Bernie Sanders Health Plan Savings for Nearly Everybody

I'm not too comfortable with this plan, especially the elimination of copays and deductibles. Insurance companies do those things today to make sure patients have some skin in the game so that they will make smart buying choices -- won't authorize unnecessary procedures, won't buy expensive name-brand drugs, won't consent to exorbitant fees. They mostly don't work, which is why we have so many unnecessary procedures, such expensive name-brand drugs, and such exorbitant fees. But, I'm not real clear on how this plan would prevent the healthcare industry from completely raping us. They'll have their fee schedule so the hospital won't charge $25 for a band-aid, but they can run a hundred unnecessary tests and who is to say they weren't necessary? The doctor has bills to pay, government can't get in the details enough to tell, and the patient pays the same whether he has one test or a thousand.

 

I wouldn't say this plan is clear and easy to understand, considering no details have been given.

What is a turn off is the alleged multi trillion dollar savings. Many of the original Obamacare supports pointed out the billions of dollars that would be saved based on deceptive math. Its very clear that this will cost, so lets be honest about it.

I am not opposed to copays of some sort, as long as they are reasonable. I dont think its a good idea to freely let people walk in for any reason. This drives up cost and response time.

What I want to see is an easy in and out for basic medical conditions, pretty much like urgent care centers.

Also I am not opposed to doctors charging a premium copay; Basically I do not want the good doctors opting out of single payer and staying in private care, forcing people to pay full price if they want to see them.

Deductibles are pointless and are counter productive.

 

Looks like something that would never make it through congress.

 

So he is paying for it with a 2.2% income, a 6.2% payroll tax on employers, and unspecified taxes on the "wealthy". The American public saves $5000 year per person because doctors, hospitals, and drug companies will all be forced to accept being paid significantly less since there is only a single payer. Oh and he is also dismantling insurance companies...

Got it Bernie. Sounds like it has a very realistic chance of passing.

Incremental changes Bernie.....

Anyhow, there was some good commentary in the comments section from the link. Here's a comment from the link that I thought was interesting and I provided the link to the OECD report he referenced. http://www.oecd-ilibrary.org/social...health-at-a-glance-2015_health_glance-2015-en

Spoiler

 

ignoring passibility, do you like the idea?

i say yes. what a great idea for the citizens of this country.

 

just like Obamacare reducing premiums by $2500?

 

In theory, it's great. In practice, I fear it would be overly expensive and care would suffer. I feel like the universal healthcare model would basically put everyone in the VA healthcare system.

 

Co-pays are a difficult thing to determine. On one hand, we want everyone to go to the doctor if there is something wrong with them, on the other hand, we want to discourage people from going for no reason, and want them to pay more if they participate in unhealthy behavior.

We could tax unhealthy foods and the such, but we can't tax people for not exercising or participating in most dangerous activities.

Ultimately, I know I prefer universal coverage, but how exactly to implement it will remain the question. And we can't just focus on decreasing costs for the individual, but rather decreasing costs, or at least normalizing the inflation of health care costs.

 

Great, all we need to do is dissolve or amend the constitution and elect legislative majority that is willing to pass it.

 

"Free medical for all!"

"Free college for all!"

"Free housing for all!"

Free food for all!"


"How are we going to pay for all this? How is any of this going to get past congress"


"Shut up and get with the program!"

 

We're trying to do something that's already being done in other countries, so it shouldn't be a total mystery. Numerous industrialized nations have achieved good health outcomes are more modest prices with universal healthcare, so we should be able to as well. I want universal coverage because I see it as a social good. But, my concern is that the real drivers of high costs don't lie with insurance at all, and therefore won't be mitigated at all by changing the funding mechanism. My intuition is that it's the healthcare system that is dysfunctional not healthcare insurance. And we're trying to leverage insurance this way and that to fix the problem in healthcare instead of tackling that industry directly.

Medical educations cost too much and doctors come out with large debts. This is a place where I think government subsidy of education makes sense (though I wouldn't give it away for free -- I'd want something from these young doctors trained on the taxpayer dime). US doctors make a lot more money than European ones. Lowering the debt burden can mean paying our doctors less. We can also make more doctors to increase the supply and lower the price.

I also wonder how appropriate it really is to have for-profit hospitals. Generally, the for-profit and nonprofit hospitals are competing for the same healthcare dollars, same doctors and nurses, etc. But, for-profits have to get an extra return to satisfy the investor while the nonprofit gets a tax break. The for-profit has to grow, while the nonprofit has to stay in the black while serving its current mandate. Hospitals could be like utilities in a lot of ways. The for-profit model should apply competitive pressure to drive down prices. But, with all the distortions in the market (from insurance), it's not clear to me that that is happening (though it may be driving innovation, idk). But, I wonder how things would look if you took the profit-motive out of the industry and instead served the market with government and nonprofit hospitals.

And, it seems to me that part of the reason why other healthcare systems are doing better than us is that we're paying for the R&D of the drugs they use. Pharm companies rely on fat margins in the US to pay for the development of drugs, meaning we effectively subsidize innovation for the rest of the planet. I think we could stand to be less bullish on the protection of intellectual capital, like the degree to which we grant patent monopolies for new drugs. Give them less protection in the US and they'll have to shift more of their revenues to other countries.

 

Why is our healthcare so much more expensive than anywhere else in the world?

 

for govt policies it's usually administration costs and the way it's set up.

 

Because insurance companies eclipse all but banking in its lobby reach. Illness and dying are very profitable enterprises in the US and great expense is taken to keep that the status quo. It's extremely difficult to reach high office without their support, and hard not to be beholden to those interests once you are there.

Obama is no exception -- insurance companies figured prominently in funding his re-election, and by no surprise, the Affordable Healthcare Act only expanded their client base. It's better than nothing, and I was on it when I came back and was glad to have it.

However, I paid significantly less in Israel as a student (before I was eligible for state insurance there) out-of-pocket for medical care than I do NOW as a state employee with insurance in Texas. I need to have oral surgery and I simply can't afford it on what I make here unless I go abroad.

 

The insurance companies are not the end-all driving factor of rising health costs. The insurance companies are the proxy that prevents transparent costs. For one example, the patient simply does care what it costs for them to see the doctor, as long as they dont pay any more than what is expected. The insurance company doesnt know what the hospitals truly performs. Imagine you are a business owner and you can automatically upgrade every customer of yours to premium services w/out asking them. Would you do it? Of course you would.
For example, I do not have dental insurance. I recently had a filling on one of my molars. I was offered a silver filling or a natural white filling. The silver filling is more reliable and cost 2/3 of a natural white. Which do you think I went with? Which do you think the dentist would "automatically upgrade" and not ask if it was being billed to insurance?

Its a cat and mouse game between the patience, insurance company and the provider to screw each other out of as much as possible. This creates skewed numbers that nobody truly knows.

This is an interesting point that is rarely brought up. I do not think we should be the ones paying for the R&D. But again, this is where insurance companies convolute the issue. And its not just R&D. When pill sales reps are making $50.00 per on some pills sold, that is frigging ridiculous.

 

High costs are due to
a- Massive admin costs of the health system. Up to 25% of costs is admin. How many people and parties do you cross to see a dr? More than you know.

b- For profit care. Free market & capitalism. Doesn't work for health. You pay anything for health and worry about price later. Without cost control, it is a one way street. This is why our drug prices, med test and procedures are out of control.

c- Multiple systems. VA, Medi, Private (multiple states and fed health exchange, large corp, small corp, governments), Un-insurable. Not efficient, overly complex, redundant in some area. This create problem with both a & b above.

d- To a lesser extend, too much health care. We are inefficient and we barely work as a team. Many specialize area that do not share information and so the same or similar medical tests and procedure are done.

Singer payer tackles at least a, b & c.

 

Absolutely. While other countries push prices down, these company can shift the cost to the US.

I would also add that reducing that fat margin is doable. They still rather a profit than no profit. Today, in the US, it's not a profit than no profit, but how big of a profit can they get away with. So far, as a big as they can imagine people are willing to pay.

 

"Free" might be the rallying cry of the faithful but "affordable" is the goal, and one that Republicans care about as much as anyone. The issue is not wanting "free stuff from the government" as much as making the humble suggestion that working people should be able to afford those things.

 

It'll really help tackle D as well, you can bet that there will be a lot less health care available and the quality would suffer in most of the country in a single payer system.