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Yavin4

(35,443 posts)
Fri Feb 19, 2016, 05:58 PM Feb 2016

Some basic questions about Bernie's Single Payer plan

1. How would doctors, hospitals, pharmaceuticals be compensated and who determines their level of compensation?

2. What procedures would be covered? Would every procedure currently covered by existing health insurance companies be covered by Single Payer?

3. What happens if doctors don't take Single Payer patients only those with private insurance? What does that mean for people who currently have relationships with these doctors but can no longer see them?

5. If people opt out of being in Single Payer and are willing to pay for private health insurance, are they exempt from the payroll tax? If they're not, why not?

4. What about funding sources? What if the payroll tax is inadequate to compensate the doctors, hospitals, and pharmaceutical companies?

5. What about reproductive health care for women? Will Single Payer pay for contraceptives? Will abortions be covered?

To answer your inevitable questions about Hillary's health care plan, she's stated that she will maintain the ACA which addresses these issues above.



14 replies = new reply since forum marked as read
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kristopher

(29,798 posts)
1. Tell you what - lay out precisely what the ACA act says first...
Fri Feb 19, 2016, 06:00 PM
Feb 2016

And then we can see what we need to do.

OK?

jillan

(39,451 posts)
2. The whole purpose of single payer is to get rid of insurance companies. Cutting out the middle man!
Fri Feb 19, 2016, 06:05 PM
Feb 2016

As someone that is a caregiver for a woman with chronic health issues, I cannot tell you how much easier my life would be without having to deal with these denial panels - and how much healthier she would be if I could just get her to the right doctors without insurance companies fighting us every step of the way!!!

Think of it as medicare. It's the same thing. If you have medicare you can go see any doctor that accepts medicare but with Bernie's plan that would not even be an issue because they all would.

Recursion

(56,582 posts)
11. Why do you say they would all accept it?
Fri Feb 19, 2016, 07:53 PM
Feb 2016

AFAIK that's the biggest unanswered question: would they be required legally to? They are in Canada, and can go to jail if they bill privately or balance bill. It makes a huge difference to what the system would actually do. Why has he never addressed that? (The answer is depressing: single payer is just a campaign gimic.)

We've seen what happens with higher ed when there's a spigot of Federal money but balance billing is still allowed: the providers still try to squeeze every dollar they can out of people. American doctors make almost twice the OECD average, and they want to keep it that way.

 

DisgustipatedinCA

(12,530 posts)
3. I'm a Bernie Sanders voter, and so can you! (thank you, Mr. Colbert).
Fri Feb 19, 2016, 06:05 PM
Feb 2016

Please read that as, we're going to vote the way we're going to vote, and neither of us will be changing the others' minds. But you can rest assured (if you so choose) that Sanders won't be leaving anyone in the lurch.

Yavin4

(35,443 posts)
6. I clicked the first link, and it doesn't answer some of my questions.
Fri Feb 19, 2016, 06:17 PM
Feb 2016

For example, the link states that "Patients will be allowed free choice of their doctor and hospital." That's untrue. If doctors/hospitals refuse Single payer patients, and only take patients with private health insurance, then patients are not free to choose. They will have limited options to choose from.

And from your second link, there's this:

Why shouldn’t we let people buy better health care if they can afford it?

Whenever we allow the wealthy to buy better care or jump the queue, health care for the rest of us suffers. If the wealthy are forced to rely on the same health system as the poor, they will use their political power to assure that the health system is well funded. Conversely, programs for the poor become poor programs. For instance, because Medicaid doesn’t serve the wealthy, the payment rates are low and many physicians refuse to see Medicaid patients. Calls to improve Medicaid fall on deaf ears because the beneficiaries are not considered politically important. Moreover, when the wealthy jump the queue, it results in longer waits for others. Studies in New Zealand and Canada show that the growth of private care in parallel to the public system results in lengthening waits. Additionally, allowing the development of a parallel, private system for the wealthy means the creation of a permanent lobby for underfunding public care. Such underfunding increases the demand for private care.


Does this mean that there will be a ban on all private health insurance? How can the government enforce that?

Cleita

(75,480 posts)
8. I have Medicare and I have yet to be refused care by any provider I
Fri Feb 19, 2016, 06:53 PM
Feb 2016

have gone to. Yet when I had private insurance my options were very limited as to whom would take my insurance/HMO. So single payer gives you more options. Before I got Medicare I could go to a doctor who refused my insurance and pay them cash. Then I could submit the bill to my insurance to try to get them to pay it. Sometimes they did but seldom the whole amount so I think the same protocol would apply although I never have had to do that since I got Medicare.

I certainly hope private insurance will be forbidden to offer basic care. Keeping them out of the pool is what makes it cost effective. I'm sure there will be provisions for insurance companies to offer coverage beyond basic care like they do in France.

 

Warren Stupidity

(48,181 posts)
5. You need to work on your numbers.
Fri Feb 19, 2016, 06:17 PM
Feb 2016

You could try reading the proposal.

1. Just like private insurers set compensation rates, a public insurer would set compensation rates. The compensation would be paid by the established government administrative agency or its delegates, as it is today for Medicare.

2. The proposal is "comprehensive" and covers all standard healthcare except things like elective cosmetic surgery. Generally this is more than standard insurance plans cover, and their are no additional costs, no copays, no deductibles. Again, read the proposal.

3. There is no requirement on doctors to do anything. It is really unlikely that doctors currently working within the awful private insurance system would refuse to participate in a public insurance system. This is a silly non-problem.

4. There are multiple funding sources. If they are inadequate then the rates will have to go up.

5. If you don't want to use your health insurance I'm sure you can pay cash. No you do not get to not pay your taxes.

6. Comprehensive Of course all reproductive health care is covered. It will require repealing the Hyde Amendment (last authorized by Clinton) but of course abortions are part of reproductive healthcare.


Yavin4

(35,443 posts)
9. My response
Fri Feb 19, 2016, 07:21 PM
Feb 2016
1. Just like private insurers set compensation rates, a public insurer would set compensation rates. The compensation would be paid by the established government administrative agency or its delegates, as it is today for Medicare.


So, the govt. will determine how much healthcare providers/hospitals are paid. Now is this going to be a national rate or a state or local rate. Based on cost of living alone, Doctors in Silicon Valley, CA need higher compensation than Doctors in Jackson, MS. So, how would you adjust for that?

2. The proposal is "comprehensive" and covers all standard healthcare except things like elective cosmetic surgery. Generally this is more than standard insurance plans cover, and their are no additional costs, no copays, no deductibles. Again, read the proposal.


What if certain procedures are extremely expensive and yield poor results? Is it no longer covered?

Finally, there's no mention of women's reproductive healthcare.

libtodeath

(2,888 posts)
10. In order
Fri Feb 19, 2016, 07:45 PM
Feb 2016

1.The government would be the payer and would be protecting the people from predatory fees that value money more then health and care.

2.All of them,that is part of what universal means.

3.They run the risk of losing most of their patients and income.

4.What if *insert X* happens.
We deal with it but his plan has been vetted.

5.No,why would they be?

6.All health care issues will be covered,not sure what is hard to understand about that.

Baobab

(4,667 posts)
12. SINGLE payer is the ONLY payer, -its the only payer and it has to be free for that reason. No tiers
Fri Feb 26, 2016, 09:35 PM
Feb 2016

First, you should be aware that the US signed a treaty in 1995 the WTO GATS, that seems to agressively block single payer in all nations that signed it. That treaty applies to us and we should be discussing it, instead its being hidden.

Since then thats been our position, but we lie about it to ou own people.
you might even say we are waging an unholy war with dishonesty and coercive trade deals against health unless it can be used to extort peoples money. We're also fighting against free public education. Its sick.

Electing Sanders would not be enough if TiSA, TPP, TTIP passes before then. As South Africa learned, sinply having a revolution did not discharge their WTO obligations. Something similar happened in Slovakia when a President won on a platform of single payer but was stopped by the appearance of an ISDS suit under a bilateral investment treaty they signed with Holland and a Dutch insurer Achmea, a Clinton donor. Read those two cases on italaw.com


1. How would doctors, hospitals, pharmaceuticals be compensated and who determines their level of compensation?

I suspect that they would do what they do now with medicare, send them the bil and it would get paid. Since everybody in the country, rich and poor would be in the system, and getting the same level of care, Americans would have tomake wiser choices when voting.

2. What procedures would be covered?

Since the single payer would be the only payer (thats the only way it works) all medically necessary procedures that were done in teh US would be covered, like they are in Canada, they all would be covered and there would just be them, there would not be any other system for payment besides the single payer. People would not be socked with bills when they got sick so when they got sick they would not delay going to the doctor hoping they would get better unless they were not really that sick and knew it. People would never be in the position where they could not afford to see a doctor. people would not have to impoverished before they got free medical care, all medical care would be free.


Would every procedure currently covered by existing health insurance companies be covered by Single Payer?

Yes, and doctors would have the final say on their patients treatment, not insurers. They could speak freely with patients about their health, no gag clauses. There would be no separate waiting rooms and imaging would be free, not cost so much that doctors could not get an MRI for a patient when that same MRI only cost 99 in Japan.

3. What happens if doctors don't take Single Payer patients only those with private insurance?

Retired doctors would not be practicing medicine. There would not be "private insurance". That is ESSENTIAL to single payer working. That is an issue that agreat many paid confusers are trying to confuse us on. Single payer means just that one payer. Otherwise it cannot be free and a punishment system has to only give those who do not pay a monthly bill inferior care or no care. That breaks everything. One of the most important aspects of single payer is its simplicity. Also, the WTO GATS only allows completely noncommercial services to escape its dictates. Only service sectors excludes from mandatory privatization and onerous provisions completely noncommercial services that existed before its signing, See http://www.policyalternatives.ca/sites/default/files/uploads/publications/National_Office_Pubs/putting_health_first.pdf

Most importantly, you cannot pick and choose parts of single payer its all or nothing. More specifically "Public Option" was a bait and switch scheme invented by health insurance companies to use to pass Obamacare which is basically a tactic to delay the country and prevent discussion of single payer, and then provide a crisis at exactly the right moment, but the most important thing to remember is that all of single payer has to rmemain together, and if you ditch any of those requirements you wont save any money, itwill fail which is what the insurance companies and politicians want so dont expect them to tell you the truth. Also, the wealthy being far more influential than the poor are needed in order to prevent a slide into bad quality health care. The entire country have to be users of the system to insure its integrity. People cannot be given a way to buy better care because then the quality for those who dont pay will rapidly decine. the dirty secret politicns dont tell us is that the world economy is changing and the era of the job as we know it is ending. Nobody knows what the workplace in a few decades will look at except that it likely will contain far fewer people. So, the trade deals which try to eliminate public health care and education are insanity.

>What does that mean for people who currently have relationships with these doctors but can no longer see them? They will be able to go to any doctor who is licensed. Everybody in, nobody out.

5. If people opt out of being in Single Payer and are willing to pay for private health insurance, are they exempt from the payroll tax?

There is no tax connected to medical care in Single Payer, you are born into the world, and you get care from birth until your death. Hospitals dont have any place to put money so they dont ask for it.

If they're not, why not? Because money and healthcare DONT MIX.

4. What about funding sources? What if the payroll tax is inadequate to compensate the doctors, hospitals, and pharmaceutical companies?

That question doesnt make sense in the SINGLE payer context, you are talking aboyt something that is NOT SINGLE PAYER.

5. What about reproductive health care for women? Included as is all other medical care.

Will Single Payer pay for contraceptives? Yes, of course, it will cover all medically effective drugs that are approved for use.

Will abortions be covered? Everything has to be covered if it is done, its covered.

To answer your inevitable questions about Hillary's health care plan, she's stated that she will maintain the ACA which addresses these issues above.

The ACA is based on a pack of lies. #1 lie is the reason we are forced into it - which has nothing to do with health - See the first link above

Yavin4

(35,443 posts)
13. Thank you for that detailed response.
Fri Feb 26, 2016, 09:51 PM
Feb 2016

Also, if that truly is Bernie's plan, there' no way in hell that it will ever pass. He would not only need a political revolution, he would need a massive cultural revolution as well. Even if you banned health insurance companies, healthcare professionals, and big pharma from lobbying on the bill. Banned campaign contributions from them as well. Bernie's plan fails to even get enough Democratic support to pass.

Baobab

(4,667 posts)
14. You forgot one little thing, ITS THE ONLY PLAN THAT WILL WORK
Fri Feb 26, 2016, 10:10 PM
Feb 2016

Sorry! NO FREE PASS ON THIS SCHEME THIS TIME

Everything else has been tried multiple times and failed.

For scientists there are additional LEGAL OBLIGATIONS under international law. This kind of international law TRUMPS all other international laws.

Please read the Helsinki Declaration on medical experiments on humans and the Nuremberg Code on unspeakable crimes against humanity.

Instead of "Business As usual"

Consider the lack of any statute of limitations in crimes against humanity!

They will be hunted down and brought to justice.

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