How in the World is Single Payer affordable to the Middle Class?

[NorthCarolina]

Judging from the facts, I think I'll choose Bernie's plan. It's time to eliminate the for-profit insurance middle man.

[Scuba]

1. Sending our precious healthcare dollars to fatten the bank accounts of corporate investors ...

... in London, Tokyo and Hong Kong isn't just bad fiscal policy, it's immoral.

[Doctor_J]

4. Here we go

Keep in mind that these are profits - money that's left after they pay their CEO bonuses, ration care as much as possible, make their clients go through obstacle courses to get their money, take their board of directors on cruises, golf vacations, and trips to the strip clubs, and so on.

But hey - it's the best we can do, and besides, it's her turn!

UnitedHealth's Optum Boosts Profits As Obamacare Demands Population Health

Hospital Profits Soar As Obamacare Prescribes More Paying Patients

Thanks, Obamacare! Health insurer stocks soar

The best metric to use in answering this question is profit margin -- the amount of profit made as a percent of revenue. Below are the 10 most profitable healthcare companies based on profit margin with market caps of at least $200 million.

observers say proves that the biggest winners of Obamacare are the healthcare giants themselves....

INSURANCE BEHEMOTHS FORMING TO MAXIMIZE OBAMACARE PROFITS, CONSUMER CHOICE TO SUFFER

[Admiral Loinpresser]

7. Bookmark. n/t

[Doctor_J]

8. Thanks. that was 5 minutes of web search. Since woo me with science is gone, I should in his/her

memory make a thorough list.

[Scuba]

11. +1,000 for the woo reference.

[daleanime]

21. Gone....

not forgotten.

[Enthusiast]

47. PLUS ONE, a huge bunch!

[Maraya1969]

78. and remember the law that insures that money from premiums must be paid at

a rate of 80% toward actual care. So all this profit is honestly gotten and not just robbed by the insurance companies from it's policy holders.

[A Simple Game]

86. You could also call it an honest incentive to raise prices. Higher prices = higher profit.

Is that really what we want for a healthcare system?

[TexasBushwhacker]

90. And then there's those juicy stock options

You know, the way that the highly compensated executives make even MORE money.

UnitedHealth group - Stock price in 2009 - $25, today $113.

Cigna - Stock price in 2009 - $20, today $134.

WellPoint (Blue Cross Blue Shield) - in 2009 around $50, today $130.

[Enthusiast]

48. Huge +1!

It is immoral!

[D Gary Grady]

63. ACA caps non-medical spending by insurers

Under the ACA, insurance companies must spend at least 80% of revenues on medical care for the insured. Administrative costs (including CEO salaries) and profits can't be more than 20%. For large group plans (which are cheaper to administer) the cap on profits and overhead falls to 15%. Any excess is refunded to customers. Here in North Carolina insurers are repaying a total of $8.5 million in excess premiums. See this report.

[eridani]

76. There are a lot of ways to redefine administration as actual health care n/t

[Doctor_J]

87. at 20% unlike Medicare, which has 3% overhead.

And you know as well as I do that the profiteers will lie, cheat, and steal, and probably not get caught. If you really believe this is better than Canada system, you're not trying

[D Gary Grady]

97. Who said it's better than the Canadian system?

Certainly not I. I want to see single payer as well. I just pointed out a fact some seemed unaware of. Also, no disagreement that a lot of insurance companies will try to cheat, but as I already pointed out, here in North Carolina alone companies are returning millions in premiums to customers based on this rule, so they aren't entirely getting away with it. (Also, as a general rule. cynical suspicion, however justified, doesn't actually count as fact until there's actual evidence. Just saying...)

[FlatBaroque]

94. By my estimation

An entire ecosystem of consultants has already figured out how the CEO's Palm Springs estate can be classified as providing health care.

[markmyword]

82. Paying For Nothing!

My daughter just had a baby, I'm told I have to have a whooping cough vaccination! I've had that vaccination, but now anyone visiting the baby needs a booster shot.

Just whose idea is that?
I think it's the pharmaceutical companies, who are making a ton of money off this.

Whose recommending this vaccination shot?
The doctors, who more than likely are on the payroll of the pharmaceutical companies.

I have medicare, in which $104 is taken out of my very small check.
I've been forced to get Part D which is for prescriptions (I don't take any) that's $45 a month!
I had to get supplemental insurance and that's $113 a month!

When I went to Walgreens I was told the shot would cost $63 and medicare doesn't cover it, another pharmacy said $60 and medicare doesn't cover it.
My Part D doesn't cover the vaccination and neither does my supplemental, they only cover what medicare covers!
So I'm spending $262 every month FOR NOTHING!!
Medicare only covers the Flu, Hepatitis B and a shot for pneumonia!

We are the wealthiest nation in the world and yet our healthcare covers NOTHING!!
If we didn't spend billions of dollars on defense, maybe the American people would have proper medical coverage!

We need Bernie Sanders as our next President! He fights for the people of this country. Our country NEEDS a political revolution!

[hill2016]

102. that's how insurance works

for most people you pay premiums without having claims.
the actual people who have claims offsets the revenue from the premiums

granted this is medicare so it's more complicated than that

[Doctor_J]

2. The New Dems' view of this can probably be assessed as willful blindness to some extent

You have to really block out a lot of very simple facts to believe Heritage Care is better than SP. Seriously, just ask how many people on Medicare want to give it up in favor of the Bronze plan or whatever the bottom of the barrel Gingrich scam is called.

[hill2016]

3. bad maths is sad

the 8% tax increase isn't on the current taxes paid but on the ENTIRE pay.

to be fair, most it of would be paid by employers who would then not have to pay partly for health insurance premiums.

but still, bad maths is bad maths

[HerbChestnut]

13. You're right, but fortunately the 8% number is incorrect.

According to Bernie's proposed legislation, earners making less than $250,000 will pay 2.2%, which ends up saving money.

[hill2016]

18. check post 17

[thesquanderer]

14. Yes, some reference to the source and detail of the 8.6% figure would be helpful

There are multiple ways to interpret a figure like that.

[hill2016]

17. it refers to Sanders 2013 plan

page 164, excise tax on employers
http://www.pnhp.org/PDF_files/American-Health-Security-Act-single-payer.pdf

[LongTomH]

32. Individuals would only be assessed 2.2%

Actual text:

‘‘PART VIII—HEALTH CARE INCOME TAX ON
9 INDIVIDUALS

‘‘Sec. 59B. Health care income tax.

10 ‘‘SEC. 59B. HEALTH CARE INCOME TAX.

11 ‘‘(a) IMPOSITION OF TAX.—In the case of an indi-

12 vidual, there is hereby imposed a tax (in addition to any

13 other tax imposed by this subtitle) equal to 2.2 percent

14 of the taxable income of the taxpayer for the taxable year.

[taught_me_patience]

70. Holy delusion. Bernie is absolutely crazy

He believes a tax of 2.2% is going to cover single payor for all, including all those that don't work? Denmark has an 8% tax for health insurance and their per capita health spending is 1/2 of the US. Either Bernie is literally insane or he's purposely misleading.

[Scuba]

88. Or you're purposely not understanding ...

Actual text:

‘‘PART VIII—HEALTH CARE INCOME TAX ON
9 INDIVIDUALS

‘‘Sec. 59B. Health care income tax.

10 ‘‘SEC. 59B. HEALTH CARE INCOME TAX.

11 ‘‘(a) IMPOSITION OF TAX.—In the case of an indi-

12 vidual, there is hereby imposed a tax (in addition to any

13 other tax imposed by this subtitle) equal to 2.2 percent

14 of the taxable income of the taxpayer for the taxable year.

[rhett o rick]

40. My rates went up 33% for 2016. I understand that math. The ACA is headed for an implosion.

It was to be the first step. Funny that the New Democrats aren't mentioning the next step. Insurance companies are loving this.

[Doctor_J]

49. 50% for me

I work for a small non profit, which provides our healthcare. We went from 500/year to 8500/yr in 2014, and to 12500 this year (maximum annual). The small business are bearing the load for Gingrich care.

[SHRED]

58. Why do you say this?

Why wouldn't it be on taxes already paid?

[Turn CO Blue]

5. How do people get insurance for those rates? Honest question. We pay over $1400 a month.

My hubby works for a rather small company 25 employees maybe, but we have insurance for him, me and our daughter (her last year she can be on our plan). We pay $1420 per MONTH for medical, dental and vision. Don't recall how that breaks out for just the medical. The company pitches in about $400.

So total WOULD be $1800 without the employer contribution.

We can't have Obamacare plan one of which would be like $300 a month cheaper (still would be over $1000 per month though for we three) because have an employer who offers insurance. Also, hubby's premium ALONE would be less than 10% of income, so we still can't qualify. That is one way the insurance companies jerk peope around.

I have a small business, but seems like I'm still disqualified since I'm married to someone with access to insurance iirc. Anyway, we also made too much money -- ha ha. The average rent in Denver is now over $1300 a month for a cheap apartment - turning into San Francisco here, with housing shortage, and very high rent rates.

Anyway, it seems like I was disqualified for several reasons.

I get the feeling that we are still somehow being charged a higher rate -- Even though that should be against the law -- because hubby had cancer 3 years ago (completely cured btw, hallelujah).

This is NOT a gold plan, or silver even. The dental is the bare basic, as is the vision. The medical is one of the lowest they had - so bronze plan maybe, and it's completely in network, so sort of like an HMO - can only go to one doctor, one hospital. Have to get preapproval for everything. Copays seem high - $30 for doctor, $15 for generics, more for name brand. $3000 out of pocket.

Is this normal?

We spend a HUGE percentage of our income on health insurance (plus dental and vision). Last year for our taxes, it was over $21K in premiums alone that we had spent.

So when I see people on the internet complaining about their premiums that still are under $200 a month, I feel like I want to rip my hair out. ARe they crazy?! I would LOVE to have that kind of premium, where in the hell can I find that?

And also -- have a heart people - when I see all these threads about people poo-pooing any possibility of single payer, or any kind of large pool, or Medicare for All - when they are being all Eeyore about it -- IT WILL NEVER WORK, it feels like a punch in the gut. Everything we make goes to rent and medical insurance. Every dollar it seems.

[pugetres]

38. If purchasing insurance off of the exchange will

save you money, even after losing an employer contribution, then purchase from the exchange.

Having an employer offer "affordable" insurance does not disqualify you from using the exchange, it only disqualifies you from receiving any subsidies/tax credits that you may have been eligible to receive (but you say that you earn too much anyways).

It is the right time of year to be looking at your insurance options.

[NorthCarolina]

50. I believe they used the lowest amount obtainable on the exchange for their basis.

If they would have based it off of what you pay then folks would accuse them of using high average for calculating plan savings to make the plan look better. On the bright side, you would end up saving an even greater amount.

[Doctor_J]

51. The scam of obamacare is for working stiffs to pay for the bonuses and profits

The old and sick are covered by Medicare and Medicaid. The young people buy minimum policies which don't supply the hundreds of millions in profits that the insurance industry demands. So they jack up the cost for working people and make their money there.

[truedelphi]

54. Morgan Spurlock agrees with you.

As do I.

Those with premium coverage that is paid by their employer are doing okay. (If they have a job, of course.)

But the middle aged, who are still too young for MediCare, are being stiffed right and left.

And should anyone in that group end up unemployed, then it is way harder for them to get hired as they are competing with younger workers whose premiums are one third or even one fourth of what their would be!

[truedelphi]

53. It is not at all against the law to charge more for prior conditions -

It is against the law to deny coverage outright because of prior conditions.

Often, for many people, the fact that their age or their prior conditions results in a huge increase in premiums is leaving many households having to choose between insurance or utilities or food.

And then here in California, health care doesn't exist for many of those on the exchange. The clinic doctors will agree to see you, but they don't do a damn thing for you, if they can get away with doing nothing.

[D Gary Grady]

64. It is against the law to charge more to those with pre-existing conditions

... at least in the case of plans bought through the exchanges. Under the ACA, insurance companies are required to use "modified community rating" -- premiums are based on where you live, whether you smoke, and how old you are, provided sixty-somethings are charged no more than three times what young adults are charged. For more see this link.

(Possible exception: I vaguely recall that Medigap policies, but not Medicare Advantage [Part C] policies, may be able to charge a higher premium based on the overall health of the insured. But I'm not certain about that, and the Medigap policies I've looked at have prices that depend on location and in some case age and tobacco use but one's personal medical history.)

[truedelphi]

101. Good to know.

And the exchanges are not available to that many people.And here in California it is a roll of the dice if you can even get through to enroll, as you are competing with a few phone lines with a gazillion other people.

[november3rd]

6. Don't Forget

The Single Payer will have the power to negotiate down a lot of costs, and cut out some Waste, Fraud and Abuse.

[randys1]

27. basic first steps 1) all hospitals are non profit 2)RX to be negotiateed

3) specialist physicians have to stop expecting to be paid too much
4) GP's need to be paid more

[restorefreedom]

92. agree with all 4. nt

[randys1]

95. Thanks...I have the answer to all problems of the world, just ask me LOL

[restorefreedom]

96. good to know someone has them! :) nt

[valerief]

9. How in the world is WAR affordable to the middle class?

And yet...

[Admiral Loinpresser]

10. Especially war without raising taxes massively on the rich? n/t

[valerief]

20. And it's the rich who make all WAR PROFITS.

How can people let their kids join the military? Is a college education worth losing your legs or life over?

[Enthusiast]

46. Huge +1!

[Fast Walker 52]

62. yep...

[Dcoast]

12. BUT BUT BUT

I was told we couldn't do this. that it couldn't happen.

I was told that we are aiming for pie in the sky, instead of right ahead of us

I was told that we can't have these things, that we're not realistic enough, that we need to mimmick republicans in order to get elected.................................................................................................


Go big or get the fuck out of here.

Want higher min wage? Then start high and learn how to negotiate. Maybe we'll only get 12, but if you start at 12 you'll only get 8

Want single payer? Then start high and learn how to negotiate. Maybe we'll only get more people included in ACA and more premiums will be tax subsidized, but if you're not for single payer, you'll probably get nothing.

Want tuition free 4 year college? Then start high and learn how to negotiate. Maybe we'll only get community college free, but if your not willing to start high, you'll get nothing.

zip. zilch. nada.

You aim high and you negotiate. You don't open with the least you're willing to accept, because you will never, ever, get that.

[zeemike]

28. "Go big or get the fuck out"

That is exactly what we need to tell Democratic leadership. Enough of this wishy washy low expectations.

And welcome to DU...

[Enthusiast]

45. Huge +1!

Way to go, zeemike!

[Mnpaul]

57. They are already telling us what they can't do

All that is remaining is more of the same

[Cleita]

15. Since our healthcare costs twice as much per capita as anywhere else in

the world because of the for profit insurance and HMO industries inserting themselves between patient and provider, it seems our health care costs should decrease with single payer.

[randys1]

30. and for profit hospitals, insane profits in RX, outrageous costs of equipment

We have unbridled and massively destructive capitalism fucking up everything, especially healthcare

[firebrand80]

16. Reducing a policy proposal to a Facebook photo

doesn't quite convince me. Call me crazy.

[SoapBox]

19. No.

But it brings up points for discussion.

And No...Third...Way...Ever.

[MrMickeysMom]

22. I don't have to call you crazy...

[liberal N proud]

23. If ony that were an achievable goal

But we all have to live in reality

[arcane1]

26. "America, where we just aren't good enough to even try" n/t

[Change has come]

79. But we can still be proud and liberal.

[nradisic]

24. Bingo!

It is THE only viable long term solution. It had become un-affordable for too many Americans or the payments have become a serious burden. Single payer eventually. Medicare for all and we will have better care for way less than we pay now. No more for profit insurnace, drug company ads and hospital ads! More money saved for care...

[glinda]

25. As a lower middle class and currently using husband's retirement savings to buy insurance we would

save about $600/mo.
I am for SP. God please!!!!!!!!!!!

[Enthusiast]

44. I am so with you, glinda!

[exboyfil]

29. Germany is a 15.5%

withholding split between employer and employee. That is probably the best we are going to do given how much higher our per capita spend is so much higher.

[LongTomH]

31. Individuals would only be assessed 2.2%

Actual text from the PDF file quoted in reply 17:

8 ‘‘PART VIII—HEALTH CARE INCOME TAX ON
9 INDIVIDUALS

‘‘Sec. 59B. Health care income tax.

10 ‘‘SEC. 59B. HEALTH CARE INCOME TAX.

11 ‘‘(a) IMPOSITION OF TAX.—In the case of an indi-

12 vidual, there is hereby imposed a tax (in addition to any

13 other tax imposed by this subtitle) equal to 2.2 percent

14 of the taxable income of the taxpayer for the taxable year.

http://www.pnhp.org/PDF_files/American-Health-Security-Act-single-payer.pdf

[zalinda]

33. If anyone thinks that single player

isn't the way to go, I invite you to watch http://codeblackmovie.com/ I watched it last night and it was fascinating, eye opening and sad, all at the same time.

To give you a short summary: It is a documentary. It takes place at LA County Hospital, and gives you a history of the Emergency Room. While the hospital is the star, the supporting actors are the new doctors who give their thoughts on patients care. Make sure you keep going past through the credits, as there are stats listed among them. It gives new insight into how medicine is practiced in this country.

Z

[Enthusiast]

43. Thank you, zalinda!

[GoneFishin]

34. (Money currently spent on health care) - (CEO bonuses and stock dividends) = (more money for

actual medical care or lower premiums)

[Ferd Berfel]

35. and Hilary is AGAINST Single Payer - huh.

Don't you have to wonder why? Could it be..............Big Pharma DONORS?

[Enthusiast]

42. There is no good argument against adopting single payer in the USA.

You really do have to question the motives of anyone against single payer.

[Recursion]

66. Sure there is: it doesn't address provider costs. In fact it locks them in.

Worse yet, once single payer is adopted, any attempt at lowering provider costs (which are the actual problem, not payment financing) is vulnerable to being attacked as "cutting Medicare".

Of course physicians love single payer: they currently make more than their counterparts in every industrialized country, and single payer makes sure it stays that way.

[D Gary Grady]

71. Provider costs aren't the biggest problem

True, U.S. specialists typically make two or three times what their counterparts do in other countries, and Americans go to specialists much more often than do patients in other countries. But doctor bills as such aren't anywhere near the lion's share of healthcare spending or the main reason for the cost difference. It's a combination of things, from ridiculous levels of overhead to soaring drug costs.

The ACA's constraints on the growth of Medicare reimbursement rates did indeed provoke cries of "cutting Medicare," but that didn't stop them from happening, and since the ACA became law Medicare's costs have been rising more slowly than they had been. In other developed countries, those with single payer (such as the UK) as a rule have the lowest per-capital healthcare spending. Systems with multiple insurers (Germany, Japan, France, etc) aren't far behind, though.

[Recursion]

73. Provider costs are absolutely the biggest problem

The Centers for Medicare and Medicaid Services fortunately provide us with very good data on where our health care spending actually goes:

https://www.cms.gov/Research-Statistics-Data-and-systems/Statistics-Trends-and-reports/NationalHealthExpendData/index.html

I even took the time a few weeks ago to make pie charts out of them. The relevant ones here are:



That's where all of our money, public and private, goes. The "overhead" wedge includes administrative costs for Medicare/Medicaid/etc. as well as private insurance profits. The "stuff" wedge includes all drugs (about two thirds of that wedge) and all devices and consumables (the rest). The big Pac Man that's eating our health care spending and driving it to twice the percent of GDP of every other country is not drugs, not administration, not insurance profit, but services.

What are those services? CMS tells us that, too:



Hospitals and physicians (hospitals more than physicians, notice).

That's what makes our health care so expensive.

Plenty of other countries have private insurance, including for-profit private insurance, including mandatory for profit private insurance. But they all explicitly limit what providers can charge, unlike us. That's the step we have to take. Financing is not the problem.

Frankly I don't care how we finance it, for the most part; single payer probably is marginally better. But if we come at this with the assumption that the financing rather than the price is the problem, we're not going to actually fix anything.

[D Gary Grady]

98. It's not the price that's the major problem

I think we're to some extent talking past each other, but I do respectfully suggest you're oversimplifying a bit.

Yes the difference in what physicians and surgeons are paid is part of the cost difference between the U.S. and the rest of the world, but you also have to look at what doctors and hospitals are charging for and what they themselves are in turn paying for. For just one example: In comparison with other countries the U.S. has a lot more MRI machines and those machines are each typically more expensive (way, way more than in Japan, for example), and U.S. patients get far more MRI scans done. The price of each MRI is part of the problem, but so is the quantity of MRIs.

Also, a fair chunk of doctor and hospital costs goes into the overhead of billing patients and dealing with insurance companies. A U.S. hospital often has dozens or even hundreds of people on staff dedicated to that, vastly more than in a typical Canadian or British hospital, where single-payer hugely reduces overhead. Standardization (as in France and Germany) achieves similar savings even in non-single-payer countries (though in practice single payer systems do tend to be the least costly). U.S. doctors also tend to have huge loans from medical schools to pay off, whereas in many other countries medical education is free.

There's a lot of research on this, and simply attributing it to overpaid doctors isn't much better than blaming it on greedy insurance company executives (or malpractice awards, for that matter, the favorite magic bean of the right). Yes, doctor pay and insurance CEO pay and profits are part of the problem, but the problem is unfortunately a good deal bigger and more complicated.

[Enthusiast]

80. Single payer can address anything we want it to. Stop with your nonsense.

You aren't going to convert anyone. I have been arguing with anti-single payer posters on the internet since 1999.

"Worse yet" LMFAO!

[Recursion]

81. The doctor fix is an empirical example, and nobody here seems to have an idea to fix it

Physicians have been overcharging Medicare by 15% for 20 years, and everybody agrees that's true, and Congress can't do a damn thing about it because fixing it is attacked as "cutting Medicare".

I don't care one way or the other about single payer. If we get it, fine. If not, fine. I care about lowering costs, which Medicare on its own hasn't done (again, see the doctor fix), but which explicit price regulation has.

[Ferd Berfel]

99. Here, In case you missed this - It was posted on DU

Medicare for All’ would cover everyone, save billions in first year: new study
- Physicians for a National Health Program
http://www.pnhp.org/news/2013/july/%E2%80%98medicare-for-all%E2%80%99-would-cover-everyone-save-billions-in-first-year-new-study

[colsohlibgal]

36. Raise Taxes On The Upper Class Not The Middle Class

Also add a VAT tax and quit building tanks and planes the military does not use.

Lots of ways to raise the cash without really hitting the middle class.

[blackspade]

37. "Judging from the facts, I think I'll choose Bernie's plan."

Me too.

[beam me up scottie]

39. K & R!

[Enthusiast]

41. Kicked and recommended to the Max!

Single payer, NOW!

We can get single payer. All we need to do is get the facts out there.

Single payer Medicare for All should be the stated goal of the Democratic Party, the sooner the better.

[Hoyt]

52. Single payer won't happen overnight. And if the OP is any indication

of Sanders' math and budgetary skills, those who "trust" him are quite gullible. Single Payer should be the goal, but not tomorrow with our Congress and what is clearly a flawed plan.

[Fuddnik]

55. The only thing we have to fear, is fear itself.

You've lost the battle before you got off the couch.

[George II]

56. The thing is that "middle class" income is different in different parts of the country.

The bottom of the "Middle class" income range in Manhattan is almost $50,000 and your $2,480 income tax on $40,000 is woefully low.

[Dont call me Shirley]

59. Tax the uber-rich heavily so they don't have enough money to commit their heinous shenanigans.

[alittlelark]

60. OMG!!!!! I 'm gonna go broke !!!!

.... except I'm not.

The plan works and YOU know it....

Start thinking for yourself..

[Thespian2]

61. You're right...

Bernie has the answer...

[D Gary Grady]

67. How do other countries afford it?

Here are two facts that need to be considered together: (1) About half of U.S. medical costs are already paid by governments (state and federal) in the form of Medicare, Medicaid, SCHIP, the VA, etc. (2) Per capita, the U.S. pays about double the total cost of medical care in other developed countries with similar or better healthcare outcomes.

Notice what that means: If the U.S. could move to a single-payer system like that in, say, Australia, we could cover everybody's medical care with what government already spends, with no need for private insurance, co-pays, or coinsurance, or higher taxes. Or we could adopt a system like that of Germany, Japan, Israel, or the Netherlands (which use multiple insurance companies rather than single-payer, but regulate them better) with very similar results.

I mentioned this to a conservative, Obamacare-hating acquaintance of mine, and after convincing him I wasn't making it up, he was stunned for a while, then announced, "What we need to do is bring somebody in from one of those foreign countries and have him set up their system here!" (He didn't trust Americans to do it.)

[Recursion]

74. Easy: they regulate costs

Every other country I've looked at has a board that sits around once a year and says "A leg MRI can cost no more than $500. Lisinopril 10mg can cost no more than three cents per pill." etc.

Having done that, they finance it in several different ways, from single payer to multi-tier to public catastrophic insurance to public deductible insurance to... hell, there are as many ways to finance health care as there are countries. But the key difference is everybody else regulates costs and we don't.

That's the step we need to take, and the step neither Sanders nor Clinton is talking about, and O'Malley is.

[D Gary Grady]

100. Global budgets are a major factor as well

My question was mainly rhetorical (and a question that should be directed at every Republican who contends that government-financed or -regulated systems can't possibly work), but that's a fair point.

In fact, as I suspect you know, not all countries go about this in the same way, and of course it's always more complicated, with a lot of negotiation with drug companies, unions representing doctors and nurses, etc., and the prices aren't always strictly fixed. For example, in France doctors don't have to charge the scheduled prices, but if they differ, they have to post their prices in the waiting room (rather they way most mechanics used to have a board giving the prices for oil changes, tune-ups, and so on).

In addition, some countries (especially those with single payer) have a fixed global budget. The U.S. doesn't do this even for Medicare and Medicaid (though Republicans keep trying). Here Medicare and Medicaid are in the "mandatory" part of the budget not subject to annual appropriations. They cost what they cost, i.e., they are "entitlements" in the correct sense of something people are legally entitled to get. This is one reason single-payer systems often do the best job of containing costs, but of course at the expense of delaying or denying some treatments (not necessarily a bad thing medically; see Aaron Carroll's commentaries on the Healthcare Triage YouTube channel).

[shadowmayor]

68. The Bigger Issue

Profiting off of the misfortunes, illnesses, and infirmities of others is plainly immoral. That's the truth that seems to be glossed over by our fawning corporate media. Running health care as a service and not as a business is the only human model that makes any sense. Yes money must be invested, but it should be from all of us through taxes. Why do those insurance companies have giant buildings with glossy commercials on TV and stadiums with their names on them? Because they make boat-loads of money.

We don't let fire departments make money and public utilities are run as non-profit services. They provide the greatest good for the people at the lowest cost.

What also is never mentioned is what to do with all those employed by private insurance companies should we shift to a public health service like Britain did in the 1970's? Election season is the prime time to be asking these big questions. Unfortunately, we are a well-trained, knee-bending populace bombarded with propaganda, and too many are immediately suspicious of questioning the status quo.

[TumbleAndJumble]

69. How can anyone not only attempt to justify, but demand that insurance companies profit

from health care for the citizens of a nation.

The insurers are guaranteed to be profitable and still are complaining that they also have to actually provide coverage.

[taught_me_patience]

72. Complete utter misleading bullshit

It's not an 8% increase in taxes, its an 8% tax on income, which, according to the infographic, would be $3,200... more than doubling the tax burden. Even the 8% tax is probably a low assessment. Denmark has an 8% tax income for single payor. Germany is 15%. We'd probably be closer to the 15%, given how expensive costs are throughout our system.

Again, this graphic is complete and utter bunk. Why do DUers purposely post misleading information like this?

[Elmergantry]

93. Why? Becasue facts take a backseat to the ideology

Not that its a uniquely Dem problem mind you...

Anyway, I thought the AFFORDABLE Care Act was to solve all of our problems?
Problem with ACA is it didn't nothing to control costs...but hey its all about the ideology right? Warm fuzzies went all around when it passed.

I'm for single payer, but there is no such thing as a free lunch.

[hill2016]

103. that's what I tried to point out too

now to be fair a lot of the new taxes would be offset by not paying premiums

[LS_Editor]

75. Long beyond time.

[cantbeserious]

77. Say No To HRC For Profit Health Care - Say No To Oligarchs, Corporations And Banks

eom

[akbacchus_BC]

83. It can be affordable and not only for the middle class, it will work for the

working class. Just ask your Senator to come to Canada and see how ours work and tailor your medicare to suit working people. It is that simple.

I am not saying that we have the best health care system, Europe has the best. But in Canada, it is affordable. After Harper took away a lot of medicare for seniors am hoping the Liberals will reinstate them. Lots of older folks after Harper got elected had to pay for things that they never had to pay for before!

[gordyfl]

84. Want Medicare for All? One Place to Start -

The Public Option -- Medicare Buy-In. Give people (and employers) a choice between paying for private insurance or Medicare.

Another idea - begin by lowering the Medicare to 55 years of age. I can assure you, politicians who oppose this would lose the 55-65 electorate.

This would be a winning formula for Democrats. People understand Medicare more than they do ObamaCare. Medicare is already in place, it's well understood, so it's merely a matter of expanding it. There are no "Death Panels" to scare people away.

The biggest roadblock would be the insurance companies and the politicians who depend on their campaign contributions.

If I'm not mistaken, insurance companies were BIG contributors to Obama in 2008 AND 2012. He had little choice but to compromise. I'm not saying the ACA is bad. It's a step forward. But, we must remember that money influences policy. Vote for the candidates who are least influenced. Bernie Sanders comes to my mind. That would be a start.

[loudsue]

85. That is a great sign!

I want to post it in the middle of the road in my very right wing county.

[tazkcmo]

89. Dreamers!

Don't you know hope and change is so '08? Get with the program you pony wanters! It's about practicality, incremental change and working within the system! Gumdrop rain and cotton candy clouds. Single payer is difficult so don't even try. If we do try, we'll have to ignore something else that's equally important to the U.S. because you know we can't focus on more than one thing at a time!

Now enough of this pie in the sky waste of time! Get back to work proles!






sarcasm

[George II]

91. I don't understand this statement:

"A current, low-ball health insurance estimate of someone making $40,000 is about: $154/month, NOT INCLUDING ANY PREMIUMS."

So, what is the $154/month if it's not PREMIUM?

[Vinca]

104. That was my question.

Premiums can cost a whole lot more than that if you happen to be self-employed or otherwise not provided employer insurance. Single-payer would be a great deal for people, but also a great deal for businesses. They should never have been saddled with providing health insurance to begin with.