OT: COVID-19 thread #3

[moorhosj]

There is the real data. Other websites have done similar analysis. The median household with health insurance spends $3000 per year on premiums and out of pocket costs.

If we were in, say, Canada, we would have a national VAT that would take roughly twice that out of the median household's pocket to pay for health insurance.

That is kind of a problem.

If we are going to fix this, we can't start by lying to ourselves.

If we aren't going to lie to ourselves, we should include the amount the median family already pays in taxes to support Medicare. A median household income of $60,000 * 2.9% = $1,769 in Medicare taxes.

Next we need to find out how much of my taxes go to Medicaid, CHIP, and the VA. Then we won't be lying to ourselves anymore. You can also add in the amount o health insurance an employer pays annually. We can add employer-funded, tax-advantaged HSA and FSA accounts to get an ever clearer picture.

[Susan]

Tbh, we have to act like we are the greatest country in the world.

That is all.

Now imagine if we put that kind of missionary zeal towards:

1) Making our Education system the best in the world
2) Making our Healthcare accessible to all - no ifs and buts
3) Making our infrastructure the best in the world

We're great but it's not possible to be the greatest at everything.

You can't fix these problems overnight. Any major improvements costs us extreme amounts of money to do so which we can't really afford because of the amount of money we're currently borrowing. We have to take small steps at a time. You also need a congress that is proactive at combating all these issues which we currently don't have.

I want to be healthy.

I want to feel like I dont need to be in a job where I am being sexually or racially discriminated against just because I have medical insurance through that job.

I dont need 19 Aircraft Carriers.
I dont need to worry about inflation.

I worry about my health. And my mental health and emotional health as I worry about my physical health.

I am almost 100 Million underinsured Americans. Most of us are healthy. We can take care of our health. We just need to feel the safety net.

Check in on your boy Joe Biden's thoughts on healthcare.

I'm right here with you musiq on our end goal but this is going to be a fight.

[moorhosj]

I'll try to be polite but I can't explain what isn't true. I have pretty average health insurance and given family history, had a colonoscopy last year. It cost me like $150 out of pocket.

That $2500 is what the insurance company pays. What you quoted isn't "out of pocket" for a person with insurance.

I'll get picture of my mother-in-law's bill to prove my point, you will likely pivot to something else by then. I know it's hard to believe, but sometimes other people have different experiences than you. It's almost like this lack of transparency is the hallmark of the American healthcare system and is the exact thing that leads to some people paying $2,500 and others paying far less.

There is a reason they won't give you a price before you agree to the procedure and you can't shop around. Is there anything else you buy that works like that (maybe a time-share)?

Also:

For patients covered by health insurance, out-of-pocket costs can range from zero to more than $1,000, depending on deductibles, copay and coinsurance amounts. For example, a Medicare patient at Dartmouth-Hitchcock Medical Center would pay $1,477, including deductibles and coinsurance. However, some insurance plans, such as the Blue Cross Blue Shield of Michigan Community Blue PPO plan, cover "wellness" screenings 100 percent, with no deductible or copay, usually with some restrictions.

https://health.costhelper.com/colonoscopy.html

[coldfish]

I'll try to be polite but I can't explain what isn't true. I have pretty average health insurance and given family history, had a colonoscopy last year. It cost me like $150 out of pocket.

That $2500 is what the insurance company pays. What you quoted isn't "out of pocket" for a person with insurance.

I'll get picture of my mother-in-law's bill to prove my point, you will likely pivot to something else by then. I know it's hard to believe, but sometimes other people have different experiences than you. It's almost like this lack of transparency is the hallmark of the American healthcare system and is the exact thing that leads to some people paying $2,500 and others paying far less.

There is a reason they won't give you a price before you agree to the procedure and you can't shop around. Is there anything else you buy that works like that (maybe a time-share)?

Also:

For patients covered by health insurance, out-of-pocket costs can range from zero to more than $1,000, depending on deductibles, copay and coinsurance amounts. For example, a Medicare patient at Dartmouth-Hitchcock Medical Center would pay $1,477, including deductibles and coinsurance. However, some insurance plans, such as the Blue Cross Blue Shield of Michigan Community Blue PPO plan, cover "wellness" screenings 100 percent, with no deductible or copay, usually with some restrictions.

https://health.costhelper.com/colonoscopy.html

Sigh, I try not to make decisions based on anecdote. That's why I told my personal story and then backed it up with national data. The median person with health insurance pays $3000 per year in premium and out of pocket. Those are the real numbers.

More likely than not, your mother in law has what is referred to as a "high deductible plan". The first $XXXX comes out of her pocket and then after that, insurance kicks in. She probably wasn't anywhere near her limit so she had to pay the full amount.

Again, I have no issue with doing something about our medical system. I can dig up quotes from when the ACA was passed years ago and I said my biggest issue with it was that it did nothing substantial to control costs, which is the primary issue. Now I'm getting bitched at because costs are too high.

[Dresden]

The US is really two systems. Those with health care and those with marginal or none. Without healthcare coverage, the system sucks. With it (which is the majority of the population), the system offers world class healthcare with minimal wait times and a low cost.

Please explain the cost of colonoscopies in the US (one of the most standard procedures one can get). In the US it costs $2,500 out-of-pocket even with good insurance. Other wester countries pay well under $1,000.

Americans go to Canada for healthcare all the time. Senator Rand Paul, a rich man, chose to have a procedure done in Canada, even with their socialist medicine.

American pharmaceutical companies spend more money on advertising than R&D.

I'll try to be polite but I can't explain what isn't true. I have pretty average health insurance and given family history, had a colonoscopy last year. It cost me like $150 out of pocket.

That $2500 is what the insurance company pays. What you quoted isn't "out of pocket" for a person with insurance.

.....

I'm all for improving our health care system, increasing access and reducing costs. The problem is that the people discussing M4A and such are in an echo chamber telling each other how smart they are while ignoring real issues with it.

https://www.commonwealthfund.org/publications/issue-briefs/2019/may/how-much-us-households-employer-insurance-spend-premiums-out-of-pocket

There is the real data. Other websites have done similar analysis. The median household with health insurance spends $3000 per year on premiums and out of pocket costs.

If we were in, say, Canada, we would have a national VAT that would take roughly twice that out of the median household's pocket to pay for health insurance.

That is kind of a problem.

If we are going to fix this, we can't start by lying to ourselves.

Many studies have been done on what it would cost to make sure everyone in the US had health care coverage. A prestigious medical journal, either The Lancet or JAMA, put out a summary of these studies not long ago. What they found was that universal coverage of one form or another would actually save Americans money in the long run (like over a 10 year period), and might well even save money in the short term (like in 2-3 years).

That's what should be forming the baseline of our discussion- the fact that we CAN cover everyone, keep the same quality we have now, and pay less (as a whole) for it.

[Dresden]

Here’s that Medicare-for-all study Bernie Sanders keeps bringing up

A single-payer health-care system would save more than 68,000 lives and $450 billion a year, new research shows

All told, the study concludes, a single-payer system akin to Sanders’s plan would slash the nation’s health-care expenditures by 13 percent, or more than $450 billion, each year. Not only that, “ensuring health-care access for all Americans would save more than 68,000 lives.”
In their breakdown of the numbers, researchers applied the existing Medicare fee structure across the entire health-care system and found it would save about $100 billion annually. Keep in mind that this basically represents less money going to doctors and hospitals, a major sticking point for medical groups that oppose Medicare-for-all. But those declines would be more than offset by several hundred billions in savings from reduced administrative and billing costs, Galvani and her colleagues estimate. The lack of patient billing under a Medicare-for-all system would also eliminate the roughly $35 billion a year that hospitals now pay to chase down unpaid bills.

The authors estimate an additional $219 billion in savings from reduced “administrative overhead” that the current decentralized system creates, including “the elimination of redundant corporate functions and the truncation of the top-heavy salary architecture of health insurance corporations.” For instance, the plan would replace dozens of health insurance executives, many of whom make well over $20 million a year, with one administrator paid the same salary as the current Secretary of Health and Human Services.

Finally, letting the national Medicare system negotiate pharmaceutical prices would save about $180 billion, according to the analysis.
Add it all up and here’s what you get: a new system that would cost about $3 trillion a year, instead of the $3.5 trillion that is being spent now.
...

https://www.washingtonpost.com/business/2020/02/20/lancet-medicare-for-all-study/

[Dresden]

So, I guess if you don't want to support a plan like that, you need to explain all those dead American bodies (68,000 of them), just like you were asking us to explain all the dead Americans that would result from a NHS like system.

[TheEndIsNigh]

I'll try to be polite but I can't explain what isn't true. I have pretty average health insurance and given family history, had a colonoscopy last year. It cost me like $150 out of pocket.

That $2500 is what the insurance company pays. What you quoted isn't "out of pocket" for a person with insurance.

I'll get picture of my mother-in-law's bill to prove my point, you will likely pivot to something else by then. I know it's hard to believe, but sometimes other people have different experiences than you. It's almost like this lack of transparency is the hallmark of the American healthcare system and is the exact thing that leads to some people paying $2,500 and others paying far less.

There is a reason they won't give you a price before you agree to the procedure and you can't shop around. Is there anything else you buy that works like that (maybe a time-share)?

Also:

For patients covered by health insurance, out-of-pocket costs can range from zero to more than $1,000, depending on deductibles, copay and coinsurance amounts. For example, a Medicare patient at Dartmouth-Hitchcock Medical Center would pay $1,477, including deductibles and coinsurance. However, some insurance plans, such as the Blue Cross Blue Shield of Michigan Community Blue PPO plan, cover "wellness" screenings 100 percent, with no deductible or copay, usually with some restrictions.

https://health.costhelper.com/colonoscopy.html

Sigh, I try not to make decisions based on anecdote. That's why I told my personal story and then backed it up with national data. The median person with health insurance pays $3000 per year in premium and out of pocket. Those are the real numbers.

More likely than not, your mother in law has what is referred to as a "high deductible plan". The first $XXXX comes out of her pocket and then after that, insurance kicks in. She probably wasn't anywhere near her limit so she had to pay the full amount.

Again, I have no issue with doing something about our medical system. I can dig up quotes from when the ACA was passed years ago and I said my biggest issue with it was that it did nothing substantial to control costs, which is the primary issue. Now I'm getting bitched at because costs are too high.

What would you consider a high deductible plan? Almost everyone I know has at least a $6,000 deductible at this point. I would consider that high, but a very average deductible for the most common plan, at least in this market, Americans get. Therefore, while the deductible is high, I wouldn't consider it a high deductible plan. It's an average plan. So, I'm curious, what would you consider high deductible? Most people I know can't afford $6,000 oop medical costs. Their insurance is basically in place for catastrophic occurrence protections, as they can't afford to seek nonessential care under that deductible.

[GetBuLLish]

Informative article on health care systems, for people that are interested in learning information on the issue:

https://freopp.org/key-findings-from-the-freopp-world-index-of-healthcare-innovation-b085f6364057

US ranked 4th.

[coldfish]

I'll get picture of my mother-in-law's bill to prove my point, you will likely pivot to something else by then. I know it's hard to believe, but sometimes other people have different experiences than you. It's almost like this lack of transparency is the hallmark of the American healthcare system and is the exact thing that leads to some people paying $2,500 and others paying far less.

There is a reason they won't give you a price before you agree to the procedure and you can't shop around. Is there anything else you buy that works like that (maybe a time-share)?

Also:

https://health.costhelper.com/colonoscopy.html

Sigh, I try not to make decisions based on anecdote. That's why I told my personal story and then backed it up with national data. The median person with health insurance pays $3000 per year in premium and out of pocket. Those are the real numbers.

More likely than not, your mother in law has what is referred to as a "high deductible plan". The first $XXXX comes out of her pocket and then after that, insurance kicks in. She probably wasn't anywhere near her limit so she had to pay the full amount.

Again, I have no issue with doing something about our medical system. I can dig up quotes from when the ACA was passed years ago and I said my biggest issue with it was that it did nothing substantial to control costs, which is the primary issue. Now I'm getting bitched at because costs are too high.

What would you consider a high deductible plan? Almost everyone I know has at least a $6,000 deductible at this point. I would consider that high, but a very average deductible for the most common plan, at least in this market, Americans get. Therefore, while the deductible is high, I wouldn't consider it a high deductible plan. It's an average plan. So, I'm curious, what would you consider high deductible? Most people I know can't afford $6,000 oop medical costs. Their insurance is basically in place for catastrophic occurrence protections, as they can't afford to seek nonessential care under that deductible.

There are lots of different types of plans. For mine, I pay a percentage up to a limit (which is around $5k I believe) and then its covered 100%. For others, they pay 100% up to a limit and then its either covered 100% or a percentage is paid.

Paying $6000 out of pocket before your insurance company contributes a penny seems high to me. I don't know anyone with a plan that bad. TBH, these type of plans were common years ago but they have been disappearing due to the ACA.

Just to take the anecdotes out of it, the ACA made it really hard to have specialized plans. Most health care plans fall into one of many predetermined tiers. The absolute worst plan you can get is a bronze plan:
https://www.policygenius.com/health-insurance/what-are-bronze-plans/

Bronze plans are the lowest level of the metal tiers, which means you will have to pay the most out of pocket for your health care expenses. Generally, that means the insurance company pays 60% of health care costs and you pay 40%. This primarily applies after you’ve passed your deductible. So if you pay $100 over your deductible, your insurance will generally cover about $60, leaving you to pay about $40.

The out of pocket max is $8,150 and most plans are lower. In this example, insurance would cover 60% of all costs until you have spent at most $8,150.

[coldfish]

Here’s that Medicare-for-all study Bernie Sanders keeps bringing up

A single-payer health-care system would save more than 68,000 lives and $450 billion a year, new research shows

All told, the study concludes, a single-payer system akin to Sanders’s plan would slash the nation’s health-care expenditures by 13 percent, or more than $450 billion, each year. Not only that, “ensuring health-care access for all Americans would save more than 68,000 lives.”
In their breakdown of the numbers, researchers applied the existing Medicare fee structure across the entire health-care system and found it would save about $100 billion annually. Keep in mind that this basically represents less money going to doctors and hospitals, a major sticking point for medical groups that oppose Medicare-for-all. But those declines would be more than offset by several hundred billions in savings from reduced administrative and billing costs, Galvani and her colleagues estimate. The lack of patient billing under a Medicare-for-all system would also eliminate the roughly $35 billion a year that hospitals now pay to chase down unpaid bills.

The authors estimate an additional $219 billion in savings from reduced “administrative overhead” that the current decentralized system creates, including “the elimination of redundant corporate functions and the truncation of the top-heavy salary architecture of health insurance corporations.” For instance, the plan would replace dozens of health insurance executives, many of whom make well over $20 million a year, with one administrator paid the same salary as the current Secretary of Health and Human Services.

Finally, letting the national Medicare system negotiate pharmaceutical prices would save about $180 billion, according to the analysis.
Add it all up and here’s what you get: a new system that would cost about $3 trillion a year, instead of the $3.5 trillion that is being spent now.
...

https://www.washingtonpost.com/business/2020/02/20/lancet-medicare-for-all-study/

To cover the bolded: The US federal government limited executive pay years ago. I believe the highest salary any CEO can get it $1m. Many take much less than that. Their total compensation is usually paid in stock options because it allows them to get taxed at the lower capital gains rate. Those stock options don't come from premium payments. They are paid out of the shareholder pockets in the form of share dilution.

I bring this up because this is a common knowledge type thing. If you eliminate CEO's, you aren't saving $20m. This whole study has to be filled with bad math, half truths and lies just to sell an idea.

In the real world, doctor's offices hate medicare because it pays poorly. Some outright refuse to take it because the compensation level doesn't cover their costs.

https://www.hlc.org/news/more-physicians-no-longer-seeing-medicare-patients/

If everyone was paying at medicare rates, doctors would have to cut seriously into their service or just plain go away. As it stands, the private insurance system subsidizes the medicare system. If this actually happened, you would end up having more customers seeing less doctors with the obvious end result of worse service for most people.

As far as cost, I have no doubt that M4A would be cheaper than our current system on aggregate. That said, employers pay the lion's share of that cost making it very progressive. If you implement a less progressive system for payment, a whole lot of people would see their out of pocket medical expenses go up, not down.

Worse coverage, more money, more dead people (not less).

Again, there are things that could and should be done. Bernie Sanders just shouldn't be involved because I suspect he doesn't even understand that $20m CEO thing.

[samwana]

I didn't read through this thread yet, but know that here in Germany I heard from a nurse that strange things happen with test kits. Assumingly there are kits contaminated so people that are tested get sick from a substance on the kits. Same rumor floats in England too.

And I hope all people that are longing for vaccines are taking them, because I don't want anything to do with a vaccine that changes my DNA. And I don't want to be a guinnea pig for a vaccine that isn't properly tested. There is no way a proper vaccine can be developed this quickly, because you don't know anything about longterm issues. It takes 5-8 years to have an idea about it, no way it is ready after just one year. And that's only if you believe vaccine is the right way.




Sent from my POT-LX1 using RealGM mobile app

[bentheredengthat]

Please explain the cost of colonoscopies in the US (one of the most standard procedures one can get). In the US it costs $2,500 out-of-pocket even with good insurance. Other wester countries pay well under $1,000.

Americans go to Canada for healthcare all the time. Senator Rand Paul, a rich man, chose to have a procedure done in Canada, even with their socialist medicine.

American pharmaceutical companies spend more money on advertising than R&D.

I'll try to be polite but I can't explain what isn't true. I have pretty average health insurance and given family history, had a colonoscopy last year. It cost me like $150 out of pocket.

That $2500 is what the insurance company pays. What you quoted isn't "out of pocket" for a person with insurance.

.....

I'm all for improving our health care system, increasing access and reducing costs. The problem is that the people discussing M4A and such are in an echo chamber telling each other how smart they are while ignoring real issues with it.

https://www.commonwealthfund.org/publications/issue-briefs/2019/may/how-much-us-households-employer-insurance-spend-premiums-out-of-pocket

There is the real data. Other websites have done similar analysis. The median household with health insurance spends $3000 per year on premiums and out of pocket costs.

If we were in, say, Canada, we would have a national VAT that would take roughly twice that out of the median household's pocket to pay for health insurance.

That is kind of a problem.

If we are going to fix this, we can't start by lying to ourselves.

That's because people aren't using their health insurance (to save money). I'll speak for my family and myself, lot of us have been self-employed, independent contractors, or small businesses - been a juggle between "catastrophe insurance" to basically pay the lowest premium possible and just insure in case of a near-death emergencies or major surgeries (relatively healthy people so it made sense). But that also meant we basically would never go to the doctor unless it was really, really necessary. And you know, over years, my dad got really bad hip and knee problems from minor injuries that added up until he needed a hip replacement... which when you add the premium, deductible, out-of-pocket limit, it cost around $20k or so with a decent plan.

My wife recently got corporate insurance. It's night-and-day. It's like a nearly-free 5-star hotel instead of ratty Motel 8 that costs $500 a stay with a mini-bar that costs $100 for a Coors Light. I don't know, I'm used to the BS because I've tried many different plans over the years. They all felt like highway robbery. Not to mention when the disputes for a bill come up with the more nuanced plans. Talk about anxiety. If I'm paying $600 a month as a 27 year old , and I'm healthy like 11 out of 12 months, can I at least not have to worry about the possibility of being snuck some $300 bill that happened to examine part of my *** that wasn't covered by the policy (j/k, but kind of)?

Now here's the problem; she hates her job and wants to go back to a smaller business or self-employment. Here's the catch; we're both getting older and we can really benefit from the insurance, but I don't want her to be miserable. So I guess we're going to have re-evaluate in the next year whether we take the big ole savings hit and play health care roulette again.

Just wait until you are self employed and over 50 but make too much money for subsidies on ACA.

It's nothing less than the catastrophic Heath care plans that we decried 10 years ago. There are literally zero benefits for a healthy single person until you spend 12k + per year.

[bentheredengthat]

Paying $6000 out of pocket before your insurance company contributes a penny seems high to me. I don't know anyone with a plan that bad. TBH, these type of plans were common years ago but they have been disappearing due to the ACA..

It's all that's available to me. 6k deductible, or 50% higher premium (my premium isn't low) for a 3500 deductible.

However you cut it, whatever plan you choose, it's 12k out of pocket before any benefits.

[TheEndIsNigh]

Sigh, I try not to make decisions based on anecdote. That's why I told my personal story and then backed it up with national data. The median person with health insurance pays $3000 per year in premium and out of pocket. Those are the real numbers.

More likely than not, your mother in law has what is referred to as a "high deductible plan". The first $XXXX comes out of her pocket and then after that, insurance kicks in. She probably wasn't anywhere near her limit so she had to pay the full amount.

Again, I have no issue with doing something about our medical system. I can dig up quotes from when the ACA was passed years ago and I said my biggest issue with it was that it did nothing substantial to control costs, which is the primary issue. Now I'm getting bitched at because costs are too high.

What would you consider a high deductible plan? Almost everyone I know has at least a $6,000 deductible at this point. I would consider that high, but a very average deductible for the most common plan, at least in this market, Americans get. Therefore, while the deductible is high, I wouldn't consider it a high deductible plan. It's an average plan. So, I'm curious, what would you consider high deductible? Most people I know can't afford $6,000 oop medical costs. Their insurance is basically in place for catastrophic occurrence protections, as they can't afford to seek nonessential care under that deductible.

There are lots of different types of plans. For mine, I pay a percentage up to a limit (which is around $5k I believe) and then its covered 100%. For others, they pay 100% up to a limit and then its either covered 100% or a percentage is paid.

Paying $6000 out of pocket before your insurance company contributes a penny seems high to me. I don't know anyone with a plan that bad. TBH, these type of plans were common years ago but they have been disappearing due to the ACA.

Just to take the anecdotes out of it, the ACA made it really hard to have specialized plans. Most health care plans fall into one of many predetermined tiers. The absolute worst plan you can get is a bronze plan:
https://www.policygenius.com/health-insurance/what-are-bronze-plans/

Bronze plans are the lowest level of the metal tiers, which means you will have to pay the most out of pocket for your health care expenses. Generally, that means the insurance company pays 60% of health care costs and you pay 40%. This primarily applies after you’ve passed your deductible. So if you pay $100 over your deductible, your insurance will generally cover about $60, leaving you to pay about $40.

The out of pocket max is $8,150 and most plans are lower. In this example, insurance would cover 60% of all costs until you have spent at most $8,150.

The $6,000 deductible is from the ACA bronze plan. It's has exactly the same benefits offered by the largest employers where I live. The maximum out of pocket is $7,200. So the window between copay and $0 oop is relatively low.

This leads to self imposed rationed health care, because people in this market generally don't have $6,000 to spend on health care here.

Also, I was speaking to the CFO and human resources manager at one of these companies and he said one of the largest drivers in the increase of the cost of insurance coverage is the rising cost of prescription drugs, which, by their assessment, is arbitrary and not market driven.

[Dresden]

Here’s that Medicare-for-all study Bernie Sanders keeps bringing up

A single-payer health-care system would save more than 68,000 lives and $450 billion a year, new research shows

All told, the study concludes, a single-payer system akin to Sanders’s plan would slash the nation’s health-care expenditures by 13 percent, or more than $450 billion, each year. Not only that, “ensuring health-care access for all Americans would save more than 68,000 lives.”
In their breakdown of the numbers, researchers applied the existing Medicare fee structure across the entire health-care system and found it would save about $100 billion annually. Keep in mind that this basically represents less money going to doctors and hospitals, a major sticking point for medical groups that oppose Medicare-for-all. But those declines would be more than offset by several hundred billions in savings from reduced administrative and billing costs, Galvani and her colleagues estimate. The lack of patient billing under a Medicare-for-all system would also eliminate the roughly $35 billion a year that hospitals now pay to chase down unpaid bills.

The authors estimate an additional $219 billion in savings from reduced “administrative overhead” that the current decentralized system creates, including “the elimination of redundant corporate functions and the truncation of the top-heavy salary architecture of health insurance corporations.” For instance, the plan would replace dozens of health insurance executives, many of whom make well over $20 million a year, with one administrator paid the same salary as the current Secretary of Health and Human Services.

Finally, letting the national Medicare system negotiate pharmaceutical prices would save about $180 billion, according to the analysis.
Add it all up and here’s what you get: a new system that would cost about $3 trillion a year, instead of the $3.5 trillion that is being spent now.
...

https://www.washingtonpost.com/business/2020/02/20/lancet-medicare-for-all-study/

To cover the bolded: The US federal government limited executive pay years ago. I believe the highest salary any CEO can get it $1m. Many take much less than that. Their total compensation is usually paid in stock options because it allows them to get taxed at the lower capital gains rate. Those stock options don't come from premium payments. They are paid out of the shareholder pockets in the form of share dilution.

I bring this up because this is a common knowledge type thing. If you eliminate CEO's, you aren't saving $20m. This whole study has to be filled with bad math, half truths and lies just to sell an idea.

In the real world, doctor's offices hate medicare because it pays poorly. Some outright refuse to take it because the compensation level doesn't cover their costs.

https://www.hlc.org/news/more-physicians-no-longer-seeing-medicare-patients/

If everyone was paying at medicare rates, doctors would have to cut seriously into their service or just plain go away. As it stands, the private insurance system subsidizes the medicare system. If this actually happened, you would end up having more customers seeing less doctors with the obvious end result of worse service for most people.

As far as cost, I have no doubt that M4A would be cheaper than our current system on aggregate. That said, employers pay the lion's share of that cost making it very progressive. If you implement a less progressive system for payment, a whole lot of people would see their out of pocket medical expenses go up, not down.

Worse coverage, more money, more dead people (not less).

Again, there are things that could and should be done. Bernie Sanders just shouldn't be involved because I suspect he doesn't even understand that $20m CEO thing.

Why do you keep posting things that are outright lies?

Below is As You Sow's list of the 17 most overpaid CEOs in healthcare industry on the S&P 500:

Leonard Schleifer (Regeneron Pharmaceuticals)
Salary: $26.5 million
CEO to worker pay ratio: 215:1
Excess pay: $12.9 million

Brenton Saunders (Allergan)
Salary: $32.8 million
CEO to worker pay ratio: 349:1
Excess pay: $19.4 million

Marc Casper (Thermo Fisher Scientific)
Salary: $22.3 million
CEO to worker pay ratio: 324:1
Excess pay: $7.9 million

Michael Neidorff (Centene Corp)
Salary: $25.3 million
CEO to worker pay ratio: 379:1
Excess pay: $9.7 million

Alex Gorsky (Johnson & Johnson)
Salary: $29.8 million
CEO to worker pay ratio: 452:1
Excess pay: $16.1 million

John Hammergren (McKesson Corp.)
Salary: $18.1 million
CEO to worker pay ratio: 473:1
Excess pay: $4.9 million

Ian Read (Pfizer)
Salary: $27.9 million
CEO to worker pay ratio: 313:1
Excess pay: $14.3 million

Bruce Broussard (Humana)
Salary: $19.8 million
CEO to worker pay ratio: 344:1
Excess pay: $4.7 million

Miles White (Abbott Laboratories)
Salary: $18.9 million
CEO to worker pay ratio: 251:1
Excess pay: $4.9 million

Mark Bertolini (Aetna)
Salary: $18.8 million
CEO to worker pay ratio: 235:1
Excess pay: $4.0 million

Timothy Wentworth (Express Scripts Holding)
Salary: $15.9 million
CEO to worker pay ratio: 303:1
Excess pay: $2.5 million

Ludwig Hantson (Alexion Pharmaceuticals)
Salary: $15.3 million
CEO to worker pay ratio: 92:1
Excess pay: $1.9 million

David Taylor (Procter & Gamble)
Salary: $17.4 million
CEO to worker pay ratio: 287:1
Excess pay: $4.1 million

Howard Robin (Nektar Therapeutics)
Salary: $18.1 million
CEO to worker pay ratio: 91:1
Excess pay: $2.8 million

Milton Johson (HCA Healthcare)
Salary: $17.3 million
CEO to worker pay ratio: 312:1
Excess pay: $2.6 million

Richard Gonzales (AbbVie)
Salary: $22.6 million
CEO to worker pay ratio: 144:1
Excess pay: $8.1 million

John Milligan (Gilead Sciences)
Salary: $15.4 million
CEO to worker pay ratio: 94:1
Excess pay: $1.8 million

[dice]

Trump
Biden
All what I will say..

promise?

another trump supporter that wants nothing more than to grow up and be a troll just like him. it's not about the ideology (he has none other than self-interest). it's about revenge for centuries of losing the culture war. well, that losing has just continued under trump and will continue to. progress always wins out. and ignorant, self-serving intolerance inevitably goes the way of confederate relics

Trump is a smart guy, he just likes to goof around with stupid and fake media

donald trump's twitter account is the #1 distributor of "fake news" in the history of the world

and no, he's not that bright either. countless examples of that on COVID-19 alone:

-wondering whether huffing disinfectants can help treat it
-thinking that a person can't have a case of COVID if they aren't tested

"the united states greatly appreciates [china's] efforts and transparency....in particular, on behalf of the american people, i want to thank president xi!" - donald trump, jan. 24

"within a couple of days, [infections are] going to be down to close to zero. one day, it's like a miracle. it will disappear" - don the con, march 6

"i've always known this is a real...this is a pandemic. i've felt it was a pandemic long before it was called a pandemic" - dumbass don, march 17

"i tested very positively [for COVID-19]. in another sense, i tested positively toward negative, right? so no. i tested perfectly this morning, meaning i tested negative. but that's a way of saying it. positively toward the negative" - dip**** don

"we inherited broken testing [for COVID-19]." the virus obviously did not exist when trump entered office

Watch on YouTube

bonus round:

"no administration has accomplished more in the first 90 days." after polling suggests that voters are not impressed with his first 100 days in office..."[the first 100 days] is a ridiculous standard"

"the electoral college is a disaster for a democracy" - 2012
"the electoral college is actually genius" - days after winning election

"to our very foolish leader, do not attack syria" - 2013
2017 - trump attacks syria

"an extremely credible source has called my office and told me that obama's birth certificate is a fraud" - 2012
"remember, don't believe 'sources said' by the very dishonest media. if they don't name the sources, they don't exist" - 2016

"nobody knew that healthcare could be so complicated"

"we have 50 governors and territories, by the way. people don't ever mention that. we have territories. we have 50 governors and territories"

"governors can't do anything without the approval of the president of the united states"

"when somebody is the president of the united states, the authority is total"

"i think i took my own advice on the ban. i don't know"

[dice]

There is the real data. Other websites have done similar analysis. The median household with health insurance spends $3000 per year on premiums and out of pocket costs.

If we were in, say, Canada, we would have a national VAT that would take roughly twice that out of the median household's pocket to pay for health insurance.

That is kind of a problem.

If we are going to fix this, we can't start by lying to ourselves.

If we aren't going to lie to ourselves, we should include the amount the median family already pays in taxes to support Medicare. A median household income of $60,000 * 2.9% = $1,769 in Medicare taxes.

Next we need to find out how much of my taxes go to Medicaid, CHIP, and the VA. Then we won't be lying to ourselves anymore. You can also add in the amount o health insurance an employer pays annually. We can add employer-funded, tax-advantaged HSA and FSA accounts to get an ever clearer picture.

and once again, we're lying to ourselves if we don't think that what our employers spend on health insurance isn't actually coming out of our own pockets

employee premium contribution, employer contribution, medicare and medicaid taxes, deductibles, co-pays...it all comes out of our pockets. america spends far more on health care than any other nation. and it's the average taxpayer that bears the brunt of it

additionally, there are better systems than canada's if we're looking to improve this mess

[Dresden]

I'll try to be polite but I can't explain what isn't true. I have pretty average health insurance and given family history, had a colonoscopy last year. It cost me like $150 out of pocket.

That $2500 is what the insurance company pays. What you quoted isn't "out of pocket" for a person with insurance.

.....

I'm all for improving our health care system, increasing access and reducing costs. The problem is that the people discussing M4A and such are in an echo chamber telling each other how smart they are while ignoring real issues with it.

https://www.commonwealthfund.org/publications/issue-briefs/2019/may/how-much-us-households-employer-insurance-spend-premiums-out-of-pocket

There is the real data. Other websites have done similar analysis. The median household with health insurance spends $3000 per year on premiums and out of pocket costs.

If we were in, say, Canada, we would have a national VAT that would take roughly twice that out of the median household's pocket to pay for health insurance.

That is kind of a problem.

If we are going to fix this, we can't start by lying to ourselves.

That's because people aren't using their health insurance (to save money). I'll speak for my family and myself, lot of us have been self-employed, independent contractors, or small businesses - been a juggle between "catastrophe insurance" to basically pay the lowest premium possible and just insure in case of a near-death emergencies or major surgeries (relatively healthy people so it made sense). But that also meant we basically would never go to the doctor unless it was really, really necessary. And you know, over years, my dad got really bad hip and knee problems from minor injuries that added up until he needed a hip replacement... which when you add the premium, deductible, out-of-pocket limit, it cost around $20k or so with a decent plan.

My wife recently got corporate insurance. It's night-and-day. It's like a nearly-free 5-star hotel instead of ratty Motel 8 that costs $500 a stay with a mini-bar that costs $100 for a Coors Light. I don't know, I'm used to the BS because I've tried many different plans over the years. They all felt like highway robbery. Not to mention when the disputes for a bill come up with the more nuanced plans. Talk about anxiety. If I'm paying $600 a month as a 27 year old , and I'm healthy like 11 out of 12 months, can I at least not have to worry about the possibility of being snuck some $300 bill that happened to examine part of my *** that wasn't covered by the policy (j/k, but kind of)?

Now here's the problem; she hates her job and wants to go back to a smaller business or self-employment. Here's the catch; we're both getting older and we can really benefit from the insurance, but I don't want her to be miserable. So I guess we're going to have re-evaluate in the next year whether we take the big ole savings hit and play health care roulette again.

Just wait until you are self employed and over 50 but make too much money for subsidies on ACA.

It's nothing less than the catastrophic Heath care plans that we decried 10 years ago. There are literally zero benefits for a healthy single person until you spend 12k + per year.

I'm over 60, self employed, and I pay about $ 9,600 a year for Kaiser HMO. I pay $25 for a doctor's visit, $10-$15 for prescriptions, and I had a heart procedure a few years ago that only cost me $100.

[dice]

Paying $6000 out of pocket before your insurance company contributes a penny seems high to me. I don't know anyone with a plan that bad. TBH, these type of plans were common years ago but they have been disappearing due to the ACA..

It's all that's available to me. 6k deductible, or 50% higher premium (my premium isn't low) for a 3500 deductible.

However you cut it, whatever plan you choose, it's 12k out of pocket before any benefits.

2019 average ACA annual premiums:

lowest - $3,912 (minnesota)
illinois - $5,736
highest - $10,380 (wyoming)

2019 average ACA deductible:

bronze - $6,258
silver - $4,375

2018 average employer-provided annual premiums:

lowest - $5,971 (tennessee) - $1,410 direct employee contribution
illinois - $7,123 - $1,541 direct employee contribution
highest - $8,432 (alaska) - $1,154 direct employee contribution

2018 average employer-provided annual deductible:

lowest - family $2,362 (DC), individual $1,308 (DC, hawaii)
illinois - family $3,324, individual $1,752
highest - family $4,644 (n. hampshire), individual $2,447 (maine)