Canada uses a non-profit that finances itself through fees charged airlines (and ultimately their customers). Other countries use a mixed bag of public, private and public/private partnership systems. I would say the government has a role in safety, but there's no compelling reason for them to operate the system.Originally Posted by jp1
Personally I would not mind a system that relied on airline fees rather than government funding. I'd like to see the airline security go this route as well.
Megan McArdle published a very readable piece today exploring the question "Why not Medicare for all?"
https://www.bloomberg.com/view/artic...glad-you-asked
If my private insurance reimburses the hospital more than Medicare for the same services.....wouldn't that be like the airline charging me for first class and seating me in coach anyway? Or Amazon prime providing a discount to welfare recipients and the full price customers subsidize it?
That happens all the time to people without insurance - they don't get the rates negotiated by the insurance companies, they get to pay higher rates to make up the difference.
I read the Bloomberg piece and I understand how it would be a really huge undertaking to switch to single payer as an "experiment" but I still need for someone to explain why this "experiment" works so well in other countries. We're not sending someone to Saturn. This crazy idea is actually implemented in many countries.
The context set in the article is unique to the US in terms of how costs of healthcare are managed. But that's a function of a dysfunctional system. If they could address the shaky underpinnings of the system, maybe a solid, stable "medicare for all" would be possible.
The tone of the article to me was like saying "We could never fly in an airplane because look at the Edsel!" Revamping the system admittedly would take a lot of work, will and vision, but mostly vision.
"Do any human beings ever realize life while they live it--every, every minute?" Emily Webb, Our Town
www.silententry.wordpress.com
One of my friends has spent bunches of money on health issues. She has no insurance. i guarantee she does not pay the rate she is charged.
I bet she has racked up $1 million in health care costs --initial billings--over the past ten years with cancer surgery then radiation/chemo, then she was hit by a car as a pedestrian, then she had an appendicitis attackand surgery, then she had gall bladder surgery, then she had some sort of complicated dental surgery to wipe out a 20 year old infection, surgery that was performed by some high end dental surgeon.
She pays the bills but she negotiates the final amount.
Last edited by iris lilies; 6-8-17 at 7:19am.
If I get one of the basic premise of the article, the profits from Medicare are small and the only way doctors and hospitals can stay in business is that this is off set by payments from private insurance. I'm sure it's complicated, but the solution if there is to be "Medicare for all" is to allow larger Medicare payments. Whatever version of single payer may come around, it is going to cost taxpayer dollars. And that maybe partially or totally offset in savings over traditional insurance costs. (Or my favorite idea, funnel money from the military budget).
The article says people love Medicare, but people coming from a good employer provided or private insurance policy may have some disappointments. Many doctors in my area do not accept medicare patients, including mine. Since I am coming up on this, I asked my doctor for any general advice. His reply was that the Medicare guide book for providers was over 5000 pages and if it were a novel it would be the fifth longest novel ever and he has his office administration handle it all. He obviously didn't like it. Before modeling any thing on existing Medicare, they need to take a hard look at it. And that's aside from notions that Medicare is underfunded and unsustainable.
Rather, I like Catherine's idea of looking at other countries and what features they have and how things are paid for. Expanding Medicare to Medicare for all is an easy solution to understand, but it limits what other options might be out there.
A friend of mine owns several clinics. He said Medicare does not pay enough for him to stay open. He takes some, but considers it charity. He would close his doors if he had to rely on what Medicare paid.
It "works in other countries" because the citizens (not just the wicked rich or nasty corporations) are taxed at a higher rate for the real cost of care and because care is rationed (either formally or through compromised quality and long waits). Some European countries seem to have a greater fondness for euthanasia than we do. A similar system would "work" here, if the citizens were willing to tolerate it. It's possible, with enough work, will and coercion.
I suspect we will eventually wind up with a public system, but would hope US citizens would be allowed to supplement it with private care. Sort of how education works. If you don't like what's offered by the government schools, you can at least pay extra for something you like better.
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