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Honored Social Butterfly

Questioning Buttigieg’s Claim About Keeping Your Health Care

KHN -2/25/2020 - Past As Prologue: Questioning Buttigieg’s Claim About Keeping Your Health Care 

 

" If you like your private plan, you can keep it.”  . . . . . POTUS Candidate Pete Buttigieg 02/21/2020 said about his healthcare coverage plan of Medicare for All Who Want It”

.

Remember those words . . . in fact, haven't we heard something very similar to them before from another high profile Democrat who later changed our healthcare insurance system with the ACA.

 

Don't Get Suckered AGAIN !!!!

 

The real question here is IF you want Government to take over healthcare coverage - be that Medicare for All (single payer) or some form like "Medicare for All That Want It" ( public option) - which will both get to the final result of government control.

 

We know that if government controls something, the emphasis would be put on controlling cost.

So why not start controlling cost now and see how we like it - there is a wealth of cost cutting knowledge and practices in those other industrialized countries that tout better care at a lower price - let's try some of them knowing that we will have to take some of the bad that comes with the good.  We just need to understand that there will be some trade-offs. 

 

from the link ~

 

. . . .Under Buttigieg’s proposal, the ad says, “Everyone gets access to Medicare, if they choose.” Specifically, according to campaign documents, people or employers could buy into a government-provided health plan, which the campaign says would provide an “affordable, comprehensive alternative” to what is sold on the private market.

 

But, the voiceover adds, “if you like your private plan, you can keep it.”

 

This isn’t the first time a politician has made such a promise. Arguing in favor of the Affordable Care Act, then-President Barack Obama repeatedly said the health law would let people keep their private health plans, if they liked them.

 

That didn’t pan out: Millions of Americans’ plans were canceled, spawning months of controversy. In 2013, PolitiFact rated Obama’s statement the “Lie of the Year.”

 

An Uncertain Market

Experts we talked to said the former mayor’s remark is remarkably similar to Obama’s ― right down to the pitfalls it encounters.

 

Those policy analysts said Buttigieg is trying to differentiate his plan from Sanders’ sweeping proposal, arguing his offering is more moderate than Sanders’ and preserves choice. He suggests many Americans would be able to pick between buying private insurance or opting into the government plan.

 

But does that mean that if you like your plan, you can keep it? As the Obama White House learned, not necessarily.

 

The problem is that private insurance availability isn’t up to the government. To be sure, state and federal regulators have the power to dictate, for example, the inclusion of certain benefits and to set basic consumer protections. But the government cannot specifically require insurance companies to offer plans, and any carrier has the option to stop providing coverage.

“It’s like déjà vu all over again,” said Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms.

 

Already, market forces dictate what health insurance is available from year to year. For example, negotiations between an insurer and physicians could mean that an insurer drops doctors from its network. Changing profit margins could drive a private carrier to exit a certain market. An employer looking to trim expenses might decide to change health insurers, changing coverage offerings for employees.

 

Buttigieg’s health plan — which would more generously subsidize people buying private insurance than the ACA does and create a public health insurance option that individuals and employers could buy ― wouldn’t change any of those economic scenarios.

 

“When you have private plans offered and sold by private companies, those private companies are going to make business decisions that might affect your coverage,” Corlette said. “They can opt to get out of the business.”

 

That’s been especially clear in the ACA individual marketplace. In many counties, only one private insurer sells coverage on the marketplace. It’s impossible to predict, but a competing public option might change the financial incentives for those plans and push some of those carriers to abandon the exchange. If that happened, people using that plan would lose the insurance they have, regardless of how they feel about it.

 

Put more forcefully, “There’s no way the government can guarantee a private plan will continue, without mandating it will,” said Cynthia Cox, a vice president at the Kaiser Family Foundation.

 

So, she added, suggesting that people who like their private plans will have the option to keep them under Buttigieg’s proposal is “probably not true.” (KHN is an editorially independent program of the foundation.)

 

The Employer Question

This is especially the case when it comes to the nearly 160 million people who get their insurance from an employer.

 

Already, that group experiences volatility when it comes to their health insurance. In 2019, 53% of employers providing coverage considered changing the plan or the carrier they offered, according to a KFF survey. Of that group, almost a fifth — 18% ― ultimately did change insurance carriers.

 

That flux would likely increase under a plan like Buttigieg’s. Already, many employers (particularly smaller ones) indicate frustration with providing a health benefit that is increasingly complex and expensive. If a public option were cheaper, more might shift employees into that pool, dropping private insurance.

 

“Even if you don’t want the public option, your employer might decide that they do,” Cox said.

How big the change would be is difficult to gauge. It depends, for instance, on how generous the public option is, how much it costs employers and whether current private insurance trends continue.

 

Still, “any change you make to the health care environment would cause changes to reverberate throughout the system,” said Sherry Glied, a health economist and dean of New York University’s Wagner School of Public Service. “Any government action will cause change to happen more than they would otherwise.”

 

. . . .

And, in contrast with Sanders’ Medicare for All single-payer proposal, Buttigieg’s plan would preserve much of the current private insurance. But Buttigieg suggests that Medicare for All Who Want It — if administered well — could function as a “glide path” to a Medicare for All world, eventually bringing everyone into the public system.

 

“There’s good reason to think some of the private insurance competition won’t fare well against ‘Medicare for All Who Want It,’ ” Sommers said. “You might see some of the private plans dropping out. And that may be a sign the policy is working.”

 

The Ruling

In a new campaign ad, Buttigieg claims that under his proposal to overhaul the health care system, “if you like your private plan, you can keep it.”

 

This may be true for some Americans who have private coverage, but it is not true for all. It ignores the inherent instability of the private insurance markets — in which plans are canceled or changed all the time, people often don’t get to pick which private plan is even available to them, and government intervention would likely exacerbate that volatility.

 

Introducing a public option, as Buttigieg intends to do, could create more incentives for employers to drop private coverage and switch to the public Medicare plan — and, in some cases, for private carriers to exit the individual marketplace. The fact that it would be less disruptive than Medicare for All doesn’t change this.

 

Buttigieg’s claim has some truth to it, but leaves out key facts and context. We rate it Mostly False.

 

Honored Social Butterfly

The only real question about keeping your healthcare is the one posed by Republicans who will, if allowed to remain in office, answer by repealing Obamacare WITH NO REPLACEMENT.

 

For those with GOPer-length memories, that will put us back where your INSURANCE COMAPNY was the one deciding if you'd remain insured, and if you got really sick, or if they discovered a pre-existing condition, or if they paid out some arbitrary amount for your health care over time YOU LOST YOUR COVERAGE.

 

All that went away with Obamacare, as did 34MILLION people who used the ER as their primary care physician because they could not get health insurance so the cost of their care was included in the cost of the premiums paid by those who did have insurance. tRump has added nearly 8 million parasites back into the system, which is why your premiums are beginning to increase more rapidly after 7 years of declining increases under President Obama.

 

There are over 50 countries with no uninsured citizens and not one has the Government taken over the health care industry, so the Republican boogieman, like all good boogiemen, exists only  to frighten children and those who can only hink like children because all they listen to is FOX.

 

Doing NOTHING will cost us around $40TRILLION over the next decade and adding a public option to Obamacare and repealing the tRump Parasite Protection Law will cut that figure substantially AND provide health care for ALL Americans.

Honored Social Butterfly


@Olderscout66 wrote:

The only real question about keeping your healthcare is the one posed by Republicans who will, if allowed to remain in office, answer by repealing Obamacare WITH NO REPLACEMENT.

 

For those with GOPer-length memories, that will put us back where your INSURANCE COMAPNY was the one deciding if you'd remain insured, and if you got really sick, or if they discovered a pre-existing condition, or if they paid out some arbitrary amount for your health care over time YOU LOST YOUR COVERAGE.

 

All that went away with Obamacare, as did 34MILLION people who used the ER as their primary care physician because they could not get health insurance so the cost of their care was included in the cost of the premiums paid by those who did have insurance. tRump has added nearly 8 million parasites back into the system, which is why your premiums are beginning to increase more rapidly after 7 years of declining increases under President Obama.

 

There are over 50 countries with no uninsured citizens and not one has the Government taken over the health care industry, so the Republican boogieman, like all good boogiemen, exists only  to frighten children and those who can only hink like children because all they listen to is FOX.

 

Doing NOTHING will cost us around $40TRILLION over the next decade and adding a public option to Obamacare and repealing the tRump Parasite Protection Law will cut that figure substantially AND provide health care for ALL Americans. 


I am extremely surprised by your post. I do't see anyone here with the exception of the Trump followers advocating for what the Republicans would like to see. but,
Are you saying also, that the only choice that we all have is Medicare for All? I guess that my question to you is. Do we have any other choice that is not Medicare for all?

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Honored Social Butterfly

Roxanna35 -  Are you saying also, that the only choice that we all have is Medicare for All? I guess that my question to you is. Do we have any other choice that is not Medicare for all?

**********************

Hillary Clinton in the early 90's wanted congress to address the healthcare issues and the republicans refused to discuss it.   I know we should never look back but I can't help it....cause maybe by this time this country would have had a plan that works for everyone.    

Chuck Schumer   said  of the republicans     “Translation: they have no health care plan.   It’s the same old song they’ve been singing.   They’re for repeal. They have no replace.”

I don't remember the era when medicare for seniors began but I do know Reagan said If medicare for seniors was provided then we would lose our freedom .( not in text).  It  happened anyway and had to be improved over time.   


The past  is what we would be up against  in this present time when putting up Medicare for All  for a vote.   If people believe Sanders is their fairy-godfather it's a fantasy as congress is stll involved.   

 

 We have a better chance  of improving Obamacare and expanding it.     Let people keep their plans with employers if they want to.    That drug bill that got passed in the middle of the night--needs to be reviewed and fixed.    At least this would be a good start and  not a long-drawn out fight for years.   

Sometimes you can't have everything you want  and this may be one of those times.     

Honored Social Butterfly

From 2000 to 2010 the cost of health care insurance increased 7.4% each year.

After the PPACA passed in 2010, the increase in health care premiums stayed below 5% and dropped to 2.6% in 2013.

 

In 2017 GOPers resumed their all out attack on affordable health care, and the premium increases moved back above 5% and each GOPer-year MORE people were without health insurance.

 

The only choice we have to make health care available to ALL Americans is to get rid of the elected GOPers who insist it remain a perk only available to the top 10% with everyone else risking bankruptcy from a single illness.

 

I perfer a public option along these lines:

1.Option avaliable to everyone.

2.Government collects low premiums from those who can afford it (e.g., income over twice the poverty level for their family) plus a small tax paid by all employers and employees, probably around 1-2 %) to cover those who cannot affort it)

3.Government pays all medical bills according to the average of payment schedules already established by private insurers for those with the Public Option.

4.Everyone else either has private insurance or pays a fine equal to the cost of the Public Option for that individual.

5.No ability of physicians or care facilities to opt out of accepting whatever the patient's coverage allows - no more "out of network" charges.You treat/admit the patient, you automatically agree to accept whatever their coverage allows.

Honored Social Butterfly


@Olderscout66 wrote:

From 2000 to 2010 the cost of health care insurance increased 7.4% each year.

After the PPACA passed in 2010, the increase in health care premiums stayed below 5% and dropped to 2.6% in 2013.

 

In 2017 GOPers resumed their all out attack on affordable health care, and the premium increases moved back above 5% and each GOPer-year MORE people were without health insurance.

 

The only choice we have to make health care available to ALL Americans is to get rid of the elected GOPers who insist it remain a perk only available to the top 10% with everyone else risking bankruptcy from a single illness.

 

I perfer a public option along these lines:

1.Option avaliable to everyone.

2.Government collects low premiums from those who can afford it (e.g., income over twice the poverty level for their family) plus a small tax paid by all employers and employees, probably around 1-2 %) to cover those who cannot affort it)

3.Government pays all medical bills according to the average of payment schedules already established by private insurers for those with the Public Option.

4.Everyone else either has private insurance or pays a fine equal to the cost of the Public Option for that individual.

5.No ability of physicians or care facilities to opt out of accepting whatever the patient's coverage allows - no more "out of network" charges.You treat/admit the patient, you automatically agree to accept whatever their coverage allows.


Here is a thought on your item 3. If you use payment schedules by private carriers they will be a large increase in the costs to you. The gold standard for Carriers is to get as close to what Medicare pays providers. The best way is to use the existing medicare way of setting rates to providers which is fair. 

Honored Social Butterfly


@john258 wrote:

@Olderscout66 wrote:

From 2000 to 2010 the cost of health care insurance increased 7.4% each year.

After the PPACA passed in 2010, the increase in health care premiums stayed below 5% and dropped to 2.6% in 2013.

 

In 2017 GOPers resumed their all out attack on affordable health care, and the premium increases moved back above 5% and each GOPer-year MORE people were without health insurance.

 

The only choice we have to make health care available to ALL Americans is to get rid of the elected GOPers who insist it remain a perk only available to the top 10% with everyone else risking bankruptcy from a single illness.

 

I perfer a public option along these lines:

1.Option avaliable to everyone.

2.Government collects low premiums from those who can afford it (e.g., income over twice the poverty level for their family) plus a small tax paid by all employers and employees, probably around 1-2 %) to cover those who cannot affort it)

3.Government pays all medical bills according to the average of payment schedules already established by private insurers for those with the Public Option.

4.Everyone else either has private insurance or pays a fine equal to the cost of the Public Option for that individual.

5.No ability of physicians or care facilities to opt out of accepting whatever the patient's coverage allows - no more "out of network" charges.You treat/admit the patient, you automatically agree to accept whatever their coverage allows.


Here is a thought on your item 3. If you use payment schedules by private carriers they will be a large increase in the costs to you. The gold standard for Carriers is to get as close to what Medicare pays providers. The best way is to use the existing medicare way of setting rates to providers which is fair. 


True - Medicare rates are the best for the SENIOR customer, but they're "slanted" toward eldercare proceedures and might not be the best for younger patients. The insurance companies negotiated those other rates for a more comprehensive patient base, and since the insurance folks are looking to maximize their profits by minimizing their costs, the existing rates should be pretty reasonable for all concerned.

I would add another provision that the Government would determine how many spaces were available in Medical School so the number of doctors would increase and I'd provide full scholarships plus a living allowance for any future doctor who agrees to serve 7 years in an underserved area in the State they get their training or 5 years in another State AND a law that prevents drug companies from charging Americans more than the lowest price they charge anywhere else in the World. That all by itself would cut drug costs by over 50%.

Honored Social Butterfly


@Olderscout66 wrote:

@john258 wrote:

@Olderscout66 wrote:

From 2000 to 2010 the cost of health care insurance increased 7.4% each year.

After the PPACA passed in 2010, the increase in health care premiums stayed below 5% and dropped to 2.6% in 2013.

 

In 2017 GOPers resumed their all out attack on affordable health care, and the premium increases moved back above 5% and each GOPer-year MORE people were without health insurance.

 

The only choice we have to make health care available to ALL Americans is to get rid of the elected GOPers who insist it remain a perk only available to the top 10% with everyone else risking bankruptcy from a single illness.

 

I perfer a public option along these lines:

1.Option avaliable to everyone.

2.Government collects low premiums from those who can afford it (e.g., income over twice the poverty level for their family) plus a small tax paid by all employers and employees, probably around 1-2 %) to cover those who cannot affort it)

3.Government pays all medical bills according to the average of payment schedules already established by private insurers for those with the Public Option.

4.Everyone else either has private insurance or pays a fine equal to the cost of the Public Option for that individual.

5.No ability of physicians or care facilities to opt out of accepting whatever the patient's coverage allows - no more "out of network" charges.You treat/admit the patient, you automatically agree to accept whatever their coverage allows.


Here is a thought on your item 3. If you use payment schedules by private carriers they will be a large increase in the costs to you. The gold standard for Carriers is to get as close to what Medicare pays providers. The best way is to use the existing medicare way of setting rates to providers which is fair. 


True - Medicare rates are the best for the SENIOR customer, but they're "slanted" toward eldercare proceedures and might not be the best for younger patients. The insurance companies negotiated those other rates for a more comprehensive patient base, and since the insurance folks are looking to maximize their profits by minimizing their costs, the existing rates should be pretty reasonable for all concerned.

I would add another provision that the Government would determine how many spaces were available in Medical School so the number of doctors would increase and I'd provide full scholarships plus a living allowance for any future doctor who agrees to serve 7 years in an underserved area in the State they get their training or 5 years in another State AND a law that prevents drug companies from charging Americans more than the lowest price they charge anywhere else in the World. That all by itself would cut drug costs by over 50%.



@Olderscout66 wrote:

@john258 wrote:

@Olderscout66 wrote:

From 2000 to 2010 the cost of health care insurance increased 7.4% each year.

After the PPACA passed in 2010, the increase in health care premiums stayed below 5% and dropped to 2.6% in 2013.

 

In 2017 GOPers resumed their all out attack on affordable health care, and the premium increases moved back above 5% and each GOPer-year MORE people were without health insurance.

 

The only choice we have to make health care available to ALL Americans is to get rid of the elected GOPers who insist it remain a perk only available to the top 10% with everyone else risking bankruptcy from a single illness.

 

I perfer a public option along these lines:

1.Option avaliable to everyone.

2.Government collects low premiums from those who can afford it (e.g., income over twice the poverty level for their family) plus a small tax paid by all employers and employees, probably around 1-2 %) to cover those who cannot affort it)

3.Government pays all medical bills according to the average of payment schedules already established by private insurers for those with the Public Option.

4.Everyone else either has private insurance or pays a fine equal to the cost of the Public Option for that individual.

5.No ability of physicians or care facilities to opt out of accepting whatever the patient's coverage allows - no more "out of network" charges.You treat/admit the patient, you automatically agree to accept whatever their coverage allows.


Here is a thought on your item 3. If you use payment schedules by private carriers they will be a large increase in the costs to you. The gold standard for Carriers is to get as close to what Medicare pays providers. The best way is to use the existing medicare way of setting rates to providers which is fair. 


True - Medicare rates are the best for the SENIOR customer, but they're "slanted" toward eldercare proceedures and might not be the best for younger patients. The insurance companies negotiated those other rates for a more comprehensive patient base, and since the insurance folks are looking to maximize their profits by minimizing their costs, the existing rates should be pretty reasonable for all concerned.

I would add another provision that the Government would determine how many spaces were available in Medical School so the number of doctors would increase and I'd provide full scholarships plus a living allowance for any future doctor who agrees to serve 7 years in an underserved area in the State they get their training or 5 years in another State AND a law that prevents drug companies from charging Americans more than the lowest price they charge anywhere else in the World. That all by itself would cut drug costs by over 50%.



@Olderscout66 wrote:

@john258 wrote:

@Olderscout66 wrote:

From 2000 to 2010 the cost of health care insurance increased 7.4% each year.

After the PPACA passed in 2010, the increase in health care premiums stayed below 5% and dropped to 2.6% in 2013.

 

In 2017 GOPers resumed their all out attack on affordable health care, and the premium increases moved back above 5% and each GOPer-year MORE people were without health insurance.

 

The only choice we have to make health care available to ALL Americans is to get rid of the elected GOPers who insist it remain a perk only available to the top 10% with everyone else risking bankruptcy from a single illness.

 

I perfer a public option along these lines:

1.Option avaliable to everyone.

2.Government collects low premiums from those who can afford it (e.g., income over twice the poverty level for their family) plus a small tax paid by all employers and employees, probably around 1-2 %) to cover those who cannot affort it)

3.Government pays all medical bills according to the average of payment schedules already established by private insurers for those with the Public Option.

4.Everyone else either has private insurance or pays a fine equal to the cost of the Public Option for that individual.

5.No ability of physicians or care facilities to opt out of accepting whatever the patient's coverage allows - no more "out of network" charges.You treat/admit the patient, you automatically agree to accept whatever their coverage allows.


Here is a thought on your item 3. If you use payment schedules by private carriers they will be a large increase in the costs to you. The gold standard for Carriers is to get as close to what Medicare pays providers. The best way is to use the existing medicare way of setting rates to providers which is fair. 


True - Medicare rates are the best for the SENIOR customer, but they're "slanted" toward eldercare proceedures and might not be the best for younger patients. The insurance companies negotiated those other rates for a more comprehensive patient base, and since the insurance folks are looking to maximize their profits by minimizing their costs, the existing rates should be pretty reasonable for all concerned.

I would add another provision that the Government would determine how many spaces were available in Medical School so the number of doctors would increase and I'd provide full scholarships plus a living allowance for any future doctor who agrees to serve 7 years in an underserved area in the State they get their training or 5 years in another State AND a law that prevents drug companies from charging Americans more than the lowest price they charge anywhere else in the World. That all by itself would cut drug costs by over 50%.


They are the best rates for all and that is why the Insurance Carriers use them  as the gold standard for all their health insurance reimb. Your suggestion on increasing the number of Dr. is a good one. They should increase the number of medical schools, and the number they can handle also. In the long run it could save money for the system. The drug price problem could be solved tomorrow if they wanted to. A great deal of research for new drugs is govt. funded, or by non profits, and now that cost is figured into the price by the Co who is making the drug for sale. End that and it cuts cost. Drug prices have always been a problem. There was a red book at one time they all used as it told all what to charge. Having spent some time in this area years ago I saw pills being made and put into different bottles with different labels but price diff. between the bottles was over 100% to the high end sellers, and low end sellers. It has been a rip off for years.

Honored Social Butterfly

Thank you, Olderscout, I agree with you in all your points, so no argument there. 
Glad to see that there should be options and that Medicare for all does not provide one.

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Gail 1, what you posted is very confusing. Are you talking about health insurance or health care? They are two entirely different things.

 

Health insurance is used to pay medical bills. That's it. It has no other use or purpose.

 

Single-Payer is a method used to pay for something.

 

Single-Payer Health Insurance is self explanatory.

 

What does any of that have to do with health care?

 

 

 

 

Honored Social Butterfly

   Nothing is FREE .. .     Medicare for all, popularized by Sen. Bernie Sanders of Vermont, would be “free,” with no premiums but  it would cost the federal government more than $3 trillion per year,  .   Nothing is FREE...    In fact,  his State of Vt  experimented with a  Single-Payer  and ditched it  after around 3 years   cause briefly it was "done in" by high taxes.   


  Currently, 58 countries have universal health care. They include Algeria, Argentina, Bahrain, Bulgaria, Canada, Colombia, France, Germany, Greece, Iceland, Ireland, Israel, and Norway.  Following are two examples....
https://www.worldatlas.com/articles/countries-with-universal-health-care.html

Belgium
Belgium has one the best healthcare systems in the world. The system, developed in 1945, is sponsored by competing mutuals by state-run hospitals and non-profit making hospitals. Each mutual is funded by the government depending on the membership. Members are issued health cards which are swiped at the hospital and between 50%-75% of the total cost is then reimbursed by the mutual scheme.

Germany
Germany's healthcare system dates back to the 1880s and is the oldest in Europe. Citizens contribute about 13% of gross earnings to any of the 300 statutory state sickness funds. The funds operate differently; others reimburse patients for costs incurred while others negotiate up to 75% reduction of costs during the treatment. The unemployed are funded through the social fund or Allgemeine Ortskrankenkasse which is a last resort fund covering about 13% of the population.

 

 

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Cuba has has a Universal health care system since 1950

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Thing to remember is UNLESS there's a law against it, your insurance provider or your medical care providers can decide to stop accepting you as a customer whenever they want.

 

The IMPORTANT thing to remember is all Republicans will vote to make it easier for this to happen and all Democrats will vote to make it much harder for this to happen.

 

The Republicans are STILL ranting about repealaing Obamacare which WILL end coverage for pre-existing conditions and AFFORDABLE coverage for everyone else.

Honored Social Butterfly

 

Gail  with all due respect and I don't mean mentally, but are you trying to imitate  Sarah Palin?
You mean to say that they cannot keep Obamacare and simply create a public option?  why? are the Republican in the Senate will try   to stop it?
So are you scaring us about Government control? Well Medicare for All really fits that bill, don't you think? And please tell me which country that has a single payer is not government controlled.
Look you and I have discussed this for many years. and yes we need a better health care a single payer would be fine if they do it correctly not by Medicare for all but, if they cannot come up with a decent plan a public option in which you have choices is the best bet for the ;moment.
                     

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@Roxanna35 wrote:

 


You mean to say that they cannot keep Obamacare and simply create a public option? 
So are you scaring us about Government control? Well Medicare for All really fits that bill, don't you think?

 

                    


Really, you don't see it???  Think about it -  either way we go, government is gonna end up with control of the industry - how do you see it working?

 

So we establish a public option plan that would compete with private insurance companies to provide coverage.  It is suppose to be a government-provided health plan, which would provide an “affordable, comprehensive alternative” to what is sold on the private market.

 

The 1st thought is how they would develop such a plan.  Where are the savings UNLESS government uses it's power to dictate.  The only real savings that can be squeezed out would be (maybe) in Profit - so a savings of 15% at the most. 

Consider these points of competition:

  • Build the providers:  What provider will accept a lower reimbursement rate from a public option than from a private insurer?  So right off the bat, I either see no saving here unless government dictates it or forces it somehow.  That's not competing - that's dictating.
  • Managing Care:  How will the public option control cost?  Networks?  Co-pays?  Rules for referrals to specialist (in the public option plan).  Prior Approvals?  Quantity Limits?  Step-therapies?  Will the public option plan have these cost saving strategies?  If not, where is the savings?
  • Coverage - of course, the ACA dictates some major coverage areas but private insurance still has some oversite.  Will the public option maintain oversite too?  Case in point - how will emergency room care be handled especially if it is not an actual emergency?  On the other side of the equation, would the public option decide to offer more coverage - the definition of "medically necessary" sometimes covers some controversial ground.
  • Formulary development - private insurance companies do negotiations to cover their list of medications and develop co-pays and tiers to manage these cost.  How would a public option plan develop their formulary and the price of the drugs within it? 
  • Out of Network charges or Providers that make not take any insurance plans even if they supply services to an in-network facility under contract with that facility like Emergency Room doctors. Pathologist, Anesthesiologiest, Radiologist, Neonatal ICU doctors - to name a few.

If government cannot get their public option plan to come in cheap enough by competing with private insurers, they can dictate their plan to make sure it does - that is not competing, that is dictating.  Dictating by government forces would still drive the private insurance industry out of existence - the optimum goal of the public option is to get to single payer to completely control this industry - all of it - the coverage, the insurance, the providers.

 

True single payer models in other countries are far and few between - many other countries use a decentralized method of providing care for their citizens.  Some do not use a single payer system but use rather a hybrid system of coverage - government coverage with insurance coverage with that insurance being a either non-profit entity or a for-profit entity.

 

Health system Organizations: 

Commonwealth Fund - Health System Structure in 12 Countries 

A common misconception among U.S. policymakers and the public is that all universal health care systems are highly centralized, as is the case in a true single-payer model. However, across 12 high-income countries with universal health care systems, centralization is not a consistent feature.

 

Both decision-making power and financing are divided in varying degrees among federal, regional/provincial, and local governments. U.S. single-payer bills give most legal authority for resource allocation decisions and responsibility for policy implementation to the federal government, but this is not the international standard for countries with universal coverage. Rather, there are significant variations among countries in how policies are set and how services are funded, reflecting the underlying structure of their governments and social welfare systems.

 

 

 

Screenshot_2020-02-27 Considering “Single Payer” Proposals in the U S Lessons from Abroad Exhibit 1 - Infogram.png

 

 

 

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@GailL1 wrote:

@Roxanna35 wrote:

 



                   


Really, you don't see it???  Think about it -  either way we go, government is gonna end up with control of the industry - how do you see it working? A single payer is government control. anywhere. but many countries have private options in which you can have a private insurace with whatever you want to pay extra for.

 

So we establish a public option plan that would compete with private insurance companies to provide coverage.  It is suppose to be a government-provided health plan, which would provide an “affordable, comprehensive alternative” to what is sold on the private market. No a private option means not done by the govermentm but by the Insurances as a private option if you don't wnat to enhance what the government offers. I don't think that you can opt out with the basics that a single payer offers.

 

The 1st thought is how they would develop such a plan.  Where are the savings UNLESS government uses it's power to dictate.  The only real savings that can be squeezed out would be (maybe) in Profit - so a savings of 15% at the most. Why would the goverment get involved in creating a private option?

Consider these points of competition:

  • Build the providers:  What provider will accept a lower reimbursement rate from a public option than from a private insurer?  So right off the bat, I either see no saving here unless government dictates it or forces it somehow.  That's not competing - that's dictating.
  • Managing Care:  How will the public option control cost?  Networks?  Co-pays?  Rules for referrals to specialist (in the public option plan).  Prior Approvals?  Quantity Limits?  Step-therapies?  Will the public option plan have these cost saving strategies?  If not, where is the savings?
  • Coverage - of course, the ACA dictates some major coverage areas but private insurance still has some oversite.  Will the public option maintain oversite too?  Case in point - how will emergency room care be handled especially if it is not an actual emergency?  On the other side of the equation, would the public option decide to offer more coverage - the definition of "medically necessary" sometimes covers some controversial ground.
  • Formulary development - private insurance companies do negotiations to cover their list of medications and develop co-pays and tiers to manage these cost.  How would a public option plan develop their formulary and the price of the drugs within it? 
  • Out of Network charges or Providers that make not take any insurance plans even if they supply services to an in-network facility under contract with that facility like Emergency Room doctors. Pathologist, Anesthesiologiest, Radiologist, Neonatal ICU doctors - to name a few.

If government cannot get their public option plan to come in cheap enough by competing with private insurers, they can dictate their plan to make sure it does - that is not competing, that is dictating.  Dictating by government forces would still drive the private insurance industry out of existence - the optimum goal of the public option is to get to single payer to completely control this industry - all of it - the coverage, the insurance, the providers. You are making a public option a parall program as the single payer which should never be. and in that case it would be another goverment mprogram and unecessary and redundant.

 

True single payer models in other countries are far and few between - many other countries use a decentralized method of providing care for their citizens.  Some do not use a single payer system but use rather a hybrid system of coverage - government coverage with insurance coverage with that insurance being a either non-profit entity or a for-profit entity. And why should we go for a centralized system? why not adopt a hybrid one? 

 

Health system Organizations: 

Commonwealth Fund - Health System Structure in 12 Countries 

A common misconception among U.S. policymakers and the public is that all universal health care systems are highly centralized, as is the case in a true single-payer model. However, across 12 high-income countries with universal health care systems, centralization is not a consistent feature. AGAIN WHY NOT SEE IF THAT IS WHAT WE NEED HERE.

 

Both decision-making power and financing are divided in varying degrees among federal, regional/provincial, and local governments. U.S. single-payer bills give most legal authority for resource allocation decisions and responsibility for policy implementation to the federal government, but this is not the international standard for countries with universal coverage. Rather, there are significant variations among countries in how policies are set and how services are funded, reflecting the underlying structure of their governments and social welfare systems.

We are back to the discussion that you and I have had for years. instead of copying what others have. we need first before we even consider anything is to have  some control in the pricing of the drugs which is the most important part in all of this. and then see wheter a centralized or a Hybrid Single payer is what is to be used in the USor come up with a plan that suits this society.

 

 

 

 

 

 


 

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@Roxanna35 

 

It pays to understand the healthcare system vocabulary -

 

Universal health care:  Universal health coverage means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.

 

All it means is that everybody has coverage.

 

Single payer is just that - a system means to Universal health care.  One payer for all people - usually this means government - but that could also mean several government entities - federal / state/ province / local.  Canada is a single payer system but the federal government only really collect taxes and dictates what the federal program covers, which is not all coverage.  The provinces and territories of Canada also have other mandated coverage items for their citizens or some of them for which province and territories also collect taxes to pay for these more local mandate.

 

Example - Canada (the federal government) has NO coverage for prescription med.

Some, maybe all, of the provinces and territories have a plan to cover some of the meds for the elderly / disabled / poor.  For the rest of the population, these citizens buy an insurance policy to cover some of the cost of their meds -

 

Hybrid System:  some countries have both a government plan and a private (non-profit or for-profit) health insurance plan.  They work in lockstep.  This is kind of a (2) tier system because the insurance plan if one can afford to buy it will add to their benefits.

 

Example:  those who have the government plan may have to go to public hospitals - stay in a ward.,

wait for an MRI or like non-emergency services

 

Those who buy added private insurance can go to a private hospital, have a private room and can get a more reasonable schedule for MRI or like non-emergency services.

 

These are just (2) examples of systems of Universal Health Care -

(1) Single Payer systems

(2) Hybrid Systems

 

Under either of these cost containment methods are used to hold down medical cost.

Under either of these there are beauracies which are set up to run the various components of the overall system - A best practices commission, a drug negotiation commission, one for medical infrastructure - like where to put or approve MRI or Radiology facilities, where is a new hospital needed, how to increase the number of primary care physicians or certain specialist, their preventive care commission (comparable to our U.S. Preventive Services Task force - to name a few.

 

When Mayor Pete and other more moderate Democratic hopefuls talk about a PUBLIC OPTION (not a Private Option).  They mean to set up a (public) insurance program which would compete with the private insurance industry.  with the hopes being that it could hold down cost by this competition.

 

. . .Under Buttigieg’s proposal, the ad says, “Everyone gets access to Medicare, if they choose.” Specifically, according to campaign documents, people or employers could buy into a government-provided health plan, which the campaign says would provide an “affordable, comprehensive alternative” to what is sold on the private market.

 

The problem is that private insurance availability isn’t up to the government. To be sure, state and federal regulators have the power to dictate.

So why negotiate when you have the power to dictate when setting up a public option plan.

By this very unfair advantage, sooner or later, private insurers will become a thing of the past at least in this respect and we would still be on our way to a single payer system or perhaps a hybrid system.  But I think many would think that the Hybrid system is unfair because it is a 2-tier system - haves and have nots, so to speak.

 

The jest of this thread is to point out that

 

 

 

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Healthcare won't be FREE and that's the one thing that bothers me with Bernie and Warren's plans.    I read the comments via their supporters who must believe a magic wand would be waved and then UTOPIA.  


With free health care, costs would be paid through higher taxes on the employed who would pay for their own personal health care needs and that of the indigent.     The wealthy on average pay less in taxes so the burden would go to the middle class or what remains of  the middle class when the aristocrap republicans control govt.    .     

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@GailL1 wrote:

@Roxanna35 

 

It pays to understand the healthcare system vocabulary -

 

Universal health care:  Universal health coverage means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.

 

All it means is that everybody has coverage.

 

Single payer is just that - a system means to Universal health care.  One payer for all people - usually this means government - but that could also mean several government entities - federal / state/ province / local.  Canada is a single payer system but the federal government only really collect taxes and dictates what the federal program covers, which is not all coverage.  The provinces and territories of Canada also have other mandated coverage items for their citizens or some of them for which province and territories also collect taxes to pay for these more local mandate.

 

Example - Canada (the federal government) has NO coverage for prescription med.

Some, maybe all, of the provinces and territories have a plan to cover some of the meds for the elderly / disabled / poor.  For the rest of the population, these citizens buy an insurance policy to cover some of the cost of their meds -

 

Hybrid System:  some countries have both a government plan and a private (non-profit or for-profit) health insurance plan.  They work in lockstep.  This is kind of a (2) tier system because the insurance plan if one can afford to buy it will add to their benefits.

 

Example:  those who have the government plan may have to go to public hospitals - stay in a ward.,

wait for an MRI or like non-emergency services

 

Those who buy added private insurance can go to a private hospital, have a private room and can get a more reasonable schedule for MRI or like non-emergency services.

 

These are just (2) examples of systems of Universal Health Care -

(1) Single Payer systems

(2) Hybrid Systems

 

Under either of these cost containment methods are used to hold down medical cost.

Under either of these there are beauracies which are set up to run the various components of the overall system - A best practices commission, a drug negotiation commission, one for medical infrastructure - like where to put or approve MRI or Radiology facilities, where is a new hospital needed, how to increase the number of primary care physicians or certain specialist, their preventive care commission (comparable to our U.S. Preventive Services Task force - to name a few.

 

When Mayor Pete and other more moderate Democratic hopefuls talk about a PUBLIC OPTION (not a Private Option).  They mean to set up a (public) insurance program which would compete with the private insurance industry.  with the hopes being that it could hold down cost by this competition.

 

. . .Under Buttigieg’s proposal, the ad says, “Everyone gets access to Medicare, if they choose.” Specifically, according to campaign documents, people or employers could buy into a government-provided health plan, which the campaign says would provide an “affordable, comprehensive alternative” to what is sold on the private market.

 

The problem is that private insurance availability isn’t up to the government. To be sure, state and federal regulators have the power to dictate.

So why negotiate when you have the power to dictate when setting up a public option plan.

By this very unfair advantage, sooner or later, private insurers will become a thing of the past at least in this respect and we would still be on our way to a single payer system or perhaps a hybrid system.  But I think many would think that the Hybrid system is unfair because it is a 2-tier system - haves and have nots, so to speak.

 

The jest of this thread is to point out that

 

 

 


Well lets tart out with the fact that the ACA never made a person loose their health insurance. What it did do was set standards so that the cheap rip off insurance was gone and people who had that did not have real insurance which they found out at claim time. Other carriers decided they wanted out and cancelled peoples coverage. Most of them returned after a year. What the ACA did was clean out the trash in the medical insurance market, and if you had one of those policies they were gone and they should have never been.

Univ. Health Care is the same as medical care for all. It means everyone can get medical care with the ER part the most costly, and has the poorest outcome of all sections. The public option they talk about is coverage that will have about a 95% loss ratio. The ACA is forcing carriers to have an 80% loss ratio so that is a 15% saving to start with and that will force the carriers to in the end meet that or go out of business. There will be no cost containment while Trump is President. Trump everyday destroys the health care system. You will see the pre ex return shortly due to the way Trump has gutted the ACA. A govt. option would be available to everyone since Fed. law over rides state law and reg. With a govt option you can keep your insurance if you want, but the carrier can cancel you, and many will due to the fact they can not or will not meet the 95% loss ration so do not be fooled by the nonsense you hear otherwise.

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Come on guys and gals. we all knew that Obamacare was the fist step into eventually going to single payer system.
The worse thing that happened to Obamacare is the fact that people could opt out of it, pay a penalty and that was it. a single payer cannot work under those circumstances. so in many ways it failed.
Any country that has a single payer or a hybrid program has also  private insurances. that handle what the basic government program may not be able to provide. Those programs are design to provide extras to the basic plan and it is the individual that chooses which program is best for them. Companies can also choose for their employees. I don't understand as to why Gail tries to underestimate a single payer program as a failure in the US.  
Gail, you  hand I have been having this discussion since before Obama came into office. I don't unerstand as to why you don't think that a single payer would workk in the US if is done properly and provide insucance choices.

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