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> We can and must design the next round of insurance reforms with patients as a priority. With low deductibles that actually facilitate the consumption of care,

> We can and must design the next round of insurance reforms with patients as a priority. With low deductibles that actually facilitate the consumption of care, our health care system can directly benefit the well-being of low- and middle-income people—not just the holders of for-profit hospital stock. No, we need to get rid of private insurance with Medicare for All. The amount of money, corruption, and lobbying insurance companies engage in is staggering, especially given that their whole profit model is designed around limiting or denying access to healthcare. Denying access to treatment for the disabled, the chronically ill, and others, often unto their deaths or bankruptcy. In a more civilized country, corporations that have behaved like US insurance companies have would have been done away with along time ago.

kapuasuite 7y ago
Other countries, yes even in Europe, have better healthcare than us with multi-payer systems. Medicare for All is a joke.
- ska 7y ago
  Other countries have better healthcare with single payer systems also.
  - tptacek 7y ago
    Doesn't that strongly suggest that the structure of the payer side is not as outcome-determinative as advocates (for M4A, or for conservative reforms like across-state-lines insurance) make it out to be? What if payer structure really is a sideshow? What if we can make single payer work, or make private insurance work, but doing either job perfectly doesn't make care affordable in the US?
- bduerst 7y ago
  Medicare for all doesn't eliminate other payers, and is more similar to the European system than what we have now.
  - dragonwriter 7y ago
    > Medicare for all doesn't eliminate other payers The Sanders bill does eliminate most other payers (except for the VA). Other candidates with plans (or vague descriptions of plans) borrowing the name sometimes do, and sometimes do not, and sometimes are not entirely clear (or consistent over time) as to which category they fall into.
  - rayiner 7y ago
    There is no "European system." Many European countries don't have a single payer, or even a "public option." The Netherlands has something quite close to ACA, for example. Germany has non-profit, but numerous, insurance companies.
dsfyu404ed 7y ago
>No, we need to get rid of private insurance Insurance works well for rare events. Using insurance for an annual physical (or any other routine thing) is just pissing money away. Cutting insurance out of routine and preventative care will require far less political capital and should have a massive impact on costs. No need to go all the way to eliminating private insurance. A government option would have benefits but there's no reason private insurance can't exist also.
- claudeganon 7y ago
  It’s possible that there could be some boutique secondary private insurance market, like what compliments the NHS in the UK, although I think given the vast, predatory behavior of US health insurance companies, it’s better that they’re just done away with. It’s not as if they haven’t show themselves to be bad actors, preying on the vulnerable as much as is legally possible, time and time again. Costs and the barrier to care they impose are primary problem in the US. Mixed systems perform far worse at controlling them (look at the history of South Africa’s transition to a mixed system as an example). Given how far things have gone with costs in the US, I don’t see how a “public option” would resolve them, short of the kind of literal government price setting as is done in Japan, in which case, a single payer system is more efficient anyway.
- headcanon 7y ago
  Seems like a reasonable ask. Gov't pays for preventative care like physicals, flu shots, and STI testing (sort of already happening on the last bit through Planned Parenthood), insurance takes care of traumatic events. Seems to me though the greatest cost in healthcare, and thus causing the greatest amount of contention, are chronic ailments that can't really be classified as preventative or traumatic, and require constant doctor visits to treat. Care for the elderly is a similar story since they make up most doctor visits and are the biggest consumers of medications overall.
  - balls187 7y ago
    What if we pay for affordable preventative care, and the government covers the cost of traumatic events?
refurb 7y ago
Umm.. a good part of Medicare is run by private insurers. Medicare Part C and D. Are you saying get rid of those too?
- claudeganon 7y ago
  Yes. Medicare for All is different from Medicare and gets rid of the hollowing out of traditional Medicare services through these side channel attacks on it. https://www.congress.gov/bill/116th-congress/house-bill/1384 https://www.congress.gov/bill/116th-congress/house-bill/1384
  - refurb 7y ago
    Part D leverages the competitive nature of private, for profit markets. As a result, costs for Part D have been much lower than projected.its a very successful program.
- bduerst 7y ago
  And why do you think that is? Part C and D have privatized options because it offers gap coverage from Part A and B, so yes, privatized Part C and D would disappear if the gaps are closed.
  - refurb 7y ago
    Coverage gaps? Medicare Part C is just another option to get coverage. So you'd take that option away? And Medicare Part D is prescription drug coverage. You'd take that away?
  - tptacek 7y ago
    At the point where you're saying we simply "close the gaps" in existing Medicare, you're really not talking about Medicare anymore; you're just using it as a synonym for a hypothetical US NHS. That's fine, but you should be up front about it if you do; you're not just expanding Medicare to new customers, but building a fundamentally new system and giving it the old Medicare name.
balls187 7y ago
We do need Health Care reform, but I'm not convinced single payer government is going to lead to better outcomes. > No, we need to get rid of private insurance with Medicare for All. That would shift the incentivization from maximizing profits, to instead solely minimizing tax payer dollars. Lobbying would still exist (see defense industry). Denying care wouldn't be based on health reasons (dubious), but shift to class based reasons (see welfare). And, our healthcare will instead be subject to the whims of the politics, rather than the profits for Shareholders. Medicare works because it's beneficiaries are a strong voting block. There are population segments in America who aren't.
- claudeganon 7y ago
  >And, our healthcare will instead be subject to the whims of the politics, rather than the profits for Shareholders. Medicare works because it's beneficiaries are a strong voting block. There are population segments in America who aren't. The point of Medicare for All is also to instantiate this new voting block across as much of the population as possible, to imbue them with this political power and free them from control by their employers and the profit-seeking of healthcare companies. You have the causation backwards: government provided healthcare among the elderly is what has created their defense of the system. Medicare for All extends the possibility of this defense to everyone.
- creaghpatr 7y ago
  Medicare works because it is subsidized by private insurance payers. The system in its current form would collapse instantly if every American became covered exclusively by Medicare.
  - balls187 7y ago
    Also subsidized by current tax payers.
deleted 7y ago
[deleted]
AimForTheBushes 7y ago
I disagree with this. While it may be sometimes true, it is certainly a good thing that there are checks and balances to treatment. Otherwise providers of care are able to get a blank check. That is part of the problem now- say a physical therapist prescribes 5 sessions a week @ $300 per session but in reality the patient only needs 2 sessions a week. Insurance companies provide a checks/balance system with the ability for care providers to fight back when insurance companies deny care.

kapuasuite 7y ago

Other countries, yes even in Europe, have better healthcare than us with multi-payer systems. Medicare for All is a joke.

ska 7y ago
Other countries have better healthcare with single payer systems also.
- tptacek 7y ago
  Doesn't that strongly suggest that the structure of the payer side is not as outcome-determinative as advocates (for M4A, or for conservative reforms like across-state-lines insurance) make it out to be? What if payer structure really is a sideshow? What if we can make single payer work, or make private insurance work, but doing either job perfectly doesn't make care affordable in the US?
bduerst 7y ago
Medicare for all doesn't eliminate other payers, and is more similar to the European system than what we have now.
- dragonwriter 7y ago
  > Medicare for all doesn't eliminate other payers The Sanders bill does eliminate most other payers (except for the VA). Other candidates with plans (or vague descriptions of plans) borrowing the name sometimes do, and sometimes do not, and sometimes are not entirely clear (or consistent over time) as to which category they fall into.
- rayiner 7y ago
  There is no "European system." Many European countries don't have a single payer, or even a "public option." The Netherlands has something quite close to ACA, for example. Germany has non-profit, but numerous, insurance companies.

dsfyu404ed 7y ago

>No, we need to get rid of private insurance Insurance works well for rare events. Using insurance for an annual physical (or any other routine thing) is just pissing money away. Cutting insurance out of routine and preventative care will require far less political capital and should have a massive impact on costs. No need to go all the way to eliminating private insurance. A government option would have benefits but there's no reason private insurance can't exist also.

claudeganon 7y ago
It’s possible that there could be some boutique secondary private insurance market, like what compliments the NHS in the UK, although I think given the vast, predatory behavior of US health insurance companies, it’s better that they’re just done away with. It’s not as if they haven’t show themselves to be bad actors, preying on the vulnerable as much as is legally possible, time and time again. Costs and the barrier to care they impose are primary problem in the US. Mixed systems perform far worse at controlling them (look at the history of South Africa’s transition to a mixed system as an example). Given how far things have gone with costs in the US, I don’t see how a “public option” would resolve them, short of the kind of literal government price setting as is done in Japan, in which case, a single payer system is more efficient anyway.
headcanon 7y ago
Seems like a reasonable ask. Gov't pays for preventative care like physicals, flu shots, and STI testing (sort of already happening on the last bit through Planned Parenthood), insurance takes care of traumatic events. Seems to me though the greatest cost in healthcare, and thus causing the greatest amount of contention, are chronic ailments that can't really be classified as preventative or traumatic, and require constant doctor visits to treat. Care for the elderly is a similar story since they make up most doctor visits and are the biggest consumers of medications overall.
- balls187 7y ago
  What if we pay for affordable preventative care, and the government covers the cost of traumatic events?

refurb 7y ago

Umm.. a good part of Medicare is run by private insurers. Medicare Part C and D. Are you saying get rid of those too?

claudeganon 7y ago
Yes. Medicare for All is different from Medicare and gets rid of the hollowing out of traditional Medicare services through these side channel attacks on it. https://www.congress.gov/bill/116th-congress/house-bill/1384 https://www.congress.gov/bill/116th-congress/house-bill/1384
- refurb 7y ago
  Part D leverages the competitive nature of private, for profit markets. As a result, costs for Part D have been much lower than projected.its a very successful program.
bduerst 7y ago
And why do you think that is? Part C and D have privatized options because it offers gap coverage from Part A and B, so yes, privatized Part C and D would disappear if the gaps are closed.
- refurb 7y ago
  Coverage gaps? Medicare Part C is just another option to get coverage. So you'd take that option away? And Medicare Part D is prescription drug coverage. You'd take that away?
- tptacek 7y ago
  At the point where you're saying we simply "close the gaps" in existing Medicare, you're really not talking about Medicare anymore; you're just using it as a synonym for a hypothetical US NHS. That's fine, but you should be up front about it if you do; you're not just expanding Medicare to new customers, but building a fundamentally new system and giving it the old Medicare name.

balls187 7y ago

We do need Health Care reform, but I'm not convinced single payer government is going to lead to better outcomes. > No, we need to get rid of private insurance with Medicare for All. That would shift the incentivization from maximizing profits, to instead solely minimizing tax payer dollars. Lobbying would still exist (see defense industry). Denying care wouldn't be based on health reasons (dubious), but shift to class based reasons (see welfare). And, our healthcare will instead be subject to the whims of the politics, rather than the profits for Shareholders. Medicare works because it's beneficiaries are a strong voting block. There are population segments in America who aren't.

claudeganon 7y ago
>And, our healthcare will instead be subject to the whims of the politics, rather than the profits for Shareholders. Medicare works because it's beneficiaries are a strong voting block. There are population segments in America who aren't. The point of Medicare for All is also to instantiate this new voting block across as much of the population as possible, to imbue them with this political power and free them from control by their employers and the profit-seeking of healthcare companies. You have the causation backwards: government provided healthcare among the elderly is what has created their defense of the system. Medicare for All extends the possibility of this defense to everyone.
creaghpatr 7y ago
Medicare works because it is subsidized by private insurance payers. The system in its current form would collapse instantly if every American became covered exclusively by Medicare.
- balls187 7y ago
  Also subsidized by current tax payers.

deleted 7y ago

[deleted]

AimForTheBushes 7y ago

I disagree with this. While it may be sometimes true, it is certainly a good thing that there are checks and balances to treatment. Otherwise providers of care are able to get a blank check. That is part of the problem now- say a physical therapist prescribes 5 sessions a week @ $300 per session but in reality the patient only needs 2 sessions a week. Insurance companies provide a checks/balance system with the ability for care providers to fight back when insurance companies deny care.