Quote:
Originally Posted by Biesterfield
I'm not that knowledgeable re: healthcare but isn't one of the problems with Bernie's plan (and to a lesser extent healthcare as it currently exists) that
1.) insurance would cover the most minor of treatments, and people would not be cost-conscious; similar to if you had your groceries paid for by someone else
2.) prices would decrease, and people would demand more of it than they would otherwise in a free market, and since government will still supply at this price the resulting loss will be larger than if you assume demand doesn't change
Yes. Bernie’s plan involves a benefit design where everything is free for everyone. The problem with this is, as you note as has been discussed in the thread, is that leads to their wasteful use. That’s somewhat the case now in the US, and is more the case the richer someone’s benefit plan is
Quote:
Originally Posted by SenorKeeed
And US Americans already aren't really cost conscious about healthcare. Either their insurance pays for it or they can't and don't pay for it. There are very few market forces that tend to push down healthcare costs. No one price shops.
People are certainly less cost conscious about healthcare than other goods and services. There are many reasons for this but among them: 1) good price/quality data doesn’t exist, 2) people often don’t have a choice 3) people often don’t feel as if they have a choice even though they do, 4) the health care system is hard enough to navigate as it is without adding the complexity of price shopping 5) often people are stressed about the reason they’re engaging with the health care system in the first place and can’t reasonably be expected to have the executive function necessary to price shop
Quote:
Originally Posted by CalledDownLight
This isn't true. I actively avoid going to the doctor for a decent bit of stuff I would just go in to make sure of if it wasn't for price. I think lots of middle class people are in the same boat of not wanting to pay deductibles or copays for things that are likely not serious. These same people would mostly use the services if it was at no additional measurable cost to them.
A lot of people do do this, that’s why copay/coinsurance/deductible is somewhat effective. Of course sometimes people forgo needed care, which is no good and usually leads to worse problems down the road.
Quote:
Originally Posted by SenorKeeed
Well first of all single payer doesn't necessarily mean totally free, no cost. France for example has single payer and non poors pay like 20% out of pocket. I'm not sure how Bernie has structured his plan but something like that would be best imo.
Bernie’s plan is totally “free”
Quote:
Originally Posted by CPHoya
goofball, I assume you mean that copay / coinsurance / deductibles are effective at keeping costs down for some end users, or something like that?
I mean it’s effective at keeping total health care spend down i.e. per person spend on health care. Obviously some end users will be better off (because they don’t use much care and have lower premiums) and some will be worse off (because they pay higher cost sharing) but overall the richness of someone’s benefits and how much health care they use are directly correlated.
Quote:
Originally Posted by Wooders0n
This is a problem with the current system, not with the proposed solution.
Why?
Quote:
Originally Posted by SenorKeeed
No, the argument is that the single provider has tremendous negotiating power. Medicare already does stuff like set prices for procedures and their costs are lower than private insurance. Medicare is barred by law from negotiating drug prices, which all single payer countries quite effectively do.
This could be true but I'm not making this argument. But single payer countries have high consumer satisfaction with their systems and lower overall costs, soooooooooo
Medicare also sets prices too low for most doctors to stay in business, were they to only treat medicare patients.
Quote:
Originally Posted by Wooders0n
I disagree that's the point. I don't care if total costs go up as long as quality of care goes up and people never have to worry about the financial consequences of health.
a) What does quality mean? b) you don’t care? Does that have a limit? What if health care spend were 50% of gdp?
Quote:
Originally Posted by SenorKeeed
So why would our system go off the rails if we adopted single payer but every other developed country seems to be doing quite well with a single payer system?
It probably wouldn’t.
Quote:
Originally Posted by vhawk01
Supports it but very little. Every single non single payer country on earth has lower health care costs than the US. Many of them have lower costs than say the UK. Many countries with single payer would undoubtedly have lower costs than the US regardless of what system they used.
The main thing you give up when you switch to a system like that is the ability to choose who you see and when you see them. Healthcare is still a scarce resource and has to be allocated, we can’t just have it all all the time. So most countries with single payer have chosen to (massive oversimplification incoming) give people health care “for free” but restrict their access to the system in the form of wait times for elective procedures and the need to get referrals before you can see a specialist, and not having all doctors be included as in-network. We had that in the 90s in the USA (HMOs) and people hated it.
Quote:
Originally Posted by lenC
Possibly a very stupid question:
One thing I don't get with the American system is that I've seen images of bills where a person has called for an ambulance, driven for a couple of miles to the hospital and ended up having to pay thousands of dollars. What's the break down on where this money goes? If you add up the doctors fees, possible equipment damage, gas money, whatever, how can you arrive at such a number?
Like if you have cancer and have to pay for some obscure drug that has a FREE MARKT price tag on it, I get it, might get expensive. Are these people driven to private hospitals who set the price tag to wherever they please?
Basically they can charge whatever they **** they want, and do. And they refuse to contract with insurance companies because ambulance companies know when they’re doing work it’s way more likely to be a serious medical situation and as such insulates them from pushback on their pricing.
Quote:
Originally Posted by suzzer99
I think all plans should be HMOs. I shouldn't be the one to decide if I need to see an endocrinologist. My primary doctor should make that call.
When I had an HMO and needed to go a dermatologist to get plantar's warts burned off, I would just call their office and they'd send me a clearance. I didn't have to make an appointment with my primary except for that first time so she knew I knew what a plantar's wart looked like. So it doesn't have to be some big onerous thing.
As reviled as HMOs were they were fairly good at holding down costs. But by god people hated them.
