5 ms·

Not OP, but I'll answer. Switching to a single-payer will be too costly for any political party to tolerate. The US spends $3.8T on health care per year. Tha

Not OP, but I'll answer. Switching to a single-payer will be too costly for any political party to tolerate. The US spends $3.8T on health care per year. That's $11,500 for every single person in the United States. In order to fund (raise taxes) to a single-payer system that number will need to drop dramatically. We'll have to cut out middlemen, reduce bureaucracy, negotiate domestically, etc. That $11.5k needs to drop to about $6k to be on the upper quintile of health spending per capita compared to other, successful, single-payer systems. That brings the total from $3.8T down to $1.98T. ...but therein lies the problem. The health sector is 18% of the economy and employs 14% of all US workers. You can't quickly pull $1.8T out of a single sector of the economy. Would it stabilize to 9% of the economy and 7% of all US workers? What do all those people (7% of all workers) who previously worked in health care go do? Where does that $1.8T that we used to spent show up? So it's a conundrum. You need to slowly reshape the industry over 10-20 years and carefully manage the outcomes or it's an economic and political disaster. However, the only way for that gradual plan to work is if you raise taxes to fund the $5T that it would take to maintain status quo. ...and good luck with that. The total net worth of all the billionaires in the US is $5T. There isn't a tax rate in the world that could raise that kind of revenue. Vermont tried to implement a single-payer system, did their own analysis of what it would take, and decided not to move forward.[0] So it's not that I oppose single-payer in theory, I just oppose it as policy in the US because I see it as a political impossibility that is in the way of realistic reform. To me it's chasing a perfect outcome when there are good outcomes available. [0]:https://www.vox.com/2014/12/22/7427117/single-payer-vermont-shumlin https://www.vox.com/2014/12/22/7427117/single-payer-vermont-...

seanmcdirmid 5y ago
Oddly enough, the USA already publicly funds about 40-50% of all healthcare already via medicare, health insurance for federal employees (and military), the VA, etc... So they aren't going from 0 to 100%. But I agree in general: healthcare reform should do something about costs, and healthcare is so much apart of our economy that any attempted cost reduction will be painful.
beeboop 5y ago
How much of the $3.8T is profits that don't need to exist? Why should public medicine be for-profit when public education isn't? Why does no one complain that the military doesn't turn a profit yet also costs nearly a trillion a year? Presumably the entire industry isn't going to magically become less complicated when a single payer option begins. There will still be a need for many of those roles, but they will be employed by the state instead of private companies siphoning profit. I have not seen, and I am not sure it would be possible to generate, evidence in the number of jobs that would be lost (or created) by a single payer system.
- parkingrift 5y ago
  > Why does no one complain that the military doesn't turn a profit yet also costs nearly a trillion a year? People complain all the time. The military budget is $700 billion. Healthcare expenses would be $5T to cover everyone in our current situation. For reference, the total federal tax revenue is $3.86T. That’s individual, corporate, payroll, everything. > Presumably the entire industry isn't going to magically become less complicated when a single payer option begins. There will still be a need for many of those roles, but they will be employed by the state instead of private companies siphoning profit. Yes that’s the exact problem. How to not destroy millions of lives and the economy. You’re suggesting these people will go work for the state? We will literally have to, at minimum, double the effective tax at every single level. Double the federal income tax, double the payroll tax, etc. Would you personally vote to double your total effective taxes? I would not. Single payer just isn’t going to happen in the US anytime soon. Democrats can’t even corral the votes to fund an infrastructure bill that is a fraction of the cost an single player health plan would cost. …and Democrats are going to get thrown out of Congress this year. So it’s time to move on to reforms that might actually happen. Or we can keep endlessly chasing the perfect outcome and endlessly achieve nothing.

seanmcdirmid 5y ago

Oddly enough, the USA already publicly funds about 40-50% of all healthcare already via medicare, health insurance for federal employees (and military), the VA, etc... So they aren't going from 0 to 100%. But I agree in general: healthcare reform should do something about costs, and healthcare is so much apart of our economy that any attempted cost reduction will be painful.

beeboop 5y ago

How much of the $3.8T is profits that don't need to exist? Why should public medicine be for-profit when public education isn't? Why does no one complain that the military doesn't turn a profit yet also costs nearly a trillion a year? Presumably the entire industry isn't going to magically become less complicated when a single payer option begins. There will still be a need for many of those roles, but they will be employed by the state instead of private companies siphoning profit. I have not seen, and I am not sure it would be possible to generate, evidence in the number of jobs that would be lost (or created) by a single payer system.

parkingrift 5y ago
> Why does no one complain that the military doesn't turn a profit yet also costs nearly a trillion a year? People complain all the time. The military budget is $700 billion. Healthcare expenses would be $5T to cover everyone in our current situation. For reference, the total federal tax revenue is $3.86T. That’s individual, corporate, payroll, everything. > Presumably the entire industry isn't going to magically become less complicated when a single payer option begins. There will still be a need for many of those roles, but they will be employed by the state instead of private companies siphoning profit. Yes that’s the exact problem. How to not destroy millions of lives and the economy. You’re suggesting these people will go work for the state? We will literally have to, at minimum, double the effective tax at every single level. Double the federal income tax, double the payroll tax, etc. Would you personally vote to double your total effective taxes? I would not. Single payer just isn’t going to happen in the US anytime soon. Democrats can’t even corral the votes to fund an infrastructure bill that is a fraction of the cost an single player health plan would cost. …and Democrats are going to get thrown out of Congress this year. So it’s time to move on to reforms that might actually happen. Or we can keep endlessly chasing the perfect outcome and endlessly achieve nothing.