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Trumpcare- Passed the House and onto the Senate; will it pass there? And what will it finally look like? (1 Viewer)

First thing I'd do is force healthcare individuals to create price lists and charge the same amount to everyone for similar procedures, products and services.

 
The Commish said:
As it pertains to this topic, what outcome will be evidence (to you) that their counterparts are "good" at their jobs?  I think it will all do us some good to remember what Pelosi and Reid finally got agreement on.  I don't think the GOP is going to be any worse in that regard, so if they simply get legislation passed, will that be considered "doing a good job"?
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All I meant, Commish, as a passing remark, was that if you simply look at the political aspects of this, Pelosi and Reid were very good at pulling together disparate forces, doing some hard horse trading, and getting ACA passed. Dems had been trying to do something like this for 60 years and they were the first ones to do it. Hillary Clinton also had her husband and Democratic majorities between 1993-94 and she couldn't do it. It takes a lot of skill. 

Now Ryan, McConnell and Trump face the same problem from the other side. On paper their job should be easier because they've got a larger majority than Pelosi and Reid had, and because at least the repeal part has the support of every Republican. But will they get this thing passed? Hard to say at this point. 

 
adonis said:
For many folks, it's not cost that's the major issue, it's access to healthcare and costs are a secondary issue.  Everyone should be able to have quality healthcare available to them regardless of income.

Once that's taken care of, costs are definitely something we should strive to keep as low as possible.  But it seems to me to be a fundamental difference on the real issue regarding healthcare in the US.  

Should your access to healthcare be dependent upon whether or not you can afford it?  I say no, others say yes, and we should do whatever we can to keep costs low enough where many more can afford it.  I'd say that's not enough, EVERYONE should be able to get it.
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Cost IS the major issue.  It's a free country.  If anyone can't get quality healthcare, it's because it's too expensive for them.  If it wasn't so expensive, they could get quality healthcare and if they couldn't afford it, a gov't plan could allow them to get it (because the gov't would now have the ability to provide great healthcare).

But anyway, this is a waste of time.  It's a one-way trip to disaster, it's just a matter of when.

 
timschochet said:
So far, conservatives are split on this new proposal, with Heritage, Club for Growth, and Freedomworks coming out firmly against. 

Now we'll find out how much power Trump and Ryan have to bring them all in line. People underestimate just how good Nancy Pelosi and Harry Reid were. 
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One thing about her verses Boehner. Whether you liked her or not if Nancy told you she had the votes then SHE HAD THE VOTES. 

 
shader said:
First thing I'd do is force healthcare individuals to create price lists and charge the same amount to everyone for similar procedures, products and services.
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You are a conservative right? Because that is signficantly out of line with that viewpoint. I love it but then I would. 

 
timschochet said:
The Commish said:
As it pertains to this topic, what outcome will be evidence (to you) that their counterparts are "good" at their jobs?  I think it will all do us some good to remember what Pelosi and Reid finally got agreement on.  I don't think the GOP is going to be any worse in that regard, so if they simply get legislation passed, will that be considered "doing a good job"?
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All I meant, Commish, as a passing remark, was that if you simply look at the political aspects of this, Pelosi and Reid were very good at pulling together disparate forces, doing some hard horse trading, and getting ACA passed. Dems had been trying to do something like this for 60 years and they were the first ones to do it. Hillary Clinton also had her husband and Democratic majorities between 1993-94 and she couldn't do it. It takes a lot of skill. 

Now Ryan, McConnell and Trump face the same problem from the other side. On paper their job should be easier because they've got a larger majority than Pelosi and Reid had, and because at least the repeal part has the support of every Republican. But will they get this thing passed? Hard to say at this point.
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They'll get "something" passed....so success, right?

ETA:  Personally, neither is really impressive to me, given the results thus far.  Simply getting it passed is a pretty low bar to set IMO.

 
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Gr00vus said:
adonis said:
EVERYONE should be able to get it.
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That can't really happen without reigning in costs and/or completely socializing everything to do with healthcare. Some would say those are essentially the same thing. I think there's plenty of grey area between. Which of those do you think is more possible near term?
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It depends on what you focus on.  The solutions are completely different in terms of directions.

If you want to focus on reducing costs, you're almost inevitably going to limit access to healthcare or the ability to afford health insurance as you go away from Obamacare.  If you make revisions to Obamacare with respect to costs, you're also not focusing entirely on expanding access...you'll be primarily focused on reducing costs, right?  And since costs and access to healthcare/health insurance are strongly correlated, how is it different?

If you want to focus on expanding access, the cost discussion goes in different directions.  You start to engage in ideas that help overhaul the system as it exists currently, which would be necessary to be able to support something like a single payer system.

The difference is ideological, and it is largely based on the role of government.  That's why we can't agree on a fundamental level here.  If republicans start out from the perspective that government needs to be small, they're de-facto accepting the free market solution as it exists, and they're working to reduce costs or expand care, within that system...and expanding access/healthcare insurance in that system necessarily correlates to income.

The democratic view follows the idea that access to healthcare/health insurance is a right.  And the government responds accordingly...programs, incentives, etc...

Didn't expect this to be controversial.  Obviously, in both approaches, cost is important...but in one it's primary, and in the other it's something that follows from something else that's primary.

 
shader said:
adonis said:
For many folks, it's not cost that's the major issue, it's access to healthcare and costs are a secondary issue.  Everyone should be able to have quality healthcare available to them regardless of income.

Once that's taken care of, costs are definitely something we should strive to keep as low as possible.  But it seems to me to be a fundamental difference on the real issue regarding healthcare in the US.  

Should your access to healthcare be dependent upon whether or not you can afford it?  I say no, others say yes, and we should do whatever we can to keep costs low enough where many more can afford it.  I'd say that's not enough, EVERYONE should be able to get it.
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Cost IS the major issue.  It's a free country.  If anyone can't get quality healthcare, it's because it's too expensive for them.  If it wasn't so expensive, they could get quality healthcare and if they couldn't afford it, a gov't plan could allow them to get it (because the gov't would now have the ability to provide great healthcare).

But anyway, this is a waste of time.  It's a one-way trip to disaster, it's just a matter of when.
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I'm not sure what this being a free country has to do with anything.  If we had a single payer system, it'd be a free country.  If we look to the free market to solve the health care access/costs, it's still a free country.  The issue at heart is what the role of government is in ensuring access to affordable health care for all citizens.  Republicans don't believe it has a role, others on the democratic side do...

 
adonis said:
It depends on what you focus on.  The solutions are completely different in terms of directions.

If you want to focus on reducing costs, you're almost inevitably going to limit access to healthcare or the ability to afford health insurance as you go away from Obamacare.  If you make revisions to Obamacare with respect to costs, you're also not focusing entirely on expanding access...you'll be primarily focused on reducing costs, right?  And since costs and access to healthcare/health insurance are strongly correlated, how is it different?

If you want to focus on expanding access, the cost discussion goes in different directions.  You start to engage in ideas that help overhaul the system as it exists currently, which would be necessary to be able to support something like a single payer system.

The difference is ideological, and it is largely based on the role of government.  That's why we can't agree on a fundamental level here.  If republicans start out from the perspective that government needs to be small, they're de-facto accepting the free market solution as it exists, and they're working to reduce costs or expand care, within that system...and expanding access/healthcare insurance in that system necessarily correlates to income.

The democratic view follows the idea that access to healthcare/health insurance is a right.  And the government responds accordingly...programs, incentives, etc...

Didn't expect this to be controversial.  Obviously, in both approaches, cost is important...but in one it's primary, and in the other it's something that follows from something else that's primary.
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That's a lot of vaguely worded sentences to say "socialism."

 
Jackstraw said:
You are a conservative right? Because that is signficantly out of line with that viewpoint. I love it but then I would. 
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It is?  Advertising your prices upfront is significantly out of line with being a conservative?  I think it's simply in line with being an honest person.

 
The Commish said:
adonis said:
For many folks, it's not cost that's the major issue, it's access to healthcare and costs are a secondary issue.  Everyone should be able to have quality healthcare available to them regardless of income.

Once that's taken care of, costs are definitely something we should strive to keep as low as possible.  But it seems to me to be a fundamental difference on the real issue regarding healthcare in the US.  

Should your access to healthcare be dependent upon whether or not you can afford it?  I say no, others say yes, and we should do whatever we can to keep costs low enough where many more can afford it.  I'd say that's not enough, EVERYONE should be able to get it.
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You're proving my point.  Ignoring the fact that you're conflating access to health insurance with access to healthcare, I hear what you're saying.  The reason people don't have access to healthcare is because it's too expensive for those that don't have insurance.  It comes right back to cost.  Access is a symptom of the larger problem.

And for the record, I am one that believes that we should not have major industry built directly on top of the country's health.  I believe it's a right and not a priv and I believe it's one of the few things our government should be standing up for on our behalf....just like other countries do for their citizens.
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At a certain point, I think you have to admit that there's a baseline to healthcare costs in the current system that are "cost".  And even if we got the price of healthcare services and health care insurance down to "cost" many people still couldn't afford it.  Are you OK saying those people shouldn't have access to affordable healthcare or affordable insurance?

I mean, either we focus on pushing down costs as far as we can, and letting folks fall where they do based on their ability to afford whatever that lower limit cost is, OR we focus on continually expanding healthcare access/insurance/services to folks regardless of income levels.

 
shader said:
First thing I'd do is force healthcare individuals to create price lists and charge the same amount to everyone for similar procedures, products and services.
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That is simply not possible. Even Mcdonald's can't charge the same everywhere across the country. If you are saying that locally you know what your hospital would charge up front then possibly. But there are just too many variables.  

 
adonis said:
It depends on what you focus on.  The solutions are completely different in terms of directions.

If you want to focus on reducing costs, you're almost inevitably going to limit access to healthcare or the ability to afford health insurance as you go away from Obamacare.  If you make revisions to Obamacare with respect to costs, you're also not focusing entirely on expanding access...you'll be primarily focused on reducing costs, right?  And since costs and access to healthcare/health insurance are strongly correlated, how is it different?

If you want to focus on expanding access, the cost discussion goes in different directions.  You start to engage in ideas that help overhaul the system as it exists currently, which would be necessary to be able to support something like a single payer system.

The difference is ideological, and it is largely based on the role of government.  That's why we can't agree on a fundamental level here.  If republicans start out from the perspective that government needs to be small, they're de-facto accepting the free market solution as it exists, and they're working to reduce costs or expand care, within that system...and expanding access/healthcare insurance in that system necessarily correlates to income.

The democratic view follows the idea that access to healthcare/health insurance is a right.  And the government responds accordingly...programs, incentives, etc...

Didn't expect this to be controversial.  Obviously, in both approaches, cost is important...but in one it's primary, and in the other it's something that follows from something else that's primary.
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The difference between you and the people giving you grief (myself included) in this discussion is you're looking at it in terms of political ideology.  Personally, I couldn't care less what the parties claim.  I care about the issues and solutions to those issues.  No matter what you present me as an ideology or problem, it's going to be rooted in cost...it will always come back to the :moneybag:  

 
Ratbone said:
That is simply not possible. Even Mcdonald's can't charge the same everywhere across the country. If you are saying that locally you know what your hospital would charge up front then possibly. But there are just too many variables.  
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But the Big Mac is the same price to every person at any particular McDonalds.  That's what he's saying. 

 
Ratbone said:
That is simply not possible. Even Mcdonald's can't charge the same everywhere across the country. If you are saying that locally you know what your hospital would charge up front then possibly. But there are just too many variables.  
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Medicare seems like it deals with this problem.

 
timschochet said:
All I meant, Commish, as a passing remark, was that if you simply look at the political aspects of this, Pelosi and Reid were very good at pulling together disparate forces, doing some hard horse trading, and getting ACA passed. Dems had been trying to do something like this for 60 years and they were the first ones to do it. Hillary Clinton also had her husband and Democratic majorities between 1993-94 and she couldn't do it. It takes a lot of skill. 

Now Ryan, McConnell and Trump face the same problem from the other side. On paper their job should be easier because they've got a larger majority than Pelosi and Reid had, and because at least the repeal part has the support of every Republican. But will they get this thing passed? Hard to say at this point. 
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:goodposting:

You can hate the substance all you want, but Pelosi and Reid were effective at forging consensus within their own party, or even crossing the aisle from time to time, and pushing legislation through to passage. Ryan and McConnell have yet to demonstrate that ability.  Whether it's their fault, a function of the sort of people elected to represent many GOP majority districts, a function of the fact that their party's president has no idea how government works,  or some combination of those things, it's a real problem.

 
The Commish said:
The difference between you and the people giving you grief (myself included) in this discussion is you're looking at it in terms of political ideology.  Personally, I couldn't care less what the parties claim.  I care about the issues and solutions to those issues.  No matter what you present me as an ideology or problem, it's going to be rooted in cost...it will always come back to the :moneybag:  
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And to be honest, i don't self-identify as a democrat.  I self-identify as a left-of-center (slightly) person who has a view that healthcare, or your access to healthcare, or your ability to have healthcare issues that don't bankrupt you, is a right in our country.

What follows from that is how to reform our system to impose that ideological belief.  It's a right I believe all americans have, and the solution to ensuring that right necessarily carries with it different steps than it would if I didn't hold that belief.

If I held a belief that it's not a right, and that we need to make the best of the system we have, I would likely focus on cost.  Try to drive down cost to provide care, service, insurance to as many folks as possible.  But necessarily, folks will be left out of this approach, which makes it different than the approach I'd choose due to my ideological belief that it should be a right.

I'm not disagreeing with any of you about how to cut costs, or anything like that. I was responding directly to people not focusing where some folks think they should, because they fundamentally disagree on the starting point.  

 
adonis said:
At a certain point, I think you have to admit that there's a baseline to healthcare costs in the current system that are "cost".  And even if we got the price of healthcare services and health care insurance down to "cost" many people still couldn't afford it.  Are you OK saying those people shouldn't have access to affordable healthcare or affordable insurance?

I mean, either we focus on pushing down costs as far as we can, and letting folks fall where they do based on their ability to afford whatever that lower limit cost is, OR we focus on continually expanding healthcare access/insurance/services to folks regardless of income levels.
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Yes...there is a cost baseline.  The poorest of the poor might not be able to afford it.  That's what government is for...to help.....just like they do in many other countries.  Your conclusions/scenarios aren't matching the circumstances best I can tell.

This isn't an either/or discussion.  We focus on getting costs as low as we possibly can SO THAT we can expand some basic level of healthcare to everyone.

 
To put it more simply, the healthcare system right now is designed not to deliver low cost solutions to all americans.  It's designed to offer services to folks who can pay for it.

If you attempt to work in the system as it exists, without huge government meddling, you're going to leave folks out until you reach a single payer system...at which point, the system as it exists will need to be overhauled.

The major issue I see is that the country needs to determine whether they're ok with income determining whether or not you get access to quality healthcare, or whether all americans should have access.  

 
FatUncleJerryBuss said:
Medicare seems like it deals with this problem.
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Medicare tells you what they will pay you then you have to take it. That is not insurance but a government program. Big difference. If you are saying that a single payer system would do that when it is mandated by the government then yes. But not possible with insurance companies as businesses. 

 
The Commish said:
Yes...there is a cost baseline.  The poorest of the poor might not be able to afford it.  That's what government is for...to help.....just like they do in many other countries.  Your conclusions/scenarios aren't matching the circumstances best I can tell.

This isn't an either/or discussion.  We focus on getting costs as low as we possibly can SO THAT we can expand some basic level of healthcare to everyone.
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I agree.  Do you agree that the system we have now isn't a great system to get costs for healthcare down as low as other options might allow?  Such as a single payer system?  

If we try to jury-rig the free market healthcare solution to provide the lowest cost healthcare solutions it can offer, and compare that to the costs associated with a different solution that stems from a single payer philosophy, which do you think will be more effective at producing lower costs for more people?

 
adonis said:
To put it more simply, the healthcare system right now is designed not to deliver low cost solutions to all americans.  It's designed to offer services to folks who can pay for it.

If you attempt to work in the system as it exists, without huge government meddling, you're going to leave folks out until you reach a single payer system...at which point, the system as it exists will need to be overhauled.

The major issue I see is that the country needs to determine whether they're ok with income determining whether or not you get access to quality healthcare, or whether all americans should have access.  
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I said essentially this to a comment from Dickies above about the morality of charging more for pre-existing conditions, but that's a different discussion than talking about the tangible realities of the healthcare industry and how they'd need to be changed because the reality is, even if we were able to shift attitude from "pay to play" to "it's a right and the government will provide it" the issue of cost is still the most impactful issue we'd need to address if we could all agree it was a "right".  There is NO WAY our government could afford healthcare for all for everyone in this country at the current cost levels.

 
adonis said:
It's odd that you think that proves any kind of point.
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I'm not proving a point. I'm trying to clarify your poorly worded statements by applying what I think to be the appropriate term for what you're trying to convey. It's more concise. Unless you were trying to state something else, in which case please restate more clearly so I don't misunderstand.

 
Another poster mentioned the correlation between his car insurance and how if he was a bad driver his rates go up.  That is a big issue here also. If someone chooses to live an unhealthy lifestyle others should not be on the hook for their poor decisions. If I choose to smoke 2 packs a day why should you pay for my cancer treatments? I chose to spend my money on cigarettes and my poor decision is costing everyone 100's of thousands in medical bills. When you are allowed to live in a free society then you have freedoms to make bad choices but there should also be freedom for others to not pay for those choices. 

 
adonis said:
I agree.  Do you agree that the system we have now isn't a great system to get costs for healthcare down as low as other options might allow?  Such as a single payer system?  

If we try to jury-rig the free market healthcare solution to provide the lowest cost healthcare solutions it can offer, and compare that to the costs associated with a different solution that stems from a single payer philosophy, which do you think will be more effective at producing lower costs for more people?
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I've said this a million times....probably ten times in this thread.  None of these "plans" address costs in any substantive way.  Because of that, they are pointless.  The system we have right now has allowed the politicians to pander to the industry leaving the insurance companies as their scapegoat for why things aren't going well.  Until they do the needful and put caps/restrictions on industry (aka....addressing costs), it's not going to change.

 
Ratbone said:
Another poster mentioned the correlation between his car insurance and how if he was a bad driver his rates go up.  That is a big issue here also. If someone chooses to live an unhealthy lifestyle others should not be on the hook for their poor decisions. If I choose to smoke 2 packs a day why should you pay for my cancer treatments? I chose to spend my money on cigarettes and my poor decision is costing everyone 100's of thousands in medical bills. When you are allowed to live in a free society then you have freedoms to make bad choices but there should also be freedom for others to not pay for those choices. 
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A current policy for this is to address it via tax at the point of sale. Do you find that inadequate?

 
matttyl said:
How about this (which was in some GOP proposal, but I haven't seen it in this one specifically yet) - you only have a pre-ex waiting period if you were uninsured prior to the coverage going into effect.  So say you've always had coverage and you obtain new coverage via the individual market in this "replaced ACA market" - there is no pre-ex waiting period for you.  If on the other hand you go without coverage for 9 months and only then obtain coverage - you have a 9 month pre-ex waiting period (how long you'd have to wait to get coverage for any pre-exisiting condition) but anything new that comes up would be covered.  That sounds fair, doesn't it?

Does away with a "mandate" penalty - we'll still have guaranteed issue coverage - if people don't go uninsured there will be no pre-ex limitation (so that effectively is your mandate to obtain and keep coverage), and keeps people from gaming the system by only obtaining coverage when they need it.  Anybody opposed to this?  Really interested in the thoughts of @timschochet, @TobiasFunke, and @Henry Ford on this.
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I certainly don't know the health care industry 1/10th that you do but I guess I don't understand the point of a waiting period for pre-existing conditions.  If you have one and need treatment and/or meds what are you supposed to do?

 
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Ratbone said:
shader said:
First thing I'd do is force healthcare individuals to create price lists and charge the same amount to everyone for similar procedures, products and services.
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That is simply not possible. Even Mcdonald's can't charge the same everywhere across the country. If you are saying that locally you know what your hospital would charge up front then possibly. But there are just too many variables.  
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Perhaps poorly worded on shader's part, but I think he's talking about the reality of what happens today.  That is, I can walk in to the exact same hospital, have the exact same doctor and the exact same procedure as you and pay two completely different amounts.  That's crap and needs to be cut out.  He can speak for himself though.

 
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BassNBrew said:
That's not true.

By not true, I mean many people prefer the coverage a Blue policy offers over Medicare.  Ask a Type 1 diabetic.
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Is there a marked difference between Blue Cross/Shield private insurance and BCS Medicare Advantage on that front?

 
The Commish said:
adonis said:
I agree.  Do you agree that the system we have now isn't a great system to get costs for healthcare down as low as other options might allow?  Such as a single payer system?  

If we try to jury-rig the free market healthcare solution to provide the lowest cost healthcare solutions it can offer, and compare that to the costs associated with a different solution that stems from a single payer philosophy, which do you think will be more effective at producing lower costs for more people?
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I've said this a million times....probably ten times in this thread.  None of these "plans" address costs in any substantive way.  Because of that, they are pointless.  The system we have right now has allowed the politicians to pander to the industry leaving the insurance companies as their scapegoat for why things aren't going well.  Until they do the needful and put caps/restrictions on industry (aka....addressing costs), it's not going to change.
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Do you believe a single payer system would address costs in a substantive way?

 
adonis said:
Do you believe a single payer system would address costs in a substantive way?
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Just because it's single payer?  No.  Our politicians would still have to do the needful and draw a line in the sand with the industry.  I can easily see a version of single payer that is an unmitigated disaster for the citizens of this country.

 
Godsbrother said:
I certainly don't know the health care industry 1/10th that you do but I guess I don't understand the point of a waiting period for pre-existing conditions.  If you have one and need treatment and/or meds what are you supposed to do?
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The only way you'd have one (pre-ACA, or with what I was describing) is if you had been uninsured for over 63 days straight.  So the solution is to not do that. 

We can't have a system where someone can simply just buy coverage when they need it.  That simply won't work.  I myself sold a policy to a woman 7 months pregnant (she created her own qualifying event by having a justice of the peace wedding)....only to have her drop the policy 2 months after delivery.  Pre-ACA she couldn't have done that because it would have been a pre-exisiting condition (unless she had always had coverage). 

If our goal is getting and keeping people in the pool, a pre-exisition condition limitation will do that.  Might even do it better than the current "individual mandate".  But people turned it into such a bad word, even though I think many didn't really know what it meant.

 
matttyl said:
Ok, add all that up then.  Salaries for their entire staff, executives included - marketing - admin - broker commissions - fees - government regulations - consumer services - provider support and billing - taxes - compliance - claims processing....on and on and on.....that comes to 13 cents of every dollar of health insurance premium paid (and keeps over half a million Americans gainfully employed directly with the companies, as well as hundreds of thousands of agents/brokers like myself). 
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So what you're saying is, even without dealing with the costs of the care itself, simply moving to single payer could save the country 13% of health care costs?  Isn't that about half a trillion dollars?

To be less sarcastic, what's the actual insurance number? Total premium costs?

 
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The Commish said:
Perhaps poorly worded on shader's part, but I think he's talking about the reality of what happens today.  That is, I can walk in to the exact same hospital, have the exact same doctor and the exact same procedure as you and pay two completely different amounts.  That's crap and needs to be cut out.  He can speak for himself though.
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I can see that. But even then it is so nuanced. I can't imagine that a Dr sees the exact same thing very often. There are different symptoms, etc. Take more or less time with a patient. This is not a Big Mac that looks the same every time. 

 
Gr00vus said:
A current policy for this is to address it via tax at the point of sale. Do you find that inadequate?
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For my specific illustration but you can't do that on everything that is bad for you. I know several diabetics who eat Oreo's all day and just get their toes removed regularly. That is no one else's responsibility but theirs. 

 
Henry Ford said:
For someone who corrects people on health care vs health insurance, you use this figure a lot to talk about health care. 
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Huh?  Health insurance companies on average have a 3.3% profit margin.  The health care industry, though, obviously has a much higher one.  If that were only 3.3%, we wouldn't have nearly the issues we have today.

 
matttyl said:
Huh?  Health insurance companies on average have a 3.3% profit margin.  The health care industry, though, obviously has a much higher one.  If that were only 3.3%, we wouldn't have nearly the issues we have today.
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Right, that's my point. He said health care profits. You came back with insurance. 

 
The Commish said:
adonis said:
Do you believe a single payer system would address costs in a substantive way?
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Just because it's single payer?  No.  Our politicians would still have to do the needful and draw a line in the sand with the industry.  I can easily see a version of single payer that is an unmitigated disaster for the citizens of this country.
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The issue that I see is that you have a lot of middle men in the free market solution who are set up to make profits.  There are so many intermediaries in the system that profits are taken at multiple locations.  What's more, information is held by many of these different folks and not shared in meaningful ways to help drive down costs.  These, and many more, are relics of a free market healthcare system that sprung up to meet the needs of those with healthcare issues who could afford care.

We're trying to adapt a system that was a pay-to-play designed system to one that provides healthcare for people it was never designed to provide care for.  We're twisting the free market solution in ways that it's not designed to perform, and we're seeing the issues from that.  The profit motives, and control structure, of the existing system makes it such that providing the ideological goal of some (myself included) of healthcare for everyone regardless of income, is nearly impossible to do at a reasonable rate that just doesn't result in a transfer of wealth from those paying taxes to the for-profit companies providing services in the middle.

So we can have discussions about how best to minimize the costs and maximize coverage in the current system, which will be destined to fail because we're disfiguring a system in order to meet needs it wasn't designed to support, or we could take about reforming the system as a whole in order to be one that is designed to both meet the needs of all citizens AND provide care at low cost.  

 
Henry Ford said:
So what you're saying is, even without dealing with the costs of the care itself, simply moving to single payer could save the country 13% of health care costs?  Isn't that about half a trillion dollars?

To be less sarcastic, what's the actual insurance number? Total premium costs?
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If it could do so without a single dollar of overhead - without needing a single employee, or a single computer to compute claims, or anything else to actually function......then yes. 

 
matttyl said:
If it could do so without a single dollar of overhead - without needing a single employee, or a single computer to compute claims, or anything else to actually function......then yes. 
Click to expand...
But we already have computers and things for State run insurance.   Medicare uses them. 

 
adonis said:
The issue that I see is that you have a lot of middle men in the free market solution who are set up to make profits.  There are so many intermediaries in the system that profits are taken at multiple locations.  What's more, information is held by many of these different folks and not shared in meaningful ways to help drive down costs.  These, and many more, are relics of a free market healthcare system that sprung up to meet the needs of those with healthcare issues who could afford care.

We're trying to adapt a system that was a pay-to-play designed system to one that provides healthcare for people it was never designed to provide care for.  We're twisting the free market solution in ways that it's not designed to perform, and we're seeing the issues from that.  The profit motives, and control structure, of the existing system makes it such that providing the ideological goal of some (myself included) of healthcare for everyone regardless of income, is nearly impossible to do at a reasonable rate that just doesn't result in a transfer of wealth from those paying taxes to the for-profit companies providing services in the middle.

So we can have discussions about how best to minimize the costs and maximize coverage in the current system, which will be destined to fail because we're disfiguring a system in order to meet needs it wasn't designed to support, or we could take about reforming the system as a whole in order to be one that is designed to both meet the needs of all citizens AND provide care at low cost.  
Click to expand...
If everyone had healthcare starting in 2 years from now even the entire healthcare industry would collapse. There is not enough care to go around. The waits for Dr's would be unreal. There is a lot of foundational things that would have to happen to provide this kind of over-arching coverage.  

 
matttyl said:
Um, he said "Charging more or denying coverage for pre-existing conditions".  It's the health insurance company doing that. 
Click to expand...
That part.  But he was responding to Commish, talking about health care as a for profit industry being a problem. 

I suppose I could be wrong.  It looked like a conversation of State run health care (not just insurance.)  I've certainly misread before - was trying to be vaguely amusing but it's been a tiring day.

 
Henry Ford said:
But we already have computers and things for State run insurance.   Medicare uses them. 
Click to expand...
And medicare has ~55m people.  Those with private insurance today is over 3x that amount.  My point is that we'd have some amount of overhead cost on top of the actual cost of care no matter what system we have.  Our current one has about 13% (and possibly dropping since the carriers are losing money on the individual market now rather than making it).  And again, that keeps around 1m people gainfully employed in this country. 

 
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Henry Ford said:
That part.  But he was responding to Commish, talking about health care as a for profit industry being a problem. 

I suppose I could be wrong.  It looked like a conversation of State run health care (not just insurance.)  I've certainly misread before - was trying to be vaguely amusing but it's been a tiring day.
Click to expand...
There were lots of different, but similar conversations going on at once between different people.  I try to keep up, and to add some facts when possible. 

 
adonis said:
The issue that I see is that you have a lot of middle men in the free market solution who are set up to make profits.  There are so many intermediaries in the system that profits are taken at multiple locations.  What's more, information is held by many of these different folks and not shared in meaningful ways to help drive down costs.  These, and many more, are relics of a free market healthcare system that sprung up to meet the needs of those with healthcare issues who could afford care.

We're trying to adapt a system that was a pay-to-play designed system to one that provides healthcare for people it was never designed to provide care for.  We're twisting the free market solution in ways that it's not designed to perform, and we're seeing the issues from that.  The profit motives, and control structure, of the existing system makes it such that providing the ideological goal of some (myself included) of healthcare for everyone regardless of income, is nearly impossible to do at a reasonable rate that just doesn't result in a transfer of wealth from those paying taxes to the for-profit companies providing services in the middle.

So we can have discussions about how best to minimize the costs and maximize coverage in the current system, which will be destined to fail because we're disfiguring a system in order to meet needs it wasn't designed to support, or we could take about reforming the system as a whole in order to be one that is designed to both meet the needs of all citizens AND provide care at low cost.  
Click to expand...
This is an argument to be made to politicians.  Not sure you'd get much push back from those of us in this thread.  There are many many many reasons costs are high and many many many changes that COULD be made.  You and I can't do them by ourselves and unfortunately a very large portion of those changes will cause industry to not like politicians.

ETA:  And when I say "Industry" it's all encompassing from the pill pushers, to the insurance companies, to the hospitals, to the doctors, everyone.

 
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