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On February 07 2016 06:39 JW_DTLA wrote:Show nested quote +On February 07 2016 06:32 zlefin wrote:
Those numbers do show that single payer is quite feasible, it's just that Bernie's costs are off.
The biggest way to save on healthcare costs in the US is to stop spending money on low effectiveness treatments.
Some simple QualY metrics would handle that fine. What are you going to do about the 6 digits of people that work in the health insurance industry? Fire them all? Hire them into the government insurance agency? What happens to all the state level insurance regulations? The Democrats wisely chose not to blow up the American insurance system in 2009-2010. Bernie's plan will move that whole industry into the government.
Care itself isn't usually nationalized in single-payer systems and still private, insurers would probably be nationalized and obviously would earn less than they did before, the whole point of a single-payer system after all is to turn the healthcare sector from a for-profit business into a public service.
Or you have a more decentralized system with multiple public insurers and some private insurers on top so the rich guys can buy themselves out like here in Germany, if the first option is too communist for you
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On February 07 2016 06:39 JW_DTLA wrote:Show nested quote +On February 07 2016 06:32 zlefin wrote:
Those numbers do show that single payer is quite feasible, it's just that Bernie's costs are off.
The biggest way to save on healthcare costs in the US is to stop spending money on low effectiveness treatments.
Some simple QualY metrics would handle that fine. What are you going to do about the 6 digits of people that work in the health insurance industry? Fire them all? Hire them into the government insurance agency? What happens to all the state level insurance regulations? The Democrats wisely chose not to blow up the American insurance system in 2009-2010. Bernie's plan will move that whole industry into the government.
Yeah lets not fix American healthcare because it would cost jobs...
Sorry but "what about the jobs" is very low on the list of priorities when it comes to fixing the problem.
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On February 07 2016 06:52 Gorsameth wrote:Show nested quote +On February 07 2016 06:39 JW_DTLA wrote:On February 07 2016 06:32 zlefin wrote:
Those numbers do show that single payer is quite feasible, it's just that Bernie's costs are off.
The biggest way to save on healthcare costs in the US is to stop spending money on low effectiveness treatments.
Some simple QualY metrics would handle that fine. What are you going to do about the 6 digits of people that work in the health insurance industry? Fire them all? Hire them into the government insurance agency? What happens to all the state level insurance regulations? The Democrats wisely chose not to blow up the American insurance system in 2009-2010. Bernie's plan will move that whole industry into the government. Yeah lets not fix American healthcare because it would cost jobs... Sorry but "what about the jobs" is very low on the list of priorities when it comes to fixing the problem.
But as an implementation challenge (which IMO s far downstream considering the budget would have to be properly done and the thing would have to get through Congress) its pretty huge. I don't think the Sanders' plan even checks off the first thing in the process.
Here are a couple highlights, the pricetag on this would probably be a trillion or more.
1. UnitedHealth, Aetna, Anthem and every single other insurer would have to agree to a government takeover.
2. Have to void and renegotiate every single provider contract
3. Secure buy-in from major health systems like HCA, CHS, Tenet, Lifepoint (the non profit ones might be more willing)
4. Get basically every physician and physician in training to take a really big paycut
A reduction by cutting low-effectiveness treatments is nice in theory, but there's a whole can of worms there. First one would be "death panels".
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On February 07 2016 05:56 Rebs wrote:Show nested quote +On February 07 2016 05:42 IgnE wrote:On February 07 2016 05:38 Rebs wrote:On February 07 2016 05:12 IgnE wrote:On February 07 2016 00:50 oneofthem wrote:
problem with idealism in this instance is not the distance of the ideal but the effectivrnrss of policy and action the particular idealist support.
the free slaves analogy does not apply because freeing slaves is far better policy than three trillion unfunded spending That's not how analogies work. The analogy is fine you just don't want to free the slaves. Bernie is the guy saying give each slave a mule and 40 acres. You think it's too expensive. People can say they don't like Bernie's policies. My point is that it's idiotic to say, Bernie has some great ideas but he won't "get shit done" like Hillary will so I'm voting for Hillary. Uhh,,, Bernie has great ideas, which from a policy standpoint are not realistic. No one is going to sit here and say they are against free healthcare or getting rid of money from politics. But you cannot convert these into policy just because Bernie and millennials like them. Application even in the presence of political will is unlikely. But yeah go for it. Also that analog7 is terrible and strongly undermines the impact of slavery. Coherent enough for you ? Have you heard of wage slavery? Dude, im from Pakistan. I find it amazing that you can ask me that question. You havent seen wage slavery.
Hey man, I'm amazed you could fail to see the parallels too.
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On February 07 2016 06:59 ticklishmusic wrote:Show nested quote +On February 07 2016 06:52 Gorsameth wrote:On February 07 2016 06:39 JW_DTLA wrote:On February 07 2016 06:32 zlefin wrote:
Those numbers do show that single payer is quite feasible, it's just that Bernie's costs are off.
The biggest way to save on healthcare costs in the US is to stop spending money on low effectiveness treatments.
Some simple QualY metrics would handle that fine. What are you going to do about the 6 digits of people that work in the health insurance industry? Fire them all? Hire them into the government insurance agency? What happens to all the state level insurance regulations? The Democrats wisely chose not to blow up the American insurance system in 2009-2010. Bernie's plan will move that whole industry into the government. Yeah lets not fix American healthcare because it would cost jobs... Sorry but "what about the jobs" is very low on the list of priorities when it comes to fixing the problem. But as an implementation challenge (which IMO s far downstream considering the budget would have to be properly done and the thing would have to get through Congress) its pretty huge. I don't think the Sanders' plan even checks off the first thing in the process. Here are a couple highlights, the pricetag on this would probably be a trillion or more. 1. UnitedHealth, Aetna, Anthem and every single other insurer would have to agree to a government takeover. 2. Have to void and renegotiate every single provider contract 3. Secure buy-in from major health systems like HCA, CHS, Tenet, Lifepoint (the non profit ones might be more willing) 4. Get basically every physician and physician in training to take a really big paycut A reduction by cutting low-effectiveness treatments is nice in theory, but there's a whole can of worms there. First one would be "death panels".
Yes. This is what I was getting at. There are a lot of databases to rebuild and a whole lot of people to fire, and much fewer to hire into the new medicare for all agency. The great strength of ACA was that it got the buy in from the existing insurance industry and reformed it to fix the glaring problems it had (e.g., pre-existing condition test). Medicare for all would still leave room for a much smaller private insurance industry (like they have in Canada). But the Bernie crew needs to be upfront about just how drastic going to single payer will be.
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On February 07 2016 06:59 ticklishmusic wrote:Show nested quote +On February 07 2016 06:52 Gorsameth wrote:On February 07 2016 06:39 JW_DTLA wrote:On February 07 2016 06:32 zlefin wrote:
Those numbers do show that single payer is quite feasible, it's just that Bernie's costs are off.
The biggest way to save on healthcare costs in the US is to stop spending money on low effectiveness treatments.
Some simple QualY metrics would handle that fine. What are you going to do about the 6 digits of people that work in the health insurance industry? Fire them all? Hire them into the government insurance agency? What happens to all the state level insurance regulations? The Democrats wisely chose not to blow up the American insurance system in 2009-2010. Bernie's plan will move that whole industry into the government. Yeah lets not fix American healthcare because it would cost jobs... Sorry but "what about the jobs" is very low on the list of priorities when it comes to fixing the problem. But as an implementation challenge (which IMO s far downstream considering the budget would have to be properly done and the thing would have to get through Congress) its pretty huge. I don't think the Sanders' plan even checks off the first thing in the process. Here are a couple highlights, the pricetag on this would probably be a trillion or more. 1. UnitedHealth, Aetna, Anthem and every single other insurer would have to agree to a government takeover. 2. Have to void and renegotiate every single provider contract 3. Secure buy-in from major health systems like HCA, CHS, Tenet, Lifepoint (the non profit ones might be more willing) 4. Get basically every physician and physician in training to take a really big paycut A reduction by cutting low-effectiveness treatments is nice in theory, but there's a whole can of worms there. First one would be "death panels".
Eliminate student debt for doctors and effectively reduce cost of malpractice insurance to doctors. It's not like doctors can say no if the people vote to abolish the current bloated system and replace it with single payer. My experience is that most doctors (rightly) feel exploited by the current system anyway.
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A reduction by cutting low-effectiveness treatments is nice in theory, but there's a whole can of worms there. First one would be "death panels".
This is the single most bullshit argument. It acts like people aren't already dying from not getting healthcare because it is prohibitively expensive.
I get you're supporting Hillary, but the repeated disingenuous arguments against Bernie from you and Hillary is a big part of why I am not going to vote for her.
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On February 07 2016 06:59 ticklishmusic wrote:Show nested quote +On February 07 2016 06:52 Gorsameth wrote:On February 07 2016 06:39 JW_DTLA wrote:On February 07 2016 06:32 zlefin wrote:
Those numbers do show that single payer is quite feasible, it's just that Bernie's costs are off.
The biggest way to save on healthcare costs in the US is to stop spending money on low effectiveness treatments.
Some simple QualY metrics would handle that fine. What are you going to do about the 6 digits of people that work in the health insurance industry? Fire them all? Hire them into the government insurance agency? What happens to all the state level insurance regulations? The Democrats wisely chose not to blow up the American insurance system in 2009-2010. Bernie's plan will move that whole industry into the government. Yeah lets not fix American healthcare because it would cost jobs... Sorry but "what about the jobs" is very low on the list of priorities when it comes to fixing the problem. But as an implementation challenge (which IMO s far downstream considering the budget would have to be properly done and the thing would have to get through Congress) its pretty huge. I don't think the Sanders' plan even checks off the first thing in the process. Here are a couple highlights, the pricetag on this would probably be a trillion or more. 1. UnitedHealth, Aetna, Anthem and every single other insurer would have to agree to a government takeover. 2. Have to void and renegotiate every single provider contract 3. Secure buy-in from major health systems like HCA, CHS, Tenet, Lifepoint (the non profit ones might be more willing) 4. Get basically every physician and physician in training to take a really big paycut A reduction by cutting low-effectiveness treatments is nice in theory, but there's a whole can of worms there. First one would be "death panels".
the pricetag is basically the same amount currently spent on healthcare, it just goes through the government instead of a large mix of private groups.
Yeah, stupid people fear death panels, when it's those panels that are essential to rein in medical costs. Of course there already are death panels, they're just run by private insurers instead of the government (with some gov't regulatory requirements of course).
As I'm just on TL, I'm free to focus on sound policy ideas, like QualY metrics, rather than the complicated politics of the stupid and obnoxious resisting implementation of sound ideas.
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Cayman Islands24199 Posts
i don't much care for the healthcare cost part of bernie's plan. a singlepayer system would definitely reduce overall burden of healthcare on economy but at probable decrease in quality in some areas. this would have to be augmented with increased basic research.
the main thing i don't like about bernie's big projects is that there is a lot fo focus on the amount of spending and govt involvement without discussion of whether the spending is effective or even perpetuating bad things like student loans with no jobs. when you have a systematic problem like 'lack of good jobs', of course investment in human resources is a key, but a part of the problem is the low value added of existing education. if you throw a lot of government money at this it may simply mean a lot of useless degrees and even more dashed expectations.
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Partially addressing GH's point as well: I personally am 100% behind the idea of having a board of physicians approve/deny expensive treatments, but that's going to be an incredibly important component of rationing care but one that is going to be impossible to get through Congress considering current attitudes towards care.
Single payor is one way to prevent people dying from being unable to afford care. My problem is that it is not the only one, nor is it the best one. I support a public option, but we couldn't even get that through as part of the ACA. I don't see single payor or nationalizing everything as a solution either. Hopefully we'd move to a Swiss model where public pays for a bunch of basic stuff and we have regulated "supplemental" insurance for additional things eventually.
@ Igne: And now we'd have to get the buy-in of the AMA, about 900K physicians in the US and the medical schools. Eliminating debt for medical students while cutting their lifetime earnings so significantly sounds like a rather poor trade off. Point is, changing one part is gonna affect others Healthcare is hard.
Tl;dr of what I think of Berniecare: good idea, bad plan, potentially disastrous in execution
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I agree on that; imho if the government is providing student loans, it should have more say in what majors get chosen, to make sure they're employable ones.
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The arguments "it's too hard" and "our politicians wont do what we want them to" are not arguments that hold much if any weight to me.
+ Show Spoiler +
Bernie is plenty reasonable, if adjustments need to be made to be more effective (not undermine the intentions), I'm sure he would listen and implement them.
It's a helluva lot better than Hillary's plan.
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On February 07 2016 07:49 GreenHorizons wrote:The arguments "it's too hard" and "our politicians wont do what we want them to" are not arguments that hold much if any weight to me. + Show Spoiler +https://youtu.be/fFPt9ps3Iac?t=30s
I'm not saying it's hard, I'm saying it's impossible. The plan has too many holes on too many levels.
And that's where we differ, and I think we can do it respectfully. Call it choosing the battlefield, but you need to explain why Bernie's proposals will work. Let's focus on the very first bit which is what it covers, how much it costs and how it's paid for, and I think it already fails there.
Defend the Affordable Care Act. Hillary will continue to defend the Affordable Care Act (ACA) against Republican efforts to repeal it. She'll build on it to expand affordable coverage, slow the growth of overall health care costs (including prescription drugs), and make it possible for providers to deliver the very best care to patients.
Lower out-of-pocket costs like copays and deductibles. The average deductible for employer-sponsored health plans rose from $1,240 in 2002 to about $2,500 in 2013. American families are being squeezed by rising out-of-pocket health care costs. Hillary believes that workers should share in slower growth of national health care spending through lower costs.
Reduce the cost of prescription drugs. Prescription drug spending accelerated from 2.5 percent in 2013 to 12.6 percent in 2014. It’s no wonder that almost three-quarters of Americans believe prescription drug costs are unreasonable. Hillary believes we need to demand lower drug costs for hardworking families and seniors.
Transform our health care system to reward value and quality. Hillary is committed to building on delivery system reforms in the Affordable Care Act that improve value and quality care for Americans.
This is pulled from Hillary's website. It outlines specific areas that she wants to target-- copays, prescription prices and a focus on value-based care. It's far less ambitious than Medicare for all, but those are pain points that can be solved.
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On February 07 2016 07:54 ticklishmusic wrote:Show nested quote +On February 07 2016 07:49 GreenHorizons wrote:The arguments "it's too hard" and "our politicians wont do what we want them to" are not arguments that hold much if any weight to me. + Show Spoiler +https://youtu.be/fFPt9ps3Iac?t=30s I'm not saying it's hard, I'm saying it's impossible. The plan has too many holes on too many levels. And that's where we differ, and I think we can do it respectfully. Call it choosing the battlefield, but you need to explain why Bernie's proposals will work. Let's focus on the very first bit which is what it covers, how much it costs and how it's paid for, and I think it already fails there.
I'm pretty sure if so much of the rest of the world can figure it out so can the richest one on the planet. Whether his plan is perfect is irrelevant, if universal care is what we want, we can have it, period.
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On February 07 2016 07:56 GreenHorizons wrote:Show nested quote +On February 07 2016 07:54 ticklishmusic wrote:On February 07 2016 07:49 GreenHorizons wrote:The arguments "it's too hard" and "our politicians wont do what we want them to" are not arguments that hold much if any weight to me. + Show Spoiler +https://youtu.be/fFPt9ps3Iac?t=30s I'm not saying it's hard, I'm saying it's impossible. The plan has too many holes on too many levels. And that's where we differ, and I think we can do it respectfully. Call it choosing the battlefield, but you need to explain why Bernie's proposals will work. Let's focus on the very first bit which is what it covers, how much it costs and how it's paid for, and I think it already fails there. I'm pretty sure if so much of the rest of the world can figure it out so can the richest one on the planet. Whether his plan is perfect is irrelevant, if universal care is what we want, we can have it, period.
I encourage you to read analysis of Bernie's plan-- I posted some a couple pages ago. Also, as I mentioned during the debate, there is a difference between universal healthcare and single payer, and that single payer is only one way of achieving universal healthcare.
That sounded very Trump btw.
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On February 07 2016 07:58 ticklishmusic wrote:Show nested quote +On February 07 2016 07:56 GreenHorizons wrote:On February 07 2016 07:54 ticklishmusic wrote:On February 07 2016 07:49 GreenHorizons wrote:The arguments "it's too hard" and "our politicians wont do what we want them to" are not arguments that hold much if any weight to me. + Show Spoiler +https://youtu.be/fFPt9ps3Iac?t=30s I'm not saying it's hard, I'm saying it's impossible. The plan has too many holes on too many levels. And that's where we differ, and I think we can do it respectfully. Call it choosing the battlefield, but you need to explain why Bernie's proposals will work. Let's focus on the very first bit which is what it covers, how much it costs and how it's paid for, and I think it already fails there. I'm pretty sure if so much of the rest of the world can figure it out so can the richest one on the planet. Whether his plan is perfect is irrelevant, if universal care is what we want, we can have it, period. I encourage you to read analysis of Bernie's plan-- I posted some a couple pages ago. Also, as I mentioned during the debate, there is a difference between universal healthcare and single payer, and that single payer is only one way of achieving universal healthcare. That sounded very Trump btw.
I've read several, I don't accept that we can't do it. Call it Trump like if you want. I think providing healthcare as a right isn't something that only other countries can do. Whether Bernie's plan, as it sits now, is the only or best way to do it doesn't matter.
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On February 07 2016 08:15 GreenHorizons wrote:Show nested quote +On February 07 2016 07:58 ticklishmusic wrote:On February 07 2016 07:56 GreenHorizons wrote:On February 07 2016 07:54 ticklishmusic wrote:On February 07 2016 07:49 GreenHorizons wrote:The arguments "it's too hard" and "our politicians wont do what we want them to" are not arguments that hold much if any weight to me. + Show Spoiler +https://youtu.be/fFPt9ps3Iac?t=30s I'm not saying it's hard, I'm saying it's impossible. The plan has too many holes on too many levels. And that's where we differ, and I think we can do it respectfully. Call it choosing the battlefield, but you need to explain why Bernie's proposals will work. Let's focus on the very first bit which is what it covers, how much it costs and how it's paid for, and I think it already fails there. I'm pretty sure if so much of the rest of the world can figure it out so can the richest one on the planet. Whether his plan is perfect is irrelevant, if universal care is what we want, we can have it, period. I encourage you to read analysis of Bernie's plan-- I posted some a couple pages ago. Also, as I mentioned during the debate, there is a difference between universal healthcare and single payer, and that single payer is only one way of achieving universal healthcare. That sounded very Trump btw. I've read several, I don't accept that we can't do it. Call it Trump like if you want. I think providing healthcare as a right isn't something that only other countries can do. Whether Bernie's plan, as it sits now, is the only or best way to do it doesn't matter.
Why doesn't it matter?
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On February 07 2016 08:18 ticklishmusic wrote:Show nested quote +On February 07 2016 08:15 GreenHorizons wrote:On February 07 2016 07:58 ticklishmusic wrote:On February 07 2016 07:56 GreenHorizons wrote:On February 07 2016 07:54 ticklishmusic wrote:On February 07 2016 07:49 GreenHorizons wrote:The arguments "it's too hard" and "our politicians wont do what we want them to" are not arguments that hold much if any weight to me. + Show Spoiler +https://youtu.be/fFPt9ps3Iac?t=30s I'm not saying it's hard, I'm saying it's impossible. The plan has too many holes on too many levels. And that's where we differ, and I think we can do it respectfully. Call it choosing the battlefield, but you need to explain why Bernie's proposals will work. Let's focus on the very first bit which is what it covers, how much it costs and how it's paid for, and I think it already fails there. I'm pretty sure if so much of the rest of the world can figure it out so can the richest one on the planet. Whether his plan is perfect is irrelevant, if universal care is what we want, we can have it, period. I encourage you to read analysis of Bernie's plan-- I posted some a couple pages ago. Also, as I mentioned during the debate, there is a difference between universal healthcare and single payer, and that single payer is only one way of achieving universal healthcare. That sounded very Trump btw. I've read several, I don't accept that we can't do it. Call it Trump like if you want. I think providing healthcare as a right isn't something that only other countries can do. Whether Bernie's plan, as it sits now, is the only or best way to do it doesn't matter. Why doesn't it matter?
It's an idea. Ideas can be adjusted and improved for one.
Part of what Obama did so wrong is he negotiated with himself to give Republicans (and centrists*) what they wanted before he even presented his preferred plan. So by the time he got to the negotiating table he was just making concessions while getting nothing he wanted.
Let's say Hillary's plan is the right one (I obviously disagree) opening with it ensures whatever she would pass would be further right than the plan she's currently proposing.
EDIT: We would also have to presume the millions that Hillary has gotten from the folks who's profits would most be at risk haven't influenced her opinion on the matter. In which case, I've also got a bridge to sell.
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On February 07 2016 07:38 oneofthem wrote:
i don't much care for the healthcare cost part of bernie's plan. a singlepayer system would definitely reduce overall burden of healthcare on economy but at probable decrease in quality in some areas. this would have to be augmented with increased basic research.
the main thing i don't like about bernie's big projects is that there is a lot fo focus on the amount of spending and govt involvement without discussion of whether the spending is effective or even perpetuating bad things like student loans with no jobs. when you have a systematic problem like 'lack of good jobs', of course investment in human resources is a key, but a part of the problem is the low value added of existing education. if you throw a lot of government money at this it may simply mean a lot of useless degrees and even more dashed expectations.
That's one of the better points you've made. Higher education is fucked up.
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do apprenticeship systems exist in the US? I've always felt they're one of the strong reasons why some countries do a lot better at closing the gap between people with and without college education.
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EPT
