New York Single Payer. $91 Billion. (2 Viewers)

[MarvinTScamper]

Well, no, you're actually not required by law to have car insurance.  For example, I suspect that very few residents of Manhattan have car insurance.

Yeah definitely an assumption you own a car first. 

 

[dickey moe]

Amazing that this mythical country (I'll call it "France") manages to have universal health care - which is not "socialized medicine" - and still operate as a functioning state.  Why, I hear that this "France" even still has doctors who didn't all leave for some physicians' paradise where they can charge patients anything they want to subsidize their high incomes!!  Wonder how they do it?  

By taking on huge amounts of debt.

 

[NCCommish]

It might work in low population states with unemployment rates on the lower side.  Take South Dakota.  Less than a million people, with an unemployment rate of 2.8%. In a situation where there is less potential for "free loaders" or abusers of the system, a managed state-run single payer with clearly defined guidelines might work.

Not to mention there is less potential for a bunch of drama queen protesters to ruin it (read: make coverage more expansive/expensive).

Managing a pool of 800,000 people HAS to be easier than managing a pool of 5 million (and several million more undocumented)

I guess that makes sense

 

[NCCommish]

Why?  There are health insurance companies that operate in just a few counties of western NY that do all right.  Bigger is always better for insurance.  And who says it has to be affordable?

If it is enacted and fails in NY, it will be because of corruption IMO.  The way things work in this state is companies bribe politicians for contracts and then charge whatever they want to do the work.  See the Buffalo Billion and Ciminelli....

Because when we talk about Medicare for all we are talking around 3% of pre-tax cost at the high-end. Economies of scale and all that. I don't think individual states can get it that low. I could be wrong.

 

[Zigg]

I'm a 38 year old Canadian, and the only thing I've ever heard people complain about is MRIs.  My dad has had both hips replaced, step-daughter broke her arm, I had kidney stones, no issues whatsoever.  Pretty lucky that we've never encountered anything serious, but have had friends with cancer and have never heard a single complaint from any of them.

What I've always seen from America, is that they'll point out the flaws in other countries, rather than address their own issues.  American health care is a disaster, but it always turns into a discussion about how Canadian health care isn't perfect.  I don't know what the issue with single payer is in America, but I'm pretty confident the main hurdle is greed.

 

[NCCommish]

I'm a 38 year old Canadian, and the only thing I've ever heard people complain about is MRIs.  My dad has had both hips replaced, step-daughter broke her arm, I had kidney stones, no issues whatsoever.  Pretty lucky that we've never encountered anything serious, but have had friends with cancer and have never heard a single complaint from any of them.

What I've always seen from America, is that they'll point out the flaws in other countries, rather than address their own issues.  American health care is a disaster, but it always turns into a discussion about how Canadian health care isn't perfect.  I don't know what the issue with single payer is in America, but I'm pretty confident the main hurdle is greed.

Yes it is. And what they like to do here is talk about waits for elective care as if that is the same as a heart attack or cancer so Canada sucks because you have to wait to have something done that is elective. I don't know where they go to the doctor but I have had to wait weeks to get into specialists with my wife and not for elective stuff. Vet's sometimes wait for months to get into the VA. In fact they have died waiting. And of course on the average day in America over 100 people die because they don't have adequate access to healthcare. But yeah Canada is the suck. Greedy idiots.

 

[Sabertooth]

There are only two reasons you need car insurance. 

1. You hurt someone or their property with your car

2. You don't fully own your car. 

You can control 2, but not 1.  

Youre so wrong here, it's painful. 

I need to show proof of insurance to register my vehicle.  I own both my vehicles.  I've never been in an accident other than hitting deer.  So.....

 

[Sabertooth]

However, you are not required to have a service maintenance plan for your car. That is probably a better comparison to a medical plan.

Maybe.  However to me stuff is just stuff.  People are people.  Big difference.  

 

[Sabertooth]

Maybe you just need a different insurance company. I have never had a problem getting my claims covered. In fact most of the hassle is probably between the insurance company and the body shop on the supplementals.

Could be.  There's a reason they are called insurance adjusters though and not claims payers.  

 

[Sabertooth]

Well, no, you're actually not required by law to have car insurance.  For example, I suspect that very few residents of Manhattan have car insurance.

http://www.dmv.org/mi-michigan/car-insurance.php

 

[AAABatteries]

If we want to solve healthcare in this country, the first step is to get serious about helping the public become healthier. Any other approach is just treating the symptoms instead of the disease.

My Link

 

[Ramblin Wreck]

http://www.dmv.org/mi-michigan/car-insurance.php

No one is forcing you to own a car or drive.  That's a choice and having insurance goes with that choice.

 

[MarvinTScamper]

I need to show proof of insurance to register my vehicle.  I own both my vehicles.  I've never been in an accident other than hitting deer.  So.....

yes, I know.  You have to show proof of insurance BECAUSE OF THE RISK OF YOU HITTING SOMEONE ELSE.  They don't care if you put insurance on your own car, as long as you own it, but you cannot seriously be telling me that since you've never been in an accident you have no liability risk.

 

[Sabertooth]

No one is forcing you to own a car or drive.  That's a choice and having insurance goes with that choice.

Meh.  Why don't I need insurance when I buy a gun?  Or a bottle of Grey Goose?

 

[Sabertooth]

yes, I know.  You have to show proof of insurance BECAUSE OF THE RISK OF YOU HITTING SOMEONE ELSE.  They don't care if you put insurance on your own car, as long as you own it, but you cannot seriously be telling me that since you've never been in an accident you have no liability risk.

There's liability walking down the street.  Should I need to pay somebody so I can walk down the street?   There's a risk entering a national park, should I be mandated to have insurance in case I fall in a lake?  

 

[bigmarc27]

There's liability walking down the street.  Should I need to pay somebody so I can walk down the street?   There's a risk entering a national park, should I be mandated to have insurance in case I fall in a lake?  

I get that you hate insurance. Nobody likes to pay their premiums, but you're kind of being purposefully obtuse here. 

I don't like paying taxes, but I understand that part of being a resident in this country requires me to pay them.  

 

[Sabertooth]

I get that you hate insurance. Nobody likes to pay their premiums, but you're kind of being purposefully obtuse here. 

I don't like paying taxes, but I understand that part of being a resident in this country requires me to pay them.  

Except taxes go to the government.  Insurance is a private company.  I wish I could own a company that mandated the populace pay me for my service.  

 

[bigmarc27]

Except taxes go to the government.  Insurance is a private company.  I wish I could own a company that mandated the populace pay me for my service.  

Where do you think money will go to in a single payer situation?

You need to stop viewing government and business as separate entities. They've been intermingled for a long time.  

 

[MarvinTScamper]

There's liability walking down the street.  Should I need to pay somebody so I can walk down the street?   There's a risk entering a national park, should I be mandated to have insurance in case I fall in a lake?  

there's liability in everything yes.  It's not really possible for you to kill someone "walking down the street" or to paralyze someone "entering a national park"

So, the liability of driving a car has massively increased risk, both in chances, and in the amount of damage.  I don't know what you're struggling with here.

 

[Sabertooth]

there's liability in everything yes.  It's not really possible for you to kill someone "walking down the street" or to paralyze someone "entering a national park"

So, the liability of driving a car has massively increased risk, both in chances, and in the amount of damage.  I don't know what you're struggling with here.

How about purchasing a firearm?  Should I need to pay to do that too?

 

[MarvinTScamper]

How about purchasing a firearm?  Should I need to pay to do that too?

unintentional shootings (not deaths) in 2017 (so far) - 829

accidental deaths in autos > 35,000 - in 2015, 2.4 MILLION people were injured in car accidents.

are we done with the inane comparisons?

 

[Tau837]

I watched how my mom was used by the medical industry for profit.  Cancer! Yay! Let's do all kinds of tests and drugs! Then more tests...and don't forget the false hope.  What was that?  Feeling better?  Here let's do a PET scan even though you are stage 4 just about everywhere in your body.  Do you need pain killers?  Sure we have all you need.  Can we do some more tests? 

So you didn't want more tests for your Mom? You didn't want her to have medication to ease her pain? Did you want to just put her down and get it over with? Having a hard time following your perspective here.

 

[Tau837]

Yes, lots of people have coverage through work. And I would wager most of them would be better off with some kind of single payer system.

IMO this is false and it's not close.

 

[Tau837]

Why?  There are health insurance companies that operate in just a few counties of western NY that do all right.  Bigger is always better for insurance.  And who says it has to be affordable?

If it is enacted and fails in NY, it will be because of corruption IMO.  The way things work in this state is companies bribe politicians for contracts and then charge whatever they want to do the work.  See the Buffalo Billion and Ciminelli....

Did you not read the articles linked? If NY implements it, they will have to double or triple incoming tax revenue to pay for it. Same deal for CA. Are you prepared to pay double or triple the taxes you are currently paying? In many cases, it's not just that, it is that you would pay double or triple taxes AND get worse healthcare out of it. That would apply to me and my family in CA. #### that.

 

[Thorpe]

Did you not read the articles linked? If NY implements it, they will have to double or triple incoming tax revenue to pay for it. Same deal for CA. Are you prepared to pay double or triple the taxes you are currently paying? In many cases, it's not just that, it is that you would pay double or triple taxes AND get worse healthcare out of it. That would apply to me and my family in CA. #### that.

I doubt I could have worse health insurance than I have now, and I don't care if I pay more tax if I don't pay premiums.  You aren't making any sense to me.

 

[Statorama]

One of the problems with providing "healthcare for all" is that people seem to want to fix it all at once.  IMO the way to work toward the solution is to start small and work your way up.  Take a federally funded "disaster plan" for example.  Work with a very small parameter, very tightly defined set of "bankruptcy level" illnesses.  A high-deductible catastrophic plan would be an easy sell to taxpayers.  Then move on to prenatal care.  Who is going to be the villain that votes against saving babies?

Fix one piece, learn from your mistakes and successes, and move on to the next.  Alzheimers....Parkinsons...tackle the easiest sells first, get a foothold, and then tackle the others.

 

[Statorama]

Where do you think money will go to in a single payer situation?

You need to stop viewing government and business as separate entities. They've been intermingled for a long time.  

We used to be a nation with a government, now we're a government with a nation

 

[Sabertooth]

unintentional shootings (not deaths) in 2017 (so far) - 829

accidental deaths in autos > 35,000 - in 2015, 2.4 MILLION people were injured in car accidents.

are we done with the inane comparisons?

Where's  the cutoff for acceptability? 1000?  12500?

 

[Tau837]

And of course on the average day in America over 100 people die because they don't have adequate access to healthcare

This is false propaganda and has been proven as such. For example, this article describes and links to multiple studies that show no statistically significant correlation for Americans dying due to lack of access to adequate healthcare.

 

[Sabertooth]

So you didn't want more tests for your Mom? You didn't want her to have medication to ease her pain? Did you want to just put her down and get it over with? Having a hard time following your perspective here.

My point is near the end, they were ordering test after test for no reason that had to do with her state.  They were running up the score. 

 

[Tau837]

I don't care if I pay more tax if I don't pay premiums

Who says you won't pay premiums? Many national healthcare systems in the world that are perceived as universal care, single payer systems are augmented by private insurance. For example, France was mentioned earlier, and France does have national health insurance, but 90% of the residents of France have supplemental insurance.

Even here in the US, more than 25% of people on Medicare have supplemental insurance plans, and that number is growing every year.

 

[Jobber]

My point is near the end, they were ordering test after test for no reason that had to do with her state.  They were running up the score. 

They (hospital and doctors) were taking advantage. However, they can't do any of that without permission.

 

[MarvinTScamper]

Where's  the cutoff for acceptability? 1000?  12500?

appears to be in the millions.  I'm comfortable with that.

 

[Arsenal of Doom]

Who says you won't pay premiums? Many national healthcare systems in the world that are perceived as universal care, single payer systems are augmented by private insurance. For example, France was mentioned earlier, and France does have national health insurance, but 90% of the residents of France have supplemental insurance.

Even here in the US, more than 25% of people on Medicare have supplemental insurance plans, and that number is growing every year.

This is really how it should here. Basic coverage for everyone and then let people pay themselves for additional coverage if they choose. It doesn't need to be as complicated as we make it.  

 

[Arsenal of Doom]

This is false propaganda and has been proven as such. For example, this article describes and links to multiple studies that show no statistically significant correlation for Americans dying due to lack of access to adequate healthcare.

Kinda funny this article spends a good deal of space attacking Charles Gaba for an early estimate of 23-25 million people losing coverage if ACA was repealed and saying that even in the wort case scenario it would only be 15 million (the article is from January, before the CBO analyses).

Apparently the ACHA is much worse than the author's worst case scenario. 

ETA: FWIW I think the article does a good job pointing out why it's difficult to quantify the exact number of people who die due to a lack of coverage. Then again, there are many studies that go beyond mortality and show people without coverage are more likely to go untreated for chronic conditions, which leads to mortality and lower quality of life, and are more likely to have medical debt and/or bankruptcy. 

 

[matttyl]

I doubt I could have worse health insurance than I have now, and I don't care if I pay more tax if I don't pay premiums.  You aren't making any sense to me.

What's your insurance?  Your employer plan?  Individual plan?  Medicaid/Medicare?

 

[matttyl]

How about purchasing a firearm?  Should I need to pay to do that too?

Should you?  Yes, you should have some coverage for that.  Are you mandated to?  No.  Now there are also things that you can do to make your gun purchase safer - keeping ammo in a separate place, trigger locks, gun safes....  It's not that easy with a car, you can't control the weather for instance when you're driving - nor can you control a deer or child that jumps out in front of you, or your vehicle if the brakes fail, or any other driver on the road.

As pointed out above, the odds of you accidentally injuring another with a firearm is drastically, drastically lower than injuring someone with a car - and the numbers spell that out very clearly. 

I know you're being purposefully difficult here, but please tell me you see the difference between needing to have insurance for a 4,000 pound vehicle traveling at 65 miles per hour....and needing to have insurance for walking down the street.

 

[Sabertooth]

Should you?  Yes, you should have some coverage for that.  Are you mandated to?  No.  Now there are also things that you can do to make your gun purchase safer - keeping ammo in a separate place, trigger locks, gun safes....  It's not that easy with a car, you can't control the weather for instance when you're driving - nor can you control a deer or child that jumps out in front of you, or your vehicle if the brakes fail, or any other driver on the road.

As pointed out above, the odds of you accidentally injuring another with a firearm is drastically, drastically lower than injuring someone with a car - and the numbers spell that out very clearly. 

I know you're being purposefully difficult here, but please tell me you see the difference between needing to have insurance for a 4,000 pound vehicle traveling at 65 miles per hour....and needing to have insurance for walking down the street.

Meh, still highway robbery.  You don't get to use your streets that you pay for in your town with your vehicle unless you pay Flo over here.  

 

[Ramblin Wreck]

Meh, still highway robbery.  You don't get to use your streets that you pay for in your town with your vehicle unless you pay Flo over here.  

The streets are for everyone's benefit.  Kind of like how everyone pays taxes for public schools even if they don't have kids in public schools.  And everyone can't go use the school whenever they want either whether they pay Flo, Uncle Sam, or anyone else.  It's life.

 

[Sabertooth]

The streets are for everyone's benefit.  Kind of like how everyone pays taxes for public schools even if they don't have kids in public schools.  And everyone can't go use the school whenever they want either whether they pay Flo, Uncle Sam, or anyone else.  It's life.

Do people not see the distinction between taxes and forced payment to a private company?  I thought you guys were all about the free market?  Making people pay insurance is anything but free market.  

 

[bigmarc27]

Do people not see the distinction between taxes and forced payment to a private company?  I thought you guys were all about the free market?  Making people pay insurance is anything but free market.  

I just think your anger is oddly misplaced.  

 

[matttyl]

Meh, still highway robbery.  You don't get to use your streets that you pay for in your town with your vehicle unless you pay Flo over here.  

That's the key to your statement.  WITH YOUR VEHICLE.  You're free to use them to walk, run, ride a bike on or anything else.  They're also being used by people on your behalf - the fireman coming to your house to put out a fire, or other emergency vehicle.  The pizza delivery guy.  The school bus coming to pick up your child.  Yada yada. 

Again, no one is forcing you to buy a car.  If you do, though, it will come with stipulations that you have it insured.  Don't you want the guy that hits your car with his to have insurance?

 

[Sabertooth]

I just think your anger is oddly misplaced.  

Gotta place it somewhere.  

 

[Statorama]

Do people not see the distinction between taxes and forced payment to a private company?  I thought you guys were all about the free market?  Making people pay insurance is anything but free market.  

The federal government forcing the population to purchase a commercial product regardless of whether or not they were personally inclined to use the product was a very low point in American history.

 

[Thorpe]

What's your insurance?  Your employer plan?  Individual plan?  Medicaid/Medicare?

Individual plan.

 

[matttyl]

Individual plan.

ACA compliant (did you buy it in the last 4 years)?  In what state (New York, right)?

I imagine both of those answers are yes, and because of that I can go into detail about why you don't like your coverage if you'd like - but I think you already know most of those details.  New York, as a state, has a weird and horrible history when it comes to individual health insurance - mainly because it enacted rules years ago that the ACA enacted nationwide in 2014 (guaranteed issue, community rating, elimination of pre-ex conditions) and the entire market went into a death spiral in only a few years, much like we're seeing nationwide in the individual market now. 

 

[SaintsInDome2006]

Bans private health insurance. Passed State Assembly 87-38. This is awesome!

I think it's worth quoting the original article:

The state Assembly voted 87-38 on Tuesday night to pass the New York Health Plan, which would abolish private insurance plans in the state and provide all New Yorkers (except those enrolled in Medicaid and Medicare) with health insurance through the state government. The same proposal cleared the state Assembly in 2015 and 2016, but never received a vote from the state Senate.

The bill might get a vote in the state Senate this year—for reasons that I'll get into a little later—but the real hurdle for New York's single-payer health care plan, like similar efforts in other states, is a fiscal one.

New York collected about $71 billion in tax revenue last year. In 2019, when the single-payer plan would be enacted, the state expects to vacuum up about $82 billion. To pay for health care for all New Yorkers, though, the state would need to find another $91 billion annually.

And that's the optimistic view. In reality, the program is likely to cost more—a lot more.

So the cost isn't 91 Bill, it's really $173 billion. And more.

And the law has already failed twice.

I also don't see how the state of NY has any business telling insurers they can't sell a product or private consumers from purchasing it. If someone wants to offer me a contract to insure my future costs at a rate or coverage better than the state I should be able to do that.

 

[matttyl]

So the cost isn't 91 Bill, it's really $173 billion. And more.

Exactly.  $173B, for a state with around 20m people (really only 17m not on Medicare or Medicaid).  Do the math - it's about $10k per person in taxes that would be needed. 

So, above Thorpe said he'd be fine with higher taxes if he didn't have premiums.  Are your premiums really $10k per person ($40k for a family of 4)?