It can be confusing…
They say a conservative is a liberal that got mugged and a liberal is a conservative that got arrested (Tom Wolfe). And that if you’ve got them by the balls, their hearts and minds will follow (Teddy Roosevelt). And how about this one, Everyone’s got a plan until they get punched in the mouth (Mike Tyson). Clever wordings can go a long way in helping to make a point.
My theory is that people can really focused on an issue or event, but then sometimes take a completely opposite view when it touches them personally. They may have a really strong, ideology, perceptions, whatever on a topic until it hits them or their life in the face. Then they get passionate and dig deeper to address and hopefully resolve matters.
Like the family man/politician a few years back who was staunchly anti-abortion right up to the moment his mistress got pregnant. Then she was off to the nearest clinic that performed the procedure.
Hypocrisy and bad behavior isn’t limited to just one political party.
My issue today is the current healthcare system debate in this country and the hugely negative effect it has on every single one of us.
There’s a view that the federal government should stay out of healthcare and leave it to the private sector and the states (through Medicaid although even this is partially funded by the Feds).
If my piece doesn’t change your mind on this issue that’s fine but my goal is to have you at least consider the pro’s and con’s a bit more.
Do you have a family member or friend that has medical challenges and no health coverage because of cost or access? If so, you see the issue up close and personal. It’s not just a question of whether healthcare is a right or a privilege. It is very much also a question of finances and economics.
Some may say the country cannot afford to cover healthcare for all its citizens. It’s just way too expensive. My contention is that we cannot afford NOT to cover healthcare for all our citizens.
Currently the United States spends almost 20% of its’ GDP on healthcare. With a GDP of about $18 trillion that translates into over $3.5 trillion annually. The rest of the developed, first world nations (where the government covers their citizens for healthcare expenses) are all clustered around 10% of their GDP.
That gap has accelerated rapidly over the last 40 – 50 years.
In the early 70’s, the US was pretty much in line with the rest of the world where we all were spending about 5% of our GDP. The gap has really accelerated in just the past 10 years or so and is on track to blow past the 20% threshold while the rest of the world remains relatively flat.
If we followed the model the rest of the developed world does and got our spending down to around the 10% level, that’s a saving to our economy of almost $2 trillion annually. That would go a long way to addressing other issues facing the nation. It’s not just money coming out of government coffers, it’s money coming out of our pockets.
Costs are not just reflected in rising premiums. These costs are built into everything we buy. Ok, so you might say that we pay more for healthcare here because we have the best healthcare system in the world.
Not even close.
According to the World Health Organization (WHO) in terms of healthcare outcomes across the spectrum of our population, the US doesn’t even crack the top 35!!
Specifically regarding maternity, pregnant women in this country face some really scary outcomes. And this will get substantially worse now with the action against Planned Parenthood.
We pay twice or more of what we should for our healthcare and we get lower tier outcomes. This is an issue that begs for government intervention.
Before you label me as a flaming socialist, I’m not.
I’m a capitalist and a free market guy first and foremost.
The private sector should always have the first shot and there are lots of places where the government does not belong. I work for a private insurance brokerage firm and a sizable portion of my employer’s income is derived from health insurance commissions and fees.
A chunk of my personal income as well is derived from commissions and fees from healthcare insurance so this issue affects my paycheck directly. What is best for me personally on this issue is very much at odds with what is best for the country as a whole but we would all derive financial benefit from a single payer model.
The job of a private sector insurance company, or any private sector company is to generate profits for owners/shareholders and not address or try to resolve social or economic issues facing the nation as a whole.
Lots of issues that drive our costs through the roof but close to the top of the list is the pricing structures of drug companies, hospitals, doctors, and insurance companies. Depending on what sort of health plan you have now and where you go for healthcare/drugs/etc. the cost differences can be ridiculous.
One person gets billed $5,000 for a surgical procedure while someone else get a bill for $80k. One person pays $5 for a med while someone else gets charged $200+.
For a critical, life saving drug, the cost to the consumer directly may be six figures and above.
I see “Explanations of Benefits (EOBs)” regularly but if you have health insurance and interact with providers, you get them as well. That’s the form you get from your insurance carrier that shows you the cost that they were billed for, the amount they allow, your deductible status, your copay, and what the provider must write off. It shows you what amount you owe in the end for that encounter.
Often the differences between what the provider bills and what they agree to accept is approaching criminal.
It is very much the leverage the carrier has with the provider that dictates this.
A carrier like BCBS that can deliver large numbers of patients to a provider has the leverage to negotiate a far bigger discount. Pretty basic concept.
If you go in to buy a vehicle from Hearne, he’ll give you a good price. If you buy a fleet from him, he will do a WHOLE lot better on the pricing.
Carriers have networks of providers where they have negotiated discounts. Your EOBs will usually show you in-network and out-of-network costs. If you see a dr. or go to a hospital in the network, you may have a $1,000 deductible. Out of network encounters may turn that deductible into $2,500.
In network encounters get you copays of 20% up to a total out of pocket of maybe $3,500 to $5,000. Out of network may cost you 30% up to an out of pocket of $10,000 or higher.
The carrier will be dictating (or financially motivating you) to who you can see and where you can go.
Yes, it was stupid and false for Obama to say you can keep your doctor.
It was NEVER that way before the ACA and it is not that way now.
For those that say the federal government cannot successfully and economically administer healthcare, ask someone on Medicare what they think of their healthcare. BCBS has a big hammer when negotiating discounts with providers versus what smaller/regional carriers but the federal government has a sledge hammer.
Providers may not be crazy about Medicare reimbursement levels compared to what they can charge individuals under 65 but it works. The same principal works in the states with Medicaid reimbursements.
The ACA introduced a couple of items into the mix that both Republicans and Democrats love.
The first is the prohibition on exclusions for pre-existing conditions.
Insurance carriers had the right to deny coverage for someone who had a pre-existing condition (i.e. Cancer). They are private sector organizations that answer to their shareholders/owners and their goal was profits.
Why should they take on a losing bet?
That’s like asking a homeowners insurance company to insure a house that is currently on fire.
Health insurance before the ACA dictated life choices.
I had a co-worker years ago that was offered a job for a substantial pay hike but he couldn’t take it because his wife had developed cancer and the carrier for the potential new employer would not cover her expenses. He had no choice but to turn down the offer.
The other item was the extension of coverage for dependent children up to the age of 26.
That’s a great perk for parents and supported by Republicans and Democrats as well.
The restriction on excluding pre-existing conditions pierced that private sector corporate veil of profit motivation. Here was the federal government telling the private sector what they had to do and it clearly hit their bottom line, however support for these two items remains with Republicans, even though they want the ACA repealed.
Huh???
It’s a peripheral issue but single payer also allows American companies to eliminate offering healthcare to their employees, thus lowering the end cost of their product. Allows a little more of a level playing field. Certainly there remains a role for private health insurance carriers to offer products or supplemental coverages on the margins. Lots of details I’m not addressing here but the bottom line is – in my opinion – that the US needs to go with a single payer healthcare system.
Just sayin’
too late stomp.
You think the insuranece companies (who run the country)
the pharma companies (who run the country)
or even the doctors (who are screwed) or the trillion of other dollars involved
will give up all this money.
The insurance comanies will kill single payer along with pharma. They’ve got
billions to kill off any pol who gets close to this form of insurance.
Move on…..and just stay healthy as long as you can cause anint nothing going to
change.
Nice try……but you’re like the last horse to cross the finish line at the kentucky
derby….all dirty and looking at all the horses asses in front of you.
But keep trying. Hearne needs guys like you to fill up space.
I think if the Stomper ended this piece by looking at anyone’s ass, it probably was yours, Boom
yes…again you’re right admin…although stomper seems a coool
guy…the chances of single payer are about the same chance
as you getting yourj job back at star….zero.
the power s that be will kill this program and any like it
as long as the pharmas are making billions on opiods and
the insurance companies call their own shots.
But thanks…I don’t think stomp would be liking that you
said he’d be looking up my a$$ on anything! take care bud.
We’ve all heard this “argument” a million times, Stomper. I have multiple relatives on Medicare and all are perfectly happy with their coverage. I’ve nursed a child through leukemia, so I’m well versed in what gets billed vs. what’s paid. I’ve had direct experience with the abortion that was the ACA, that was rammed down our throats by the brainless nitwits in the democratic party. Before the ACA my now wife was able to cover her 3 children for about $150 per month with AffordaBlue. Then good old Obummer shoved the ACA in, and her plan was cancelled because of the ACA, and she was forced to choose a new plan which tripled her monthly premiums. Luckily, we got married soon after and I was able to put her children on my company’s self insured plan. There is NO way on God’s green earth that I want the government any further involved in my health and healthcare than they are right now. The government could fuck up a cup of coffee. The less involved they are, the better. One payer will not happen in my lifetime.
Thanks for at least reading my piece and for sharing that your multiple relatives are perfectly happy with their single payer coverage.
Nice work Stomper.
I will leave the rebuttal to Stomper’s well thought out and reasonable treatise on Health Care to GWSWOT, who seems to have a great deal more knowledge than I do on the subject.
However, that said, the last election, was lost, in part, by voters who were enraged at order of magnitude increases in Health Care and pretending that Obama Care was anything other than an ill advised, desultory, ham handed Wealth Transfer to those who “Vote For A living” is disingenuous at best.
There is another, Government Health Care Agency that we are all, very, very familiar with. It is run by the government and without exception, is a bipartisan effort that both sides of the aisle are all in on. It’s Called The VA.
What are our experiences, with, an existing, up and running, Government sponsored Health Care System, that has few, if any, political enemies and is supported by most if not all of the American people?
Not great.
Substandard.
Keeping in mind, how inefficient, cumbersome and difficult it is to keep the VA working correctly and providing service to Veterans (Who again, are supported by most Americans and both political parties.)), I am less than sanguine, that a much larger government enterprise encompassing the entirety of the United States would be a panacea for our current Health Care woes, which, as I said, were exacerbated by the last, inept, incompetent, “pen and phone” president.
Thanks Chuck. I knew you would not be a supporter of my position but, knowing your are a bit of a fan of Tom Wolfe, I had that in mind when I quoted him at the start of my piece.
I’ll start out by saying that the ACA clearly had lots of problems and was not the final answer but it was an important first step. The refusal of the red state legislatures to accept the federal funding to expand Medicaid in their states doomed any hope for improvement with those particular voters/states. It did just the opposite. I know you quote Obama’s “You can keep your dr.” and I agree that it was not supported by the facts and was not well thought out. What Ks. and Mo. did in refusing the Fed $ made a statement but it also screwed the citizens of both states imho.
The VA is a huge mess and the problems there go far deeper and wider than the issues here. I agree totally with you on that topic.
Thanks for the comments,
Well done, Stomper. That was an excellent read and some enlightened points. The problem with talking to people about any type of single payer system is that they ALWAYS take a myopic view of it. “Oh, it’s not good for me, so it sucks.”
I don’t know if single payer will ever happen or not. Probably makes too much sense, so that eliminates it from any serious consideration by the loons in D.C.. People/Companies don’t like to lose power and there is a boat load of it in the health care industry.
Again, excellent read.
Good gawd but we are far a stream. The essence of life is our own humanity and the recognition of such in all others. Politics, the whore mother of government, has from time immemorial had the sole focus of the preservation of wealth for the already wealthy, which in turn spawns conventional leadership which deems itself capable of determining how and to what extent the lesser of us financially and socially shall be kept.
While not a person of faith (oh the hypocrisy) note the concern of Jesus for those that are in need. If the hyperchristians would but turn to those pages and develop empathy for others, then single payer is the human thing to do. Forget the politics.
Ireland for instance has healthcare or all and a secondary system for the wealthy that for additional private expense will provide faster and usually better care. So wealthy can perk away and the rest at least have access.
Forget the rest of it, we are all humans first. Act like it, live like it.