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Single payer healthcare
Topic Started: Apr 11 2016, 11:21 AM (1,101 Views)
estonianman
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How does it work? My understanding is you nationalize all the insurance companies and then the government forces healthcare provides to sell a product or service at a specified price.

How is this ideal? When in history has price fixing ever worked?

In the past, suppliers of a product have just stopped selling that product if there is no profit. This is exactly what is happening in Venezuela where the price of food is fixed by the government.
MEEK AND MILD
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estonianman
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No one wants to take a shot? Not baiting here.
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Two a.m.
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I don't know that there is such a thing as an "ideal" healthcare system. No method produces utopia. Various methods produce various results. Our completely private method produces a system that is highly innovative and creates the best technology. Unfortunately, it also creates massive costs and limited coverage because people get priced out of the system. By contrast, socialized systems produce a lot of different results depending on their exact structure. But generally speaking, they tend to lower the insured rate but they won't be as innovative. Obamacare is actually an attempt to bridge the two. It doesn't really socialize much beyond expanding Medicaid. But it does create a marketplace with certain rules which try to promote private competition.

How will that work? We really don't know yet and probably won't for some time to come. It will certainly not be perfect. Neither was the system it replaced.
"The stars can be near or distant, according as we need them." - George Orwell, 1984
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estonianman
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Two a.m.
Apr 11 2016, 02:39 PM
I don't know that there is such a thing as an "ideal" healthcare system. No method produces utopia. Various methods produce various results.

It might not be perfect, but a system that provides options, all competing with each other with quality and cost is better then a system with only one option.

Our completely private method produces a system that is highly innovative and creates the best technology. Unfortunately, it also creates massive costs and limited coverage because people get priced out of the system.

I am not sure I would call the US system a "completely private". Yes there are private components, but they are all regulated and subsidized by government systems. This produces an artificial effect on the market which by some is considered negative.

By contrast, socialized systems produce a lot of different results depending on their exact structure. But generally speaking, they tend to lower the insured rate but they won't be as innovative. Obamacare is actually an attempt to bridge the two. It doesn't really socialize much beyond expanding Medicaid. But it does create a marketplace with certain rules which try to promote private competition.

i'll be the first to tell you there are market friendly aspects of the ACA - such as encouraging competition. That said - the number one issue with socialized systems is supply. There is no incentive (other then a democratic election) to produce supply. The motivator in market based systems is profit. High profit margins are dealt with by competition.

The problem with the US healthcare system is while it is market based, it also creates barriers of entry for competition. Therefore high profit margins (and it is debatable whether they are all high, the devil in the details is net profit) remain unchallenged by competition.


How will that work? We really don't know yet and probably won't for some time to come. It will certainly not be perfect. Neither was the system it replaced.

We have seen situations where the government implements price controls on food, and other essentials and it ends in disaster. The premise of this thread was to find out how a government insurance plan would be any different.

We have some specific examples as well. I believe Japan put something similar to single payer in place - and the result was a huge shortage of doctors. It also resulted in doctors doing shady shit like giving you pointless prescriptions and tests to make money.

I am not convinced how single payer is any better than rent control in terms of suffering from the typical pitfalls involved in rationing and price controls.
Edited by estonianman, Apr 11 2016, 03:10 PM.
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estonianman
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dp
Edited by estonianman, Apr 11 2016, 03:10 PM.
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BuckFan

The problem with relying purely on market forces for health care is that the typical market force controls are not equally weighted.

In a typical market, suppliers can continue to raise prices until the demanders stop buying. However, if you have a heart condition or cancer, you cannot stop buying or you die. So the supply side can raise their prices well beyond the capability of a significant portion of demanders can, on their own, afford. The result is people die or live in misery.

To counter this, demanders have banded together to pool resources and try to balance the power equation with suppliers in negotiations. This is effectively what insurance companies are.

Single payer takes this to the most extreme level, all demanders are represented in one pool for negotiations with suppliers. While they may be able to dictate terms, they have to be careful because they may end up driving suppliers out of the marketplace. If the government (assuming that is the single payer) dictates prices too low, providers in the terms of doctors and hospitals will just close up shop and go do something else. As you pointed out this will lead to shortages which will lead to unrest in the pool.

So the demander has to provide enough incentive to the supplier to stay in business while negotiating a cost structure that is acceptable to the demander pool.
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BuckFan

estonianman
Apr 11 2016, 11:21 AM
How does it work? My understanding is you nationalize all the insurance companies and then the government forces healthcare provides to sell a product or service at a specified price.

How is this ideal? When in history has price fixing ever worked?

In the past, suppliers of a product have just stopped selling that product if there is no profit. This is exactly what is happening in Venezuela where the price of food is fixed by the government.
I don't think this is the case. Insurance companies will not be nationalized but quite a few may be driven out of business and all will significantly reduced in size.

The government, representing the people, will provide a basic level of health coverage. An example can be found in Medicare or Medicaid. The government will negotiate, with a heavy hand since they represent the complete demand pool, rates for these services.

Insurance companies would then be free to provide "gap" coverage and other services to those that can afford to pay. Medicare is an example of this.

As I just posted there is a balance that must be struck between dictating prices that cause suppliers to leave the marketplace and costs that are untenable to the demander base.
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estonianman
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BuckFan
Apr 11 2016, 03:45 PM
The problem with relying purely on market forces for health care is that the typical market force controls are not equally weighted.

In a typical market, suppliers can continue to raise prices until the demanders stop buying. However, if you have a heart condition or cancer, you cannot stop buying or you die. So the supply side can raise their prices well beyond the capability of a significant portion of demanders can, on their own, afford. The result is people die or live in misery.

The market counteracts this with competition. The problem with US healthcare is the big companies help (or in some cases, author) government legislation specifically designed to limit the effect of competition. We see this in other industries in the US as well - so it is not exclusive to healthcare. In my opinion this is a deal breaker - in that the market will not work if competition is blocked.

To counter this, demanders have banded together to pool resources and try to balance the power equation with suppliers in negotiations. This is effectively what insurance companies are.


Single payer takes this to the most extreme level, all demanders are represented in one pool for negotiations with suppliers. While they may be able to dictate terms, they have to be careful because they may end up driving suppliers out of the marketplace. If the government (assuming that is the single payer) dictates prices too low, providers in the terms of doctors and hospitals will just close up shop and go do something else. As you pointed out this will lead to shortages which will lead to unrest in the pool.

That is the overall concern - and why price fixing always leads to scarcity. Suppliers will not produce something if they break even or worse - lose money.

So the demander has to provide enough incentive to the supplier to stay in business while negotiating a cost structure that is acceptable to the demander pool.

Here's what happens. Government plays favorites and a select group of suppliers get the government contracts. Profit margin is increased by government rebates - meanwhile innovation stagnates because there will be no incentive to differentiate yourself in the marketplace with technology.

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estonianman
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BuckFan
Apr 11 2016, 03:50 PM
estonianman
Apr 11 2016, 11:21 AM
How does it work? My understanding is you nationalize all the insurance companies and then the government forces healthcare provides to sell a product or service at a specified price.

How is this ideal? When in history has price fixing ever worked?

In the past, suppliers of a product have just stopped selling that product if there is no profit. This is exactly what is happening in Venezuela where the price of food is fixed by the government.
I don't think this is the case. Insurance companies will not be nationalized but quite a few may be driven out of business and all will significantly reduced in size.

The government, representing the people, will provide a basic level of health coverage. An example can be found in Medicare or Medicaid. The government will negotiate, with a heavy hand since they represent the complete demand pool, rates for these services.

Insurance companies would then be free to provide "gap" coverage and other services to those that can afford to pay. Medicare is an example of this.

As I just posted there is a balance that must be struck between dictating prices that cause suppliers to leave the marketplace and costs that are untenable to the demander base.
What is your opinion on Medicair/Medicaid's effect on the cost of healthcare?
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Robert Stout
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estonianman
Apr 11 2016, 04:08 PM
BuckFan
Apr 11 2016, 03:50 PM
estonianman
Apr 11 2016, 11:21 AM
How does it work? My understanding is you nationalize all the insurance companies and then the government forces healthcare provides to sell a product or service at a specified price.

How is this ideal? When in history has price fixing ever worked?

In the past, suppliers of a product have just stopped selling that product if there is no profit. This is exactly what is happening in Venezuela where the price of food is fixed by the government.
I don't think this is the case. Insurance companies will not be nationalized but quite a few may be driven out of business and all will significantly reduced in size.

The government, representing the people, will provide a basic level of health coverage. An example can be found in Medicare or Medicaid. The government will negotiate, with a heavy hand since they represent the complete demand pool, rates for these services.

Insurance companies would then be free to provide "gap" coverage and other services to those that can afford to pay. Medicare is an example of this.

As I just posted there is a balance that must be struck between dictating prices that cause suppliers to leave the marketplace and costs that are untenable to the demander base.
What is your opinion on Medicair/Medicaid's effect on the cost of healthcare?
Medicaid has reduced hospital and doctor cost shifting to those with insurance or money...The only alternative is to allow the poor to die without any treatment...... :banghead:
Jesus can raise the dead, but he can't fix stupid
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BuckFan

estonianman
Apr 11 2016, 04:08 PM
BuckFan
Apr 11 2016, 03:50 PM
estonianman
Apr 11 2016, 11:21 AM
How does it work? My understanding is you nationalize all the insurance companies and then the government forces healthcare provides to sell a product or service at a specified price.

How is this ideal? When in history has price fixing ever worked?

In the past, suppliers of a product have just stopped selling that product if there is no profit. This is exactly what is happening in Venezuela where the price of food is fixed by the government.
I don't think this is the case. Insurance companies will not be nationalized but quite a few may be driven out of business and all will significantly reduced in size.

The government, representing the people, will provide a basic level of health coverage. An example can be found in Medicare or Medicaid. The government will negotiate, with a heavy hand since they represent the complete demand pool, rates for these services.

Insurance companies would then be free to provide "gap" coverage and other services to those that can afford to pay. Medicare is an example of this.

As I just posted there is a balance that must be struck between dictating prices that cause suppliers to leave the marketplace and costs that are untenable to the demander base.
What is your opinion on Medicair/Medicaid's effect on the cost of healthcare?
Since the government is not a generous as private insurance I would say marginal.

The overall demand for healthcare is what is driving cost. We want our new knees, hips and hearts and expect to get them.
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estonianman
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BuckFan
Apr 11 2016, 09:35 PM
estonianman
Apr 11 2016, 04:08 PM
BuckFan
Apr 11 2016, 03:50 PM

Quoting limited to 3 levels deep
What is your opinion on Medicair/Medicaid's effect on the cost of healthcare?
Since the government is not a generous as private insurance I would say marginal.

The overall demand for healthcare is what is driving cost. We want our new knees, hips and hearts and expect to get them.
One thing I have noticed in the last couple years is satellite emergency rooms, urgent cares and general clinics opening up everywhere.

I went to one for some poison ivy a few years ago - not sure to the cost as I have insurance.
Edited by estonianman, Apr 12 2016, 10:15 AM.
MEEK AND MILD
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clone
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Director @ Center for Advanced Memetic Warfare
Just get the Nanny out of healthcare and all will be well....we just took on a relatively large DPC network of doctors...for an average of 50 bucks a month you get direct access to your primary care doctor. Combine that with a relatively inexpensive catastrophic policy or HSA and you're good to go....
Only liberals can choose not to go down the road to widespread, systematic violence.
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BuckFan

clone
Apr 12 2016, 01:20 PM
Just get the Nanny out of healthcare and all will be well....we just took on a relatively large DPC network of doctors...for an average of 50 bucks a month you get direct access to your primary care doctor. Combine that with a relatively inexpensive catastrophic policy or HSA and you're good to go....
What do you do for the people cannot afford a catastrophic insurance policy. We were on one of those with an HSA and they are not all that cheap. No insurance policy is, especially if you are not part of a group and end up on the individual side.

That is the whole reason ACA was passed, people could not afford health care and were not covered by an employer. It is those people, the ones that cannot afford any policy plus feed an HSA, that needed help.
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estonianman
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BuckFan
Apr 12 2016, 01:56 PM
clone
Apr 12 2016, 01:20 PM
Just get the Nanny out of healthcare and all will be well....we just took on a relatively large DPC network of doctors...for an average of 50 bucks a month you get direct access to your primary care doctor. Combine that with a relatively inexpensive catastrophic policy or HSA and you're good to go....
What do you do for the people cannot afford a catastrophic insurance policy. We were on one of those with an HSA and they are not all that cheap. No insurance policy is, especially if you are not part of a group and end up on the individual side.

That is the whole reason ACA was passed, people could not afford health care and were not covered by an employer. It is those people, the ones that cannot afford any policy plus feed an HSA, that needed help.
How Government Solved the Health Care Crisis

Medical Insurance that Worked — Until Government "Fixed" It
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Robert Stout
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estonianman
Apr 12 2016, 06:56 PM
BuckFan
Apr 12 2016, 01:56 PM
clone
Apr 12 2016, 01:20 PM
Just get the Nanny out of healthcare and all will be well....we just took on a relatively large DPC network of doctors...for an average of 50 bucks a month you get direct access to your primary care doctor. Combine that with a relatively inexpensive catastrophic policy or HSA and you're good to go....
What do you do for the people cannot afford a catastrophic insurance policy. We were on one of those with an HSA and they are not all that cheap. No insurance policy is, especially if you are not part of a group and end up on the individual side.

That is the whole reason ACA was passed, people could not afford health care and were not covered by an employer. It is those people, the ones that cannot afford any policy plus feed an HSA, that needed help.
How Government Solved the Health Care Crisis

Medical Insurance that Worked — Until Government "Fixed" It
The key to Obamacare success is forcing negligent people to buy health insurance...The greater the penalties are for not having health insurance, the more successful Obamacare becomes...Health insurance corporations were confronted by increasing numbers of people not having health insurance, causing cost shifting and rapidly rising premiums for those who had health insurance...We saved their industry...Trumpcare will be the same with minor modifications............ :biggrin:
Jesus can raise the dead, but he can't fix stupid
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clone
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Director @ Center for Advanced Memetic Warfare
BuckFan
Apr 12 2016, 01:56 PM
clone
Apr 12 2016, 01:20 PM
Just get the Nanny out of healthcare and all will be well....we just took on a relatively large DPC network of doctors...for an average of 50 bucks a month you get direct access to your primary care doctor. Combine that with a relatively inexpensive catastrophic policy or HSA and you're good to go....
What do you do for the people cannot afford a catastrophic insurance policy. We were on one of those with an HSA and they are not all that cheap. No insurance policy is, especially if you are not part of a group and end up on the individual side.

That is the whole reason ACA was passed, people could not afford health care and were not covered by an employer. It is those people, the ones that cannot afford any policy plus feed an HSA, that needed help.
Get the nanny out of healthcare and HSA's come way down....there was another thread where someone was saying the price of an end of life drug went up significantly so the endoflifers went out and created their own for under $500....significantly cheaper...capitalism by socialists at work...got to love it
Only liberals can choose not to go down the road to widespread, systematic violence.
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grannyhawkins
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I say that big talk's worth doodly-squat
This has been the goal since day one and those of you that been around awhile know I've stated this before we ever got moozlum care and hare we are!!!

The bottom line is, it's all about the money, Gubment needs assets and they've about stolen all the middle class has. It used ta be that we'd have an economic meltdown every generation, so the banks could reclaim real estate, farms an ranches an such, then it was every 10 years, now it's down to the seven year itch an the pickens is gettin slimmer all the time, seein how most farms an ranches are now mostly corporate an the middle class has shrunk, that leaves healthcare as the last bastion of wealth that the middle class, has!!! Folks ull pay anythin an empty thar savins, ta live another day!!!

We will have single payer in short order!!!
Endeavor to Persevere!!!
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BuckFan

estonianman
Apr 12 2016, 06:56 PM
BuckFan
Apr 12 2016, 01:56 PM
clone
Apr 12 2016, 01:20 PM
Just get the Nanny out of healthcare and all will be well....we just took on a relatively large DPC network of doctors...for an average of 50 bucks a month you get direct access to your primary care doctor. Combine that with a relatively inexpensive catastrophic policy or HSA and you're good to go....
What do you do for the people cannot afford a catastrophic insurance policy. We were on one of those with an HSA and they are not all that cheap. No insurance policy is, especially if you are not part of a group and end up on the individual side.

That is the whole reason ACA was passed, people could not afford health care and were not covered by an employer. It is those people, the ones that cannot afford any policy plus feed an HSA, that needed help.
How Government Solved the Health Care Crisis

Medical Insurance that Worked — Until Government "Fixed" It
So we compare costs 150 years ago and conclude that prices have gone up. Who wudda guessed?

So the solution is to go back to fraternal organizations providing health insurance ... got it. :rollseyes:
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BuckFan

clone
Apr 12 2016, 07:43 PM
BuckFan
Apr 12 2016, 01:56 PM
clone
Apr 12 2016, 01:20 PM
Just get the Nanny out of healthcare and all will be well....we just took on a relatively large DPC network of doctors...for an average of 50 bucks a month you get direct access to your primary care doctor. Combine that with a relatively inexpensive catastrophic policy or HSA and you're good to go....
What do you do for the people cannot afford a catastrophic insurance policy. We were on one of those with an HSA and they are not all that cheap. No insurance policy is, especially if you are not part of a group and end up on the individual side.

That is the whole reason ACA was passed, people could not afford health care and were not covered by an employer. It is those people, the ones that cannot afford any policy plus feed an HSA, that needed help.
Get the nanny out of healthcare and HSA's come way down....there was another thread where someone was saying the price of an end of life drug went up significantly so the endoflifers went out and created their own for under $500....significantly cheaper...capitalism by socialists at work...got to love it
How can HSA's come way down? HSA are savings accounts, a dollar in and a dollar out.
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