Western world does not have a pure single payer system. In fact almost all of them don't. What we have e.g. in Australia is a mixed system closer to Obamacare. If you don't pay for private health insurance you get public coverage (but you have to pay an increased tax).
  - flukus 9y ago
    The increased tax is our governments attempt to copy the American system.
ncallaway 9y ago
Right, it adds an insane cost. You then need to raise that same amount of money. However, when you consider that people are no longer paying for health insurance there's a large pool of money available. CA needs somewhere between $50-100B to fund this project. The population of CA is around 39M (https://www.google.com/publicdata/explore?ds=kf7tgg1uo9ude_&met_y=population&idim=state:06000:48000&hl=en&dl=en https://www.google.com/publicdata/explore?ds=kf7tgg1uo9ude_&...). That means, you need about $2,564/person/year. Or about $214/person/month. If you compare that figure to the average health insurance cost for people in CA everything starts to look possible or reasonable. Of course, there's still some massive political hurdles to get over. But the money is out there.
- csuwldcat 9y ago
  You forgot to account for two significant factors: that 40% of Californians pay no state income tax, and that California dramatically skews toward higher brackets paying for the state's expenditures - the top 1% already pay an absurdly massive 48% of state income tax. Per person numbers like the ones you included are basically meaningless, given they bear almost no reflection of the actual fiscal implementation and unique issues it would create. Alexander Tyler nailed the broader issue of 'democracy' long ago: “A democracy cannot exist as a permanent form of government. It can only exist until the voters discover that they can vote themselves money from the public treasure. From that moment on the majority always votes for the candidates promising the most money from the public treasury, with the result that a democracy always collapses over loose fiscal policy followed by a dictatorship."
smileysteve 9y ago
> I mean, do people not realize that the money has to come from somewhere? If You read some of the above comments, you'll see that the money is already coming from "somewhere", that Medicare and Medicaid already cost more than what Japan spend per capita, or that $400bln may be half of what is currently being collectively. https://news.ycombinator.com/item?id=14398948 https://news.ycombinator.com/item?id=14398948 https://news.ycombinator.com/item?id=14398974 https://news.ycombinator.com/item?id=14398974
jernfrost 9y ago
If you pay 200 dollars today per month for health insurance but instead have to pay 200 dollars in extra taxes tomorrow for health insurance, what difference does it make?
- dragonwriter 9y ago
  Quite a lot to people who are ideologically opposed to taxes and/or government spending irrespective of the cost-effectiveness of the programs they find compared to alternatives. Which California—Democratic majority notwithstanding—is hardly short on. And those are exactly the people this Sac Bee headline is aimed at.
- DrScump 9y ago
  Can you name an Obamacare-compliant plan (even just bronze) with a total (unsubsidized) $200 premium for the median or mean adult? One?

stmfreak 9y ago

It will also provide excellent cover for California's pension shortfalls.

aphextron 9y ago

This headline is really misleading and clickbaity. It makes it seem as if the state is facing a budget shortfall. The cost they are referring to is a hypothetical number crunching of possible future healthcare systems.

gzuki 9y ago
And even further, they are misrepresenting that somewhat. They admit further down the article that after offsetting from the existing employer based tax that "total new spending to implement the system would be between $50 billion and $100 billion per year". They make it sound like it's $400b more, rather than total. There is also no discussion of the kind of external savings this might create. Usually that kind of thing is included in budget office analysis.
- tanderson92 9y ago
  More good analysis here too: http://mattbruenig.com/2017/05/22/californias-surprisingly-cheap-single-payer-plan/ http://mattbruenig.com/2017/05/22/californias-surprisingly-c...
DrScump 9y ago
The state is facing a budget shortfall, per Brown administration estimates.

sologoub 9y ago

TLDR; $400 billion total, $200 billion is currently spent on subsidies and medi-cal, $150 billion is already spent by employers. The state would need to "find" ~$50 billion or ~$1,300 per resident more to fully fund this. Personally, this seems like a relative bargain and some modest extra taxes should offset the difference. Article reads pretty poorly and sensationalist. Not to mention that the missing amount is less than most people have in various deductables and co-pays already. EDIT: Turns out in 2015, per capita health spending was $9,990 already, which translates to ~$390 billion for 39 million Californians. So $400 Billion is cheaper than what we already spend in 2017, assuming modest growth since 2015. Further, if we assume that this money already gets spent, just not very evenly, we'll end up with a much fairer system and a lot smaller downside for people if/when they get sick. Personally, I'll gladly trade some immediate savings for long term protection from not having insurance when I need it most. The data seems to imply that I won't even have to pay all that much more.

jlarocco 9y ago
Yeah, the headline is sensationalist. With the current spending factored in, it's really not that bad. A big enough tax on fast food could probably cover it, with the added bonus of decreasing the amount needed. If that doesn't work, then there are a lot of programs they can cut that are less important than healthcare.
- tuxracer 9y ago
  > A big enough tax on fast food could probably cover it Exactly this kind of statement is what worries some about universal healthcare. I highly support single payer, universal healthcare. But statements like this undermine the cause by feeding fuel to the idea universal healthcare will inherently lead to more government intrusion into your personal decisions.
  - jlarocco 9y ago
    Like it or not, it's already done with cigarettes, alcohol, marijuana, gasoline, and a ton of other stuff. These type of taxes are the only way I'm in favor of government healthcare programs. Cigarettes, alcohol, and junk food directly increase medical costs, and people who indulge (and over indulge) in those things should be partly responsible for those increased costs.

carsongross 9y ago

Few know this: The United States currently spends more money per capita on socialized medicine than any other country except Norway: https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita#/media/File:OECD_health_expenditure_per_capita_by_country.svg https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... In fact, the US spends more on socialized medicine than Japan, the UK and Finland spend in total, private and public spending. The US healthcare system is totally out of control. Nothing will fix it until there is a collapse.

therealmarv 9y ago
Wow, I'm surprised. So doctors/hospitals are extremely expensive in USA? What is spend monthly very roughly on health care in USA (if you're have one)? I'm originally from Germany and I always assumed we pay more for health care generally.
- curun1r 9y ago
  One aspect that makes care in the US cost more is our culture of being highly litigious. We seem to believe that if doctors make honest mistakes, it entitles the patient or their heirs to a large settlement. So doctors/hospitals need expensive malpractice insurance and that cost gets bundled in with the cost of care. To add to that, settlements encompass both medical costs and compensation for pain and suffering, which is usually a multiple of the medical costs. So the cost of lawsuits increases the cost of care which, in turn, increases the size of settlements which, in turn, increases the cost of malpractice insurance which increases the cost of care. It's a feedback loop. It's not the only reason why our health care costs are spiraling out of control, but it is a reason that will naturally continue to increase over time unless we cap malpractice claims.
  - brownbat 9y ago
    Allow me to play devil's advocate... Medical negligence is the third leading cause of death in the United States. We have an epidemic of "honest mistakes" like scalpels left in patients after surgeries,[0] often leading to deaths, or amputations of the wrong limb[1] leading to enormous harms to the patient. Something as innocent as 'forgetting to wash your hands' has outsized consequences in this industry, forgiving 'honest mistakes' is not a safe standard. It's also not generally true that plaintiffs in tort cases receive exorbitant damages, this is a popular myth because there are a few outlandish examples. The most popular examples, such as the "Stella awards," are completely made up.[1][2] States that have capped medical malpractice have seen no difference in medical costs, and it has not been found to be a significant contribution to costs in the industry.[3] Meanwhile, capping costs hurts patients - some mistakes end up costing millions in additional medical costs throughout an injured patient's life, and most importantly for getting improved care over time, it lightens incentives for billion dollar hospitals to actually correct underlying procedures that make harms more likely. [0] https://en.wikipedia.org/wiki/Retained_surgical_instruments https://en.wikipedia.org/wiki/Retained_surgical_instruments [1] http://www.hotcoffeethemovie.com/default.asp?pg=mcdonalds_case http://www.hotcoffeethemovie.com/default.asp?pg=mcdonalds_ca... [2] http://www.snopes.com/legal/lawsuits.asp http://www.snopes.com/legal/lawsuits.asp [3] http://www.decof.com/decof/wp-content/uploads/2015/12/five-myths-about-medical-negligence.pdf http://www.decof.com/decof/wp-content/uploads/2015/12/five-m... [4] More on handwashing as a challenge to health in hospitals: http://annals.org/aim/article/712481/compliance-handwashing-teaching-hospital http://annals.org/aim/article/712481/compliance-handwashing-...

a3n 9y ago

Separate from the cost debate, the bill is labeled a "job killer," I assume because of all the insurance and related jobs lost. Which would be bad for the people losing their jobs, but they're only employed because they work for an arguably unnecessary middle-man industry. There's no "right" to those jobs, and if we can find a way to deliver health care, as opposed to health insurance, to close to everyone, we should figure that out, regardless of insurance jobs.

Frondo 9y ago
Yep, health care administrators--this century's buggy whip makers, telephone sanitizers, ...
flukus 9y ago
How many are in state anyway? I'd of thought most of the middle men would be parts of large companies located in cheaper states.
tuxracer 9y ago
Both the military and the private health insurance industry are Keynesian jobs programs first, their stated purposes second.
jernfrost 9y ago
How is this supposed to kill jobs? Total money spent should be no different. It just shifts from out of pocket to taxes.
- adt2bt 9y ago
  If you read the other parent comment in this thread, total expenditures on health care would actually drop by close to 50% overall (with a few fraught assumptions, of course). In the best/worst case, that's a $350B economic blow to those who rely on insurers for their employment. Given the complexity of the health care system around the US, I'm sure any move to universal health care will be extremely economically disruptive and render quite a few people jobless without competitive skills.
- 9y ago

ChuckMcM 9y ago

These discussions rarely include a discussion about existing extortionate pricing models do to distort the discussion.

curtis 9y ago

If your universal health care system is some variant of "single payer", which is what I think is proposed here, then the fact that it is really expensive is largely irrelevant, and for a really obvious reason: You may be paying a lot of money for government funded health insurance, but you are not paying all that money to a private health insurer like you are now. Essentially you are just writing a check to the government rather than a private company.

jernfrost 9y ago

Really weird talking about how expensive this is. Whether you pay through it out of pocket or through taxes what difference does it make? Why do Americans think there is somethink inherently more difficult with paying taxes than paying other expenses. Weird how these people talk about health care as unaffordable but somehow there are always money for wasting trillions in wars like Iraq and Vietnam.

adt2bt 9y ago
Yea, nobody seems to talk about it that way for some reason. If we 'save' on health care, it's either from making the system more efficient, or not providing care to people who need it. Maybe it's too complicated for a sound byte, I'm not sure.
ryanx435 9y ago
You should look into how much the federal and state governments pay to Medicare and Medicaid and other medical programs than compare it to the budget for the various military expenditures. Also, although iraq and Vietnam were failures on the surface, I challenge you to put a dollar value on the pax Americana that American military spending has enabled in the last 70 years, a dollar value on the various technologies developed through military funding over the years, and a dollar value on a thriving capitalistic economy that was saved from fascist and communist takeovers by military spending. Than maybe it won't be so strange to you why the us spends so much on the military.
- threeseed 9y ago
  No one is disputing that the US needs a military. What everyone is questioning (and rightly so) is whether the levels of investment are warranted. Especially when the US has such a pitiful social safety net compared to other Western countries. And let's be serious here. The rest of the world has done more to save the world from fascism and communism than the US has. And entrepreneurship has done far more for innovation than military spending has.
  - ryanx435 9y ago

eecc 9y ago

Well, signle player, universal health care provider also means one powerful actor with the weight and leverage to aggressively pursue economies of scale and optimizations and preventive care. As an individual you're just a sucker, a sitting duck to be plucked one feather at a time

anovikov 9y ago

Why all discussions about healthcare reform revolve around money to pay for it? I am sure this is the wrong side of it. Whatever money you pay, you have a limited supply of doctors. So in the end, more money just raises prices, redistributing who gets which care, anyway. Why not start with supply side? Automatically recognize diploma of doctors from all developed countries (you may start with a limited list - very rich countries with life expectancy higher than U.S. - start with UK, France and Germany, add a few more if it's not enough - no one can say that their doctors are not 'good enough') - and make them instant immigration papers - literally, hand out green cards right at the airport on arrival. Millions will flock and quickly saturate the market. Then you will not have a problem with either new single-payer, or old system.

teekert 9y ago

Perhaps they should not accept healthcare cost as is? Wages of physicians are insane in the US (because the price of the education is insane?), as are the prices of medcine. Just think of what Pharma has to spend on commercials in the US. All that money is a big waste.

GiorgioG 9y ago

As much as I'm a proponent for free markets & lower taxes, I want universal healthcare in the US. When big pharma companies & hospital systems are forced to negotiate with the government for rates, costs will go down. My 5 year old's type 1 diabetes quarterly supplies are billed at $6,000 per shipment. Looking at what's in the box, I'm hard pressed to guess there's more than $100 of material costs. The technology has been around forever, and yet these companies continue to extort these exorbitant prices because nobody had said 'Enough!' Same story with a friend's Gleevec. $14,000 per month. It's time to put cost controls in place. If universal care is how that's achieved, then so be it.