5 ms·

As an American who has worked closely with the Federal government, I'm significantly more afraid of the idea that the government would be responsible for my med

As an American who has worked closely with the Federal government, I'm significantly more afraid of the idea that the government would be responsible for my medical care.

jakelazaroff 5y ago
What issues with government-run health insurance are you worried about?
colinmhayes 5y ago
That's not what anyone in the US is proposing though. Even medicare for all would still have the same private companies responsible for your care, they would just be paid by the federal government.
dangerlibrary 5y ago
Medicare (single payer healthcare in the US for everyone over age 65) has a lower fraud rate than private insurance, serves millions of seniors and has for decades, and as an American there is a big discontinuity in actuarial data where your life expectancy literally goes up at 65 because you get access to it. Maybe don't generalize from a few personal anecdotes to the functioning of the entire 4 million employee federal government?
- deleted 5y ago
  [deleted]
- sidewndr46 5y ago
  Why would I care about the fraud rate of anything? I'm not a fraudster.
  - dangerlibrary 5y ago
    A common right-wing criticism of Medicare that I was trying to pre-empt is that it is rife with waste, fraud, and abuse. But to directly answer your question: if you want your dollars spent effectively, you should care about fraud rates in services you pay for (public or private).
    - sidewndr46 5y ago
      Alright, well I guess I'll take your comment as an attempt at a real conversation. But fraud in the medical industry isn't really something that crosses my mind, nor is it part of my concern about the government dictating my healthcare.
      - Apocryphon 5y ago
        It's a concern that affects even startups! https://www.cfo.com/risk-compliance/2021/03/ubiome-founders-charged-with-60-million-fraud/ https://www.cfo.com/risk-compliance/2021/03/ubiome-founders-...
    - akvadrako 5y ago
      Medicare is very wasteful, but it doesn't matter why. The US government spends about as much per capita on healthcare as say France, but doesn't cover everybody and without part B is pretty incomplete.
      - colinmhayes 5y ago
        Medicare not only covers the most at risk of our population, but is also by far the cheapest per capita beside medicaid. Yes, American health care is expensive, but medicare is the cheapest way to deliver it.
  - downrightmike 5y ago
    Why would I care if you were on fire, if I'm not on fire?
- downrightmike 5y ago
  And the management cost is only 1%, vs 17% for healthcare comapnies. A lot of waste that could be helping people.
idiotsecant 5y ago
I guess you should probably tell that to the entire rest of the civilized world where state insurance seems to work quite well.
- sidewndr46 5y ago
  I have no problem believing that other nations governments do a great job. I also do not live there nor am I a citizen of those countries. American government is a uniquely incompetent form of government. Despite being one of the largest & most expensive governments it gets little to nothing done. Anything that is 'done' is often done far over the original projected budget.
  - dlp211 5y ago
    You're conflating things like physical infrastructure and defense contracts with welfare. The welfare that we do give, for the most part, is exceptionally well run and effective.
    - nmhancoc 5y ago
      Why do you think this? Do you count social security as a welfare program and if so would you consider it exceptionally well run and effective?
      - dlp211 5y ago
        Because giving individuals money, targeted or otherwise, is given/spent to enhance an individual or families life in some way. It is a direct benefit to them. And yes, SS is absolutely welfare and it is extremely effective. It reduces the poverty rate of the elderly by nearly 30%. It also reduces, directly and indirectly, child and young adult poverty by meaningful amounts as well, 1.5% and 3% respectively.
        nmhancoc 5y ago
        Hey I appreciate your answer. Regarding your first point, I disagree. I think the intention is clearly to provide a direct benefit, but that isn’t always the effect. One example which seems to be entering the zeitgeist now is student aid. The presence of additional student aid has a high correlation with the rise in tuition over time, but I think we’d all struggle to say it was commensurate with to the cost. Addressing your second point re: social security and perhaps generalizing my first point slightly, I think the statistics you cite are reductions in poverty vs simply abolishing the benefit. I don’t think they measure the counterfactual scenario of there never having been social security to begin with, and those current seniors having had their take home pay increase by some portion of the 15% of their gross pay which otherwise went to SS. Additionally, it doesn’t take into account the future debt servicing cost of current SS recipients on future generations.
Kranar 5y ago
Most of the world does not have government run health care, what they have is government run health insurance. Hospitals, doctors, health care providers in general are privately operated and anyone with the right credentials can go ahead and start their own practice/clinic, but the government provides single payer and universal health insurance.
CameronNemo 5y ago
Just because health care is untethered from your employment status does not mean it is single payer or fully nationalized. See this plan for example: https://en.m.wikipedia.org/wiki/Healthy_Americans_Act https://en.m.wikipedia.org/wiki/Healthy_Americans_Act It would transition away from employer-provided health insurance, to employer-subsidized insurance, having instead individuals choose their health care plan from state-approved private insurers. It sought to make the cost of health insurance more transparent to consumers, with the expectation being that this would increase market pressures to drive health insurance costs down.
beaconstudios 5y ago
doctors would be responsible for your medical care; taxes would foot the bill. The primary involvement of the government is the logistics involved in getting from A to B.
retrac 5y ago
It already is extensively involved (FDA, etc.) Health insurance is one of the least concerning things for the government to get involved in with healthcare, really. Worst thing that happens is they don't insure you or the procedure, and you have to pay for it yourself somehow. I would question the viability of government for handling many things, but collecting taxes and distributing funds is one of the things they usually are pretty good at. Some of the leanest health insurers in the US in terms of overhead are public enterprises, e.g. the VA and various state assistance programs.

As an American who has worked closely with the Federal government, I'm significantly more afraid of the idea that the government would be responsible for my medical care.

jakelazaroff 5y ago

What issues with government-run health insurance are you worried about?

colinmhayes 5y ago

That's not what anyone in the US is proposing though. Even medicare for all would still have the same private companies responsible for your care, they would just be paid by the federal government.

dangerlibrary 5y ago

Medicare (single payer healthcare in the US for everyone over age 65) has a lower fraud rate than private insurance, serves millions of seniors and has for decades, and as an American there is a big discontinuity in actuarial data where your life expectancy literally goes up at 65 because you get access to it. Maybe don't generalize from a few personal anecdotes to the functioning of the entire 4 million employee federal government?

deleted 5y ago
[deleted]
sidewndr46 5y ago
Why would I care about the fraud rate of anything? I'm not a fraudster.
- dangerlibrary 5y ago
  A common right-wing criticism of Medicare that I was trying to pre-empt is that it is rife with waste, fraud, and abuse. But to directly answer your question: if you want your dollars spent effectively, you should care about fraud rates in services you pay for (public or private).
  - sidewndr46 5y ago
    Alright, well I guess I'll take your comment as an attempt at a real conversation. But fraud in the medical industry isn't really something that crosses my mind, nor is it part of my concern about the government dictating my healthcare.
    - Apocryphon 5y ago
      It's a concern that affects even startups! https://www.cfo.com/risk-compliance/2021/03/ubiome-founders-charged-with-60-million-fraud/ https://www.cfo.com/risk-compliance/2021/03/ubiome-founders-...
  - akvadrako 5y ago
    Medicare is very wasteful, but it doesn't matter why. The US government spends about as much per capita on healthcare as say France, but doesn't cover everybody and without part B is pretty incomplete.
    - colinmhayes 5y ago
      Medicare not only covers the most at risk of our population, but is also by far the cheapest per capita beside medicaid. Yes, American health care is expensive, but medicare is the cheapest way to deliver it.
- downrightmike 5y ago
  Why would I care if you were on fire, if I'm not on fire?
downrightmike 5y ago
And the management cost is only 1%, vs 17% for healthcare comapnies. A lot of waste that could be helping people.

idiotsecant 5y ago

I guess you should probably tell that to the entire rest of the civilized world where state insurance seems to work quite well.

sidewndr46 5y ago
I have no problem believing that other nations governments do a great job. I also do not live there nor am I a citizen of those countries. American government is a uniquely incompetent form of government. Despite being one of the largest & most expensive governments it gets little to nothing done. Anything that is 'done' is often done far over the original projected budget.
- dlp211 5y ago
  You're conflating things like physical infrastructure and defense contracts with welfare. The welfare that we do give, for the most part, is exceptionally well run and effective.
  - nmhancoc 5y ago
    Why do you think this? Do you count social security as a welfare program and if so would you consider it exceptionally well run and effective?
    - dlp211 5y ago
      Because giving individuals money, targeted or otherwise, is given/spent to enhance an individual or families life in some way. It is a direct benefit to them. And yes, SS is absolutely welfare and it is extremely effective. It reduces the poverty rate of the elderly by nearly 30%. It also reduces, directly and indirectly, child and young adult poverty by meaningful amounts as well, 1.5% and 3% respectively.
      - nmhancoc 5y ago
        Hey I appreciate your answer. Regarding your first point, I disagree. I think the intention is clearly to provide a direct benefit, but that isn’t always the effect. One example which seems to be entering the zeitgeist now is student aid. The presence of additional student aid has a high correlation with the rise in tuition over time, but I think we’d all struggle to say it was commensurate with to the cost. Addressing your second point re: social security and perhaps generalizing my first point slightly, I think the statistics you cite are reductions in poverty vs simply abolishing the benefit. I don’t think they measure the counterfactual scenario of there never having been social security to begin with, and those current seniors having had their take home pay increase by some portion of the 15% of their gross pay which otherwise went to SS. Additionally, it doesn’t take into account the future debt servicing cost of current SS recipients on future generations.

Kranar 5y ago

Most of the world does not have government run health care, what they have is government run health insurance. Hospitals, doctors, health care providers in general are privately operated and anyone with the right credentials can go ahead and start their own practice/clinic, but the government provides single payer and universal health insurance.

CameronNemo 5y ago

Just because health care is untethered from your employment status does not mean it is single payer or fully nationalized. See this plan for example: https://en.m.wikipedia.org/wiki/Healthy_Americans_Act https://en.m.wikipedia.org/wiki/Healthy_Americans_Act It would transition away from employer-provided health insurance, to employer-subsidized insurance, having instead individuals choose their health care plan from state-approved private insurers. It sought to make the cost of health insurance more transparent to consumers, with the expectation being that this would increase market pressures to drive health insurance costs down.

beaconstudios 5y ago

doctors would be responsible for your medical care; taxes would foot the bill. The primary involvement of the government is the logistics involved in getting from A to B.

retrac 5y ago

It already is extensively involved (FDA, etc.) Health insurance is one of the least concerning things for the government to get involved in with healthcare, really. Worst thing that happens is they don't insure you or the procedure, and you have to pay for it yourself somehow. I would question the viability of government for handling many things, but collecting taxes and distributing funds is one of the things they usually are pretty good at. Some of the leanest health insurers in the US in terms of overhead are public enterprises, e.g. the VA and various state assistance programs.