5 ms·
> We would all contribute to the payment of expensive operations via taxes in a single payer system. That's just insurance, managed by the state. > But with s
by conanbatt 8y ago
> We would all contribute to the payment of expensive operations via taxes in a single payer system.
That's just insurance, managed by the state.
> But with single payer, we cut out companies in the middle pulling a heafty profit
Oh boy. Lets say I concede, for the sake of argument, that government can run a private business with the same efficiency, and that the profits it would make as private are given back to its consumers (healthcare.gov cost almost 2 billion dollars to make, remember that. Or Blue shield is actually a non-profit, and its not gobbling up the space by reinvesting its supposed profits).
To add to that, the profits of healthcare insurances companies are not that large: they have a 6% operating margin, lower than other insurance companies. Cumulatively, the big companies must have around 20~30 billion dollars a year in profits. It's a staggering number, but in the healthspace thats nothing: only the subsidy of tax-exemption for insurance benefits is estimated to be 260 billion a year. You could eliminate that benefit and expand medicaid: but that would help the poor, and wreck the rich and the middle class together, which is often politically unfeasible.
https://www.axios.com/profits-are-booming-at-health-insurance-companies-1513302495-18f3710a-c0b4-4ce3-8b7f-894a755e6679.html https://www.axios.com/profits-are-booming-at-health-insuranc...
https://www.verywellhealth.com/health-insurance-companies-unreasonable-profits-1738941 https://www.verywellhealth.com/health-insurance-companies-un...
- toomuchtodo 8y agoI’d still prefer the state over private insurance companies (Medicare is well run and popular). As Steve Jobs said about Dropbox, you’re a feature (insurance companies) not a product.
- conanbatt 8y ago> I’d still prefer the state over private insurance companies (Medicare is well run and popular). And I vote accordingly. Thats perfectly reasonable, but no need to make a single payer system for that. Just allow medicare to compete in the open market. Thats a much smaller program with a lot less risk. Unfortunately the chances of such a plan to succeed are nil. Thats why big healthcare reform proposals want to strong-arm the position, with single-payer proposals. Its true medicare is popular, but remember it's free insurance for its patients today. If you eliminated the medicare payroll tax and made it a monthly payment, I assure you old people will not have the same opinion on the topic.
- deleted 8y ago[deleted]
- vertex-four 8y agoThe NHS “competes in the open market”, so to speak - you pay taxes to get free healthcare for everyone, then you can get private insurance which picks and chooses what it wants to treat and dumps complex cases back on the NHS. Routine treatment is also dealt with by some combination of the NHS and private pharmacies (for flu jabs etc), generally speaking. Unsurprisingly, private health insurance is not very popular here. It’s mostly just something people get through work. And I’ll remind you that we spend less per capita on our healthcare than the US does. I’m sure that if there was actually demand to meet that spending, private insurance here would happily eat it up - but there just doesn’t seem to be.
- conanbatt 8y agoIf you get private health insurance, do you get your NHS contribution back? Thats what would make it "competing" in the open market. If you have to pay for it no matter what, there is no competition, there is double charging.
- vertex-four 8y agoThere isn’t double charging, because private health insurance universally doesn’t cover the same things as the NHS does, and universally depends on the NHS to work with for anything they think might be too expensive to cover. Given that we spend less money on healthcare than countries that do have healthcare “on the open market” like you suggest, I’d say this is a system that obviously works. If there were an imbalance between what those countries provide and what we provide, and people were willing to pay for it, you’d see private healthcare providers successfully taking more money (up to what Americans spend) to make up the gap in service - but they’re not. Do you have an explanation for why that’s not happening?
- conanbatt 8y agoIf there are general practicioners in the private market in the UK, that means their patients pay for the NHS and also for the private GP, thus double charging. Particularly with your primary care provider, continuity is important in medical care, not everything is replaceable like a cog. > Given that we spend less money on healthcare than countries that do have healthcare “on the open market” like you suggest, I’d say this is a system that obviously works. Sorry but this is a ludicrous claim. Argentina spends 2% less of GDP than the UK, and 70% of its care is private. And not only that, it gives free healthcare services to other countries, including organ transplants.
- refurb 8y agoYou realize Medicare Part C and D are entirely run by private companies right?
- toomuchtodo 8y agoI am. Part C is optional (Medicare Advantage, akin to an upgraded private insurance plan in European universal healthcare systems), and D is prescription drug coverage that a single payer system can administer as part of its system for all participants.
- refurb 8y agoPart C is not an upgrade, it’s soup to nuts. The gov’t just writes the check to the insurer. A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits.
- toomuchtodo 8y agoWe’re splitting hairs. It’s an upgrade in the sense it replaces primary Medicare coverage while also including supplements (vision, dental, and other such coverage).
- refurb 8y agoYou're original comment says you prefer government run insurance and give Medicare as an example, but neglect to note that 36% of Medicare is privately run.
- toomuchtodo 8y agoFair point.
- fatbird 8y agoIn Canada, 16% of the money spent on health care is spent on administration; in the U.S., 28%. Tell me again how the free market is more efficient?
- conanbatt 8y agoThe US healthcare market is not a free market. I know this well enough to commit to a challenge: name me any two actors in the space and I can name you how each one is screwing the other one thanks to a law or regulation.