6 ms·

> If anyone in government really gave a shit FWIW the government gets a better deal for healthcare than private insurers do (e.g. Medicaid is cheaper per perso

> If anyone in government really gave a shit FWIW the government gets a better deal for healthcare than private insurers do (e.g. Medicaid is cheaper per person than if they were covered in a private plan). So I would say they do give a shit and have gotten to the bottom of it. It would be cheaper still if Medicaid covered everybody.

JBReefer 9y ago
The coverage is substantially worse than most private plans - Medicaid looks worse than my crappy ACA plan.
- jonknee 9y ago
  That depends on where you live, but also your income. If you don't have the cash, Medicaid wins no matter what. A ACA plan with a co-payment that you don't have is worthless.
- kurthr 9y ago
  That is why in every country that has single payer there are additional coverage plans that allow you to have even better coverage... and it's still cheaper! See Canada, Australia, England, Germany, Japan... well, basically everywhere else. What is really amazing is that it also returns Emergency Rooms back into a place where you go in an emergency so you can actually get treatment in 15min rather than wait for a few hours at 3am as you drip blood on the floor through the towel you've wrapped your arm in, and watch in horror as the lady next to you screams and shakes on the floor as she passes kidney stones (yes you would recognize the world renowned hospital where this happened).
  - alacombe 9y ago
    > That is why in every country that has single payer there are additional coverage plans that allow you to have even better coverage... No there isn't, unless you go private, speaking of which France has pretty much made private "mutuelle" mandatory. > What is really amazing is that it also returns Emergency Rooms back into a place where you go in an emergency so you can actually get treatment in 15min rather than wait for a few hours at 3am as you drip blood on the floor You have obviously never been in an emergency room in Canada, and I really hope you have not to, ever. My friend got a whiplash injury and got told to go back home, and I had to walk 3 days on a broken foot in Quebec because the ER turned me down (and incidentally asked me to pay CAN$1k to have my foot looked at).
sidlls 9y ago
Cheaper, and more terrible. Medicaid is not something anybody wants and in many ways is worse than the ER as a measure of last resort for acquiring care. Medicare on the other hand is much better, though still not all that great (it's better than private insurance in many if not most cases). It is universal coverage for folks over a certain age in this country. There aren't any good reasons I've seen to not lower that age to 0 (i.e. covered from birth).
- jonknee 9y ago
  > Medicaid is not something anybody wants Tell that to the people in states with Republican governors who won't expand Medicaid to cover them... > in many ways is worse than the ER as a measure of last resort for acquiring care What are you talking about? If you are in an emergency and on Medicaid you can go to the ER[1]. ERs give great care, they are just expensive. Medicaid is not expensive, so if their patients are getting ER quality care that is an amazing deal. [1] https://www.medicaid.gov/medicaid/cost-sharing/out-of-pocket-costs/index.html https://www.medicaid.gov/medicaid/cost-sharing/out-of-pocket... Not only can you go, you won't be charged unlike almost all private insurance plans. > Out of pocket costs cannot be imposed for emergency services, family planning services, pregnancy-related services, or preventive services for children.
  - zanny 9y ago
    The partial medicaid expansion coverage of the ACA isn't actually putting people on medicaid, it is subsidizing private insurance at a percentage of cost. If you hit 100% of the ACA subsidy you are in medicaid territory, if you are up to 4x poverty you get a diminishing % of your insurance bill paid by the state. My Dad has a $750/month plan but only pays $150 because of the medicaid subsidy in PA from the ACA for his income bracket.
    - jonknee 9y ago
      How it works depends on the state because a lot of Republican governors wanted to stick it to Obama and poor people by not expanding Medicaid as intended under the ACA. That said, the Medicaid expansion definitely puts people on Medicaid! That's a big part of the reason why it's politically suicidal to repeal the ACA. http://www.kff.org/medicaid/issue-brief/what-coverage-and-financing-at-risk-under-repeal-of-aca-medicaid-expansion/ http://www.kff.org/medicaid/issue-brief/what-coverage-and-fi... > Between Summer 2013, just prior to the ACA, and September 2016, there was a net increase in Medicaid and CHIP enrollment of 15.7 million people.
ryanmarsh 9y ago
They didn't solve it for the rest of us. They have leverage and used it to set pricing for their patients.

JBReefer 9y ago

The coverage is substantially worse than most private plans - Medicaid looks worse than my crappy ACA plan.

jonknee 9y ago
That depends on where you live, but also your income. If you don't have the cash, Medicaid wins no matter what. A ACA plan with a co-payment that you don't have is worthless.
kurthr 9y ago
That is why in every country that has single payer there are additional coverage plans that allow you to have even better coverage... and it's still cheaper! See Canada, Australia, England, Germany, Japan... well, basically everywhere else. What is really amazing is that it also returns Emergency Rooms back into a place where you go in an emergency so you can actually get treatment in 15min rather than wait for a few hours at 3am as you drip blood on the floor through the towel you've wrapped your arm in, and watch in horror as the lady next to you screams and shakes on the floor as she passes kidney stones (yes you would recognize the world renowned hospital where this happened).
- alacombe 9y ago
  > That is why in every country that has single payer there are additional coverage plans that allow you to have even better coverage... No there isn't, unless you go private, speaking of which France has pretty much made private "mutuelle" mandatory. > What is really amazing is that it also returns Emergency Rooms back into a place where you go in an emergency so you can actually get treatment in 15min rather than wait for a few hours at 3am as you drip blood on the floor You have obviously never been in an emergency room in Canada, and I really hope you have not to, ever. My friend got a whiplash injury and got told to go back home, and I had to walk 3 days on a broken foot in Quebec because the ER turned me down (and incidentally asked me to pay CAN$1k to have my foot looked at).

sidlls 9y ago

Cheaper, and more terrible. Medicaid is not something anybody wants and in many ways is worse than the ER as a measure of last resort for acquiring care. Medicare on the other hand is much better, though still not all that great (it's better than private insurance in many if not most cases). It is universal coverage for folks over a certain age in this country. There aren't any good reasons I've seen to not lower that age to 0 (i.e. covered from birth).

jonknee 9y ago
> Medicaid is not something anybody wants Tell that to the people in states with Republican governors who won't expand Medicaid to cover them... > in many ways is worse than the ER as a measure of last resort for acquiring care What are you talking about? If you are in an emergency and on Medicaid you can go to the ER[1]. ERs give great care, they are just expensive. Medicaid is not expensive, so if their patients are getting ER quality care that is an amazing deal. [1] https://www.medicaid.gov/medicaid/cost-sharing/out-of-pocket-costs/index.html https://www.medicaid.gov/medicaid/cost-sharing/out-of-pocket... Not only can you go, you won't be charged unlike almost all private insurance plans. > Out of pocket costs cannot be imposed for emergency services, family planning services, pregnancy-related services, or preventive services for children.
- zanny 9y ago
  The partial medicaid expansion coverage of the ACA isn't actually putting people on medicaid, it is subsidizing private insurance at a percentage of cost. If you hit 100% of the ACA subsidy you are in medicaid territory, if you are up to 4x poverty you get a diminishing % of your insurance bill paid by the state. My Dad has a $750/month plan but only pays $150 because of the medicaid subsidy in PA from the ACA for his income bracket.
  - jonknee 9y ago
    How it works depends on the state because a lot of Republican governors wanted to stick it to Obama and poor people by not expanding Medicaid as intended under the ACA. That said, the Medicaid expansion definitely puts people on Medicaid! That's a big part of the reason why it's politically suicidal to repeal the ACA. http://www.kff.org/medicaid/issue-brief/what-coverage-and-financing-at-risk-under-repeal-of-aca-medicaid-expansion/ http://www.kff.org/medicaid/issue-brief/what-coverage-and-fi... > Between Summer 2013, just prior to the ACA, and September 2016, there was a net increase in Medicaid and CHIP enrollment of 15.7 million people.

ryanmarsh 9y ago

They didn't solve it for the rest of us. They have leverage and used it to set pricing for their patients.