The bottom line of Healthcare is Health and Care.

[Armstead]

Pssst. I'm going to share a dirty little secret.

Healthcare is NEVER, EVER going to make economic sense. It is NEVER, EVER going to fit into a neat little table with figures like a spreadsheet that you can push to round out to zero net cost after expenses and revenues are factored in. NEVER.

It's a lousy shitty business model. It sucks, which is why for-profit insurance corporations have been merging and squeezing and gouging the public for years, and will continue to do so, despite the ACA.

It seems like the proponents of a certain candidate have decided to break out their green eye shades and give endless reasons why another candidate's goals of affordable universal health care will never work. They've come up with all kinds of formulas and analyses to explain to the starry eyed supporters of that other candidate why we have to continue to rely on the good graces of private insurance.

Except it's all bullshit.

Healthcare makes no financial sense because it is inherently screwed up as a business model. It deals with one of the most unpredictable and potentially expensive "products" and markets that exists --Health and Disease and Accidents. No one can ever predict what will or won't happen. Supply and demand can never be counted on. No one knows whether the population will be relatively healthy at a given time, or whether the demand will rise unexpectedly because of some disease or other cause of medical over-demand.

BUT it is also one of the most important and vital "products" that exist. In fact, and this is the point -- it's not even a product at all. It's a service that has allowed us to extend our lifespans beyond our 20's. And has innumerable benefits for people of all ages.

Most civilized nations have recognized that, and developed variations of public guaranteed universal health care. And they made it a priority to make it work, at least as well as can be expected given its inherently unpredictable nature.

But in the US? Noooooooooo. We have decided that it is nothing more than a commodity. We have decided that the magic forces of the Market should determine who is worthy of living, and who gets to suffer and die needlessly based on the status as an economic unit of production and consumption.

That is to be expected from conservatives and Republicans with their "you're on your own" philosophy. But it is extremely depressing to hear a presidential candidate and her Democratic supporters denigrating the goal of Universal Coverage, by trotting out Conservative analyses that it can never work.

Health Care will always be a complicated actuarial mess.

But it IS possible to develop a system of universal coverage that makes it possible for everyone to receive adequate coverage, regardless of their economic and health status. And it is possible for smart people to develop a system that is at least as manageable and financially viable as it is possible to be in this unpredictable and imperfect world.

All that is needed is the will, and a commitment by those of a Liberal and Progressive orientation to lead, and convince the overall population that it makes financial sense for individuals and businesses and is the right thing to do for moral reasons.

[randys1]

1. Great point, the only reason universal healthcare in America would be so tough to do without

it costing taxpayers a fortune is the system is drunk with capitalism.

Obscene RX profits, obscene hospital profits, specialty physicians making exorbitant fees for their services, etc.

You take capitalism out of healthcare, you provide for reasonable profits for RX so as to incentivize them to make new ones, but hospitals, RX and specialists have to be willing to take less out of the system.

[LWolf]

2. K & R

[Paka]

3. Good points overall.

I have been arguing this with my brother for decades. Certain things, health care being one, cannot be run using a business economic model. A single-payer health system is the only thing that makes sense. Clearing away the non-contributing profiteers in the current system, i.e., insurance companies, big-pharm, etc., is the key to making it work.

[Recursion]

4. People are saying the proposed system won't work because it doesn't address exactly that problem

Medicare is marginally better than private insurance at keeping provider costs down, but it's still very very bad at it. Congress has proven itself incapable over the course of two decades of getting doctors to stop overcharging by 15% (the "doctor fix" they keep applying). For all the talk about the political clout of insurance companies (and it's real), the political clout of doctors and hospitals seems much more powerful, and now we're talking about legally locking in those prices they charge.

Other countries have a vast array of ways they have provided universal health care, from Canada's single payer system, to the UK's NHS, to France's coinsurance, to Germany's co-operative insurance market, to the Netherland's private insurance market, but they all have one thing in common: they get providers to charge less. If we could get Congress to do that, it wouldn't really matter which of those systems we went with to finance it.

[Armstead]

7. I think there is a way to combine both if the role of private insurers was changed

I think we need a basic public system that eitehr replaces or very strongly regulated rates and/or negotiates with the clout of being the pricesetter for services. Something that is fair to providers, without allowing for gouging and artificial increases in costs and prices.

If private insurance has to continue to exist, it shold be in a subsuidiary role as a service provider actibng acording to the rules ofm the road set by public insurance.

For the reasons stated in the OP

[Armstead]

6. Kick

[Autumn]

8. Yes it is possible

[restorefreedom]

9. yes yes...profits need to come out of medicine

it really is that simple.