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Why is Medicare for all bad? (1 Viewer)
- Thread starter IC FBGCav
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The Z Machine
Footballguy
We are paying for it already. Just shift the costs from businesses to residents. Sure federal expenditure would increase, and taxes commensurate (assuming defect neutral, unlike the last tax cuts), but the costs of employee officer health care would go away. How to transfer those $ to the state is a valid question.
James Daulton
Footballguy
We are all bearing these costs already. Those without insurance still seek treatment when they get bad enough. And by that time their healthcare cost multiples of what it would have cost had the person sought medical attention before they became train wrecks. Healthcare cost would likely decrease overall pretty significantly.
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timschochet
Footballguy
Here are the main arguments I hear against, in no particular order:
1. It will remove the incentives of drug companies to find new cures as they will inevitably be limited by how much they can earn. Consequently medical advances will be slower.
2. It will inevitably limit the earning value of doctors, just as public schools have done to teachers, meaning that over time talented people will be less inclined to choose this profession.
3. The government bureaucracy created will result in delays, confusion, corruption, long waiting periods, and overall a less efficient system.
4. The amount of taxation necessary to make this happen will stifle economic growth.
Make of these what you will.
1. It will remove the incentives of drug companies to find new cures as they will inevitably be limited by how much they can earn. Consequently medical advances will be slower.
2. It will inevitably limit the earning value of doctors, just as public schools have done to teachers, meaning that over time talented people will be less inclined to choose this profession.
3. The government bureaucracy created will result in delays, confusion, corruption, long waiting periods, and overall a less efficient system.
4. The amount of taxation necessary to make this happen will stifle economic growth.
Make of these what you will.
Ruffrodys05
IBL Representative
I dont feel that any of these "excuses" are valid reasons to fail to make efforts to provide basic healthcare for all americans. Just simple cop-outs. That's what I make of these.
Jackstraw
Footballguy
I pay close to 400k for our 28 employees plus dependents. Plus all the time I have to jack around with insurance and compliance issues. Much rather do what I do best.
joffer
Footballguy
NCCommish
Footballguy
These are pretty much the arguments. They are all easily debunked. That's why now even a majority if Republicans support it.
The Z Machine
Footballguy
But not the *right* Republicans. You know, the ones who vote on legislation or have deep pockets to fund those that vote on legislation.
ShamrockPride
Footballguy
timschochet
Footballguy
I don’t know if you’re correct about this.
I think the first two arguments, about drug incentives and doctors, have been debunked to my satisfaction, though not easily. But I am reasonably convinced that we can live in a society in which we have Medicare for all and still have new cures and doctors who are paid well.
The latter two arguments, about bloated government bureaucracy and high taxation which will stifle economic growth, have not been debunked, at least not in any way that I find compelling. I worry about them- not enough to necessarily be opposed to this idea (currently I’m unsure but leaning in your direction) but I worry.
Its not an argument against exactly, but my biggest concern is this: I don’t know if we can afford this particular fight right now. It seems to me that climate change is the most pressing issue of our time, and since Republicans are opposed to doing anything about it, Democrats have got to take the lead. That has to be to be the #1 priority. After that we have to deal with our rising level of debt which Trump has made far worse. Then there’s our failing infrastructure, and finally resolving the immigration dilemma. IMO, all of these issues take priority over Medicare for all. But others may disagree.
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AAABatteries
Footballguy
Some good answers/replies so far. I’m going to go in a different direction. We need to do this, full stop but I would focus on reducing subsidies for food that we shouldn’t eat - the obvious one is sugar. Not only shouldn’t we subsidize, we should tax the hell out of it to help pay for halth insurance for all. We should also stop corn and wheat subsidies.
I’m a firm believer that if we do that and educate people on how to eat we can make a big difference. Sugar is killing us.
https://youtu.be/x4sRsb0a30Y
I’m a firm believer that if we do that and educate people on how to eat we can make a big difference. Sugar is killing us.
https://youtu.be/x4sRsb0a30Y
Thunderlips
Footballguy
Freedom.
Sand
Footballguy
Concierge medicine will be a very popular specialty.
Define "basic", if you could.
timschochet
Footballguy
Yes we should do this.
But the question then becomes: should we attempt to do things that will be very politically difficult if not impossible (like taxing the hell out of sugar and corn) or should we stick with what reasonably can be accomplished? I’m not making an argument; I don’t know the answer.
fatguyinalittlecoat
Footballguy
It wasn’t that long ago that legalizing same sex marriage was politically difficult if not impossible. Decriminalizing marijuana anywhere was also politically difficult if not impossible. When public sentiment changes, politicians follow.
Thunderlips
Footballguy
The reasonable things should be an early step in conquering the "politically difficult if not impossible" things. All politicans should start by tying in the importance of preventative care to the health of the individual and by extension, the overall health of American Society by either pushing for a single payer system for (for a start) annual physicals or by pledging to work with insurance/the healthcare industry to give subsidizes(cheaper rates) to those individuals who get annual physicals.
Tom Skerritt
Footballguy
Healthcare companies, insurance companies, physicians, drug companies... all of them are paying our politicians lots and lots of money to NOT create Medicare for all.
timschochet
Footballguy
Marijuana is an entirely different issue, and the jury’s not out about what’s to happen yet.
But I don’t think you can compare same sex marriage to something with huge economic effects like sugar and corn. Changing the latter is going to be a lot more difficult.
It isn't. It works everywhere else, but there are too many vested special interests controlling both parties to implement it here.
NCCommish
Footballguy
Tim our current system ,in which we pay twice as much as our competitors, is already hurting American competitiveness. How can we afford to not pay less? As for bloated government it should be the opposite. Now there would be one program not several.
And of course changing our course on climate is necessary. Can we not walk and chew bubblegum ? Solar is already cheaper than coal. Batteries get cheaper by the day. We just need to get out of the way.
The Commish
Footballguy
These are generally the arguments, though none of our resident parrots of said points will make them outright and be able to demonstrate ANY of them. Take #1 for example. Guess how many of the last 200+ NEW drugs were created by funding from the NIH or NSF.
#3 is probably the most legit of all the arguments. It may or may not be true. We'd never know for sure unless we tried. It's a "sky is falling" sort of argument rooted completely in fear. This is why it makes absolute sense to allow a government funded healthcare plan on the private market as it sits today so that the government can prove they are capable. I think their chances are pretty good of succeeding. The issues with Medicare are political. That's on the yahoos pulling the purse strings, not the concept.
#4 is pretty much comedy gold to me personally. We hear from the GOP how companies need all this help and tax breaks so they can compete in the global economy yadda yadda yadda. I'd like to see a show of hands from these corporations that think getting out from under the responsibility of healthcare is anything but a benefit in terms of them being on a more level playing field globally.
The answer to my question about the drugs is 100% of them. Not a single one was created/invented by the private sector. Private sector R&D goes almost exclusively to current drugs and figuring out how to tweak them slightly to make a "new" drug that they can patent and be the ONLY one on the market with.
AAABatteries
Footballguy
I don’t think taxing sugar will be difficult once we get enough doctors to explain in plain language how bad the stuff is for you.
AAABatteries
Footballguy
We are already taxing soda extra in some locations. Eventually it will gain traction and at some point we will tax sweets and candy and the like. And it will be a good thing. We know how bad smoking is for you and we rightfully tax the hell out of it. We should do the same with sugar. It’s crazy the amount of sugar we pump in to our children. Babies coming out of the womb who are basically diabetic. If Climate Change is our number one problem then I would put this shortly after it on the list.
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timschochet
Footballguy
Some great points made here by NC Commish, The Commish, and AAA Batteries. You guys are turning me around for sure. Terrific discussion. 
timschochet
Footballguy
This argument is particularly compelling to me. Not sure why I didn’t consider it before; all I can say is well, duh. (And slap myself in the head.)
Sheriff Bart
Footballguy
NCCommish
Footballguy
By the way I was interested in looking at doctor pay in a single payer system. Since the Canadian system seems like the closest to what is being proposed I compared family practioners from both countries. In America they make slightly less than 190k and it is the lowest paid sector. In Canada family practioners make over 220k. Of course other specialties make more for instance Opthamalogists make over 400k.
This idea that Medicare for All would make doctors paupers seems overblown at a minimum.
This idea that Medicare for All would make doctors paupers seems overblown at a minimum.
NCCommish
Footballguy
As someone who ran a small company let me tell you they hate having to deal with insurance. It's costly. It takes time away from making money. I can't imagine it's that different for larger companies.
Grace Under Pressure
Footballguy
It's not. We should do it.
The Commish
Footballguy
It's easily the largest line of bull#### the GOP and "conservatives" have ever come up with. If there was a genuine care about "making companies more competitive on in the global market" they'd be all over single payer. Truth is, they don't give a #### about a company's global competitiveness. Never have, never will.timschochet said:
CletiusMaximus
Footballguy
I’ve been doing a lot of work with health plans lately, and would say it is striking how little Medicare pays providers compared to typical health insurance plans or employer-sponsored self-funded plans. I work with Medicare Part C plans (“Medicare Advantage”). It’s not uncommon to see Medicare plans pay something like $2,000 for $15,000-$20,000 in billed charges, whereas a normal health plan might pay $10,000 or more for the same treatment.Tom Skerritt said:
The Commish
Footballguy
I wouldn't expect any less. The companies will continue to charge these rates too because they know they can make their "profits" up in the private sector plans. Until we have a government that does their job and draws a line in the sand in terms of costs (instead of pushing it off on insurance companies to battle), these discrepancies will continue to exist and get even larger....and our private market premiums deductibles will continue to rise to cover it.
Tom Skerritt
Footballguy
Exactly. You can think of Medicare (or any government funded healthcare system) as a "fair market value" of healthcare. There will certainly be inefficiencies, delays, red-tape, some corruption, etc... but costs will be kept as low as possible. And as a result, people would have access to care that they would otherwise not have access to. And the burden of funding this type of system is spread across a much larger group of users.
The biggest difference then would be the decrease in the potential revenue, and thus a significant decrease in profits for those who really like lots and lots of money. And they are not going to accept this without a fight. And they have the deep pockets to put up a pretty good fight.
NCCommish
Footballguy
Was reading an interesting study of medical cost. According to US Bureau of Labor medical care cost are 85.5% higher in 2018 than they were in 2000. That is an inflation rate that is higher than the economy in general, some years medical inflation was more than double, and far outstrips wage inflation in general.
The Commish
Footballguy
Did the study happen to take a look at was happening around the world also or was it just here? I ask because I know other countries have been telling our pharma companies to pound sand at cost increases at a higher clip since the mid 2000s.
CletiusMaximus
Footballguy
I'm not an expert on the provider agreement side of this. I have knowledge of these paid v billed amounts as it is somewhat related to a particular service we've been providing recently. That said, I don't really understand your comment regarding the government doing its job or not doing its job. It seems to me the government has done pretty well to negotiate these extremely low (in comparison) payment rates. Why would the government be responsible for negotiating rates for private health insurers and plan administrators? When you say the gov't is "pushing it off on insurance companies to battle" - I don't get that. Of course the private plans are going to have to negotiate their own network deals, right?
The Commish
Footballguy
Well, in short, I believe that quality healthcare for all is a benefit to us as a society. Unfortunately, that's never going to happen in our "for profit" system. So, I believe it's our government's responsibility to do what's necessary to keep costs in check. It's already pretty clear that this can't be left to the industry. Supply/demand concepts don't work given the global nature of the drug industry. We already know that almost all of the innovation in new drugs stems from federally funded research. Our government is freely giving away to private industry the building blocks for their profits. But for some reason, when it comes to keeping them in check cost wise it's a big "no no" to them to be involved? "Let the market dictate the prices"? Insurance companies who have virtually no negotiating power with these big companies are suppose to be our buffer to rising costs? They're in the boat with us. It doesn't work.
TL'DR: I'm not commenting on how things are, rather how they SHOULD be IMO.
NCCommish
Footballguy
No it was a US study specifically. However as Scientific American reported the top 20 selling drugs cost 3 times as much in America as they do in the UK for one example.
ren hoek
Footballguy
Can’t really speak for anything else but most vets I’ve seen ####### hated dealing with the VA. For my part, dealing with Medicare is almost always a time-consuming, bureaucratic slog.Matthias said:
Markets work. Capitalism works. If we had real markets and the FDA didn’t grant monopolies to pharmaceutical cos. prices would fall dramatically over night. Same with doctors and licensing regimes.
I’m really not so opposed to the idea of a national health system that takes things into account like AAA’s post and enabled honest competition between vendors. The US already pays more per capita than virtually any other country. But I don’t trust the politicians and monolithic medical interests responsible for this frankenhealthcare system to ever in a million years deliver it to us.
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Grace Under Pressure
Footballguy
Do people think when they deal with United Healthcare, Aetna or Cigna that it's unicorns and rainbows? It's a time consuming, bureaucratic slog with them too.
It's anecdotal thoughts like these that do a great disservice to progress. Medicare customer satisfaction rates are over 90%. Let the private companies offer Medicare supplemental plans that cover more costs/offer additional benefits, like they already do.
roadkill1292
Footballguy
This is a pipe dream wrt the nation's health care and the evidence is all over western Europe for us to study.
ren hoek
Footballguy
Well, I’m only speaking from the standpoint of having worked in the optical field. With private insurance cos., I simply call the provider (or use their website for electronic auth), get an authorization, write down the benefits. That’s it.
With Medicare, we have to call and listen to the robot, verify Medicare is primary, figure out whether patient has met deductible, fill out an insurance evaluation form, fill out a Medicare eligibility call sheet, fill out a responsibility statement, give patient a copy of Medicare rights and supplier standards form, have patient sign an acknowledgment that they received their copy of it, fill out/sign a proof of delivery form when the patient picks up, as well as making a copy of the Medicare card, supplement card and a copy of Rx to send in. It’s just stupid hard to get the patient rolling and takes a significant amount of time away from other work.
I also had experience dealing with Medicare part D and explaining coverages to different patients. Often times the plan would cover the brand name drug that could cost 2x, 4x, 10x its generic equivalent, but wouldn’t help the patient with the generic drug.
Somehow the doctor could bill the usual $75 for an eye exam when the patient paid out of pocket, but bill Medicaid plans $125 for the same exam. To be fair, passport plans have an electronic auth webpage that is super easy and fast to use. We love getting Passports. Never really understood how that works but apparently it’s legal. Really not surprising that we pay out the ####### for healthcare when the system is just rife with waste and abuse.
Again, this is just my personal experience with it. I’m sure there’s circumstances where it isn’t so bad, and perhaps opening it up to broader responsibility would give it more leverage over pricing mechanisms. I just don’t trust the people running ours to deliver it.
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Bottomfeeder Sports
Footballguy
Medicare for All is not bad. However implementation would have challenges. Almost all of these challenges are political in nature with voters generally afraid of changes and the accompanying implementation challenges generally preferring to complain about current challenges and gripe that nothing ever changes.
