Need some economics help on universal healthcare

[txprog]

Let's see. My employer pays about $3500.00 a year to United Health Care for my health insurance. If instead of UHC there was a government run program, my employer would pay me the $3500.00 directly and I could be taxed by that amount to help pay for what should be a much more efficient and effective system. Yes a tax increase but a salary increase too to offset it. No change at all to my take home pay. OK. And the billions of TAX dollars that already go to support public facilities around the county would be re-directed into the system. And the nasty cost shifting hospitals have to do to compensate for those who can't pay would end. Bottom line, we already spend billions and billions of dollars. I don't have a clue about the economics of all of this, but why would single payer universal health care necessarily require huge amounts of additional spending and large tax increases?

[elehhhhna]

1. It wouldn't. That's propaganda.

The money that's now going to the ins. co's would go directly into the medical system and since the payee would be the Fed or some other Gov't entity, the Reeps call it a "tax".

[Flatulo]

3. I think the point is that we need a prominent, respected voice

to explain this, to counter the common perception that single payer is somehow economically unrealistic.

There seems to be a common mis-perception that states with universal health care are hell-holes of poverty.

There needs to be a strong case made, very publically, that it is actually cheaper to go with single payer. It can't be some obscure think-tank study - it has to become part of the national dialogue.

[txprog]

5. This is where Clinton messed up

Instead of using the "bully pulpit" to lead a national disucssion and build a national consensus based on fact rather than propaganda before formulating a plan and bringing it to the people, Clinton took it behind closed doors and the results were disastrous. Indeed, loud voices of expertise are mandatory.

[Flatulo]

6. With due respect to Hillary, I think her plan was too complex

to explain. Didn't she leave in place the current system of umpteen insurers?

We need a system like the French. Last time I checked, they love theirs.

[Solo_in_MD]

16. Before we get a pitchman, how about a viable plan

Yet to see one yet. The soundbite offered so far are just that, soundbites. Its a complex issue that needs some serious planning and evaluation before its starts to be sold to the electorate.

A half done job will get picked apart and set UHC back 10 years.

[TreasonousBastard]

2. It's the currently uninsured who would...

start getting health care. I doubt the savings from eliminating insurance companies or duplicated services would cover the additional costs of millions of new "covered" patients.

And, there are always costs associated with such a massive change in the way we do things. Lessay that places like East LA, Detroit, rural Alabama... now have fewer healthcare facilities relative to the population than Manhattan or Nebraska. Well, then we're gonna build facilities and hire all those professionals to staff them. At great cost.

[Flatulo]

4. The point has to be made that the cost of getting health-care to

the uninsured, via emergency room visits, far exceeds what it would cost to cover everyone to begin with.

ALmost everyone agrees the current system, while no doubt denying medical care to many, is just too expensive.

[TreasonousBastard]

11. True, but some places have experienced...

massive increases in healthcare costs, mainly Medicaid, when people have options other than the emergency room. Seems that they go to the doctor or clinic more often and more medical conditions are diagnosed and treated.

Diabetes, high blood pressure, cataract surgery, even cancers... Look at all the things that don't go into emergency rooms. In the past, many people just died from chronic or unsuspected and undiagnosed, illnesses. With everyone covered, these illnesses and conditions will be paid for. And no one knows for sure how much that will be.

[Viva_La_Revolution]

10. Yes, I think it would...

300 million people in US, 40 million with no coverage = 7.5% of the population

30 cents of every dollar spent on healthcare goes for 'Admin' and profits = 30%

30% - 7.5% = 22.5% left

est. cost of Medic-aid type Admin. - 4%

22.5% - 4% = 18.5% to build new facilities and bump everyone up to complete coverage, etc.

That's not even figuring in the outrageous cost that is incurred when people do not get cheap preventative care. So many end up spending thousands to take care of an issue that could have cost a fraction if caught early.

Obviously it CAN be done (as verified by every industrial nation except us).

[TreasonousBastard]

15. It can be done, but not by your numbers...

40 million is actually about 13% of the total population.

But, the real problem is you can't properly relate percentages of the population to percentages of healthcare costs.

Most numbers I see are about 2 trillion a year spent on healthcare in the US. First problem is that no one breaks out the nose jobs and tummy tucks that wouldn't be covered. Then, nobody knows what chronic illnesses or traumas we'll find amongst the uninsured that will now be treated.

But, OK, just for fun let's add 13% to the two trillion-- that's another 250 million or so. Then let's say that we'll save that 30% insurance overhead, which would be 321 million of the new total.

So, it looks like there's around 70 million saved by killing the insurance companies. That's not enough to guarantee actual savings, and not even enough to guarantee that any savings will cover new costs. Putting a few hundred companies out of business and dealing with a few thousand newly unemployed (without company healthcare, of course) won't be cheap. And we don't really know what the new costs will be, since we're not all that sure what the old costs are. But we are pretty sure that even without the 40 million uninsured costs are escalating faster than inflatrion or GDP growth.

Oh, and that 30% overhead is the high end of the spectrum-- most companies work at lower margins.

Several other things have to be done-- primarily, we have to reduce our per capita spending to something closer to the rest of the developed world. How we do that is yet another troublesome discussion.

[PA Democrat]

17. Do you happen to know if the overhead costs people use are those of the insurance company alone?

What about the overhead that individual doctors, hospitals and other health care providers incur to process the ridiculous amount of paperwork all of the different insurers require? How much time do doctors and their staffs spend fighting with the insurance companies to get paid, or to advocate for their patients?

My former insurance company buried my doctors alive with bullshit paperwork in an attempt to deny payment by proving that my claim was for a preexisting condition. I was outraged at the expense they incurred to AVOID payment. And I am learning that this is not an uncommon practice. This same company has been playing this little game in other states and has been cited and fined for this exact practice. But they continue to do it, because it's MORE PROFITABLE to run the risk of unfairly denying claims and delaying payment rather than paying them.

So we have departments of insurance in every single state which we the taxpayers fund to try to keep up with corrupt insurance companies.

It would seem that there's a LOT more waste in our current system than just the insurance companies' overhead.

Oh, and another little tidbit. The US should ban all direct consumer marketing (think of all of those drug ads on TV) of pharmaceuticals. The US is one of only two developed countries who permit this. Want to cut the cost of drugs in the US? Outlaw those stinking commercials. The pharmaceutical industry will cry that our drug prices are so high because of the money they are spending on research, yet the truth is that they spend 2 and 1/2 times as much on marketing as they do on R&D.

http://www.motherjones.com/news/qa/2004/09/09_401.html

[TreasonousBastard]

19. Usually it's insurance co. overhead, but...

you're absolutely right that there is not only an effect on providers, but there is a huge amount of waste in the providing itself.

Remember that no matter who pays the bills, there will be accounting departments to keep the payments and paperwork straight, although reducing the number of payers will reduce the amount of paperwork to some extent. No matter how you cut at it, though, claims adjusters will be needed to stop the whole thing from becoming a feeding frenzy.

Right now, there are too many incentives for hospitals, medical groups, and whoever to pad the bills, legally or otherwise.

Why does every hospital that can possibly afford have to have the latest diagnostic equipment that will be used maybe 10% of the time? Because they can charge enough to make it worth their while.

Why does a hospital patient have an endless line of "consulting" physicians passing by the bedside and putting a one-line comment on the chart? Because they bill and get paid for that little stop. Actually doing something for the patient is irrelevant.

Why are hospital bills in NJ higher for the insured than the uninsured? Because a deal was made years ago to soak the inurance companies for the costs of treating the uninsured.

And, yeah, why are drug companies allowed to advertise stuff that you can't buy? Because even though you can't self-medicate with their pills, you can bug your doctor until he writes the scrip just to shut you up.

[Viva_La_Revolution]

18. let's break it down to just one person...

Having basic dental care would have saved me thousands of dollars, and I would be able to chew real food today.

3 babies, 2 at Public Hospitals (taxpayers paid for those 2)

Having regular physicals - would have caught cervical cancer much earlier and saved thousands of dollars (half of which the hospital wrote off for me, ie... subsidized)

I (personally) have had to spend at least triple the amount it would have cost to just keep me basically healthy.

Ruined credit from not being able to pay the rest.

living in constant fear that one of us will get sick/hurt.

OR

$5 from each paycheck and no-one in this country has to ever worry about not getting the care they need.


And frankly, comparing the relatively few people who would lose their jobs (temporarily) or dividend payments because of the change does NOT outweigh the benefits to every one in this country who would gain.

Just because it would be difficult, does not mean that it cannot or should not be fixed.

[TreasonousBastard]

20. You're right that...

in many individual cases, like yours, the system sucks and causes more pain and expense.

But, it's a big system and can't be designed to be optimal for everyone.

[Viva_La_Revolution]

23. why not?

it's working pretty well everywhere else. :shrug:

[TreasonousBastard]

21. Dental plan insanity...

and how a plan may not have helped you.

Years ago there was some big hoopla over dental plans and it came out that most plans saved loads of money by not fixing your teeth.

Obvious, you say? Sure, but you'll never guess how.

There are some procedures that will save a tooth almost forever if you want to spend 500 bucks and up. It seems like a no-brainer that 500 bucks once and for forever vs 100 bucks every year makes the expensive procedure the one, right?

Well, the dental plans all realized that people changed plans every year or two, whether they liked it or not, so they refused to do the expensive procedure because it would be saving ANOTHER plan the money.

You can't make this stuff up!

[gravity]

7. The increased would be more than offset by the decrease insurance costs

If you have insurance, you are paying for those without insurance, who have to visit the expensive emergency room for the their medical care. That money has to come from somewhere, and hospitals just raise your costs to make up for it.

[Flatulo]

8. Also remember that insurance is a profitable business

They are betting that you will not get sick. You are betting that you will.

Guess who wins most often?

[ProfessorGAC]

9. You Have It Right

The naysayers claim that gov't is inherently less efficient than private enterprise. The post office contradicts that claim, however. So does the military. There is no private military or merc organization that can even approach doing as much as efficiently as the US military.

Very large organizations always have some waste, but dilligence is what's needed, not an automatic dismisssal of the gov't ability to be efficient. The gov't has no higher level of lost efficienty than G.E. Look at their balance sheet and see their annual write-downs.

The U.S. gov't is as efficient, as least, as General Electric.
GAC

[SoCalDem]

12. Simplicity..

Your boss would need to pay YOU the $3500 as regualr wages, and the UNIVERSAL/SINGLE PAYER/GOVERNMENT funded healthcare would cover you and your family out of GENERAL REVENUE TAXES we ALL pay in.

It's just a simple matter of deciding that having healthy citizens is more important than building bombs & military junk and funding foreign invasions.

Once employers were "off the hook" for paying for health INSURANCE, they would have NO EXCUSES left for not paying real raises..and employees would then be FREE to change jobs at will..

Entrepreneurial sorts would be free to start businesses once they knew they would not be sacrificing their family's health care..

Companies would be free to open new facilities in the US, instead of abroad, since they SAY the high cost of doing business here hinders them..

Would taxes go up?? Maybe.. BUT even if taxes went up, we would all breathe easier KNOWING that for ONCE, we were getting something for our money..

INSURANCE is the problem...NOT the solution :)

[ItNerd4life]

13. The myth: Competition is keeping the costs down.

The beauty of the marketplace is there is competition to help drive for more efficiency and thus keep the costs down. This is true for most goods and services.

However, consider that there are some services that are better provided by the government. Police and Fire protection are 2 perfect examples. Police and Fire departments are called upon in an emergency. You prepay (i.e. taxes) so they are readily available when you require their services.

The same should be true with health coverage. Many times it's an emergency. We should be able to prepay (i.e. taxes) to have these emergency services available whenever we need them.

Emergency situations like Police, Fire, and health have no marketplace. There are no market forces to improve efficiency because that structure doesn't work in emergency situations.

[Cleita]

14. Go to this website and the FAQ link.

http://www.pnhp.org. Then read all the articles they have posted. This will answer all your questions and make you very well informed on the matter. This website is the best researched and most comprehensive on universal health care that is out there.

[Rosemary2205]

22. Financing this is a big problem IMHO.

There are going to be a whole lot of people who currently get some form of employer assistance with healthcare that WON'T get a raise big enough to compensate for the added tax. IMHO there are going to be quite a lot of businesses who take the money and run. Some won't, but some will.

IMHO financing this is the real sticking point. The total dollar spent will probably be less than is spent now but getting that money to the government has it's problems.

If you put the burden on individuals, you have a whole class of people who get minimal or no healthcare dollars from employers now. You also have a whole class of businesses who will just take the money they now spend and run with it rather than up the salaries of those they currently cover. So quite frankly, IMHO quite a lot of individuals could get royally screwed by the added tax burden.

If you put the burden on employers, you have a whole host of small businesses and self employed who can't afford insurance now and won't be able to survive the added taxation. Plus you will have bigger businesses looking for any loophole they can and will figure out how to weasle out of paying the added tax for healthcare.

It seems like an easy thing to set up financing similar to the other single payer universal systems in the world - but IMHO the corporate laws in this country allow for so much corruption that I am not convince there won't be "unintended consequenses" involved.


Anyways, I am totally on board with single payer universal healthcare and have long ago began to start fighting for it. But in the back of my head I wonder about how the finances will work out given our generally easy to corrupt corporate laws.