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Re: One big thing people don’t know about single payer ( Medicare-for-All)

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Message 31 of 66

@GailL1 wrote:

@john258 wrote:

 

 

 

 

 

 


.

The statement that single payer would do away with employer based health insurance is not true. I have an employer based health policy as my Medicare supp coverage. It is provided by the employer I retired from, and that employer pays part of the premium.

 

The article you post is false, and you try and explain it as if it is true which shows you do not understand the system in any way shape or form.


OK folks in the know about a single payer system concept  

Do you think what john258 said above is true and would be part of a single payer system perhaps a Medicare for All plan?

 

Would private insurers especially under an employer plan maintain a supplemental plan or would any supplemental plan offered be the responsibility of the receipient to purchase on their own?

 

Can we ask employers to keep paying for some part of direct coverage IF we are gonna be asking them to pick up part of the overall cost of a single payer system?

 

Is Mr. Altman writing false info; he is very reputable or is john258 just one of the examples of the poll results?  john258 is satisfied with his coverage especially his employer payment of his supplemental coverage in retirement so a whatever type single payer would be for others -'

 

Do you think people on Medicare would have to do some changing - to me,mint wouldn't be the same at least from my readings from PNHP, design prelims from the Vermont Green Mountain Plan ( now defunct - no agreement on how to pay for it) and the ole Medicare for All design, H.R. 676 - but maybe that plan design left with Conyers.

 

 


Well you really are trying your best to stir up something based on the fact you posted something that was not in the real world. There are a lot of employers  who provide benefits to their retirees just as mine does and that is fact.  The thing is what you read is not in the real world it is in your world  There is no plan on the table now but you want to dig up the past. Silly. When the time comes get involved, right now you might want to work on some local events. Now when you say I said Mr. Altman wrote false information you lie. Mr Altman wrote with incomplete information, and some questionable assumptions and that is ok as it happens all the time. When one posts articles showing rules and tells people this is the way it is, and in fact the rules are just a guide which at the local level are used to benefit people that is false information.

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Re: One big thing people don’t know about single payer ( Medicare-for-All)

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Message 32 of 66

@john258

 

You might enjoy this 

H.R. 676 - Medicare For All  - AARP Community discussion by Section

http://community.aarp.org/t5/Politics-Current-Events/H-R-676-Medicare-for-All-introduced-02-2015/td-...

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: One big thing people don’t know about single payer ( Medicare-for-All)

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Message 33 of 66

@TxGrandpa2 wrote:

@john258 wrote:

There would have to be no change in what the members of the Armed Forces have. It could even remain the same for Dep. if they want to. They would bill the MediCare for all claim center just as every other provider does. The Armed Services could pay all or part of the premium for the Dep., or they could keep it the way it is now. If it were me I would have them pay 100% of the premium and bill the MediCare claim center.


To the contrary, I would believe that like in other countries with a "Medicare for All' program I would believe that all federal health care programs would be merged into one.  That is the only logical solution in such a case for healthcare to be cost effective. 

 

As it is now, those retired military like myself is required to enroll in Medicare Part B for the Department of Defense's Tricare for Life to be effective.  As far as the way it is now, Medicare pays first for those enrolled, then forwards the bill to Tricare for Life to  pay the deductible or charges not covered by Medicare.  I would believe that this is much like Medicare where a person has commercial insurance.  Single payer would no doubt mean that the funds used by the DOD would be budgeted to the department handling Single Payer.

 

But of course there is no doubt that taxes would be raised but that would be offset by premiums paid to commercial health insurance companies and possibly by the premiums we pay for Medicare.

 


I will say to you what I said to Gail. It can be designed the way I put it. Will it. I have no idea nor does anyone else as we are far away from it. Save your thoughts for when the design starts then give you ideas to the experts working on the single payer system. The premiums can be less than now, in fact far less if they put in a number of new ideas like trust fund to limit the amount of a single claim, plus many other ideas the experts working on the system will have.

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Re: One big thing people don’t know about single payer ( Medicare-for-All)

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Message 34 of 66

@GailL1 wrote:

@john258 wrote:

@TxGrandpa2 wrote:

@ChasKy53 wrote:

You forgot to mention that a single payer would eliminate the costs of health care for our military, both active and retired.


To the contrary.  It would only switch the burden of this health care from the Department of Defense to whichever federal department would be charged with administering the plan.  That would be true with the other federal programs where the administration would be shifted to that new federal department, more than likely the Department of Health and Human Services.


There would have to be no change in what the members of the Armed Forces have. It could even remain the same for Dep. if they want to. They would bill the MediCare for all claim center just as every other provider does. The Armed Services could pay all or part of the premium for the Dep., or they could keep it the way it is now. If it were me I would have them pay 100% of the premium and bill the MediCare claim center.


Who said that?  Where is your info coming from?

i was under the impression that with a single payer system, benefits would be standardized, same with any copays, deductibles.

 

There may be a few outliers like Veterans or pay amts for the poor.

 

What would happen to the FEHB - I am pretty sure they want to keep it especially the retirees.

 


Who said that. I said that. You have no idea what a single payer system would look like. It can be designed to do just what I posted. When we get to one we shall see and that is the real world. There are ways of putting money in a trust fund that would cap claim amounts to reduce costs. It is silly to try and design a system in here now, or on the Internet now. Just wait till the proper time.

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Re: One big thing people don’t know about single payer ( Medicare-for-All)

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Message 35 of 66

@johnrmoser wrote:

I have two large problems single-payer:

 

  • It incurs a lot of risk;
  • It attempts to solve the Economic Computation Problem, which can't be done

Proponents of single-payer point out that the large tax cost—which mostly falls on the poor and middle-class—is offset by the removal of health insurance costs from payrolls—which also mostly falls on the poor and middle-class.  That sounds reasonable.

 

Unfortunately, that change-over represents a large collection of immensely-complex downstream impacts.  It completely disrupts the current system, leading to an uncountable number of unpredictable unintended consequences.  Basically, you get an entire flock of black swans.  That should terrify you.

 

Proponents also claim we'll save lots of money on things like billing and claims administration.  This ignores the computation of correct price.  Medicare tries to compute price by working out the cost of inputs to healthcare, the supposed cost of each service, and then a cost-of-living adjustment to the region in which service is provided.  That's unfortunately prone to extreme distortion, as the inputs include a lot of highly-variable, unknown and unknowable factors.  Besides that, the computational power required to calculate this grows exponentially, relative to linear growth of resources (i.e. the economy).

 

There is a way to do it:  you use the economy itself as a giant wetware computer.  Essentially, you put pressure on the free market to guide it where you want, and analyze the results to get the information you need.

 

I advocate a Public Healthcare Option.  When you make a health insurance claim, it hits your insurer or the Federal PHO system; if you claim against the PHO system and you have private insurance, they redirect the claim to your insurer.  All PHO premiums are paid by taxes; copays and deductibles are (partially) waived (tax-covered) as you move down toward the poverty guidelines.

 

With the Employer Shared Responsibility Provision of the ACA, we define a baseline of insurance coverage—not CDHP—which defines the basic insurance provided by employers and the PHO.  We can expand the Shared Responsibility Provision to include part-time workers and small businesses, and give a partial subsidy to relieve the strain on employers for providing this coverage.

 

Lower payroll costs—such as insurance—allow employers to attract new customers with lower prices, so employers will want low insurance premiums for their group insurance.  This makes insurance a competitive market, seeking low prices (premiums).

 

Insurers will seek the lowest remittance rates they can negotiate from providers.  Providers, in turn, seek lower prices from their suppliers.  Providers and suppliers both require a baseline of revenue to cover costs, including the cost of risk—both threats and opportunities—which means they'll have a price floor below which they won't negotiate because it destabilizes their business.

 

Basic market dynamics.  As you know, everyone will push prices as high as they can get along the way, and many remittance rates and insurance premiums will be high anyway.

 

The PHO—basically Medicaid—can sample the remittance rates at each individual provider for each insurer and generate a distribution curve which will look something like the below:

Normal_curve_probability.jpg

Basically, they run the math for every remittance rate agreement for each service (as submitted by the insurers) and begin negotiating at, say, the bottom 2 standard deviations—the 2.5% of rates representing the lowest prices accepted at each provider for each service.

 

 

Wetware computer.  It's made of 70% water and it computes prices for healthcare.  As you can tell, it's not perfectly-optimal, just better than the available alternatives.  That's important:  Republicans think totally-unconstrained free market solutions are somehow optimal, and hate any kinds of controls like the Employer Shared Responsibility Provision.  We need these controls to make the market work toward the goal we desire.

 

As well, we tier the providers in an area:  those providing adequate service are ranked by price, and we send you to those providers if available first, moving to the more-costly as we go.  Out of 320 million Americans, 70 million go without healthcare—22%—so the PHO represents a significant portion of the market, but not the majority.  You don't want to be the provider of last resort for the Federal healthcare option!

 

This strategy both retains much of the current healthcare and health insurance market behavior (reducing risk) and leverages the information obtainable from that market to determine an appropriate price (avoiding the risks inherent in government negotiation or guessing of healthcare costs).

 

It should cost under $200Bn/year (as of 2016) to expand Medicaid into this program.  We can get that cost down by finding other ways to reduce the costs in our healthcare system.  We should avoid strategies common to single-payer systems, such as in Norway, whereby they have low healthcare costs by way of simply not covering prescription drugs and a lot of "non-core" services.


Good interesting article but it has a few problems. First we now have a health care system for all. There are quite a few parts to the total system. The part that covers all who are not in the parts we all usually look at as does your article is ER care. Anyone can go to the ER and get care. It is not always the best care but you get it whether you can pay or not. It is the most expensive part of the total health care system. We all pay for it through Fed. State Local Taxes in a lot of different ways.

 

Lets talk about Health Insurance. You get the cheapest rates when everyone is in the rating pool (100%). Just talk to the people who do the rating. The ACA tries to do this with fines if you do not purchase health coverage. Single payer get everyone into the pool. With everyone in the pool you do not need the Prex in a policy which solves a big problem we now have. Insurance Cos. need about a 18 to 30% load on the rates to cover their profit, and expenses. Medi Care has something like 3%. The ACA tries to cap the Insurance Co. load at 20%. Insurance Cos. pay a commission to agents for selling the policy which now I think is between 5 and 10%. Can be as low as 1% or 0% on large self Insured employer policies.

 

You have a nice long article on the rest but it would seem that most of it is not needed if you look at the true total health care system we have now. Single payer would end the ER Care Care part of the system and return ER care to what it was set up for, and everyone who comes in to the ER would be covered. That would really reduce the taxes that fund that section of care now thus reducing the cost to the full system. We would also get the Insurance Co mark up down to the 3% MediCare now has. That is about a 20% cost saving to the entire system. There are a lot of other things that can be done to reduce costs to which will come forwarded once we get serious about doing it.

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Re: One big thing people don’t know about single payer ( Medicare-for-All)

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Message 36 of 66

@ChasKy53 wrote:

@GailL1 wrote:

@ChasKy53

I am not mentioning anything - just stating what the poll showed - they like single payer - but it will not affect them.

 

Think proponents better get to work - OH, but maybe they don't - keep 'em dumb and they will be for it since they think it does not affect them.

 

HA, HA, HA . . . . . . . Woman LOL. . .  . Woman LOL


"Keep 'em dumb" and many against a single payer will keep posting erroneous information about it on political chat sites.

 

HA, HA,  HA .........Man LOL ........ Man LOL


Exactly, Chas. Just like the poll about people that like the Affordable Care Act, but can't stand Obamacare. And even more weren't sure that if Obamacare was repealed, that it would have any effect on the Affordable Care Act at all.

 

 

http://www.politifact.com/personalities/donald-trump/statements/byruling/false/ (11 pages of lies and growing)
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Re: One big thing people don’t know about single payer ( Medicare-for-All)

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Message 37 of 66

@john258 wrote:

@TxGrandpa2 wrote:

@ChasKy53 wrote:

You forgot to mention that a single payer would eliminate the costs of health care for our military, both active and retired.


To the contrary.  It would only switch the burden of this health care from the Department of Defense to whichever federal department would be charged with administering the plan.  That would be true with the other federal programs where the administration would be shifted to that new federal department, more than likely the Department of Health and Human Services.


There would have to be no change in what the members of the Armed Forces have. It could even remain the same for Dep. if they want to. They would bill the MediCare for all claim center just as every other provider does. The Armed Services could pay all or part of the premium for the Dep., or they could keep it the way it is now. If it were me I would have them pay 100% of the premium and bill the MediCare claim center.


Who said that?  Where is your info coming from?

i was under the impression that with a single payer system, benefits would be standardized, same with any copays, deductibles.

 

There may be a few outliers like Veterans or pay amts for the poor.

 

What would happen to the FEHB - I am pretty sure they want to keep it especially the retirees.

 

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: One big thing people don’t know about single payer ( Medicare-for-All)

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Message 38 of 66

@john258 wrote:

There would have to be no change in what the members of the Armed Forces have. It could even remain the same for Dep. if they want to. They would bill the MediCare for all claim center just as every other provider does. The Armed Services could pay all or part of the premium for the Dep., or they could keep it the way it is now. If it were me I would have them pay 100% of the premium and bill the MediCare claim center.


To the contrary, I would believe that like in other countries with a "Medicare for All' program I would believe that all federal health care programs would be merged into one.  That is the only logical solution in such a case for healthcare to be cost effective. 

 

As it is now, those retired military like myself is required to enroll in Medicare Part B for the Department of Defense's Tricare for Life to be effective.  As far as the way it is now, Medicare pays first for those enrolled, then forwards the bill to Tricare for Life to  pay the deductible or charges not covered by Medicare.  I would believe that this is much like Medicare where a person has commercial insurance.  Single payer would no doubt mean that the funds used by the DOD would be budgeted to the department handling Single Payer.

 

But of course there is no doubt that taxes would be raised but that would be offset by premiums paid to commercial health insurance companies and possibly by the premiums we pay for Medicare.

 

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Re: One big thing people don’t know about single payer ( Medicare-for-All)

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Message 39 of 66

@john258 wrote:

 

 

 

 

 

 


.

The statement that single payer would do away with employer based health insurance is not true. I have an employer based health policy as my Medicare supp coverage. It is provided by the employer I retired from, and that employer pays part of the premium.

 

The article you post is false, and you try and explain it as if it is true which shows you do not understand the system in any way shape or form.


OK folks in the know about a single payer system concept  

Do you think what john258 said above is true and would be part of a single payer system perhaps a Medicare for All plan?

 

Would private insurers especially under an employer plan maintain a supplemental plan or would any supplemental plan offered be the responsibility of the receipient to purchase on their own?

 

Can we ask employers to keep paying for some part of direct coverage IF we are gonna be asking them to pick up part of the overall cost of a single payer system?

 

Is Mr. Altman writing false info; he is very reputable or is john258 just one of the examples of the poll results?  john258 is satisfied with his coverage especially his employer payment of his supplemental coverage in retirement so a whatever type single payer would be for others -'

 

Do you think people on Medicare would have to do some changing - to me,mint wouldn't be the same at least from my readings from PNHP, design prelims from the Vermont Green Mountain Plan ( now defunct - no agreement on how to pay for it) and the ole Medicare for All design, H.R. 676 - but maybe that plan design left with Conyers.

 

 

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: One big thing people don’t know about single payer ( Medicare-for-All)

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Message 40 of 66

@GailL1 wrote:

@ManicProgressive

 

I am a little confused - why would you think that a single payer system would be any different in the rules of coverage?  Medicare does this all the time especially for rehab type of things -'what's covered, when it's covered, how long it is covered, where it is covered.

 

Like this - MedScape 12/10/2017 - New Medicare Rule Forces Some Patients into Nursing Homes

 

 

 

 


As long as there is an unneccessary middleman making a profit off of patient care, patients will not always get the care they need.  

 

The difference between a private payer (insurance) and the government is that the government is answerable to me.   A private insurance company is answerable to its shareholders.    

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