Who pays for single payer?

[county worker]

I am not against single payer.

Having said that, I don't think we really understand how much it will cost and how it will be paid for.

I have some experience with government and medical care. I work for a county Alcohol, Drug and Mental Health Services department. We have a 16 bed Psychiatric Hospital, Drug and Alcohol prevention and treatment programs. There is also a medical clinic, lab, xray and a pharmacy.

We serve people who generally cannot pay for the traditional medical delivery system. We are paid by sales tax revenue, vehicle license fees, Medicare, Medi-Cal, private insurance, and voter propositions. Many of the patients are indigent. We never cover all our costs and the difference comes from general fund money or property taxes.

This year we have to cut all services because there is not enough revenue to cover the costs. There is a tremendous amount of accounting and reporting to do or the money stops flowing. That's the part where I come in.

We are a small county. Now imagine that we are the United States Government with a single payer system.


Nothing I said changes except the size of the government body and the number of people getting coverage and care.

There are still all the costs and still the need to get tax money to cover the shortages.

So you see the cost of a single payer is not cheap. It can not be covered by what we now pay for medical services because we don't cover everyone now. Any savings would be absorbed by the increase in the number of people getting care. The increase in services will mean an increase in health care workers and medications and supplies and in administration.


So if we want to cover everyone with a single payer system we have to be willing to pay more for our health care that we are currently paying.

This is not a less costly way for us to get medical care. Anyone who thinks that is a fool.


Everyone of us has to be willing to pay more than we now pay to cover all of us.


Now one way of making it cheaper for us is to let people who have a system of care that they like to stay with it and thus we need to cover less people with a government program.

That idea doesn't seem popular here at DU.

[marmar]

1. Who says we'll pay more with single-payer?

:shrug:

When the government can play hardball with providers and pharmaceutical companies, they won't be able to charge outrageous sums.

[county worker]

3. There is just no convincing you I can see.

[Oregone]

9. You had nothing compelling to convince them with

http://www.pnhp.org/facts/singlepayer_faq.php

[county worker]

22. This is bullshit

"Undoubtedly the costs of taking care of the medical needs of people who are currently skimping on care will cost more money in the short run. However, all of these new costs to cover the uninsured and improve coverage for the insured will be fully offset by administrative savings."


There will not be a savings in administrative costs. The administrative duties will increase. The government does not now do all the administrative work that will be required. Just the cost of Medicare administration is tremendous. That will increase many more times over. Imagine everyone on Medicare!

There also no incentive for government to do things economical since there is no profit motive. I know this because I work for government. The feeling is that we can't cut spending or we will lose the money next year.

I know that this convinces no one here.

We are so enthralled by what we think is out there but in reality it doesn't exist.

[Oregone]

31. "There will not be a savings in administrative costs"

Costs of Health Care Administration in the United States and Canada

"After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada's national health insurance program had overhead of 1.3 percent; the overhead among Canada's private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers' administrative costs were far lower in Canada."

http://content.nejm.org/cgi/content/full/349/8/768


"The U.S. wastes more on health care bureaucracy than it would cost to provide health care to all of the uninsured. Administrative expenses will consume at least $399.4 billion out of total health expenditures of $1,660.5 billion in 2003. Streamlining administrative overhead to Canadian levels would save approximately $286.0 billion in 2003, $6,940 for each of the 41.2 million Americans who were uninsured as of 2001. This is substantially more than would be needed to provide full insurance coverage.

These results are derived from detailed data on administrative costs in the U.S. and Canada in 1999 which appears in tomorrow's New England Journal of Medicine. This report updates the New England Journal estimates of nationwide administrative spending and potential savings to 2003. The complex and fragmented payment structure of the U.S. health care system increases administrative overhead in the U.S. relative to Canada, where a single-payer national health insurance program has existed since 1971."

http://www.medicalnewstoday.com/articles/8800.php


Beyond what the insurance system itself saves, the actual medical facilities will be able to streamline their billing centers (or stop outsourcing) and save a bundle. Medical facilities will not need to pay pencil pushers to figure out what service costs what to which insurer, and how to file the paper work and get paid. With single-payer, this is a done deal.


"There also no incentive for government to do things economical since there is no profit motive."

Profit in itself doesn't actually directly lead to efficiency or innovation. Profits are essentially revenue taken from businesses and workers to go into private coffers of shareholders. Profits interfere with providing incentives to workers, as well as reinvesting and researching in a businesses infrastructure.


"We are so enthralled by what we think is out there but in reality it doesn't exist."

In reality it does exist. Other countries are doing this. It is ludicrous for the Democrats to not try this first

[sisters6]

39. "Imagine everyone on Medicare!:--WHAT A WONDERFUL THOUGHT.

[sisters6]

14. Send a free fax to have the CBO score Single payer bills.................

Here is the full email I got today:

On Monday, Rep. Rangel, chair of Ways & Means, will meet with single payer advocates in New York. Send a fax to Rangel asking him to hold hearings on HR 676 and send it to CBO for scoring. Click here to give him plenty of faxes before Monday.


http://www.1payer.net/campaigns/efax-send-hr-676-to-cbo.html

Daschle, former Senator and tax cheat, has abandoned his former position in favor of single payer and is advising Obama to scuttle the "public option" in order to pass something (anything) this year. Send Daschle an email telling him what a traitor he is to his own (alleged) ideals. His email address is [e-mail] .

As you know, Secretary Sebelius of HHS has suggested that Obama wants to ban single payer from any consideration, now and forever. She said single payer supporters would be 'furious.' Due to the 'transparency' of her office (NOT), we have had a hard time letting her understand just what furious means. But now, I am informed that her email address is [e-mail] . How about giving her a little taste of how furious you are.

Finally, please help expand our readership and the support for rapid response single payer action. You can click here to import contacts from your email address book or you can simply click here to forward this newletter to friends that should be joining this fight.
Join Me in Washington on June 25
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
bingo number 25
On June 25, we will be demanding real reform, not just a confused duplication of our current mess. We want you there. It's the Great American Sickout. Click here to see the details. Yes, it's short notice. Yes, it's a Thursday. And yes, it's important. So be there.
If you can't be there, at least take the day off (sick-out) and call all your legislators in Washington. Here is where you can find their names and numbers. Call on June 25 and tell them that you want single payer Medicare For All. Thousands of others will be in Washington that day delivering the demand for real health reform in person. You can help with a few phone calls if you cannot join us.

Tell Rangel to Score HR 676. Eliminate a Roadblock to Single Payer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
bingo number 25 Although he was a co-sponsor of HR 676 in the last Congress, Rep. Rangel has declined to sign on in this Congress, he has refused to hold hearings on single payer and he has refused to send HR 676 to the Congressionsal Budget Office for 'scoring.' Thus, Congresspersons can claim (with their usual duplicity) that there is no viable way to afford publicly financed health care.

Congress is like the three monkeys -- see nothing, hear nothing, say nothing. They need the evidence that single payer is the ony way to finance universal health care for America. They need the CBO scoring.

We want Rangel's Ways & Means committee to hold singlepayer hearings and ask CBO to score the single payer bill in the House -- John Conyers' HR 676.

So help out Congress with a fax campaign to Rep. Rangel and his committee members. Send the Congressman a convincing number of faxes in advance of his meeting with single payer advocates. Click on this link to send the faxes.

And for added impetus, email Rep. Rangel's communication director, Elbert Garcia. His email address is [e-mail] . Tell him to relay the message to Rep. Rangel: Score HR 676. Now. No more excuses.

Quick Links...
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
HealthJustice
Everybody In, Nobody Out Store
Simple Answers on Single Payer
Talking Points on Single Payer

[MNDemNY]

2. "...be willing to pay more for our health care..."

That is simply NOT true, most models show that the total money spent on health care would be less on single payer than it is now, with EVERYONE covered.

[county worker]

4. Can you give me the URL of the models?

[MNDemNY]

16. Read this

http://www.pnhp.org/news/2007/july/_health_insurance_fo.php

[county worker]

23. I read it.

[Oregone]

32. Too bad you can't remove a thread after you read something that contradicts you

[Oregone]

5. "Everyone of us has to be willing to pay more than we now pay to cover all of us"

Countries with single-payer spend significantly less per capita on everyone to provide universal coverage for all.

You are starting your question with a false premise.

Who pays? Everyone, according to their ability to do so. On average, instead of paying private premiums, people would pay less than that in taxes for coverage. The end result is true coverage and more disposable income.

[Statistical]

43. +1. That sums it up right there.

The proof is in other countries. They spend less and cover everyone.

Right now the uninsured still cost those with health care money.

The problem is they have no access to routine care so often their first medical care is emergency room or ambulance call which cost hundred times more than a routine doctor visit.

The hosptial has to write off the cost of the uninsured and that cost gets spread around raising premiums for everyone.

We pay more (even those with the best health care) BECAUSE not everyone is insured.

[sisters6]

6. Tell Rangel to Score HR 676. Eliminate a Roadblock to Single Payer.......

CBO has NOT been asked to even estimate the cost yet!!

Forum Name General Discussion: Presidential
Topic subject Tell Rangel to Score HR 676. Eliminate a Roadblock to Single Payer........
Topic URL http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=132x8483817#8483817
8483817, Tell Rangel to Score HR 676. Eliminate a Roadblock to Single Payer........
Posted by sisters6 on Fri Jun-19-09 05:26 PM

Chuck Schumer-a few weeks back said he was going to do this. so far its not been done.


Tell Rangel to Score HR 676. Eliminate a Roadblock to Single Payer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~


Although he was a co-sponsor of HR 676 in the last Congress, Rep. Rangel has declined to sign on in this Congress, he has refused to hold hearings on single payer and he has refused to send HR 676 to the Congressionsal Budget Office for 'scoring.' Thus, Congresspersons can claim (with their usual duplicity) that there is no viable way to afford publicly financed health care.



Here is the full email I got today:

On Monday, Rep. Rangel, chair of Ways & Means, will meet with single payer advocates in New York. Send a fax to Rangel asking him to hold hearings on HR 676 and send it to CBO for scoring. Click here to give him plenty of faxes before Monday.


http://www.1payer.net/campaigns/efax-send-hr-676-to-cbo.html

Daschle, former Senator and tax cheat, has abandoned his former position in favor of single payer and is advising Obama to scuttle the "public option" in order to pass something (anything) this year. Send Daschle an email telling him what a traitor he is to his own (alleged) ideals. His email address is [e-mail].

As you know, Secretary Sebelius of HHS has suggested that Obama wants to ban single payer from any consideration, now and forever. She said single payer supporters would be 'furious.' Due to the 'transparency' of her office (NOT), we have had a hard time letting her understand just what furious means. But now, I am informed that her email address is [e-mail]. How about giving her a little taste of how furious you are.

Finally, please help expand our readership and the support for rapid response single payer action. You can click here to import contacts from your email address book or you can simply click here to forward this newletter to friends that should be joining this fight.
Join Me in Washington on June 25
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
bingo number 25
On June 25, we will be demanding real reform, not just a confused duplication of our current mess. We want you there. It's the Great American Sickout. Click here to see the details. Yes, it's short notice. Yes, it's a Thursday. And yes, it's important. So be there.
If you can't be there, at least take the day off (sick-out) and call all your legislators in Washington. Here is where you can find their names and numbers. Call on June 25 and tell them that you want single payer Medicare For All. Thousands of others will be in Washington that day delivering the demand for real health reform in person. You can help with a few phone calls if you cannot join us.

Tell Rangel to Score HR 676. Eliminate a Roadblock to Single Payer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
bingo number 25 Although he was a co-sponsor of HR 676 in the last Congress, Rep. Rangel has declined to sign on in this Congress, he has refused to hold hearings on single payer and he has refused to send HR 676 to the Congressionsal Budget Office for 'scoring.' Thus, Congresspersons can claim (with their usual duplicity) that there is no viable way to afford publicly financed health care.

Congress is like the three monkeys -- see nothing, hear nothing, say nothing. They need the evidence that single payer is the ony way to finance universal health care for America. They need the CBO scoring.

We want Rangel's Ways & Means committee to hold singlepayer hearings and ask CBO to score the single payer bill in the House -- John Conyers' HR 676.

So help out Congress with a fax campaign to Rep. Rangel and his committee members. Send the Congressman a convincing number of faxes in advance of his meeting with single payer advocates. Click on this link to send the faxes.

And for added impetus, email Rep. Rangel's communication director, Elbert Garcia. His email address is [e-mail]. Tell him to relay the message to Rep. Rangel: Score HR 676. Now. No more excuses.

Quick Links...
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
HealthJustice
Everybody In, Nobody Out Store
Simple Answers on Single Payer
Talking Points on Single Payer

Congress is like the three monkeys -- see nothing, hear nothing, say nothing. They need the evidence that single payer is the ony way to finance universal health care for America. They need the CBO scoring.

We want Rangel's Ways & Means committee to hold singlepayer hearings and ask CBO to score the single payer bill in the House -- John Conyers' HR 676.

So help out Congress with a fax campaign to Rep. Rangel and his committee members. Send the Congressman a convincing number of faxes in advance of his meeting with single payer advocates. Click on this link to send the faxes.

And for added impetus, email Rep. Rangel's communication director, Elbert Garcia. His email address is [e-mail] . Tell him to relay the message to Rep. Rangel: Score HR 676. Now. No more excuses.

[xchrom]

7. countries similar to ours -- pay less --

have less waste -- etc.

what evidence do you have that we will pay more?

[TahitiNut]

8. The U.S. pays more than 14% of its GDP for health care while Canada and others pay less than 9%.

The nations paying less than 10% of their GDP get BETTER health care (i.e. more covered and better outcomes) than the U.S.

So ... would you rather pay $15,000 in after-tax dollars or $10,000 in tax dollars??

It's fundamentally DISHONEST to rant about "increased taxes" when the net effect is to pay less and get more.

[JustABozoOnThisBus]

10. Single-payer doesn't have to cost more

We have a system now. Employers and employees pay for insurance. The costs of the uninsured are passed on through increased prices to the insurance companies and then on to us. A single-payer system would cause some redistribution through elimination of insurance costs and increased taxes. We might even save some, if we eliminate insurance company profits, and limit health care provider profits.

Not everyone would benefit equally. But if we create a system in which nobody is at risk of being made destitute by an illness or accident, then we will have improved things.

Realistically, I think I would end up paying more with a single payer system. I'm still all for it.

[rurallib]

11. We continue to pay high premiums to insurance companies

and then we get taxed on top of that. :sarcasm: This will allow the insurance companies to have more money to buy Senators and do away with the charade of not paying claims. There would be no claims, just money rolling in.

I think that is the GoOp version anyway.
Were a true single payer to happen taxes would go up but the premiums would disappear. For some it would be an increase, for most who now pay insurance it would be a cut. It would also make eminent sense to roll back the Bushco tax cuts to help pay for this.

My opinion

[Vinca]

12. I would assume I would pay higher taxes if we had single payer,

but I doubt very much those taxes would exceed the $12,000 a year for an insurance policy plus $5,000 a head deductible plus co-pays and anything they can weasel out of covering if I could afford to buy a private health insurance policy today.

[Oregone]

15. Exactly

You increased tax burden, on average, would be less than private premiums. This changes if you are super rich though (which would be one reason they would oppose it).

[county worker]

29. You are not paying $12,000 plus $5,000 are you?

You will pay more than you are now paying.

[Oregone]

34. No they wont

Look. I have single payer. I pay about the same in taxes as I would in the US (a bit more, but I get more benefits). And my premiums are $108. No deductible/no co-pay.

People who are higher income will pay more, because taxes will hit their pocketbook more than a flat $15K for insurance. Just as with all services, this is true.

[Vinca]

41. That's the last quote I got which was a couple of years ago.

You think my taxes would go up $17,000+ a year??? I don't think so. Many people assume the cost of insurance is somehow affordable for everyone. Once you age or have a pre-existing condition it is anything but. At the point I had to drop insurance, it was 3 times my mortgage.

[Fovea]

42. I am uninsurable

and I am currently easily paying that per year and more to maintain my diabetes, hypertension, and the sequelae of a stroke and two heart attacks.
Out of pocket.
Health care is eating about a third of my income.
Soon I will go bankrupt, and all of it will be on the taxpayer dime.

Heck of a system.

[Hannah Bell]

13. over 1/3 of current "medical" costs = insurance & competing paperworks.

just paying for care = cheaper.

[Cleita]

17. Taxes. Some countries do payroll tax, value added tax or corporate tax.

It depends. However, you are taxed it will probably cost you less than what it costs for insurance premiums today in the USA. Also, a decent plan would eliminate deductibles and co-pays so that would make it more accessible. It won't cost more because we are already spending twice as much for health care in the USA with our for profit system than any other country in the world and yet more than forty million Americans are uninsured. It would cost a third less to administer because there wouldn't be a need for advertising, paying off politicians and delivering profits to stock holders. Honestly, the figures and studies are out there, yet I read posts here like this one that don't seem to be familiar with them. In the case of your hospital, one of the plans is to fund it fully for a year to be negotiated with the state every year. You would have a complete staff and all the beds paid for. Then the thing you need to do is fill those beds. You wouldn't have to worry about insurance or other sources of funding and could concentrate on filling the beds with the patients who need them the most for the length of time that they need it. It's actually the most cost effective way to run a hospital and still serve the community, yet there is a total resistance to any idea that may give something out that is free.

[Breeze54]

18. Duh!! We ALL pay and I'm willing!!

Just think about it for a few minutes.

Shifting all those welfare people (not corporate welfare recipients)

and the disabled and the elderly and the ignored ( 48 Million ? ) ?

We have the resources to do this.

Bring It ON!!!!!!!!!!!!!!!!!!!!!!! :P

:kick: & Recommended

[bdamomma]

19. done

[Lydia Leftcoast]

20. Anybody who is self-employed pays through the nose for lousy coverage

I pay big bucks for a policy that doesn't kick in till I've spent $5000, and even then it pays only 20% up to $25,000. So, in other words, in addition to my premiums, I pay $5000 before I get any benefit at all, and then another $5,000 before I don't have to worry about the cost--if, that is, my insurance company doesn't find some bullshit reason for denying coverage.

Name me one universal health care system in which the patient has to pay thousands of dollars in premiums per year AND $10,000 out of pocket (per year) in order to reach the point of where they can stop worrying about bankruptcy.

[Breeze54]

24. Well said. Universal / Single Payer IS the way to go.

;)

[sisters6]

26. Single payer needs to be scored by the CBO...send free fax here....

http://www.1payer.net/about-us/whats-next.html

Call the White House

It's more important than ever. Tell the White House to support a Single Payer National Health Plan.
1-800-578-4171


Send Your Free Fax

Choose from the following list to send your free fax to congress members:

* eFax - Send HR 676 to CBO

* Congratulate and Encourage Single Payer Supporters

* Let Everyone in on Healthcare Reform

* Don't Believe the Lies

* Improve and Expand Medicare

* Stop Obstructing Health Care Reform

[Breeze54]

28. I did and thanks for posting that important info!!

:yourock:

[sisters6]

35. So do you. Please pass around.

[lsewpershad]

21. How do we pay

for all the un-necessary wars and waste-full stupid things we do? Where do we find the funds for all the bombs and war implements we create? Where does the money come from to pay billions to contractors who do shoddy work? What about all the cost overruns? Need I go on? Is our health less important? I think not.

[Breeze54]

27. Well said (TY) and Welcome to DU!

[LuckyLib]

25. CEO salaries alone would be the first step in looking for waste. Let's begin there.

[SidDithers]

30. Single payer is much less expensive...

"In 2006, per-capita spending for health care in the U.S. was US$6,714; in Canada, US$3,678."

http://www.oecd.org/dataoecd/46/33/38979719.pdf

Sid

[Breeze54]

33. That's the Truth!! ---- Thanks, Sid!

;)

[LanternWaste]

36. you can validate your claim, yes?

"So if we want to cover everyone with a single payer system we have to be willing to pay more for our health care that we are currently paying."

You can of course cite peer-reviewed, relevant, and current studies which would validate that claim, yes? Because the three models looked at most often in the here and now (Canada, France and Great Britain) seem to contradict your assertion. :shrug:

[Fovea]

37. economy of scale.

The current system wastes money making your investor class overlords fatter than Jabba the Exxon CEO.

A pure universal coverage system does not offload risk and does not generate obscene profit.
We pay half again as much as the next most expensive system for far worse outcomes and far fewer people covered.

I personally would prefer to have a dozen or less foreign military bases instead of hundreds.
We have a nuke umbrella. We will never be invaded. So what makes us safer as Americans,
seeing a doctor when sick, or having the worlds biggest security guard company provided free to Exxon?

[ejpoeta]

38. those of us who pay for insurance and pay taxes are already paying.... more than once.

first we pay our premiums. then we pay taxes which pay for medicaid and other programs like it. THEN we pay again by paying more for everything anytime we go to the doctors or the hospital. This is because they figure in the cost of the people who can't pay into every bandaid and tylenol and everything else. We are already paying.

That being said... i think it would be a great help to everyone if we could all see some thing worked up to give us an idea of how much it would cost each person for this. I am positive that it wouldn't be as much as we are paying right now. If it is as much, probably not more. It's easy to demonize something that is merely an idea without any concrete numbers attached.

[LiberalFighter]

40. Who pays for your health care now?

If you work for the county they probably pay for most if not all of your premiums. And those premiums are paid to insurance companies in the business of making a profit.

Why would we be paying more for health care even if some have to be subsidized? There should be a way for all major employers that currently provide health insurance would pay a fee to the federal government either at the national or regional level that would be about 30% less than what they pay now. And major employers that don't provide health insurance to their employees (if any) would have to pay the fee. Possibly requiring everyone receiving the health care insurance to pay a monthly fee of a $100 or so and/or small co-payment for office visits and/or medical costs. Like maybe $5 or $10 for office visits and 5 or 10% for medical costs.

Variations could be worked out for minor employers. And between the major and minor employers with some work the unemployed could be covered too.

Overall, the savings from not paying money to insurance companies that are in the business of making a profit, reduction in medical charges, and a change in the hospital industry would pay for it.

[LaydeeBug]

44. Who Pays for Senseless War? nt