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> I strongly suspect that a socialized medical program in the US would not actually cost individuals any more than they're paying now The definition of progres

> I strongly suspect that a socialized medical program in the US would not actually cost individuals any more than they're paying now The definition of progressive taxation means this is not the case for anyone making more than 100-150k, given current tax brackets. Medicare already is 1/3 of the federal budget and I can assure you someone making low 6 figures definitely pays more in tax than 3x $900.

arcticbull 5y ago
> Medicare already is 1/3 of the federal budget and I can assure you someone making low 6 figures definitely pays more in tax than 3x $900. Well the first step is redirecting all the premiums paid by employers on behalf of employees into the federal pot. That should net ~$5500 per taxpayer or an additional ~$1.8T per year. That will sort out the bulk of it with no additional cost visible to individuals.
- b9a2cab5 5y ago
  That is not the plan put forth by Medicare for All advocates. There is a strong undertone of income redistribution in progressive proposals for single payer. I would also expect that if the government was taking that money my health benefits would be at least as good as they are now. And I don't think that will be the case. When I was a kid there was a period where I was on California MediCal and I distinctly remember getting glasses with _super_ thick lenses because all MediCal would pay for was the cheapest frames and lenses.
  - arcticbull 5y ago
    > That is not the plan put forth by Medicare for All advocates. I'm almost 100% confident it is. That money is currently being paid on behalf of individuals to insurers. Take the insurers away that money either goes to individuals and gets taxed, or gets sent directly to the feds. Either way it's a no-op. > There is a strong undertone of income redistribution in progressive proposals for single payer. Healthcare is the great equalizer. It's not insurance - everyone needs it and everyone will use it. There's not really a strong correlation between more spend and better outcomes past a certain point. Except in the rarest of cases you can't cure cancer with fat stacks. What offering healthcare does is give low income folks the opportunity to found companies without the fear of death. It dramatically reduces the burden on all businesses and especially small businesses by killing a massive cost center. > I would also expect that if the government was taking that money my health benefits would be at least as good as they are now. And I don't think that will be the case. Every healthcare system that ranks above America's is single payer or two-tier socialized. MediCal is set up to be punitive to the poors like all Medicaid programs. A Medicare system isn't. There's a reason not a single AARP member is advocating for eliminating Medicare. What getting everyone on the system does is it makes the political class beholden to the needs of the individuals. I watched Donald Trump in front a group of older folks literally hug a flag and say he'd do whatever it took to keep the Democrats away from their Medicare. That doesn't sound like a system itching to be upturned does it? Socialized medicine is no more a partisan issue in most countries than a socialized fire department or sidewalks.
    - b9a2cab5 5y ago
      > Healthcare is the great equalizer By income redistribution I mean most progressive proposals aim to heavily tax high earners to fund healthcare for lower income individuals. That money would otherwise be used by those earners to buy their first home, build retirement wealth, etc. Ever heard of HENRYs? > MediCal is set up to be punitive to the poors like all Medicaid programs. A Medicare system isn't. Citation is needed here. A lot of good doctors in my area won't take Medicare patients because Medicare reimbursements are too low. We also know from European systems that because everything is triaged based on need that wait times end up being very long if you don't have a life threatening condition. You also need to consider that American doctors make substantially more than European ones. If you compare the pay of specialty doctors in the NHS to ones in the US the difference is something like 5x. > What getting everyone on the system does is it makes the political class beholden to the needs of the individuals That is your perspective, and I think it's a naive one. I think it would prevent reforms that drive efficiency. Think of what happens when anyone talks about making Medicare more efficient: they get attacked as anti-elderly and portrayed as wanting to cut benefits. Or the same for military spending. At least the free market (which healthcare is not right now, but it could be) is ruthless about creating efficiency. > Socialized medicine is no more a partisan issue in most countries than a socialized fire department or sidewalks. Funny that the UK argues about NHS funding a lot then.
      - arcticbull 5y ago
        > By income redistribution I mean most progressive proposals aim to heavily tax high earners to fund healthcare for lower income individuals. As someone who would be on the giving end of that, I'm fine with it, honestly. I won't always be on top. > We also know from European systems that because everything is triaged based on need that wait times end up being very long if you don't have a life threatening condition. We don't know that at all. Triaging based on need is a feature, not a bug - and a super easy way to save a ton of money! All of these criticisms were made up by the marketing department at insurers to fleece Americans. That's not hyperbole, and don't take my word for it. Here's an interview with one of the Cigna guys admitting to doing it, and apologizing. [1] "Here's the truth. Our industry PR and lobbying group, AHIP, supplied my colleagues and me with cherry-picked data and anecdotes to make people think Canadians wait endlessly for their care. It's a lie. And I'll always regret the disservice I did to folks on both sides of the border" > You also need to consider that American doctors make substantially more than European ones. If you compare the pay of specialty doctors in the NHS to ones in the US the difference is something like 5x. Ok, and they shouldn't. I'm sorry. It's not sustainable, it's not affordable. They're taking pay cuts. Nobody is entitled to a certain salary, standard or lifestyle in perpetuity no matter how unsustainable. BMWs for doctors while 10% of Americans are told to die or pick their favorite finger after an accent is unconscionable. America pays more than anyone else anyways, and would still after cuts, where would they go? However, this is also simply not true for every system. Most similar countries socialize malpractice insurance which is a huge cost for US doctors. US OBGYNs pay up to $200,000 per year in malpractice insurance. In Canada, $40,000CAD. In the UK I think it's 0GBP handled by the CNST. That goes a long way to balancing out pay differentials. In the US anesthesiologists make 400K USD median, in Canada 335K CAD median. > Funny that the UK argues about NHS funding a lot then. They argue about funding and prioritization and all sorts of stuff, sure, but it's not a partisan matter that the NHS should exist and be the status quo. The NHS was literally in the opening ceremonies of the 2012 olympics. 87% of British folks are proud of the NHS. [2] Canada's Conservatives support single-payer medicine too. [1] https://www.npr.org/2020/06/27/884307565/after-pushing-lies-former-cigna-executive-praises-canadas-health-care-system https://www.npr.org/2020/06/27/884307565/after-pushing-lies-... [2] https://yougov.co.uk/topics/politics/articles-reports/2018/07/04/nhs-british-institution-brits-are-second-most-prou https://yougov.co.uk/topics/politics/articles-reports/2018/0...
jollybean 5y ago
A few years ago, in Canada, we were paying $4500 per person - and everyone was covered. The US was paying $5K public per person and $5K private per person. Meaning - the US is already paying more per capita in public healthcare spending, than Canada, and for that price in Canada - everyone is covered. This kind of means, the US could literally give all of its citizens 'Canadian Quality Universal Coverage' and literally save a few dollars in public spending, and wipe out the need for private spending. So 'cost' and 'profit' are different things. The US HC system is a giant elephant of inefficiency. This is not a small thing: 'Healthcare' is a 'Pillar of American Decline'. I don't mean that America is falling apart, but rather, it's having less influence in the world. 50 years ago, you went to the Hospital because you were hurt. Now - it's all about aging people who are elderly who see the doctor 20x a year and it's why costs have skyrocketed. It's also when people are the least productive and less likely to be working with good insurance. HC is a disaster that makes the US a 'much less attractive place to live' for one's entire life, unless one is rich - whereas that was not the case before. It really needs to be sorted out. The Media Left, by highlighting Woke issues, instead of things like outrageous healthcare, has completely lost their minds. MSNBC was calling Elon Musk 'racist and misogynist' for his completely benign comments about this giant tax bill. Instead of looking at inequality issues through economic lenses, they're committed to throwing around gender and racial slander. The HC system is a soft, easy target because there are unlimited stories of people getting huge bills, unfair pricing. But you won't see to many stories, because "Sponsored by Phizer".
- erichocean 5y ago
  > 50 years ago, you went to the Hospital because you were hurt. Now - it's all about aging people who are elderly who see the doctor 20x a year and it's why costs have skyrocketed. It's also when people are the least productive and less likely to be working with good insurance. Literally 100% of the elderly in the US are already covered by the socialized medicine you seem to be advocating for. It's not optional.

arcticbull 5y ago

> Medicare already is 1/3 of the federal budget and I can assure you someone making low 6 figures definitely pays more in tax than 3x $900. Well the first step is redirecting all the premiums paid by employers on behalf of employees into the federal pot. That should net ~$5500 per taxpayer or an additional ~$1.8T per year. That will sort out the bulk of it with no additional cost visible to individuals.

b9a2cab5 5y ago
That is not the plan put forth by Medicare for All advocates. There is a strong undertone of income redistribution in progressive proposals for single payer. I would also expect that if the government was taking that money my health benefits would be at least as good as they are now. And I don't think that will be the case. When I was a kid there was a period where I was on California MediCal and I distinctly remember getting glasses with _super_ thick lenses because all MediCal would pay for was the cheapest frames and lenses.
- arcticbull 5y ago
  > That is not the plan put forth by Medicare for All advocates. I'm almost 100% confident it is. That money is currently being paid on behalf of individuals to insurers. Take the insurers away that money either goes to individuals and gets taxed, or gets sent directly to the feds. Either way it's a no-op. > There is a strong undertone of income redistribution in progressive proposals for single payer. Healthcare is the great equalizer. It's not insurance - everyone needs it and everyone will use it. There's not really a strong correlation between more spend and better outcomes past a certain point. Except in the rarest of cases you can't cure cancer with fat stacks. What offering healthcare does is give low income folks the opportunity to found companies without the fear of death. It dramatically reduces the burden on all businesses and especially small businesses by killing a massive cost center. > I would also expect that if the government was taking that money my health benefits would be at least as good as they are now. And I don't think that will be the case. Every healthcare system that ranks above America's is single payer or two-tier socialized. MediCal is set up to be punitive to the poors like all Medicaid programs. A Medicare system isn't. There's a reason not a single AARP member is advocating for eliminating Medicare. What getting everyone on the system does is it makes the political class beholden to the needs of the individuals. I watched Donald Trump in front a group of older folks literally hug a flag and say he'd do whatever it took to keep the Democrats away from their Medicare. That doesn't sound like a system itching to be upturned does it? Socialized medicine is no more a partisan issue in most countries than a socialized fire department or sidewalks.
  - b9a2cab5 5y ago
    > Healthcare is the great equalizer By income redistribution I mean most progressive proposals aim to heavily tax high earners to fund healthcare for lower income individuals. That money would otherwise be used by those earners to buy their first home, build retirement wealth, etc. Ever heard of HENRYs? > MediCal is set up to be punitive to the poors like all Medicaid programs. A Medicare system isn't. Citation is needed here. A lot of good doctors in my area won't take Medicare patients because Medicare reimbursements are too low. We also know from European systems that because everything is triaged based on need that wait times end up being very long if you don't have a life threatening condition. You also need to consider that American doctors make substantially more than European ones. If you compare the pay of specialty doctors in the NHS to ones in the US the difference is something like 5x. > What getting everyone on the system does is it makes the political class beholden to the needs of the individuals That is your perspective, and I think it's a naive one. I think it would prevent reforms that drive efficiency. Think of what happens when anyone talks about making Medicare more efficient: they get attacked as anti-elderly and portrayed as wanting to cut benefits. Or the same for military spending. At least the free market (which healthcare is not right now, but it could be) is ruthless about creating efficiency. > Socialized medicine is no more a partisan issue in most countries than a socialized fire department or sidewalks. Funny that the UK argues about NHS funding a lot then.
    - arcticbull 5y ago
      > By income redistribution I mean most progressive proposals aim to heavily tax high earners to fund healthcare for lower income individuals. As someone who would be on the giving end of that, I'm fine with it, honestly. I won't always be on top. > We also know from European systems that because everything is triaged based on need that wait times end up being very long if you don't have a life threatening condition. We don't know that at all. Triaging based on need is a feature, not a bug - and a super easy way to save a ton of money! All of these criticisms were made up by the marketing department at insurers to fleece Americans. That's not hyperbole, and don't take my word for it. Here's an interview with one of the Cigna guys admitting to doing it, and apologizing. [1] "Here's the truth. Our industry PR and lobbying group, AHIP, supplied my colleagues and me with cherry-picked data and anecdotes to make people think Canadians wait endlessly for their care. It's a lie. And I'll always regret the disservice I did to folks on both sides of the border" > You also need to consider that American doctors make substantially more than European ones. If you compare the pay of specialty doctors in the NHS to ones in the US the difference is something like 5x. Ok, and they shouldn't. I'm sorry. It's not sustainable, it's not affordable. They're taking pay cuts. Nobody is entitled to a certain salary, standard or lifestyle in perpetuity no matter how unsustainable. BMWs for doctors while 10% of Americans are told to die or pick their favorite finger after an accent is unconscionable. America pays more than anyone else anyways, and would still after cuts, where would they go? However, this is also simply not true for every system. Most similar countries socialize malpractice insurance which is a huge cost for US doctors. US OBGYNs pay up to $200,000 per year in malpractice insurance. In Canada, $40,000CAD. In the UK I think it's 0GBP handled by the CNST. That goes a long way to balancing out pay differentials. In the US anesthesiologists make 400K USD median, in Canada 335K CAD median. > Funny that the UK argues about NHS funding a lot then. They argue about funding and prioritization and all sorts of stuff, sure, but it's not a partisan matter that the NHS should exist and be the status quo. The NHS was literally in the opening ceremonies of the 2012 olympics. 87% of British folks are proud of the NHS. [2] Canada's Conservatives support single-payer medicine too. [1] https://www.npr.org/2020/06/27/884307565/after-pushing-lies-former-cigna-executive-praises-canadas-health-care-system https://www.npr.org/2020/06/27/884307565/after-pushing-lies-... [2] https://yougov.co.uk/topics/politics/articles-reports/2018/07/04/nhs-british-institution-brits-are-second-most-prou https://yougov.co.uk/topics/politics/articles-reports/2018/0...

jollybean 5y ago

A few years ago, in Canada, we were paying $4500 per person - and everyone was covered. The US was paying $5K public per person and $5K private per person. Meaning - the US is already paying more per capita in public healthcare spending, than Canada, and for that price in Canada - everyone is covered. This kind of means, the US could literally give all of its citizens 'Canadian Quality Universal Coverage' and literally save a few dollars in public spending, and wipe out the need for private spending. So 'cost' and 'profit' are different things. The US HC system is a giant elephant of inefficiency. This is not a small thing: 'Healthcare' is a 'Pillar of American Decline'. I don't mean that America is falling apart, but rather, it's having less influence in the world. 50 years ago, you went to the Hospital because you were hurt. Now - it's all about aging people who are elderly who see the doctor 20x a year and it's why costs have skyrocketed. It's also when people are the least productive and less likely to be working with good insurance. HC is a disaster that makes the US a 'much less attractive place to live' for one's entire life, unless one is rich - whereas that was not the case before. It really needs to be sorted out. The Media Left, by highlighting Woke issues, instead of things like outrageous healthcare, has completely lost their minds. MSNBC was calling Elon Musk 'racist and misogynist' for his completely benign comments about this giant tax bill. Instead of looking at inequality issues through economic lenses, they're committed to throwing around gender and racial slander. The HC system is a soft, easy target because there are unlimited stories of people getting huge bills, unfair pricing. But you won't see to many stories, because "Sponsored by Phizer".

erichocean 5y ago
> 50 years ago, you went to the Hospital because you were hurt. Now - it's all about aging people who are elderly who see the doctor 20x a year and it's why costs have skyrocketed. It's also when people are the least productive and less likely to be working with good insurance. Literally 100% of the elderly in the US are already covered by the socialized medicine you seem to be advocating for. It's not optional.