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

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Message 41 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

 

 

 

 


Looks like you picked a bad article That site wants you to join before you can read the article. That is one reason you should stop searching the web for articles that for the most part are not used in the real world. What Medi Care does is not provide Long Term Care Insurance as some years ago it started to and the Seniors then put up such a fuss they dropped it. Now it forces a person on to medicaid which will provide it. Now do not give me the charts on how much money you can have etc. as in the real world that is worked around all the time. Most people in Nursing  Homes are on MediCaid or VA.

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

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Message 42 of 66

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.

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

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Message 43 of 66

@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.

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

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Message 44 of 66

@GailL1 wrote:

Just catching up on some of my reading and found this to be absolutely funny.

So much for what people think and IMO the way they vote too ~

 

Axios - 11/02/2017 - One big thing people don’t know about single payer

 by Drew Altman -

 

It is generally assumed that the biggest obstacle to a national health plan like Medicare for All will be the large tax increase needed to pay for it. But new polling shows another challenge: Almost half of the American people don't know that they would have to change their current health insurance arrangements if there was a single-payer plan.

 

The details: Overall, the general idea of a national health plan is pretty popular, with 53% of the American people favoring a national health plan — 30% strongly favoring it and 23% somewhat favoring it. On the other side, 31% strongly oppose it and 13% somewhat oppose it. Democrats and Republicans split on the idea, as expected.

 

But as the chart shows, somehow, 47% of the American people think they would be able to keep their current health insurance — even though a single payer Medicare for All style plan would do away with employer-based insurance.

  • 52% of Democrats, the group most supportive of single payer as an idea, think they will be able to keep their plan.
  • Notably, 44% of people with employer-based insurance think they would be able to keep their current plan.

The bottom line: There is no sweeping health reform plan without tradeoffs, as we learned with both the ACA and the Republican repeal-and-replace plans. The fact that so many people don't know that a national health plan would require them to change their insurance arrangements underscores the challenge of making the transition from a popular idea to a reality for a single-payer national health plan.

 

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

 


I really do not understand what you are trying to do here. It would seem you just want to trash a single payer system which by a lot of your recent posts you call for.

Lets start with the fact that people already have to switch their main carrier now when they reach the Medi Care age and there has never been a problem with that. We see most people looking forwarded to going on Medi Care, and most do not even have to switch their providers. I know I did not, and do not know anyone who did. All that happened was my costs went down in the Co-Pay area. So it would seem to me that is a bogus argument by someone who wants to spread false information.

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.

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

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Message 45 of 66

@MIseker wrote:



i guess i need to switch you to that other category of poster...never read someones post and never answer a straight question.


 

The libertarian way of lying is a well known form of disingenuity funded by extreme conservative pseudo patriotic oligarchs.

 

Those "teabag whackos" were funded by the same people.

 

Is it to any significant degree different from trump-sucking? 

 

While it goes to all ends to appear to be "genteel"...

 

The difference is in name only.

 

 

44>dolt45
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Re: One big thing people don’t know about single payer ( Medicare-for-All)

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Message 46 of 66

@MIseker wrote:


 

 

i guess i need to switch you to that other category of poster...never read someones post and never answer a straight question.


Just trying to stay on topic as much as possible.

* * * * 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 47 of 66

@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

 

 

 

 

* * * * 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 48 of 66

@GailL1 wrote:

@MIseker 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


HAHAHAHA!! . I addressed your topic and asked you a question..which you always duck. Not the first time i have asked.


You might be one of the ones which the poll takers thinks needs single payer - a fair percentage of them jjust don't think their coverage would have to change - just other people - how would that work !  Woman LOL 

 

They may have really good employer coverage, perhaps an employer that self insures.  They may have TriCare and are pleased.  Heck, they might have Medicaid and think it is great or Medicare/Medicaid.

 

Either way, they think single payer is good for other people but they are satisfied with what they have and don't think they would have to change.  The same way people who had individual coverage before Obamacare thought they could keep their plan - "If you like your plan . . . . . famous last words .


i guess i need to switch you to that other category of poster...never read someones post and never answer a straight question.

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

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Message 49 of 66

Our health care delivery system completely sucks.    Only in America would someone with cadillac coverage (my husband) get denied the acute rehab he needs (according to ALL the medical professionals).  And here he is denied subacute rehab until Monday, because nobody at the insurance company is at work over the weekend.  I didn't know medical needs could wait til Monday.....

 

And I offered to private pay for a room, cash in hand, but was told I can't do that.   We need to wait for insurance to authorize.....because what if they don't, moving forward?   

 

Needless to say, I'm not a fan right now.    Single payer, complete revamp of the system?  Bring it on. 

 

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

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Message 50 of 66

@MIseker 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


HAHAHAHA!! . I addressed your topic and asked you a question..which you always duck. Not the first time i have asked.


You might be one of the ones which the poll takers thinks needs single payer - a fair percentage of them jjust don't think their coverage would have to change - just other people - how would that work !  Woman LOL 

 

They may have really good employer coverage, perhaps an employer that self insures.  They may have TriCare and are pleased.  Heck, they might have Medicaid and think it is great or Medicare/Medicaid.

 

Either way, they think single payer is good for other people but they are satisfied with what they have and don't think they would have to change.  The same way people who had individual coverage before Obamacare thought they could keep their plan - "If you like your plan . . . . . famous last words .

* * * * It's Always Something . . . Roseanne Roseannadanna
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