3 ms·

> I take it, then, that you're totally ok with Medicare for All as a plan, as it's not single payer? Nope. I am also not okay with Medicare, Medicaid, Obamaca

by mises 7y ago

> I take it, then, that you're totally ok with Medicare for All as a plan, as it's not single payer? Nope. I am also not okay with Medicare, Medicaid, Obamacare, and any sort of transfer payment from the feds. > I'm guessing not, actually. How remarkably prescient of you. > you're using such a narrowly defined, pedantic definition of "single payer" as to make what you're railing against a total strawman. Not even the most socialist systems in the world, (Norway, Medicare, etc) come anywhere close to your extreme. Gee whiz, I interpreted "single-payer" as meaning there was a single payer in the medical system? What sophistry! I believe it was Senator Harris that recently said that "Medicare for All" included abolishing all private health insurance, and this has seemed to get traction among the far left. Senator Sanders has similar ideas; he would allow a small amount of private insurance, but only in addition to mandatory enrollment in his plan. Reason Magazine corroborates the general definition: https://reason.com/2019/01/24/new-poll-shows-medicare-for-all-is-popul/ https://reason.com/2019/01/24/new-poll-shows-medicare-for-al... Show me the part of the constitution where it says the government may sell health care. Show me the part that justifies transfer payments of any kind. I proposed something of a solution above: remove the onerous regulations and allow industrialization of common procedures. This would cut out the bulk of health-care expense. And how would you pay for such a plan? Even doubling taxes wouldn't do it: https://www.wsj.com/articles/even-doubling-taxes-wouldnt-pay-for-medicare-for-all-1533163559 https://www.wsj.com/articles/even-doubling-taxes-wouldnt-pay... We're in a hole, financially speaking. America has about ninety-five trillion dollars in about household value; the "one percent" hold about forty percent of that. Seizing all the money they have, thirty-eight trillion dollars, would just about cover the costs of this "medicare for all" thing for a decade. What do you do then? We're spending too much, not taking too little.

arcticbull 7y ago
> Show me the part of the constitution where it says the government may sell health care. Show me the part that justifies transfer payments of any kind. No that's fine, you can tell grandma why she's not going to get that hip replacement or cancer treatment. It's because of your free market principals and she should have made more money when she was young. See, grammy, it says so right here in the constitution - and The Fountainhead! If only there was a way to update or modernize or uh, what's the word, amend the constitution. > I proposed something of a solution above: remove the onerous regulations and allow industrialization of common procedures. This would cut out the bulk of health-care expense. Yes, it's the regulations, for sure. Like the ones that keep the air and water clean, and the rivers not-on-fire. And drugs safe. See if we just got rid of that, we'd be in great shape. You know what would make it really cheap? Let's get rid of medical licensing requirements. Now that's a money saver. > And how would you pay for such a plan? Even doubling taxes wouldn't do it: https://www.wsj.com/articles/even-doubling-taxes-wouldnt-pay.. https://www.wsj.com/articles/even-doubling-taxes-wouldnt-pay.... That's absurd. Even a Koch funded study showed MFA would be +/- 5% of what it costs right now, but would cover everyone, accidentally showing the unit economics to be much better. [1] You take all the money employers are currently spending on employee cover via a combination of payroll and personal taxes, direct it to the Medicare pool and enroll everyone. This isn't some sort of new wild plan. Other OECD member states do that right now. By the way, the paper I link is the one the WSJ article cites (your link is broken) and if you read anything past the first page it clearly states that not only would everyone be covered it would cost less per capita and in total. Another study recently showed that Medicare and Medicaid do a better job of controlling costs than the private sector setting us up for success in the longer term, too. [2] [1] https://www.mercatus.org/system/files/blahous-costs-medicare-mercatus-working-paper-v1_1.pdf https://www.mercatus.org/system/files/blahous-costs-medicare... [2] https://www.modernhealthcare.com/article/20190211/NEWS/190219996/medicare-medicaid-contain-costs-better-than-private-insurers-study-says https://www.modernhealthcare.com/article/20190211/NEWS/19021...
- mises 7y ago
  > you can tell grandma why she's not going to get that hip replacement or cancer treatment I'll ignore the flame-bait. I honestly believe that we could reduce regulation and make the poorest better off. I referenced above an example: an Indian hospital has essentially mass-produced procedures for low cost. Things like hip replacements do not take a brilliant surgeon with eight years of medical training; I think breaking the monopoly of the AMA and lowering regulation will allow cheap procedures at prices reasonable to almost all. For those last few, I believe Churches and states ought to shoulder the responsibility. I said nothing of "no health-care", I said that the feds shouldn't do it and that single-payer is a bad solution. > amend the constitution. Be careful with amending our founding document to push a policy agenda. This has been rarely done in the past, because if one side does it to suit one agenda, the other will reciprocate once re-elected. Maybe the far left could get socialized medicine, but the right might repeal the 14th amendment birthright citizenship next election. > Yes, it's the regulations, for sure. Like the ones that keep the air and water clean, and the rivers not-on-fire. And drugs safe. See if we just got rid of that, we'd be in great shape. What did I say of environmental regulations? We have them to protect the rights of others, and they are important. With respect to drug safety, I do believe rules could be somewhat loosened, but I also believe some regulation is necessary. > Even a Koch funded study showed MFA would be +/- 5% of what it costs right now This is an "alternative fact" pushed by Senator Sanders and Congresswoman Ocasio. [0] > You take all the money employers are currently spending on employee cover via a combination of payroll and personal taxes, direct it to the Medicare pool and enroll eveyrone. Americans are generally leery of just "taking the money", "directing it", and "enrolling everyone". That's too heavy-handed an action for the feds to take. I would appreciate a different source for your cost, as the one you mentioned was not correctly represented. With respect to unit economics, that does not account for quality. Note that the study you cited above mentions the outrageous cost in the abstract. It also mentions that Medicare reimbursement rates are roughly 40% lower than private insurance; where will the extra money come from? That doesn't make the unit economics cheaper, that means private health insurance costs are currently subsidizing low medicare reimbursement rates. The bulk of the "cost reduction" to which you are referring (over 85% thereof) came from provider payment cuts, which assumes the current 40%-below-market rate. That's not better unit economics, that's monopolizing an industry and fixing prices. The remaining <15% came from better drug prices. I will concede that a monopsony tends to lower prices for certain things, but this is not nearly what you claimed. [0] https://www.factcheck.org/2018/08/the-cost-of-medicare-for-all/ https://www.factcheck.org/2018/08/the-cost-of-medicare-for-a...
dragonwriter 7y ago
> Show me the part of the constitution where it says the government may sell health care. That's not an argument against the policy, it's an argument that if the policy is desirable it should be pursued by means which include a Constitutional Amendment.
- mises 7y ago
  Constitutional Amendments were not designed to directly contradict the purpose of the constitution; why would you do so if not for a blatant power grab? Why not allow states to do it for themselves? Broad-brush national solutions do not always work well. Labor costs are higher in certain places, conditions vary, etc. Why do it federally?
  - dragonwriter 7y ago
    > Constitutional Amendments were not designed to directly contradict the purpose of the constitution Constitutional Amendments were designed to give each generation the power to decide both the specific content and the purpose of the Constitution; which was not ever intended to be a vehicle by which the long dead dictate the form of government to the living. Not, of course, that national health insurance costs the original purpose of the Constitution, which is laid out in the preamble, however much one might argue it violates the details of the design. > Why not allow states to do it for themselves? Broad-brush national solutions do not always work well. Why not do it nationally? Isolated local solutions do not always work well. > Labor costs are higher in certain places, conditions vary, etc. Why do it federally? My National programs can, and do, account for local variations of the type you describe, and state-level programs aren't immune to having to deal with them, anyway.
dang 7y ago
Would you please stop using HN for ideological battle and flamewar? You've been doing it a lot, and we ban accounts that do this. We have to, because it has the effect on curiosity that salt has on a slug, and curiosity is what this site exists for. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html

by mises 7y ago

arcticbull 7y ago

> Show me the part of the constitution where it says the government may sell health care. Show me the part that justifies transfer payments of any kind. No that's fine, you can tell grandma why she's not going to get that hip replacement or cancer treatment. It's because of your free market principals and she should have made more money when she was young. See, grammy, it says so right here in the constitution - and The Fountainhead! If only there was a way to update or modernize or uh, what's the word, amend the constitution. > I proposed something of a solution above: remove the onerous regulations and allow industrialization of common procedures. This would cut out the bulk of health-care expense. Yes, it's the regulations, for sure. Like the ones that keep the air and water clean, and the rivers not-on-fire. And drugs safe. See if we just got rid of that, we'd be in great shape. You know what would make it really cheap? Let's get rid of medical licensing requirements. Now that's a money saver. > And how would you pay for such a plan? Even doubling taxes wouldn't do it: https://www.wsj.com/articles/even-doubling-taxes-wouldnt-pay.. https://www.wsj.com/articles/even-doubling-taxes-wouldnt-pay.... That's absurd. Even a Koch funded study showed MFA would be +/- 5% of what it costs right now, but would cover everyone, accidentally showing the unit economics to be much better. [1] You take all the money employers are currently spending on employee cover via a combination of payroll and personal taxes, direct it to the Medicare pool and enroll everyone. This isn't some sort of new wild plan. Other OECD member states do that right now. By the way, the paper I link is the one the WSJ article cites (your link is broken) and if you read anything past the first page it clearly states that not only would everyone be covered it would cost less per capita and in total. Another study recently showed that Medicare and Medicaid do a better job of controlling costs than the private sector setting us up for success in the longer term, too. [2] [1] https://www.mercatus.org/system/files/blahous-costs-medicare-mercatus-working-paper-v1_1.pdf https://www.mercatus.org/system/files/blahous-costs-medicare... [2] https://www.modernhealthcare.com/article/20190211/NEWS/190219996/medicare-medicaid-contain-costs-better-than-private-insurers-study-says https://www.modernhealthcare.com/article/20190211/NEWS/19021...

mises 7y ago
> you can tell grandma why she's not going to get that hip replacement or cancer treatment I'll ignore the flame-bait. I honestly believe that we could reduce regulation and make the poorest better off. I referenced above an example: an Indian hospital has essentially mass-produced procedures for low cost. Things like hip replacements do not take a brilliant surgeon with eight years of medical training; I think breaking the monopoly of the AMA and lowering regulation will allow cheap procedures at prices reasonable to almost all. For those last few, I believe Churches and states ought to shoulder the responsibility. I said nothing of "no health-care", I said that the feds shouldn't do it and that single-payer is a bad solution. > amend the constitution. Be careful with amending our founding document to push a policy agenda. This has been rarely done in the past, because if one side does it to suit one agenda, the other will reciprocate once re-elected. Maybe the far left could get socialized medicine, but the right might repeal the 14th amendment birthright citizenship next election. > Yes, it's the regulations, for sure. Like the ones that keep the air and water clean, and the rivers not-on-fire. And drugs safe. See if we just got rid of that, we'd be in great shape. What did I say of environmental regulations? We have them to protect the rights of others, and they are important. With respect to drug safety, I do believe rules could be somewhat loosened, but I also believe some regulation is necessary. > Even a Koch funded study showed MFA would be +/- 5% of what it costs right now This is an "alternative fact" pushed by Senator Sanders and Congresswoman Ocasio. [0] > You take all the money employers are currently spending on employee cover via a combination of payroll and personal taxes, direct it to the Medicare pool and enroll eveyrone. Americans are generally leery of just "taking the money", "directing it", and "enrolling everyone". That's too heavy-handed an action for the feds to take. I would appreciate a different source for your cost, as the one you mentioned was not correctly represented. With respect to unit economics, that does not account for quality. Note that the study you cited above mentions the outrageous cost in the abstract. It also mentions that Medicare reimbursement rates are roughly 40% lower than private insurance; where will the extra money come from? That doesn't make the unit economics cheaper, that means private health insurance costs are currently subsidizing low medicare reimbursement rates. The bulk of the "cost reduction" to which you are referring (over 85% thereof) came from provider payment cuts, which assumes the current 40%-below-market rate. That's not better unit economics, that's monopolizing an industry and fixing prices. The remaining <15% came from better drug prices. I will concede that a monopsony tends to lower prices for certain things, but this is not nearly what you claimed. [0] https://www.factcheck.org/2018/08/the-cost-of-medicare-for-all/ https://www.factcheck.org/2018/08/the-cost-of-medicare-for-a...

dragonwriter 7y ago

> Show me the part of the constitution where it says the government may sell health care. That's not an argument against the policy, it's an argument that if the policy is desirable it should be pursued by means which include a Constitutional Amendment.

mises 7y ago
Constitutional Amendments were not designed to directly contradict the purpose of the constitution; why would you do so if not for a blatant power grab? Why not allow states to do it for themselves? Broad-brush national solutions do not always work well. Labor costs are higher in certain places, conditions vary, etc. Why do it federally?
- dragonwriter 7y ago
  > Constitutional Amendments were not designed to directly contradict the purpose of the constitution Constitutional Amendments were designed to give each generation the power to decide both the specific content and the purpose of the Constitution; which was not ever intended to be a vehicle by which the long dead dictate the form of government to the living. Not, of course, that national health insurance costs the original purpose of the Constitution, which is laid out in the preamble, however much one might argue it violates the details of the design. > Why not allow states to do it for themselves? Broad-brush national solutions do not always work well. Why not do it nationally? Isolated local solutions do not always work well. > Labor costs are higher in certain places, conditions vary, etc. Why do it federally? My National programs can, and do, account for local variations of the type you describe, and state-level programs aren't immune to having to deal with them, anyway.

dang 7y ago

Would you please stop using HN for ideological battle and flamewar? You've been doing it a lot, and we ban accounts that do this. We have to, because it has the effect on curiosity that salt has on a slug, and curiosity is what this site exists for. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html