im just guessing here, dunno if true or not, but maybe americans aren't massively more sick than euros and instead maybe your medical professionals are massively more incentivised to diagnose everyone with everything

Single payer would pave the way for America to spend much less on healthcare. You are really hung up on the absolutely wrong things.

Even with universal care there would likely be an augmented coverage market.

As for Obama's lie he did say that and ultimately they made some changes to allow people to keep their plans for a couple more years.

The biggest problem was some people claiming it somehow entitled them to the same plan forever.

If you can handle John Oliver's accents, watch this.

Cliffs:

• In 1972 the Federal government signed up to pay for universal dialysis.
  
• Since then we have a 46-fold increase in patients needing it.
  
• So today treating end-stage kidney disease takes up 1% of the entire Federal budget (compare with the 2% of the budget devoted to the Department of Education.)
  
• We could certainly drive down costs by nationalizing the for-profit private treatment facilities.

But IMO we should be far more concerned about why the **** we have a 46x-fold increase in dialysis patients in 45 years (vs. 1.5x increase in total population); rather than why we haven't fixed the incentive structure for the dialysis treatment providers.

I know it probably isn't happening here anytime soon but what do people think of the Swiss system? It has a hardcore mandate that makes pretty much everyone buy in and you still have to pay for a lot out of pocket which keeps costs down (gov't mandates prices are all listed), then it has subsidies for the poor that can't afford it.

And obviously it decouples employment from healthcare.

Somehow this is the consensus of everyone ITT, and I just don't get it at all.

Take the dialysis example. Nationalizing all treatment providers would reduce costs by x%. We should devote some energy to doing this.

But it seems truistic that we should devote far, far more energy to doing something about the root cause of the explosion in chronic kidney disease. What am I missing here?

But a lot of these people will be way more productive when they're healthy. And more productive then if they died. So it's still a net win.

Yes, but if you think the 1930's didn't generate sick people, I think you may have a problem of survivorship bias.

And what do you want to do about preventing the explosion of people needing dialysis that doesn't involve letting people die younger before they have problems?

Nevada is a pretty moderate state these days, largely due to the growth of Las Vegas (its population nearly doubled from 1990 to 2000 and went up another 22% from 2000 to 2010), and immigration in the region.

A lot of this has to do with the Western diet, and food additives that are used a ton in the US compared to the rest of the world... High fructose corn syrup being the prime example.

Nevada is actually considering something similar to this. Everyone would have an option to buy into the state Medicaid program at cost.

Obviously the risk is that employers see this, drop coverage, and view it as a cost-saving mechanism without increasing wages, which makes people lose the coverage they want to keep. My proposal would be:

1. Anyone can buy into "single payer," style coverage (Medicaid, Medicare, whatever) at cost.

2. Anyone who's employer drops their coverage can also buy into that plan, in other words the insurer must accept them at the same cost as before.

3. Any employer who drops coverage must increase their employee's salary by the cost of the plan they dropped.

Then you may get people laying off employee A to hire employee B, but ultimately there is going to be a path for the greedy and heartless to benefit, and we can fight that one on the living wage front.

Better detection and understanding of conditions that require dialysis? Expanded awareness of treatment options?

They needed 60 votes to pass obamacare, unless I'm going crazy?

It did. Some modifications had to be passed by reconciliation which limited the amount of tweaks they could do. A lot of people have the false memory that the whole Obamacare bill was passed via reconciliation because Republicans made a big stink about the modifications being passed by legislative trickery or whatever.

They needed 60 obviously. Otherwise we would have...a public option. That's right, Democrats are so ****ing spineless and inept that they didn't even try for UHC when they had the house, 60 senate seats, and the presidency.

because healthcare is a privilege, your increase comes when people are forced to avoid the doctor (for fear of bankruptcy) when their ailments could have been caught and treated and maybe even cured early on, at minimal cost. however because these people cannot afford reasonable access to basic healthcare, they only go to the hospital when their only other option is death.

but how can you take serious anyone's estimations when they're being based on grossly overinflated numbers which bear no resemblance to reality?

They are seriously a parody of ineptitude. We're 25 years into Republicans being complete pieces of **** and they remain Charlie Brown trying to kick the football.

They couldn't get to 60 without Lieberman, and they couldn't get Lieberman with the public option, come on this stuff is common knowledge man!

https://www.theatlantic.com/politics...option/347740/

The US is certainly more obese than most places, but that it might account for such a massive difference seems ridiculous. And, amazingly enough, it is:

http://www.commonwealthfund.org/publ...al-perspective http://www.mckinsey.com/industries/h...us-health-care Lest you accuse me of cherry picking, those were literally the first two results of googling "US healthcare costs analysis".

All these big lads don't seem to be consuming more healthcare, so it's unclear why they're costing you so much. Further even if obesity and diet are risk factors there are plenty of others - like smoking and drinking - where the US does well or perfectly OK compared to its peers.

Oh I know. But they never even made the case for UHC. Its negotiating 101 (this is one thing the Republicans are good at). Start way outside where you want to land and make it appear you'll follow through.

Oh, and they didn't shame the **** out of Lieberman for being the worthless POS he is. "Hey, we disagree, that's politics!" ****ing idiots.

Republican leadership just promised to run millions of dollars of ads against the Republican Senator who opposed to their bill.

They better hope there are no "tapes" of this being planned.

Tort reform easy game

"Republican promise" heh

So people are scamming the government for free dialysis? Or the dialysis companies are scamming the government by billing them for non-existing treatments?

Or did that many people always need dialysis but couldn't afford it and didn't get diagnosed? I mean there are millions of people in this country that don't get treated for whatever diseases they have simply because they can't afford it or don't go to a doctor for diagnosis.

I honestly don't know but I suspect it's more likely to be the later.