Do you agree with me that the USA government should massively CUT healthcare spending?

[Doodley]

First, I want everyone in America to have healthcare. I also want the healthcare outcomes to be better.

This is how we can do that and still slash government funding for healthcare.

Take a look at nations with universal healthcare. UK, for example. No, it is not a perfect system, but it has many better healthcare outcomes. The people in UK live almost two years longer than in USA and infant mortality is better, but total healthcare spending per person (government and private) is a fraction in the UK compared to USA.

Take a look at this chart of nations with the best healthcare:

1. United Kingdom

2. Switzerland

3. Sweden

4. Australia

5. Germany & Netherlands (tied)

7. New Zealand & Norway (tied)

9. France

10. Canada

11. United States


https://www.forbes.com/sites/danmunro/2014/06/16/u-s-healthcare-ranked-dead-last-compared-to-10-other-countries/#21e4a736576f


This quote sums up the high costs of USA compared to UK:

With development, health outcomes generally improve, but the U.S. is an anomaly. The U.S. and the U.K. are both high-income, highly developed countries. The U.K. spends less per person ($3,749) on health care than the U.S. ($9,237). Despite its high spending, the U.S. does not have the best health outcomes. [Life expectancy, for example, is 79.1 years in the U.S. and 80.9 years in the U.K. And while the U.S. spends more on health care than any country in the world, it ranks 12th in life expectancy among the 12 wealthiest industrialized countries, according to the Kaiser Family Foundation, a non-profit organization focusing on health issues.]

http://www.npr.org/sections/goatsandsoda/2017/04/20/524774195/what-country-spends-the-most-and-least-on-health-care-per-person

Next, let's look at how much the USA government contributes to healthcare per capita:

Tax-funded expenditures accounted for 64.3 percent of U.S. health spending – about $1.9 trillion – in 2013, according to new data published today [Thursday, Jan. 21] in the American Journal of Public Health. The Affordable Care Act will push that figure even higher by 2024, when government’s share of U.S. health spending is expected to rise to 67.3 percent.

SNIP

“We pay the world’s highest health care taxes. But patients are still saddled with unaffordable premiums and deductibles,” said Dr. Steffie Woolhandler. “Meanwhile, billions are squandered on paperwork, and insurers and drug companies pocket huge profits at taxpayer expense.”

http://www.pnhp.org/news/2016/january/government-funds-nearly-two-thirds-of-us-health-care-costs-american-journal-of-pub

So, these are the key facts.

1/ We already pay the highest taxes for healthcare, plus we then have to pay for insurance, co-pays and deductables, plus tens of millions of people are uninsured, but healthcare outcomes are not the best.

2/ In addition to insurance, the USA government is already paying around $6,000 per capita for healthcare.

3/ If we scrapped all health insurance and copied the UK system, everyone could be covered as in the UK, through what we already pay in taxes for healthcare, because that would equate to $6,000 per capita, compared to $3,749 in UK.

4/ We could then slash USA government healthcare spending by over 350 BILLION dollars a year and still have spending on healthcare 30 percent higher than in the UK.


In short, if we learned from other nations and were not being scammed by healthcare providers, insurers, big pharm, and our own government we could achieve:

Healthcare for all.
Better outcomes.
No insurance premiums.
No co-pays or deductables.
Less government spending.

Isn't this what the healthcare debate should be about?

[Hoyt]

1. Bet our doctors, facilities, nurses and other staff, suppliers, ambulance companies, MRI manufacture

s, drug companies, insurance companies, healthcare lobbyists, etc., would pucker if that were seriously considered. Not opposed and ultimately it will happen, but the healthcare system fills the trough for a lot of people, like military spending and a lot of other wasteful sectors in this country.

[Doodley]

2. There could be MORE doctors and nurses, etc.

For example:

UK physicians per 1000 is 2.77, compared to 2.56 in USA
UK acute care hospital beds per 1,000 is 2.46, compared to 2.28 in USA
UK MRI machines per million is 35.5, compared to 6.1 in USA

http://www.commonwealthfund.org/~/media/files/publications/fund-report/2016/jan/1857_mossialos_intl_profiles_2015_v7.pdf

Plus, I suggested USA spending could be 30 percent higher than in UK

As for healthcare insurance companies, they can go out of business. Total waste of time and money, a drain on our resources, and putting profits before lives.

[Hoyt]

3. One thing insurance companies do, that the government has been afraid to do, is say No

to worthless treatment and tests, and they actually do negotiate drug prices unlike Medicare. If that stuff is picked up by the government, at best we'll save 8% or so and government will have to come up with the capital to build and maintain systems for operating a large healthcare program. It's going to take years to do that because you can't depend on Trump or the next admin to do it.

I believe your point is right, but it is going to be absolute hell getting there from here. I'd love to live under Canadian or British system, but we are too stupid to pull it off anytime soon.

I think you have some of your stats reversed, like MRIs

[Doodley]

5. Yes, I agree. It would be difficult to implement. We would need all branches of government

to be Democrats. Also, we would have to tackle America's addiction to prescription drugs and the obesity crisis, which is a drain on spending, and that is a long-term project too. The other thing is the danger of the next Republican administration deciding to start selling it off to the private sector. They would also try to demonize it, by claiming it is failing.

The first step to make such a change would be to build on the work of Bernie Sanders in educating the people and winning people over into acknowledging we can learn from other nations that do it better.

[TreasonousBastard]

4. Interesting, but (there's always that "but")...

The US is unique in that list having a huge rural population, much of it without adequate health care. We have native americans with their barely adequate Indian Health Service. And there is that whole inner city underserved thing.

These are not excuses, but could be reasons tilting our numbers downwards.

Expenses, sure, they are too high here, but the first thing to do would be to mandate a uniform claim form. Every payer has their own, and their own rules. Hospitals and practices have to deal with dozens, sometimes hundreds, of forms. Mistakes are made and the additional clerical hours even without mistakes are huge.

Duplication of facilities could be slowed down. Not everyone has to have the latest tests and cures. And if you are transferred to one with special care, there should be no need to spend thousands on another complete workup.

Other countries use insurers for basic claims work, as does Medicare. That's an efficient use while reducing or eliminating insurance co nonsense.

[Hoyt]

8. Agree with most of that. While insurance companies do have some different rules, they

almost all use the same claim forms, 99% of same codes, etc. They have for years. Billing and admin are a hassle, but any system is going to have much of that, quality reporting and measurement, etc. I think people overestimate admin savings.

Heck, today, most of your big insurers adopt a lot of Medicare utilization and billing policies.

[Doodley]

9. What are these claim forms and insurers for basic claims work? There would be no

insurance. There would be no claims. I am from the UK, and I can tell you, you never need to fill in a form to do with claims, at least in the UK.

I agree with what you say about rural communities, far from big cities. But also consider that USA has a population almost five times the UK. That should bring economies of scale. Instead of buying 20 of a machine, USA would be buying 100.

What I have found is the general scamming by healthcare providers. For example a friend had surgery and the cost of a pencil was $42. There is nobody who is controlling prices. They charge what they like. This is a cartel.

Medication is sold like a consumer product, advertised on TV. This is ridiculous. Drugs should not be sold like that. Americans consume more pills than the rest of the world combined. 80 percent of the global opioid supply are consumed in USA, a nation with five percent of the population.

http://www.cnbc.com/2016/04/27/americans-consume-almost-all-of-the-global-opioid-supply.html

[pnwmom]

6. Yes, we spend more. But getting those costs down will be a huge, painful undertaking. n/t

[MedusaX]

7. Where is the framework/ plan for implementation? All I see are the same sound-bite catch phrases

That KGOP have been spewing for 8 years....
Better Care
Less Expensive
Healthcare Access for all

All of the data presented focuses on current expenditures by country...
it is not valid to simply substitute UK expenditures for an actual cost analysis based on US market conditions/ feasibility factors...

The links provided reference three different universal healthcare formats currently used worldwide...
Single Payer
Two-Tier
Insurance Mandate

These formats are not one-size fits all and
are not available as some As Seen on TV
pre-packaged
Universal Healthcare in a Box
Your choice of Style A, B, or C
that can be delivered tomorrow when ordered in the next 18 hours via Amazon Prime!!

Until the complete framework identifying coverage, provider requirements, service delivery logistics & options, coverage acquisition process, cost sharing responsibility ratios, allocation of fiscal resources and the distribution flow of funds required, etc..
is generated, there is no accurate way to forecast realistic cost projections.

Without valid cost projections, there is no way to know if implementation
would result in $X annual savings or
require additional funding allocations in the amount of $X/ per yr.

The debate should be the means by which the most appropriate program is determined
Based on a comparison of factual costs/benefits associated with various program options readily available for implementation...

[Doodley]

10. I agree it is not simple. What I am not proposing is to cut spending then figure it out.

However, there is no good reason why USA is paying more than twice as much for healthcare than other nations, unless there is something unusually sickly and prescription drug-additive about the American people.

I agree we need to look at all the facts. But the raw facts that even without insurance, we are spending more than other better healthcare systems shows, to me at least, that Bernie Sanders is right to make the point that we need to look at what other nations are doing.

[taught_me_patience]

11. I'll go out on a limb and guess you're not a doctor

Pretty easy to talk about other people needing to take pay cuts. How hard would you fight against a 20-30%pay cut for yourself?

[Doodley]

13. Okay, you convinced me. Let's keep the USA system the way it is.

[msongs]

15. maybe less wasteful spending could equal higher payer for actual care givers nt

[clu]

18. michael moore touched on this issue in Sicko

Yes some healthcare workers would need to take a pay cut but if you reduce the hurdle for medical school education funding maybe some of them would come around. I think the UK docs get a stronger pension but I'm not sure.

[Hieronymus]

12. As long as insurance companies and pharmaceutical companies

are paying off Congress we won't get universal care.

[Doodley]

14. Very true. How will that ever change?

[Demsrule86]

16. Absolutely not. We are a much bigger country. We should spend more on health care.

[Trial_By_Fire]

17. We need to phase out insurance companies...

...and highly regulate drug companies.

We can start with lowering the Medicare age to 55. Make this work first which
should not be difficult. Then make it Medicare for All for everyone.