Would you be in favor of a state run single payer health care system if it means that your taxes go up by 15% and you lose your current health insurance?

Yes, as long as it is modelled after the single payer healthcare system we had in Sweden. The math has been done and it didn’t raise Swedish net taxes by 15%. Not when you enter into the equation all the ER costs for people just hunting for renewel of med prescriptions and all the other non-emergency shit that goes through our ERs. It eliminates the need for free clinics privately supported by people otherwise paying taxes—and similar non-profits desperately trying to take up the slack of our terrible system.

And think of this: No longer would there be slip and fall cases, teams on the freeway causing accidents for insurance money, the plethora of bulllshit legal cases involving healthcare scams that cost every taxpayer a bundle. There are no multi-million dollar fraudulent workman’s comp cases and similar scams that ruin small businesses in a country with decent single payer healthcare. When everyone is covered from cradle to grave by good, easily accessable healthcare, there is no need for these things and the huge portion of the legal profession known as “ambulance chasing”.

And don’t forget how expensive it is to not be pro-active in medicine. Here, the uninsured must wait until they are in crisis before they go to the ER for free healthcare ultimately paid for by the taxpayer. People who receive healthcare all their lives are much healthier and rarely incur the costs of an emergency.

Maintenance and pro-activity is the name of the game in good medicine and much less costly —and as a doctor in a big city, you know that.

…And think of this as well. When people have pro-active healthcare their working lives are much longer. They pay taxes, they help relieve the burden on the rest of us. I suspect the homeless population to shrink significantly—people who eat up private and publicly supported services of all kinds throughout the homeless portion of their lives.

How much of your net income and incomes of your medical colleagues is eaten up by the cost of private malpractice insurance? The cost of that insurance will drop significantly under a decent single payer system. You will only have to be insured for outright negligence and not for the complete healthcare costs of taking care of a permanently handicapped person throughout the remainder of their lives.

I would want to see more of the specific details (such as how the timing may be affected for seeing specialists or having tests done) and understand how the program would operate on a few key aspects of treatment for everyone, but I like the idea of it. I did a little reading about this already and saw that the residents of California would not have any premiums, co-payments, or deductibles. That is something to really take into consideration when looking at the numbers as those really add up. I’m not sure what their current income tax rates are, so judging a 15% increase without knowing that is hard.

Another concern would be related to the insurance companies. While California residents may theoretically no longer need the insurance companies with this, what may happen to people visiting California that need medical care. Obviously they would need to use their private insurance, but what if there was some kind of backlash due to this?

It’s a huge undertaking and one that needs to be considered carefully and not rushed into in any way. The legislators need to investigate and research single payer systems in many areas to get an idea of what works and doesn’t work before I would ever fully support it in my area. We need healthcare reform in a major way, but we need it to be well thought out and planned.

Depends on the details. I’m not sure I’m ok with a flat 15% increase, but maybe. My problem with the flat 15% is at the high end maybe there should be a cut off like social security. I’m not sure. My cut off would be much much higher than the SS cut off though.

If I really believed the system that would be put in place was a good one, and it would cover all my medical needs, then yes, I would cough up the money, speaking from my own personal situation.

Everyone would have to pay into it. About half in the U.S. do not pay taxes due to low or no income—and our healthcare needs are covered anyway.

No matter what I made. I’d be glad to pay an equitable share into a program. 15 percent is about right—most of us pay more than that on healthcare.

No way. My taxes are too high now. This is just another reason to not live in California.

I live in CT and am highly taxed already. Based on your numbers, I would gladly do the extra 15%, as it would still be less than what I am currently paying for healthcare with a high deductible. I am a fan of the ACA, because bow I have insurance, but I pay a lot for it. (Still less than what a cancer recurrence would cost me.)
Like @Seaofclouds and others have said, I’d like to know about it before jumping in with both feet, but, really, the idea that anyone is denied treatment because they can’t pay is anathema to me.

Yes. Even though I’m over 65 and have thus won the medicare lottery, I would pay the 15% hit to pull the rest of the population out of the crippling health insurance meat grinder. I bet most people would actually come out ahead compared to their current insurance costs, and God knows the elimination of all the restrictions and rigamarole over what is and isn’t covered would be well worth it. It would also relieve small business owners struggling to cover their employees from the horrific burden of negotiating the insurance minefield.

To clarify, are we talking a 15% increase in tax rates or taxes paid?

So for example, would someone who pays 10% in California income tax currently pay 11.5%, or 25% under this plan?

My family paid over 10% of our total income in medical expenses last year, so either seems plausible.

@stanleybmanly I guess my point is that the “rest of the population” is not in the meat grinder. Many people have employer-sponsored insurance and are entirely happy with it. California is a medicaid expansion state, and has taken steps to ensure most (not all) with California’s version of Medicaid. What it would mean is that someone who has Kaiser and is happy with it would lose it and be forced to go into the state sponsored system.

@funkdaddy I am unsure on that detail. What I read was 15% increase in payroll tax charged to employers. This would be probably offset somewhat by the fact that the employer doesn’t pay premiums to whatever health insurance they pay into. But any cost overruns would probably go onto employees or to consumers with increased costs. This is why I phrased the question as a hypothetical and the first thing I said was that the numbers I quoted probably weren’t accurate. But they’re orders-of-magnitude in the ballpark.

@Rarebear Many single payer countries have the option for people to have private health insurance too – either for less wait time or for things not covered by the state. Are you sure that that will not be an optional add on for those who are wealthy and want it? In any case, yes I would pay more in taxes to have single payer.

I think it almost goes without saying but yes I would support this.

@Rarebear Gotcha. Understand it’s not exact, was just trying to get a ballpark. A 15% increase in taxes paid is an automatic “yes”, a 15% increase in tax rate is daunting.

Just to get some numbers out there, it looks like California income tax rates are tiered like this for those who are married filing jointly.

$0 – $15,700 – 1.00%
$15,700 – $37,220 – 2.00%
$37,220 – $58,744 – 4.00%
$58,744 – $81,546 – 6.00%
$81,546 – $103,060 – 8.00%
$103,060 – $526,444 – 9.30%
$526,444 – $631,732 – 10.30%
$631,732 – $1,052,886 – 11.30%
$1,052,886+ – 12.30%

And employer taxes have a couple different categories, but it looks like only the first $7000 in income is taxed for each employee in all of them, rates seem to add up to about 4% in most cases. Again, only on the first $7000. Maybe we have some California employers to confirm?

So there’s definitely going to be some pushback on bumping a 4% tax to 19%, even with healthcare taken care of. But it’s an interesting take on how to fund it. I would imagine it would probably end up with some sort of shared payment, like employer sponsored plans now. People are familiar with that scenario.

So if it’s less than 5% of income, which it seems like it would be, I’d consider moving to California under that scenario. I guess with all the usual assumptions about equal care, selecting doctors, and reasonable times to get treatment.

It will be interesting to watch.

ETA: better summary of current CA employer taxes

Controlling the high cost of drugs and medical services would be the first thing to do. Maybe the tax thing could work then, otherwise high costs would continue. I have no health care now so anything affordable would be nice. What we need is socialized medicine and health care: by the government, with their control of everything, including drugs, hospitals, doctors, the whole enchilada.

^^ @kritiper The Collective Bargaining Power of 39,849,872 citizens of the test State of California through one buyer, or better yet, 320 million Americans would take care of those prices.

Only if it is a federal crime for anyone to attempt to know the nature of the transaction between a patient and physician.

Imagine the politician or bureaucrat that you hate the most. And then imagine that they have access to your medical records-to the illnesses that you have been treated for, surgeries that you have had, discussions that you have had with a counselor etc.

They are not entitled to know what you told your confessor. They are not entitled to know what you told your attorney.

And yet they imagine they are entitled to know your medical history, and give it to the IRS.

I wonder why nobody questions the morality, if not the wisdom, of this idea.

Isn’t all of that already protected under HIPAA?

It isn’t as onerous as it sounds. I would not have to pay for the health insurance I have now, and we Californians would likely get to drop our Medicare taxes.

It would be a lot better than what we have now.

Yes, absolutely.

It will be fantastic for the economy. The next Bill Gates who is dreaming of changing the world, but is too scared to leave her job because she needs the health coverage is now free to do so. All of those bankruptcies from medical costs vanish, which means the creditors won’t loose out. Workers will be healthier in general which should improve productivity. Small businesses won’t be squeezed by insurance companies and forced into ever-increasing rate-hikes. Not having to get approval for procedures from scumbags whose livelihood depends on denying you care would produce so much more piece of mind. Eliminating the middle-men will improve costs significantly. Furthermore these insurance companies have been allowed to merge into just a handful. In some markets there is very little choice, which is terrible for the consumer. I’d much rather deal with someone who is accountable to the taxpayers/voters than someone accountable to their shareholders when it comes to healthcare.

It sounds not unlike the NHS in the UK and I certainly wouldn’t want to lose that especially at my age healthy though I am.

I’ll have to stew on that for a while. I pay enough taxes ~50% by the time it’s sll said and done. I’m not too keen on paying more. I have decent healthcare now that is affordable but I fear losing what I have if I become unemployed. I really like having a health savings account that is self directed. I would like a single payer system but fear the bureaucracy that would ensue as if we don’t have it bad enough already. I don’t think it would work without some seriously radical reform in the healthcare industry. I don’t see that happening. If we could just eliminate pre-existing conditions as a disqualifier, keep the pharmaceutical companies from raping us and make insurance affordable and portable for everyone, subsidized if not free for those without the means as a catastrophic care plan. I would be happier. @Rarebear I’m very interested to hear your take as a healthcare professional.

@kritiper @Espiritus_Corvus Well, hell, why not just control that now. Then health costs will be lower. That’s what I’ve been saying for years. We have millions of people in various health networks and no one seems to give a shit.

Collusion.

^^Yep. Collusion and greed at the cost of millions of lives and lowering the quality of others since these models were put in effect in other countries—since WWII. And these motherfuckers in Washington still want to deny equitable healthcare to all. It saves everyone money, but the corporate masters who have hijacked our democracy.

It wouldn’t be very productive and it would divide the country further, but if I had my way these fuckers would be strung up at the Capitol steps on live TV—because that’s the kind of motherfucker I am.

We’re going to wind up with single payer universal health care or descend to 3rd world status. It’s that simple.

It’s not that simple, this is a problem with a non-binary solution.

Hell no. First of all, a single payer system is awful. One only needs to ask the veterans of the United States. They have been using a single payer system for decades, otherwise known as the VA, the largest health care system in the America. With around 350,000 employees, and a near 200 billion yearly budget, they’re doing a spectacular job at torturing and killing 7 million veterans.

Secondly, I like my insurance and only 0.02% of my salary goes to paying for it. Pay 0.02% or 15%? Hmm… really tough choice.

^^I think you should ask veterans and the military who use the military system. See how many people in there want to go to a private system.

No one is stopping them from using the private system.

Been there, done that.

A) I have a few relatives that are vets. They, along with their vet friends do want private. They want vouchers so that they can use the money at any private healthcare provider. They would then be able to control their own care and this would force the VA to compete for their business.

B) I attended Trump rallies which were full of veterans, offering equivalent feedback. Plus, there is a lot of direct feedback on the internet.

C) You’re correct. No one is stopping them and that is why 75% of their health care comes from outside of the VA, despite the fact that it costs them more. The VA is so bad that 14 million veterans don’t use it at all.

If I remember correctly my dad’s vet benefit covers him at the Walgreens urgent care and other places. I’m not sure of all the coverage for outside the VA clinics, because my dad is also retired military, so he gets that benefit too. I think vets do have some options though.

My uncle is on the right wing for almost everything. He voted for Trump, and he made millions as a doctor in the private sector. He gets his care at the VA, and thinks the country should socialize medicine.

Not everyone who is entitled to benefits lives near a VA clinic or hospital, so part of that percentage is disingenuous.

The voucher they would get if there was such a thing would probably be well below what they need for private care, because private care is so astronomical.

Most people in social healthcare systems want to improve those systems, not ditch them.

The costs are either covered from their pocket or private subsidization. There are a lot of vet charities. Billions are given annually for this very reason.

I think my point went over your head. Part of the reason why 75% of veteran’s health care is private is partially because of the reason you stated (availability of VA care) and the other part being that VA care is awful.

If the voucher program doesn’t cover the care needed, then it isn’t much of a voucher program. Obviously if it gets implemented, it needs to cover the care, or else you’ll have the same nonsense.

I’m not sure where you’re getting the idea that most people in a socialized health care system want to improve it when the veterans currently participating are mostly using private care and prefer it. The unfortunate ones who can’t afford private care are stuck being tortured by the VA, longing for the voucher program.

@GregOP I think you need to give citations for what you are stating as facts. I have read good things about the VA – and bad things – and know my Dad received excellent care from them. It’s possible that the VA now needs better funding from the government because of the recent wars we’ve been mired in. Also, people I know who live in countries with single payer government run health care are very happy with it.

This is one program to help vets get care in their community.

@GregOP

“The VA is so bad that 14 million veterans don’t use it at all.” —Can you cite legitimate sources stating that the reason all 14 million veterans who don’t use the VA system is because they think it is bad? Citations, please.

_“With around 350,000 employees, and a near 200 billion yearly budget, they’re doing a spectacular job at torturing and killing 7 million veterans.—Citations, please. Give me an account for every veteran killed and tortured by the VA. I would like to see numbers, description of each event all from legitimate sources.

”...75% of veteran’s health care is private” —Citations, please.

”...the veterans currently participating are mostly using private care and prefer it” —Citations, please.

“The unfortunate ones who can’t afford private care are stuck being tortured by the VA”—Citations, please.

Or, are these just your opinions?

To be fair to @GregOP, I have a couple friends that have worked in the VA system in Dallas and they say it’s quite a bit different than private hospitals. Some things are amazing, they’ll get a wave a new very current equipment all at once for instance, some things are just tough to swallow.

I talked to one about it at length a couple years ago and she said one of the big things is they try to standardize care to a great extent. So everyone should receive the same treatments for the same conditions. That makes sense, but if you think another treatment would be better in this case, for whatever reason, it has to be handled as an exception and approved rather than just done as it would be in a private hospital system. There isn’t that level of trust in the employees. I don’t know if this is just a holdover from the military background or what. It sounds like what might happen when the insurance company and the treatment company become the same entity.

The other thing she mentioned is a high number of psych cases that just aren’t addressed during treatment. It’s handled as a separate set of requirements by another team rather than integrated and treated as a whole. That can make veterans feel like the people in front of them are saying “not my problem”, but again, standardized care.

I think the large number of psych issues will exist in any “front line” care like ERs or clinics, but from my understanding are usually handled in parallel (at the same time) within most facilities when possible. There’s a counseling team that swoops in as needed in the ER. It’s not perfect, and sometimes it seems more like a security team for psych patients, but that’s a fine line with no perfect solution.

Anyway, I would hope a government health care system for everyone might take some inspiration from the public university system, which seems to be one of the few public sectors that can hire and retain “talent” equal to the private sector. Largely that’s because there are opportunities there that you wouldn’t get elsewhere. I don’t see any reason the same couldn’t apply to single-payer healthcare.

It seems like top doctors and nurses would be more likely to seek out positions within a single payer organization if that’s also the system that handles things like state funded research, or integrates with public universities for both research and education. There is some of this, and some universities already have hospitals under their umbrella, so it doesn’t seem like a reach, we just need to get past making it absolutely cheap as possible. I don’t know that we can with the mistrust of how taxes are spent. But we can either:

1) all aspire to be able to afford private insurance on top of the public option or
2) just pay more into the public option.

We’ve tried the first scenario and I don’t think anyone is happy with where it’s lead. Maybe look at good solutions for the second option, which seems to be working well in other areas of the world.

@funkydaddy The thing is the private system also wants doctors to follow protocols, doesn’t always approve procedures that the doctor thinks are best, wants the doctor to prescribe drugs that they favor, and some even penalize the individual for going to the drug store, they want you filling drugs through the mail to get a 90 days supply. Even if I’m willing to pay more money, I’m not allowed to get 90 days at once from Walgreens, but I can from the prescription service they want me to use.

Both systems control how the patient is treated to some extent. The private system encourages unnecessary tests and procedures if the doctor believes the patient to be well insured. Money money money. Many hospitals especially take advantage of this. I have seen it over and over again, and I’m sick of it. At the same time the private system discourages people from taking care of themselves in so many ways.

There is no perfect answer, no matter what money matters. No matter what costs are attempted to be controlled.

The VA system usually gets bad press regarding mental health issues not being addressed well, and people being denied for treatment, or waiting a long time. Same shit happens in the private system. The mentally ill are not cared for well enough, and people die or go bankrupt waiting and hoping for treatment. The classic line from insurers “we didn’t deny the treatment, we just won’t pay for it.”

It’s just that people have more empathy for the soldier I guess, because he risked his life for us (well, not my dad) but really when the daughter of the nurse at my GYN’s office was losing her sight and the insurance wouldn’t approve a proven treatment, I think that’s just as awful. Or, when my insurance didn’t approve the meds to terminate my ectopic pregnancy I think it’s pretty awful. Or, when a health plan has zero mental illness coverage I think that’s pretty awful. Or, when I pay MORE for diagnostics or drugs in my health plan than if I were self pay. Or, how I have no idea how much something will cost while it’s being done to me.

They both suck in many ways, and sometimes both socialized and private suck in the same ways.

Nothing is perfect.

@janbb, @Espiritus_Corvus, Here you go….

VA is the second largest Federal department and has over 340,000 employees link

The President’s 2018 Budget includes $186.5 billion in budget authority for VA in 2018. This includes $82.1 billion in discretionary resources and $104.3 billion in mandatory funding. The discretionary budget request represents an increase of $4.4 billion, or 5.8 percent, over the 2017 enacted level. link

Total Veteran Population 2014 – 21,619,731
Veterans Using VA Health Care During 2014 – 5,908,042 link

As for the underfunding argument, since 2009, congress has doubled the VA budget and hired an extra 100,000 employees in an effort to fix the problems plaguing the VA, yet the problems increased in parallel to the increase. They make the same mistake with public education thinking money solves problems.

A lot of the VA issues came to light by whistleblowers in 2014. For example, in Phoenix, 1,700 veterans there had waited an average of 115 days just to receive an initial appointment. According to the VA’s official policy, that wait time should have been no more than 14 days. As if that wasn’t bad enough, the Phoenix VA then lied about it, releasing falsified waiting lists to the public to cover its tracks. Phoenix turned out to be the norm, not the exception. The VA’s inspector general found systemic problems across the country.

In Fort Collins, Colorado, clerks were instructed to falsify records to show that doctors were seeing more patients than they actually were.

In Columbia, South Carolina, delays in diagnosis and treatment directly led to the deaths of multiple patients. The VA program there had nearly 4,000 backlogged appointments despite a $1 million grant earmarked to reduce delays.

And in the VA’s hospital in Pittsburgh, in 2011 and 2012, there was an outbreak of Legionnaires’ Disease that officials knew about for more than a year before informing patients. At least six veterans died as a result.

@janbb

I know at least 4 families that are now here in the states partially because of how bad socialized medicine was in their country. They’re from Canada, UK, France, and Sweden. The main complaints were the shortages of staff, medical mistakes that could have been avoided, and lack of care. Considering that these problems exist despite having high taxes and abundant natural resources, it says a lot. Other non-health reasons were shity economy and insane taxes.

Their grievances don’t come as a surprise to me. The problem is when health care is treated as a right individuals can demand a doctor treat them at any given price, which not only violates the doctor’s right to charge for their services, but it also de-incentivizes jobs in health care due to the inevitably low pay that accommodates this, reducing the incentive for someone to spend many years and huge funds training to practice medicine. Works the same for pharmaceuticals and tech. U.S provides half of the world’s pharma. It patents/publishes medical innovation more than any other country. That’s because the incentive is still alive here.

California’s total tax burden is around 45–50%, 2nd worse in the country. NY takes the crown. Add another 15% for healthcare to that and you’re looking at a 65% tax rate for what is destined to be shity care.

@GregOP You did not give citations for ANY of your statements that I listed in my above post. Read it again. I am not asking for employee stats, budgetary figures, or anything else you offered. I used to work for the VA. I am well aware of those numbers. I am also well aware of bad press. But I am also aware that each of the stories in the press are about individual VA complexes and not the whole system. And I am aware that these stories are often proven to be exagerated. Because I investigate them.

Among other things, I asked you for data from legitimate source that would support your statement that the reason that 14 million veterans don’t use the VA system because they all think it’s bad. Look at that line carefully. Read it again. Notice the bold, italicized portion of that sentence. That is the key portion of your statement I would like to see you support with citations from legitimate mainstream sources.

Also, you gave no the citations supporting your statement that veterans have been tortured and killed by the VA. There should be a large amount of documentation on each of these cases, if true. Arrests, court cases, public condemnation, etc. And then read the remainider of the list. Carefully. Take your time. Then find the documentation that support your statements.

Are you new at this?

That 14 million veterans don’t use the VA because they think it’s bad is a logical conclusion. If they thought it was good care, they would be using it. It’s the same logical conclusion for why they prefer private care. They use it even though they have access to the VA. That means they prefer it. It’s really that simple.

On a personal level, I don’t need any citation to know the VA is awful because my grandpa and uncle are veterans. They, along with their veteran friends experienced the VA and have nothing but awful feedback about it. It’s the same reason why I don’t need to visit the UK to know their healthcare is crap. I have British folks living here in the states who experienced UK’s health care and think it’s awful.

Why do you think Trump tweets are praised by many? Why have the media tell you what Trump said or meant to say, or interpret what he says, when you can just read what he says directly. There’s a known joke about this. The author of a book wrote the curtains were blue. The english professor tells his students that he thinks this statement means the curtains represent his immense depression and a lack of will to carry on. When in reality the author was just telling us that the curtains were f*cking blue…

As for supporting my statements on torture and death, I gave you several detailed examples. Google them and the source will come up on the first results.

See, there is always going to be supporters and opposers in any system. My neighbor is a Soviet Union refugee. He tells me how the Soviet Union was hell on earth while his brother who lived in the same system, praises it. Praises Stalin, Lenin. When Stalin died, there were millions of russians who cried over his death while others danced with joy. It’s pretty much the same thing going on here and in europe.

^^I gave you a GA for your last paragraph. There are always people who like a system, and always people who don’t, which is true in healthcare too. I can cherry pick people who hate the private health system in America, who have had catastrophic injuries and even death from it, and also simple complaints about how they are treated. It would easily add up to millions of people.

@GregOP The point you miss involving the dismal care available from the VA is that the system basically is utilized by those with no alternatives – the broke and indigent. They are treated just as you might expect. You aren’t going to find retired generals waiting in those lines. The VA is merely a reflection of the rest of the society. General and Senators also receive free medical care, but they are catered to at Walter Reed.

@stanleybmanly My father was a Captain in the PHS (same rank as captain in the navy) and I think he gets the same treatment at the VA here as the men and women who were much lower rank. At Walter Reed and Bethesda, he is lower priority than lower ranking soldiers who are active duty. Active duty are first for almost everything.

Veterans who did not retire from the service, as far I know they can’t use Walter Reed or Bethesda. Those are not VA hospitals (they are DOD hospitals) unless they have a VA section I don’t know about.

It’s worth adding that the DOD medical care is socialized also, I’m not sure why everyone always points to the VA, and I was overall very happy with my healthcare when I was in that system, and so are my parents. They have screwed up some things, no question, some doctors missed things, but that seems to happen everywhere.

Health care in the private sector often feel adversarial rather than the doctor being on the same term as the patient.

Moreover, diagnostics aren’t such a big deal, because cost evaluated much differently. Things like ultrasounds, MRI’s, the machines are there, the employees are payrolled, if there is time available it costs nothing but the electricity to run the test and have it read. If there is breast cancer in your family and you’re overly worried the MRI doesn’t cost much more than doing the mammogram. When I say cost I mean electricity and salary. The patient isn’t paying for any of the services. So, that in turn is better healthcare.

I’m not saying higher ranks don’t possibly get others to hop to it a little better, at both the VA and DOD, but I think a lot of the care is fairly evenly distributed. I don’t think healthcare providers are looking at rank constantly. My dad wasn’t in uniform when he used to get care active duty, and never is now that he is retired.

Yes. I know this. But my point is that the VA exists as the palliative resource for throwaway people. And as one might expect, the insults suffered by these people at the hands of the VA sink to levels they experience from the society overall. They’re treated like shit, because there are no consequences for those responsible. Every once in awhile, there’s some uproar, and things shake up. Overall it must be admitted that the VA is sadly one of the more or less exemplary agencies in the register of places serving those at the bottom.

^^Ok, I see your point, and it’s well taken. So, I think we agree that the VA is not a valid comparison for what socialized medicine for the masses would be. Although, I still hold that there is a lot of good care done by the VA, it’s the worst examples that get held up and repeated over and over again.

Exactly. It’s also worth mentioning that in this economy, the VA is in fact severly overburdened by the sheer numbers of people at the bottom. Sadly this is what you would anticipate in a situation where enlistment in the military is a matter of financial necessity. Things will only get worse in a country at perpetual war. “Smart, happy, or financially secure men and women don’t volunteer”

^^Some do volunteer, there are plenty of examples of middle class men and women joining up. But, I agree that people without other opportunities look to the military more than those with other opportunities, especially at the enlisted level.

@GregOP I have NEVER met or heard of ANYONE coming to the United states to purchase one of our health insurance plans. I have had dozens of conversations with people from each of the first world countries you list in which the participants complain about the shortcomings of their socialized systems, and I can tell you that those complaints come an abrupt halt at the posing of the simple question “would you trade places with us?”

Be nice everybody.

I don’t understand. The conversation thus far seems civil to me.

@stanleybmanly

How can you compare a conversation to actual experience? You spoke with people who didn’t experience U.S health care. They never made the trade. This goes back to what I said about directness. Have health care conversations with european immigrants here in the states. The feedback will be different because they experienced both systems. They actually traded places. It wasn’t just a conversation. They have been living in the states for 30+ years. The quality and efficiency of our health care is much better than what they experienced in europe.

@GregOP Are these corporate executives living in the US as expats?

No and middle class families.

@GregOP As I said on the other thread about health care, my kids who have lived in both places are very happy with the health care they receive in France. But nobody’s going to change anyone’s minds here so there’s not much point in discussing it. There is one last thing I’d like to say and that is that we are arguing apples and oranges. It may be argued that the US has top quality medical care for the few who can afford it, but that single payer helps the many have access to health care is the more important factor in my book.

Your kids are a much better example than a mere conversation, but I agree, minds will not be changed because even though your kids experienced both and had good outcomes, others who have experienced both, had bad outcomes.

Not necessarily apples and oranges because this goes back to the 14 million veterans who need health care like anyone else but don’t use VA care. The point being that just because someone doesn’t have access to care, doesn’t mean they’re interested in having access if that care isn’t good.

@GregOP Not only have I spoken to European arrivals. I’ve had conversations with Americans stationed or assigned positions in Europe who are absolutely astonished by the quality and levels of public services in European countries. Less than a week ago a woman I know returned from a 3 year stint in Paris and found herself horrified at the child care prospects for her 2 year old here in San Francisco. She tells me that in France there are better than a thousand doctors whose state sponsored practices are specifically dedicated to house calls. She floored me with the stories of frequently summoning a doctor to her apartment at a fee of less than $25 a visit day or night.

Of note, the single payer issue is becoming the Democratic litmus test here in California. The California Nurses Association, which is probably the most powerful union in California is driving this bus and is actively campaigning anybody who expresses doubt about this plan. They are not even doing it covertly. They came out and said that this issue is going to be the Democratic litmus test just like abortion is the Republican litmus test.

The political center has died in this country.

That death was predictable as the center slides toward destitution. What’s your position @RareBear? Should healthcare be a right like a jury trial? Or should medical attention be restricted like fine dining to those who can pay on the spot?

@stanleybmanly

In light of your clarification, see my answer to Janbb.

Regardless of one’s position on this issue, the fact is that we are already confronted with people dying needlessly in epidemic numbers right here in the supposedly greatest nation on earth. No solution to this problem is likely to materialize with a for profit motive dominating any juncture in the equation. I think we must arrive (probably very painfully) at single payer universal healthcare. Our taxes may very well increase, but the benefits might well compensate for the expense. To me, it amounts to people suffering and dying because they haven’t the money to do otherwise. Taxes may go up, but if the choice boils down to death or taxes, perhaps we will continue to accept the reality as long as we can rationalize “the death isn’t my own”.

@stanleybmanly I actually don’t mind single payer if it’s the federal government. I have a problem with it if it’s state. The Federal Government has the ability to run deficits because it can print money, and deficits aren’t a problem as long as inflation stays stable. State governments do not have that flexibility, and therefore you’re going to figuratively rob Peter to pay Paul.

I think deregulation and privatization is the way to go. Pretty much get government entirely out of health care. Taxes are already high now. The total tax burden should be reduced to no greater than 10%-15%.

Get the government out of health care? Eliminate the EMTs? Public hospitals? Why not the police and fire departments as well?

Yes, get the government out of health care. Non-for-profit, volunteer, profit.

Yes. Of course that will work. Thanks for the discussion.

@Rarebear. I agree that it will have to be a Federal system. It is truly ironic that the places which would benefit most from the setup will be the fiercest fighters against it.

@Rarebear What is California saying regarding the money? How will they keep the costs down under a socialized plan?

Do they plan to run it like Canada? Where doctors bill the government for services? Or, will it be more like a military set up where doctors are salaried? What about drugs? Will they somehow control those prices too?

@GregOP *That 14 million veterans don’t use the VA because they think it’s bad is a logical conclusion. *

LOL. And by what logic could that be?

The number one reason veterans don’t use the VA system is inaccessability. They live, work, and have family support too far from the nearest facility. I’ll get you the citation from an official military site—with comments from veterans—when I have the time.

You still haven’t given any citations that support your opinion that VA employees purposely torture and kill our veterans. If you can’t, I expect you to appologize. You have basicallly compared the people that work very hard to serve these veterans to ISIS. I worked with the VA in medical research for five years. If you would have said that to me IRL, I would have wiped the floor with your ass.

As to your second hand anectdotal evidence that citizens of the UK are unhappy with their healthcare system. Fine. Maybe some are. Everybody bitches about everything. That’s how human beings improve things. But would they trade their healthcare system for ours?

I asked this question yesterday on Fluther.
https://www.fluther.com/201389/to-the-european-and-canadian-residents-among-us-would-you/

To tap into a larger population, I asked the same question on Quora:
https://www.quora.com/Would-the-European-and-Canadian-residents-among-us-trade-their-health-care-system-for-the-system-that-now-exists-in-the-USA

So far, the answer is a resounding and unanimous NO so far.

I will address how you failed to give solid references to my other 2 requests later when I have more time.

World Health Organization’s Ranking of the World’s Health Systems

World Health Organization Ranking; The World’s Health Systems

1 France
2 Italy
3 San Marino
4 Andorra
5 Malta
6 Singapore
7 Spain
8 Oman
9 Austria
10 Japan
11 Norway
12 Portugal
13 Monaco
14 Greece
15 Iceland
16 Luxembourg
17 Netherlands

18 United Kingdom

19 Ireland
20 Switzerland
21 Belgium
22 Colombia
23 Sweden
24 Cyprus
25 Germany
26 Saudi Arabia
27 United Arab Emirates
28 Israel
29 Morocco
30 Canada
31 Finland
32 Australia
33 Chile
34 Denmark
35 Dominica
36 Costa Rica

37 USA

38 Slovenia
39 Cuba
40 Brunei
41 New Zealand
42 Bahrain
43 Croatia
44 Qatar
45 Kuwait
46 Barbados
47 Thailand
48 Czech Republic
49 Malaysia
50 Poland
51 Dominican Republic
52 Tunisia
53 Jamaica
54 Venezuela
55 Albania
56 Seychelles
57 Paraguay
58 South Korea
59 Senegal
60 Philippines
61 Mexico
62 Slovakia
63 Egypt
64 Kazakhstan 65 Uruguay
66 Hungary
67 Trinidad and Tobago
68 Saint Lucia
69 Belize
70 Turkey
71 Nicaragua
72 Belarus
73 Lithuania
74 Saint Vincent and the Grenadines
75 Argentina
76 Sri Lanka
77 Estonia
78 Guatemala
79 Ukraine
80 Solomon Islands
81 Algeria
82 Palau
83 Jordan
84 Mauritius
85 Grenada
86 Antigua and Barbuda
87 Libya
88 Bangladesh
89 Macedonia
90 Bosnia-Herzegovina
91 Lebanon
92 Indonesia
93 Iran
94 Bahamas
95 Panama
96 Fiji
97 Benin
98 Nauru
99 Romania
100 Saint Kitts and Nevis
101 Moldova
102 Bulgaria
103 Iraq
104 Armenia
105 Latvia
106 Yugoslavia
107 Cook Islands
108 Syria
109 Azerbaijan
110 Suriname
111 Ecuador
112 India
113 Cape Verde
114 Georgia
115 El Salvador
116 Tonga
117 Uzbekistan
118 Comoros
119 Samoa
120 Yemen
121 Niue
122 Pakistan
123 Micronesia
124 Bhutan
125 Brazil
126 Bolivia
127 Vanuatu 128 Guyana
129 Peru
130 Russia
131 Honduras
132 Burkina Faso
133 Sao Tome and Principe
134 Sudan
135 Ghana
136 Tuvalu
137 Ivory Coast
138 Haiti
139 Gabon
140 Kenya
141 Marshall Islands
142 Kiribati
143 Burundi
144 China
145 Mongolia
146 Gambia
147 Maldives
148 Papua New Guinea
149 Uganda
150 Nepal
151 Kyrgystan
152 Togo
153 Turkmenistan
154 Tajikistan
155 Zimbabwe
156 Tanzania
157 Djibouti
158 Eritrea
159 Madagascar
160 Vietnam
161 Guinea
162 Mauritania
163 Mali
164 Cameroon
165 Laos
166 Congo
167 North Korea
168 Namibia
169 Botswana
170 Niger
171 Equatorial Guinea
172 Rwanda
173 Afghanistan
174 Cambodia
175 South Africa
176 Guinea-Bissau
177 Swaziland
178 Chad
179 Somalia
180 Ethiopia
181 Angola
182 Zambia
183 Lesotho
184 Mozambique
185 Malawi
186 Liberia
187 Nigeria
188 Democratic Republic of the Congo
189 Central African Republic
190 Myanmar

Source: World Health Organization
TAGGED WITH HEALTH SYSTEM RANKINGS, WORLD HEALTH ORGANIZATION

How’s that world of alternative facts working for ya?

@Espiritus_Corvus

Comments from veterans on an official military site is not a clear representation of 14 million veterans. The internet is probably the least reliable source because of verification. This is why live, personal experience has much more value when looking for an answer. Besides, I already know the issue of accessibility. I mentioned it in my previous answer. It’s one of the reasons charities for veterans exist.

I never claimed the VA tortures and kills veterans on purpose. I only presented you the facts that they do torture and kill veterans. Like I said, google for it the source rather than ask me to do tedious work. Working hard does not negate employee incompetence.

What a real shocker, a former employee of the VA telling me the VA is great. I experienced U.S healthcare since I was born. I like my insurance and I like the care. Should I now be offended by every person who wants socialized medicine and thinks U.S health care is bad? According to your thinking, I should wipe the floor with them.

I have already pointed out the flaw in your question about trades. You’re asking people who never experienced both U.S health care and european care. You don’t even need to ask that question because the answer is already present here in the states – millions of european immigrants who now live in the states have already made the trade. They chose our health care system over theirs. So the fact that you asked a flawed question, and the fact that some experienced both and liked socialized care does not negate the millions who immigrated here in preference for our care.

Finally, the world health organization is not a reliable source because their ranking methodology is poor. link or link

P.S, if you link me the source, there is no need for you to paste me an entire wall of text. A small snippet is all that is necessary. The rest can be read inside.

^^Plenty of Americans go to live in Europe and Canada, it’s not only Europeans living in America. I do know Europeans and Canadians who have some positive things to say about American healthcare, but that doesn’t translate into thinking the way the whole thing works is ok. Those Canadians and Europeans are all covered by insurance, have low to no premiums, because their job pays all it the bulk of it, and they all have fairly good salaries.

Also, some of them talk about America vs other countries in terms of medical standard practices. Like how fast they prescribe an antibiotic, what treatments are used for certain illness, focus on well care, how fast you get sent home from the hospital, some of the things have little to do with the system and more to do with standard practices.

It is a resounding no when you ask Canadians if they want to give up socialized medicine, there have been studies, I don’t know if it has ever gone to a vote. When socializing medicine was first introduced there, there was a lot people who were against it. A lot. A lot of resistance.

I chalk up the resistance in America as fear of the unknown, and I think the fear will bring about some of the many problems that we don’t want. Already, Obamacare has financial troubles, because it doesn’t go far enough. I think the political war over health care is a huge detriment to society.

Competition doesn’t seem to work in healthcare. Too much collusion. Especially, if it is a pill or procedure that will save your life. Get ready to pay big, even if there is no big justifiable reason except high profit.

Moreover, because we get healthcare through employers, the employer chooses the insurance companies and plans primarily. There is a little competition in the process, but there is a lot of bullshit too. Trust me. The sales people push plans that make no financial sense for the company, and you have to hope the person deciding really pays attention, and does the math.

I do think more competition will help, just not enough.

@JLeslie

I never claimed it was only europeans immigrating here. I’m merely pointing out the futility of his inquiry when, here in the states, we have a clearly visible presence of european/canadian immigrants ranging in the millions. It all goes back to my Stalin comment. There were those who cried over his death and those who danced over his grave. Same goes on with health care. Those who support free-markets, and those who want it socialized.

Competition works great in healthcare when the government stays the hell out of it and I mean fully out, no medicare, no medicaid, no regulations, nothing. Just take a look at when health care costs actually started to become a problem. It wasn’t until 1965 when the government created medicare and medicaid. The government increased demand while restricting the supply of doctors and hospitals. Health care prices responded at twice the rate of inflation. Obamacare is a repeat of this. Obamacare is basically medicare and medicaid for the middle class.

@GregOP Comments from veterans on an official military site is not a clear representation of 14 million veterans.

LOL. Roger that. But from a government research site stating that the number one reason that veterans don’t use the VA system due to inaccessibilty, is. And it is a helluva lot better than a statement from an obviously disenchanted American who just pulls statement out of his ass.

The internet is reliable. You just have to know which sources on the internet are verifiable and reliable. But you wouldn’t know that because you obviously don’t know how to do research on the internet.

How about the statement that the VA is torturing and killing our veterans?

LOL. You are also an obvious whackjob and not worth arguing with. Go live your life, but if I were you, I wouldn’t make such statements around any VA employee. You might need a hospital yourself if you do.

@GregOP “Competition works great in healthcare when the government stays the hell out of it and I mean fully out, no medicare, no medicaid, no regulations, nothing.”

Maybe that works great for the young and healthy. What of the people who are expensive to insure? Without regulations, insurers can simply deny them coverage, and they will do so because it is better for their bottom line. Is this not something that concerns you?

@GregOP Plenty of oncologists are complaining that older chemotherapies still in use double and tripled there prices when they saw a new drug could charge the higher price. Raised, not lowered. There are examples like this in healthcare all over.

HMO’s truly fucked up healthcare, and the government was involved in the collusion with the private insurers.

Medicaid and Medicare maybe helped spur in doctors charging more to non-Medicare patients for some procedures, but I see that less and less. So, read that as part of the problem is the system is “half” assed, and too much room for financial greed.

@Espiritus_Corvus

A government research site doing research on it’s own government programs is bias. Literally the opposite of reliable.

First you tell me that you would kick my ass if I made such statements to you in person and now you tell me that VA employees would kick my ass if I made such statements around them. If you VA employees turn to violence so easily on speech you don’t like, is it any wonder why people question your competence? With comments like these, you pretty much confirm the torture and killings of veterans done by the VA employees. And I’m the being called a whackjob? Some serious irony right there.

@Mariah

The people you describe are charity cases. You don’t wreck an entirely good system because of a minority of charity cases. That’s a step backwards. You get them help through charity, non-for-profit, volunteer.

One of the best reports on drug pricing in my opinion.

I recommend you (all and any of you) read it through to the end.

It does address where laws/government is detrimental to the system in some areas. It addresses collusion. It addresses where hospitals easily can pass on expensive drugs that aren’t worth it, or stop the sake of them. It depends how much they are paying attention. It addresses how doctors make “kickbacks” on medication they prescribe.

It’s scary shit. It basically illustrates how the American public is taken advantage of, especially in life and death situations, but many other health situations too. One doctor describes it as immoral.

@JLeslie You asked about how they are going to pay for it. They said they would pay for it by offsets from people who would otherwise be paying into their own health insurance plans and payroll taxes.

It is not a small number of people in this country who have expensive “pre-existing conditions.” These are the people who need healthcare the most and a GoFundMe isn’t going to cut it. What exactly do you mean by charity?

@Rarebear Thanks for going back to my question. So, “they” aren’t talking about lowering the costs, just how they will pay for them. Is that right? That scares me just like it scared me when ACA was being introduced.

As to cost versus efficiency of the US healthcare system.

Once again, U.S. has most expensive, least effective health care system in survey

U.S. health care admin costs are double the global average

Life expectancy versus expenditure over time

Anectdotal:
Are there any Americans who actually die because they can’t afford healthcare?

@JLeslie

In my opinion, most problems can be traced back to government intervention in the free market. There are website dedicated to pointing this out on any given topic.

@Mariah

Compared to the whole population, they’re a small percentage. Charity can be in any form. Organizations, communal, religious establishments, research/educational funds, or charity can come from the doctors themselves and pharmaceutical Corporations. The best hospitals in America are non-for-profits. They’re funded by the aforementioned charities.

@GregOP I disagree. I think often many of those examples are the government colluding with the private sector, protecting their profits.

We are never going to convince a free market believer on socialized medicine. That’s why I’ve stopped posting here.

I hope you never get sick, buddy. You will quickly learn how impractical it would be to rely on charity in order to survive. I don’t think you realize how cruel what you’re proposing is.

@janbb Probably we won’t on this thread, but you never know when the conversation will ring true in the future. I didn’t understand fractions very well the first time it was shown to me, but later they made sense.

25% of people have a preexisting condition, not including the seniors who would also have great difficulty getting healthcare coverage if you had your way and Medicare were torn down.

@GregOP ”..., most problems can be traced back to government intervention in the free market.

That is where your arguments fail.

Medical care is not something that falls to the free market. When one needs medical care, one does not have the ability to shop for the provider. And most people do not have the opportunity to truly comparison shop for the insurance plan.

I had a choice last “open enrollment” to choose between a “Preferred Provider” program that allowed for flexibility but a $3,000 deductible, or an HMO with a $10 co-pay, but very few providers near where I live. I know that if I had been able to truly shop, I could find a plan I could afford that met my needs.

The “open market” is really only open to businesses that are buying en masse.

@Mariah

Impractical? You’re talking about wrecking a great health care system for the majority of Americans because 25% of the population have been dealt a bad hand. Now that’s impractical. That’s cruel. You’re also missing the main point of my argument. If you get rid of government intervention in health care, prices, overtime, will decrease. Like I mentioned earlier, the cost crisis started when medicare and medicaid started. Besides, there is nearly half a trillion dollars in charity floating around and that’s despite the high tax burden. Lower those taxes, free-up the market, and donations will increase.

What even is the point of having an insurance system if sick people can’t use it? You’d pay into the system while you were well and didn’t need it, and then once you got sick you’d get kicked out. I don’t think you seriously believe that sick people would be able to be supported by charity. I think you are hand waving this issue away because you don’t care about sick people and you just want your own taxes lowered. I think your tune would change if you or anyone you care about ever got sick.

@GregOP The Republicans want just that, to open up the market. My question is, when we go back to that, and prices continue to go up, and people die, live in poverty, need constant government assistance, and don’t pay debts because they declare bankruptcy, will you then change your mind?

If the prices go down under your open market I’ll be happy to say “they” were right.

Testing it out will be horrible in my opinion, but in America we generally need the pendulum to swing to the worst, most extreme scenario, before there is enough push back to get the other extreme.

@zenvelo

You’re not suppose to shop for care when you get sick. You should have had insurance before you got sick. The concept of insurance vanishes if you are able to buy insurance when you get sick. There would not be any insurance providers. Insurance means a thing providing protection against a possible eventuality. It’s like buying house insurance after your house gets destroyed. That’s not how it works. You buy insurance for the house because it’s possible some time in the future your house might get severely damaged. Your rate is set based on the degree of risk of that happening.

We aren’t a free health care market, so any grievance you have can’t be aimed on a free market.

@Mariah

You’re asking the wrong question. Ask what is the point of an insurance provider if pre-existing conditions are allowed?

@JLeslie

No, they do not. Nothing near free-market solutions in their proposals. Most republicans in office are RINOs. If a true free market existed and the same problems recurred, I would still not change my mind because I believe the alternative is worse. It’s kind of like a lesser of two evils. Neither is perfect, but one is clearly better than the other.

Keep in mind, that it is very normal for free-markets to be swinging up and down. They call this the business cycle. You’re dealing with people and people are fallible. When they screw up, corrections are made all around before they go back up.

@GregOP Well, some republicans want it, I agree the last proposal still had government regulations in it.

A video for you. You trust the private insurers to care for you when a health catastrophe happens? Think again.

How old are you? Are you basically healthy? How often do you go to the doctor? If you barely use the healthcare system you most likely don’t know what it’s like to deal with it.

Are you saying to @Mariah that preexisting shouldn’t be allowed? Americans are enslaved to their jobs to have medical insurance. It’s really horrific. They can’t change jobs, can’t start businesses. It’s just awful.

@GregOP – Look, I think most people here are all for legitimate discussion, but you’re getting into zealot territory across the board here. If you’re going to keep throwing out claims of how well a free-market works, you need to show something at some point. Something specific, something in the real world.

Some examples:

Where does a free market healthcare system work for the people involved? Anywhere in the world? Surely someone has tried it.

If the total tax burden should be 10–15%, and the current effective rate averages around 30%, then how are you going to pay for roads, schools, defense, and the ever precious “law and order” while cutting taxes 50–75%? Again, show me somewhere low taxes have created an enormous economic or quality of life advantage.

Look at a Federal Budget, notice the ⅔ labeled “mandatory spending”. That’s money citizens have been forced to pay into the system, for a promise that they expect the government to keep. It’s not a negotiable slush fund. So how will you dissolve those promises in a government for and by the people?

You seem to be arguing a philosophy without looking at history or economics, then telling people they have it all wrong without providing something better. Saying you don’t like regulation or spending money makes perfect sense, no one likes being told what to do or forced to give things up. Not following up and researching the question of why we don’t live under a Libertarian government and why such governments don’t exist for long shows a lack of objectivity that isn’t going to convince anyone.

@GregOP The ACA solves the problem of “what if people just buy health insurance after they get sick” by mandating the purchase of health insurance. A single-payer system also solves that problem by collecting funds as a tax that everybody pays. Your proposal goes to the opposite extreme by allowing insurers to just say “fuck you” to someone who has been paying their premiums for 30 years because they had the audacity to get sick and need to use the system they’ve been paying into.

The entire point of insurance is to spread the costs of the few over the many such than everyone who needs care can get it, and everyone who doesn’t need care can live in peace knowing that care will be available once they do need it. If you want insurers to be able to kick out anyone who gets sick, there is literally no point in having insurers except to generate profits.

@JLeslie

Personally, I don’t use health care much, but I know many who do. Ranging from cancer, to broken leg, broken arm, spinal surgery, heart attack, cleaning arteries, etc. No one was denied coverage. Keep in mind that there are various plans tailored for specific needs. If someone has a history of cancer, they purchase an insurance plan that is geared more towards cancer type illnesses. You have to read the fine print. Do your due diligence. The plan might not be appropriate for you. It’s what seems to be the case in your video. A technicality that gave them a way out and cost the man his life.

Yes, that is exactly what I am telling Mariah. Acceptance of preexisting conditions destroys the purpose of insurance.

@Mariah

Prior to the ACA, preexisting conditions were denied. Once the ACA ran its course, it allowed 52 million people with preexisting conditions to purchase health insurance. So no, it didn’t solve the issue of what if people just buy health insurance after they get sick It literally train wrecked health care. Also, millions chose to pay the penalty instead of getting insurance and there is a loophole to avoid the penalty entirely. As of now, the penalty is pretty much over. The IRS no longer requires you to inform them that you purchased insurance.

Insurance should generally be based on the individual. If you’re a healthy individual, living a healthy lifestyle and not prone to genetic illnesses, your rate should be low. If you’re overweight, smoke and prone to illness, your rate should be high due to the risk.

I had an electrical box panel that was prone to causes an electrical fire because of a manufacturer error. Once I had it changed, my house insurance rate decreased significantly.

Yes, people with preexisting conditions joined the system. The point is that a lot of healthy people got forced into joining the system too. This offsets the costs of the sick people. Now those sick people can get care – but you don’t care about that, do you?

The penalty is over because the Trump administration is choosing not to enforce it. I do not support this. The ACA works when enforced as intended.

What is the point of paying for insurance if your rates will just go up as soon as you get sick? In a graduated system like that, either your rates are always higher than the cost of the medical care itself, in which case there’s no point in having insurance, or your rates are always lower than the cost of medical care, in which case the insurers go out of business.

@GregOP preexisting conditions are only preexisting because America hasn’t had a proper health care scheme up to now. There’s not much point in saying you can have an umbrella but only if the sun is shining.

@funkdaddy

You got it all wrong. By showing you how government intervention screws up everything it touches, a free-market becomes the byproduct of a criticized system.

You don’t need more than 10–15% in taxes to support a defense and justice system. As for roads and schools, are you suggesting only the government knows how to construct a road or school? I’m pretty sure if the private sector can build an Iphone, I think it can handle laying out some tar on the road. Heck, even before we had an income tax, roads, railroads were built privately in the 1800s.

Privatizing of social security would be done by allow a worker’s salary contribution to be deposited into private investment companies or public-private management funds. Workers would have the option to increase their contributions to retire earlier or to increase their payouts in retirement.At retirement, the worker would also likely be able to choose from several different payout options that are found in the private sector, such as annuity or life payments. Chile has a system like this and it works well. Their rate of return if over 9% while U.S social security is 1%-2%

@Mariah

The problem is it’s not enough to offset the costs. In the last few years, less people paid the penalty and more people signed up, yet the premiums kept rising. If you can’t control costs, it’s all over. If you try controlling costs by applying force on doctors and pharmaceuticals, you sub-standardize the system. You’re screwed with the high costs or controlling the high costs by force.

The ACA’s goal was never to guarantee no increase in premiums. Yes, premiums have gone up, because more people are now insured and receiving healthcare (as they should), but there is no evidence now of any “death spiral.”

I guess it all comes down to whether saving the lives of sick people is something that is worth paying money for. Clearly to you it is not.

@GregOP – The Chilean system produces high fees for the companies running it and low payouts for the people involved.

And it hasn’t even reached the point where the majority of retirees are on it. It’s an experiment, but I don’t see anyone rushing to implement the same plan except for those running investment firms. I mean really, most investment companies would kill for 14% fees.

I can’t find anything mentioning a 9% return, whether that’s inflation corrected or not, or how that would differ from any privately directed system. Would love some links.

@Mariah

With the overall tax burden in some states being 45–50% combined with a steadily rise in premiums, you’re basically crippling people financially. Reducing them to a eating, shitting, animal. No disposable income. Assuming they can even handle the current burden. Also, the quality of care will decline. As predicted, in several years the the U.S will be almost 100,000 short on doctors says the medical school association. ACA regulations are already cutting into doctor profits. Once you mess around with the incentive, quality of care will take a nosedive.

@funkdaddy

Link

To me sick people’s lives trump other people’s disposable income.

By the way, the most common cause of bankruptcy in the US? Medical bills.

“The details of the Dictuc study shatter this pernicious myth: Data show workers earn an extraordinary 8.7% compound rate of return above inflation over a period of 32 years from the 10% of their salaries put away.”

In Chile, a major study shows the nation’s private retirement accounts provide workers pensions worth 87% of their salaries, 73% of that from profits on savings.

The study of 28,000 households by Dictuc, a consultancy affiliated with the Catholic University of Chile, showed that male workers who contributed just 10% of their salaries to their retirements for 40 years or more on average earned retirement checks worth about 87% of their top salaries. No 401(k) account needed.

I couldn’t find any citations at your link, so had to dig.

The study
– was sponsored by the companies who oversee the accounts (AFPs)
– was intended to counter earlier statistics like the ones below
– the system was established in 1981
– covers workers who contributed for 40+ years (so 1981 until?? 2021 I guess)
– females have been completely eliminated from the quotes above for a reason, the study showed they received 58% of their salary in retirement

Here’s another take

That promise was that pensions would provide 70% of a worker’s final wages at work; the real figure is 38%, the lowest rate among developed countries other than Mexico.

So why is it so low? Well, worker’s contributions were being eaten by private fees…

The World Bank determined that fees charged by those favored investment firms consumed fully half the pension contributions of the average worker retiring in 2000.

source of quotes which cites other sources.

And

200,000 March Against For-Profit Pensions

Just three companies currently dominate Chile’s market for retirement plans, providing coverage to 80 percent of workers with pensions.

The pension funds, which are invested in the market and vary according to conditions, have suffered a hit with the recent slow down in the Chilean economy.

Uh-oh.

There’s nothing wrong with private investment accounts. But when you award those contracts and let the “free market” decide what fees can be charged, you end up with a system like that.

This isn’t an example of the free-market working.

Benjamin Franklin, one of our founding fathers, started the first insurance pool in America for fires. The concept is that you take a little from a whole group of people – sharing the risk between those who will have a loss and those who don’t. Having a pool of healthy and sick people is essential for the good of all since who knows who will be sick tomorrow. And since we have a progressive tax system, those who make the most money, pay more in taxes and still have plenty of disposable income. The argument of people being bankrupted by taxes doesn’t hold water. And so it should be for health insurance. Anything else is selfish and inhumane. (There, I did jump in again.)

But Joe Kennedy said it best.

@Mariah I’ve switched from the argument of spreading the costs over the many, to people pay into the system so when they have their own catastrophe they will be cared for. People like @GregOP don’t want to pay for your illness, but what about their own illness that is coming down the pike? They don’t think it will happen to them, but that’s just bullshit in most cases, most people have some sort of health thing eventually, or a loved one does. The government has to step in and force these people to contribute. The perfect example is Social Security, not everyone sets money aside for the future, so the government does it for them (forces them to pay into the system).

@GregOP You have no real idea what using healthcare is like when sick with chronic illness, or grave disease. Knowing people who have done it, it isn’t the same.

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