We can't afford Universal Healthcare?!?

[kpete]

[Blues Heron]

1. yup

sickening really. that graph really puts our national military insanity in perspective. and we can't defeat an enemy that drives around in pickup trucks? after decades? total scam.

[shanny]

2. yup

Plus, if we can't afford to feed all our people, educate our children, build infrastructure and protect our environment for future generations, one wonders just what they are defending.

[Bettie]

58. Corporate profits

is what they are defending. The people? LOL. No.

[BSdetect]

3. Every other actual democracy can do it. And for less than we spend already. Yes, less.

[A DAY IN THE LIFE]

5. But how?

Are they just relying on the US' big defense umbrella and building fewer pieces of equipment. I just wonder what makes this big difference. China and Russia have larger armies. Russia has as many nuclear weapons and are supposedly developing more advanced nuclear systems (hypersonic missile). China and Russia have highly advanced stealth aircraft, and reportedly more.

Is it labor costs, profit margins, waste? We do have more military actions, that is a major expense, but does it make up the big difference in expenditures?

[Larrybanal]

7. WPAFB

I grew up across the road from what was a huge base and at the end of every fiscal year we saw money being thrown at everything to use up their total budget..everything was painted or rebuilt just to say they needed more money the next year.
this results in my having very little respect for our military finances

[NewJeffCT]

12. more military action

means more wear & tear on military equipment, so it needs to be replaced more often and repaired more often.

Plus, I'm guessing that China's numbers and Russia's numbers aren't 100% accurate, either.

[Farmer-Rick]

13. Those larger Chinese and Russian Armies also have universal health care for their citizens.

What those countries do is NOT pay greedy insurance companies profits and NOT pay their $10.9 million a year salaried CEOs. And there is no built in rush for useless tests in order to make profits for useless and redundant equipment and facilities.

You take out the profit motivation for life saving services and the price drops and the quality improves. Because a dying man will pay anything to stay alive and health care corporations know it.

China and Russia are not the richest countries in the world and yet they provide each of their citizens medical care from birth to death. But we in the US are too poor.

PS Medicare for all, or even for those over 65, is NOT Free. There are taxes we pay with every dollar we earn marked for Medicare. There are co-pays of 20% and premiums you must pay out of your Social Security to use Medicare.

[LibDemAlways]

33. Thanks for stating the truth about Medicare.

I am 66. My SS Check is small and the benefit was reduced because I took it out of necessity at 62. My Medicare premium of $134 comes out of that small check. On top of that I have supplemental private insurance which covers the 20% Medicare doesn't pay for most services. Plans and costs vary greatly depending on what's available in a particular geographic area. I am in California in an area where premiums are high and private insurance demands their pound of flesh. I currently pay $214 a month for my plan and there is a yearly deductible of a couple of hundred dollars. So I'm out $348 monthly plus an additional $31.00 for prescription drug coverage. Under the prescription plan, drugs aren't free but costs of individual medications are somewhat reduced. And, on top of all this, not every provider takes Medicare because reimbursements are small.

So, while in theory Medicare for all sounds great, the system would need a considerable amount of tweaking to make it truly affordable and serviceable for everyone. And Republicans and the insurance lobby would fight it to the death.
.

[area51]

35. What's being proposed

is comprehensive Medicare for All.

[c-rational]

19. Other countries do it because of better priorities. We spend more on our military than then

next top 10 countries combined. We do it because we have been brainwashed into thinking it is for our national defense. The hugh military IMO just protects our corporate interests in robbing the natural resources of the world.

[LiberalArkie]

27. We do it because both the D's and R's in congress are heavily invested in military and aviation

stock.

[zentrum]

4. Yup.

[JayhawkSD]

6. What needs to be said is that we can't provide FREE health care.

This game that is being played is "free health care for all" and that is, indeed, not possible. It will cost more than can be paid by diverting other funding, and must be paid for by raising taxes on the people who benefit from it. That's how universal health care is provided in countries which have it. It is paid for through taxes from the people who benefit from it.

Those taxes would be considerably less than the health insurance premiums that we pay now, because the cost will be lower than what we are spending now, and so we would be paying less and receiving better health care.

But there is no such thing as a free lunch, and this image of everyone getting free health care because "the rich" will pay for it through their higher taxes, or that it will be paid for by simply making money magically appear by increasing a national debt that never needs to be repaid is nonsensical.

[riverine]

9. Yes. That graph shows that military spending at about $700 billion a year.

Health care spending in 2018 was $3.5 trillion in total.

Cutting military spending to zero would not pay for health care.

(we already collect taxes for $1.1 trillion for Medicare/caid/VA.

[rurallib]

23. current health care premiums would become taxes

overhead would decidedly drop. The two things alone should fill the gap.

[Mr Tibbs]

57. About 60 cents on the dollar of what we pay now

More money in your wallet. Universal coverage. No more medical bankruptcies.

[PeeJ52]

10. but seriously, the message is, do we REALLY need to be paying that much for defense??

couldn't we maybe get away with half as much allocated to military spending and still lead the world and still be as safe and still afford universal health care and still not raise taxes and still pay down the national debt and even cut taxes?

[JayhawkSD]

11. Did you read riverine's comment

We spend $3.5 trillion on health care last year.

Let's say we cut health care cost in half without cutting the efficacy of that care. Let's say we cut military spending in half without weakening national defense. Health care now costs $1.75 trillion, $250 billion (14%) of which came from the military spending cuts. Where are you going to get the other $1.25 trillion? Let alone "still pay down the national debt and even cut taxes" as you propose?

More glib responses from nonthinkers who can't do simple math.

[Farmer-Rick]

15. Well poorer countries like Russia, China and Mexico provide universal health care And

Some Have larger Armies. Why are Americans so poor? Why are we so poor we can't even match Russia's benefits to its citizens while still maintaining a Military?

Poor, poor Americans. So much wealth for Bill Gates, Zucherberg, the Waltons, the Kochs and the Mars but not enough for the largest group of American citizens to live above the poverty level.

[rurallib]

25. Will we still be paying insurance premiums to health care companies

that will be doing nothing?
Perhaps those premiums will become the taxes that pay for the health care?

[LanternWaste]

38. I pretend the same thing when others hold different opinions.

"More glib responses from nonthinkers who can't do simple math."

I pretend the same thing when others hold different opinions. It allows us the rare pretense our cleverness is more than reality may otherwise tell us.

[ck4829]

50. Burn

[c-rational]

22. Agreed, but I do not hear Free Health Care much, ratherr Universal Health care. I also believe we

as a country we spend much too much on our military. Your point about total cost between insurance premiums and taxes is spot on. We would spend less with a single payer option IMO because of less profit and better efficiencies. And because niether the medical community nor the private insurance commpanies see fit to do the right thing for society, then the government needs to do it for the country's betterment. The whole argument about healthcare is fraught with not enough facts and too much spin.

[AllyCat]

46. Yes. Our tax money could be used for healthcare, but we choose

To spend it on war.

[Trueblue Texan]

56. OP is correct, but...

...it is insane that we KNOW we could pay less for healthcare with universal coverage than we currently do, while not compromising quality of care. Everyone who uses our system knows it is horribly inefficient--a stress-inducing burden upon the already overwhelmingly stressed with serious or longer termed illnesses. Jesus Christ, if we can't do better than what we're doing and save money at the same time, we're doomed. It's a damned no brainer. Why are there always people who say we shouldn't take this challenge on? brainwashed.

[JayhawkSD]

8. Bye the way, you know what the second biggest expense is?

Payment of interest on the national debt.
$523 billion in FY2018 and increasing slightly this year.
This is information from a government website.

[FiveGoodMen]

39. When Clinton left office, we were in line to pay the debt off in 10 or 15 years.

Thanks to Dubya, we have the situation you're describing now.

[JayhawkSD]

40. That is incorrect.

Go to the government Treasury Department website at this link, for a breakdown of government debt year by year.

At the end of FY1993 the debt was $4.411 trillion, at the end of FY 2001 it was $5.807 trillion, and you will see in that report that it did not decrease one single year.

The debt increased every year between 1993 and 2001. Clinton conflated federal revenue with Social Security surplus to make it appear that he was reducing the debt, but he was increasing the Social Security trust fund, not reducing the national debt. Yes, he threw around some long range numbers, but it was all smoke and mirrors, same as every other president before and since. The federal government only budgets one year at a time.

[FiveGoodMen]

41. I'm not in a position to argue with you, however...

There were MANY reports about how continuing the deficit reduction trends would allow -- best case -- payoff in something like 13 years.

[JayhawkSD]

42. There are many reports about many things.

Some of them are true. Most of them are not.

The fact is, from the US Treasury's own database, that the debt increased every year during Clinton's term in office. The debt does not get paid off ever, let alone in 13 years, while spending greater amounts than is taken in. "Deficit reduction trends" is meaningless for an organization that budgets one years at a time.

Talk of "deficit reduction trends leading to payoff in 13 years" was puffery, political spin, and utter nonsense. I'm not bashing Clinton. That has been the nature of our politics for decades.

[Trueblue Texan]

55. It was Reagan, in 1983...

...that pushed for and signed legislation that allowed Social Security surpluses to be rolled into the general fund. Don't blame Clinton. oh...I guess you could somehow blame Obama, though. There MUST be a way.

[JayhawkSD]

60. Another canard. Incorrect.

Social Security surplus is put into a trust fund. The government then borrows that money for general operation, issuing treasury bonds which Social Security can redeem when it needs that money back.

For many years after Social Security was created, the money paid into that system was not included when federal revenue was reported. The cash flow of Social Security revenue and federal government were separate and were reported separately. It was indeed Reagan, if I recall, who noticed that federal revenue was showing a consistent deficit, while Social Security was showing a surplus, and that by conflating the two financial systems he could hide the fact that the government was operating in the red.

That did not mean that Social Security money was being spent by the federal government. Doing that was then and is now illegal.

[Trueblue Texan]

64. Semantics...

[LakeArenal]

14. As long as US can pay Congressional health insurance. ..

US doesn’t need any other. Done!

[SammyWinstonJack]

54. Good enough for Congress and the rest of us can go pound sand.

[IronLionZion]

16. We somehow also pay the most for healthcare

that point should not be lost when we describe how we prioritize killing people over saving lives

[Bernardo de La Paz]

17. That's because emergency care is expensive

In the U.S., the Emergency Medical Treatment and Active Labor Act requires that hospitals treat all patients in need of emergency medical care without considering patients' ability to pay for service.[24]

When there is no healthcare for people who can't afford it, then simple conditions become complex and it bankrupts people and put a big burden on taxpayers because that means more frequent and more severe indigent cases and emergency cases.

Not to forget all the lost productivity.

[IronLionZion]

18. That's one part of a more complex system

that also includes pharmaceutical and equipment costs, lab tests, in-network vs out-of-network, medical waste disposal, and many layers of businesses involved in every aspect of providing care with everyone getting nice profits along the way. There is profit in complexity.

[Bernardo de La Paz]

20. "There is profit in complexity". EXACTLY! Applies to so many other areas of government.

Ever wonder why the tax code is so complicated? Instead of paying open transparent subsidies, the government has to pay the same or more by hiding it in tax deductions for corporations. There is profit in complexity.

Ever wonder why the paperwork burden on the poor is so high? There is profit in complexity.

Why is the US health care system so byzantine and baroque? There is profit in complexity.

[IronLionZion]

21. Tax Preparation and Financial industries make their living off the complexity

wealthy people can afford an army of lawyers and accountants to save them money while the less fortunate are taken for a ride.

Ironically one person who actually did simplify and unify some parts of America's complex healthcare system was crooked Dick Nixon, who championed Kaiser HMOs as a way to integrate the various aspects of providing care.

[JayhawkSD]

43. "in-network vs out-of-network" does not add to cost.

It merely affects who pays the cost - insurance or patient.

There is not profit in complexity, per se, as it does not create additional profit in itself. It merely hides the piracy and permits price gouging to remain invisible.

[IronLionZion]

45. Insurance companies have bargaining power, patients don't

so insurance companies negotiate better prices within their network

[JayhawkSD]

47. Have you ever looked at an insurance "Explanation of Benefits" (EOB)?

The bill will be a certain amount, say $12,864, and the insurance payment will be one of two things:
"In network, we pay 80%," - or -
"Out of network, we pay 50%."

Whether insurance pays 50% or 80% the medical bill is $12,864 for the service. There is no negotiation due to the purchasing power of the insurance company. The difference is how much the insurance pays and how much the patient pays. The provider gets $12,864 regardless of whether they are in network or out of network.

[IronLionZion]

53. They Paid How Much? How Negotiated Deals Hide Health Care's Cost

https://www.npr.org/sections/health-shots/2014/11/15/364064088/they-paid-how-much-how-negotiated-deals-hide-health-cares-cost

INSURERS’ NEARLY INVISIBLE NEGOTIATED RATES CAN DRAMATICALLY AFFECT HEALTH CARE PRICES
https://www.bu.edu/questrom/2018/12/04/insurers-negotiated-rates-can-dramatically-affect-health-care-prices/

[ET Awful]

59. That is absolutely incorrect.

The reason they pay 80% in network and only 50% out of network isn't out of some altruistic motive to save you money. That is because they have negotiated a reduction with those providers that are in network. In all likelihood that reduction is even greater than the difference you pay out of pocket meaning that when you go to an in-network provider, the insurance company saves more money (meaning more profit for them).

If you truly believe the provider gets the same regardless, you haven't talked to any providers. Go ask a provider in a small office how much they get paid for services from insurance companies.

[JayhawkSD]

61. Yes, I will stand corrected on that.

Nonetheless, that does not raise prices, it reduces them. In network results in lower prices. Insurance companies don't require out of network providers to jack up their prices, they require in network providers to reduce their prices.

I have no doubt that providers charge higher prices to patients with out of network providers, or wo are uninsured, because of the cut they are giving to patients of in network insurance. But that's still not the cause of higher prices. They are making a profit at the level they are being paid by the insurer for whom they are in network, so jacking up the prices to an out of network patient is pure greed on their part. The fault lies with the provider, not with the insurance company.

"Go ask a provider in a small office how much they get paid for services from insurance companies."
If they don't like what they are paid by an insurance company, all they have to do is not accept that insurance.

[ET Awful]

62. What you're missing is this -

You are incorrect again.

The reason doctors will accept the insurance isn't because they make good money off of it but because they wouldn't make enough to stay in business otherwise.

If you knew the number hours required to document treatment treatment (the insurance companies are ever more demanding with the records they require before they will pay any claim), the amount of time spent by the provider and their staff just to provide the billing in a way the insurance company bureaucracy demands, they've cut what little profit they would make by a huge margin.

The money the insurance company saves by doing this doesn't go to care, it goes to bonuses, overhead, etc.

Your knowledge of this matter appears to be based not on fact, but opinion.

Having worked with insurers, providers, pharmaceutical companies, etc., I've seen what goes on, what happens at each and can speak from having observed the practices.

From where do you draw your information?

[JayhawkSD]

63. Well, my father was a doctor for fifty years.

My uncle was a doctor for 45 years.

Who knows. Maybe neither one of them knew what they were doing.

I go to five doctors. Two of them don't accept any insurance at all. They both are fine doctors and have been in practice for quite a long time. I pay them cash and then submit to my insurance without their involvement. Maybe they are independently wealthy and don't need to make an income from their medical practice.

Maybe I just don't know what I'm talking about. Maybe I'm just so unobservant that having spent my entire life around dozens of doctors and their families I faiied to pick up any knowledge of the business they do.

What does "worked with" mean? Were you employed by all of these companies?

[ET Awful]

65. Taking your car to a garage doesn't make you a mechanic

My grandfather was a rancher, that doesn't mean I understand how his business ran.

As to worked with? In a full time or consulting role, yes I've been employed by two insurance companies, several healthcare providers, three pharmaceutical companies and have worked for law firms that represent more of the same.

I've done so in jobs ranging from being a paralegal in the late 80s/early 90s to senior IT roles, to consulting on accounting system design and Implementation, and performing AP/AR roles where I actually saw invoices, bills, payments, etc.

When you've helped a few doctors close down their private practice and tell you the primary reason is because they simply can't afford to keep an office open because of the paltry sums they're paid by insurers because of negotiated rates maybe you'll get it.

[ck4829]

49. Crazy

[inwiththenew]

24. You need to look at it as a % of GDP

Defense spending is roughly 3% of GDP. Countries like France, UK, Australia, and China are around 2%. Russia is at 4% and Saudi Arabia is at 10%. It is still high but as a percentage of GDP it is not wildly out of line with the rest of the world. I think the average world wide is right around 2%. If you brought the US down to that level you'd probably save $200-$300 billion.

[JayhawkSD]

44. Percent of GDP is how economists disguise outrageous costs.

The amount we spend on "national defense" is obscene and outrageous. Economists disguise that by saying that it a "mere" small percent of GDP. It is also more than 40% of federal revenue. Of every dollar the federal government takes in, 40¢ is spent on national defense, 35¢ is paid to service the debt, and 25¢ is left for everything else. So take that sophomoric "3% of GDP" and put it where the sun don't shine.

"If you brought the US down to that level you'd probably save $200-$300 billion." Which would pay less than 6% of the cost of universal health care.

[democratisphere]

26. It must be more important to kill people than to save them.

Makes perfect nonsense.

[PoindexterOglethorpe]

28. While dismantling the military entirely

would clearly not cover every bit of health care expenditure in this country, it would go a long way.

This country has made a deliberate choice to invest (so to speak) in our military rather than in our citizens in the form of health care, or free college. That, coupled with the deliberate choice to shift the burden of paying taxes from the wealthy and corporations to the middle classes, is why this country is already on its precipitous decline from world power status.

We are a lot like Spain in the 16th century. It was a world power, with much (mostly stolen from the New World) wealth and colonies around the globe. Then two things happened. The Spanish Armada, a decisive military defeat by a small, unimportant country, England, and a decision not to tax the wealthy but to tax the poor. Spain's power and influence declined precipitously. It has remained an unimportant (on the world stage) country for some 400 years now.


It's the same with this country. I don't think we've yet had our Spanish Armada, but we've done the other. With Trump as President our prestige and influence on the world stage is declining precipitously. Looking forward, if your Presidents and Congress continue to fund our military while defunding everything else, it's just a matter of time before we're Spain. A pleasant country to visit I'm sure, although I've never been there. Lovely people, I'm sure. Lots of interesting art and places to visit there. But long since no longer a world player.

[PatrickforO]

32. This is an interesting, though provoking post.

I suggest we may have had Spanish Armada 1.0 in Vietnam. And perhaps 2.0 on 9/11 then subsequently in Iraq and Afghanistan, the forever wars.

Do you ever wonder how it would be if America lost its empire but kept our republic?

I can imagine some children no longer having to worry about drones and land mines. I can imagine other countries moving forward to make the lives of their people better without having to worry about us toppling their government for the sake of protecting our business interests. I can imagine us entering a national effort to come to terms with our genocide of Native Americans and with our slavery, subsequent Jim Crow, and failure to achieve the dream that people could be judged by the content of their character and not the color of their skin.

I can imagine how good it would be if we joined hands with other nations to address human-caused climate change and reverse or at least mitigate its consequences so that our grandchildren could inherit a clean planet as beautiful and majestic, and as habitable as what we inherited when we were born.

Honestly, the path I'm most worried about is the parallels I see with the Germany of the 1930s and the United States during the Trump era. Because those parallels are stunning, and not in a good way. I see Stephen Miller as an incarnation of Reinhard Heydrich, Bannon as Goering and so on. Pence is perhaps Rudolph Hess. Well, maybe I'm going laughably too far, but there are some real parallels nonetheless. And that is scary.

A last thought...interesting that you see us as parallel to Spain in the age of exploration. They did have the Inquisition. I wonder what our Inquisition is? Perhaps the white nationalism, and people with brown skin being accosted and told they ought to 'go back to their own country,' when this IS their country. I don't know. Or maybe our eagerness to carpet bomb, drone and do the whole shock and awe thing with people far weaker who do not embrace 'democracy.'

[PoindexterOglethorpe]

34. This country is its own peculiar combination

of 16th century Spain and 1930s Germany.

I often think that the way I feel about things going on in this country now must be a lot like the way many ordinary Germans felt in the mid 1930s. Terrible things are happening and I'm powerless to do anything about them. Other than vote, which I always do. I think it would be essentially impossible to do away with national elections in this country, as Hitler did after he came to power in 1933. But many other elements of what he did are certainly present as you've noted.

[PatrickforO]

29. I sent out this meme to friends on social so that perhaps it can go viral.

If most Americans really knew the truth...well - we have to keep plugging, don't we?

[The Wizard]

30. It's not the military spending but rather

framing it as military waste that will get popular support. Cutting military waste to pay for universal healthcare is a winner.

[sandensea]

31. Plus, a lot of that is sheer graft

The Pentagon itself "can't account" for over $3 trillion.

Nearly the size of all our annual health expenditures, public and private.

[pdsimdars]

36. Also, don't they have any confidence in American enginiuty? EVERY other advanced country has it

So, everyone else can figure it out and we can't? That's a bit UN-American.

[Ron Obvious]

37. While that's outrageous

We're already paying for universal healthcare! We're just not getting it. We spent a far higher percentage of GDP on healthcare than any other country, and even just the public expenditure as a percentage of GDP (Medicare, Medicaid, VA, etc) is more than enough for most countries entire universal healthcare budgets without, or minimal, copays & deductables, and include vision and dental besides!

We just have a combination of terrible wastes and inefficiencies because of all the overlapping programs and multiple insurance companies, as well as deliberate lack of cost control and rapacious big pharma.

We could easily cover everybody today, have better care besides, and spend a lot less.

I'm not optimistic, though. The government really doesn't work for us, and that includes both D&R. They work for the businesses that pay their campaign contributions. Everybody in the age of the internet should know this, but I'm always having to explain to people I meet that US care is both not very good, and extraordinarily expensive and inefficient. The myths ("greatest care in the world et al) seem to persist.

[ck4829]

48. K&R

[applegrove]

51. Socialism!!!

[Soxfan58]

52. Eisenhower told us 58 years ago

Beware the military industrial complex
https://en.m.wikipedia.org/wiki/Eisenhower%27s_farewell_address