No see, it really hasn't. Tossing out some random pro single payer talking points and ignoring the reality of just how screwed up our system is is not debunking. Our system is really, really broken. Waving the magic wand of single payer does not solve our problems, merely changes them to different ones.
Claiming it will all work out ok with no consequences because the government will fix everything with a vague plan of "taxing people" and "negotiation" does nothing to address doctor shortages, nurse shortages, or how we ration health care.
It does not even address the fact that health insurance is not health care, and does nothing to address the fact you will be taxing the middle class for health insurance they will likely never use because if they want to actual see a good doctor they will need to buy into the second tier because nobody who can get away with it will actually want to deal with the lower everyone has it insurance tier. Which means only the newest, or shittiest doctors will take it.
Single payer is not Gandalf, Erasmus, or Merlin. It does not solve our problems.
Single payer has been proven to work in Canada, Australia, the UK, Germany, France, Japan, and Sweden, all of which have higher life expectancy, lower infant mortality, and spend less per capita on healthcare than we do.
Yeah, the rest of the 1st world has huge issues with this.
Oh, wait, no they don't.
In at least some other 1st world countries, the arrangement I described is illegal. Canada, for example, where doctors and patients can't opt out of single-payer.
Modern Man on
Aetian Jupiter - 41 Gunslinger - The Old Republic
Rigorous Scholarship
"Eliminating social programs has goals that go well beyond concentration of wealth and power. Social Security, public schools, and other such deviations from the “right way” that US military power is to impose on the world, as frankly declared, are based on evil doctrines, among them the pernicious belief that we should care, as a community, whether the disabled widow on the other side of town can make it through the day, or the child next door should have a chance for a decent future. These evil doctrines derive from the principle of sympathy that was taken to be the core of human nature by Adam Smith and David Hume, a principle that must be driven from the mind. Privatization has other benefits. If working people depend on the stock market for their pensions, health care, and other means of survival, they have a stake in undermining their own interests: opposing wage increases, health and safety regulations, and other measures that might cut into profits that flow to the benefactors on whom they must rely, in a manner reminiscent of feudalism..." -- Noam Chomsky, "Hegemony or Survival"
It does not even address the fact that health insurance is not health care, and does nothing to address the fact you will be taxing the middle class for health insurance they will likely never use because if they want to actual see a good doctor they will need to buy into the second tier because nobody who can get away with it will actually want to deal with the lower everyone has it insurance tier. Which means only the newest, or shittiest doctors will take it.
what the fuck are you talking about
seriously
Reality, where some of us live and some of us occasionally visit. Quick easy example. You are a doctor. You will see 100 patients in a day. Now you are a good doctor, and thanks to the doctor shortage have no problem scheduling those 100 patients a day.
Now imagine you have two insurance companies who will pay you. The first is Brand X, they will pay you 100 dollars a visit. The second is Brand O, they will pay you 10 dollars a visit. Since you are free to chose which patients you wish to see and given the doctor shortage you are capable of seeing 100 Brand X patients a day, why do you see any with Brand O? The answer is you don't unless you are feeling charitable.
It does not even address the fact that health insurance is not health care, and does nothing to address the fact you will be taxing the middle class for health insurance they will likely never use because if they want to actual see a good doctor they will need to buy into the second tier because nobody who can get away with it will actually want to deal with the lower everyone has it insurance tier. Which means only the newest, or shittiest doctors will take it.
what the fuck are you talking about
seriously
Reality, where some of us live and some of us occasionally visit. Quick easy example. You are a doctor. You will see 100 patients in a day. Now you are a good doctor, and thanks to the doctor shortage have no problem scheduling those 100 patients a day.
Now imagine you have two insurance companies who will pay you. The first is Brand X, they will pay you 100 dollars a visit. The second is Brand O, they will pay you 10 dollars a visit. Since you are free to chose which patients you wish to see and given the doctor shortage you are capable of seeing 100 Brand X patients a day, why do you see any with Brand O? The answer is you don't unless you are feeling charitable.
so why is this not happening in every other country that has single player systems
is this american exceptionalism that this is something that will only happen in america
No see, it really hasn't. Tossing out some random pro single payer talking points and ignoring the reality of just how screwed up our system is is not debunking. Our system is really, really broken. Waving the magic wand of single payer does not solve our problems, merely changes them to different ones.
Claiming it will all work out ok with no consequences because the government will fix everything with a vague plan of "taxing people" and "negotiation" does nothing to address doctor shortages, nurse shortages, or how we ration health care.
It does not even address the fact that health insurance is not health care, and does nothing to address the fact you will be taxing the middle class for health insurance they will likely never use because if they want to actual see a good doctor they will need to buy into the second tier because nobody who can get away with it will actually want to deal with the lower everyone has it insurance tier. Which means only the newest, or shittiest doctors will take it.
Single payer is not Gandalf, Erasmus, or Merlin. It does not solve our problems.
The bolded part is simultaneously true and not true.
Health insurance is not actually health care, but it does determine one's accessibility to health care. If I have a shit policy, I'm going to get access to shit medical care. If I shell out for better policies, it's more likely I'll get access to better care.
A private insurance company and a government health care provider (Tricare, Medicare, Medicad et all) are functionally going to provide the same services- help you pay for your medical bills.
In terms of government spending, yes- a single-payer system will initially cost the government more. But this is one of the big advantages of a government-run health care provider- they're not in it for the money. They're going to try to provide you health care of pretty good quality as cheap as they can. So while it does cost money to the government, programs like this (Medicare, Medicaid) are known to be highly efficient in their current form.
A private insurance company is beholden to its stockholders, meaning they need to turn a profit.
tl;dnr: A government-run health care option or a single payer system will obviously cost the government more in the short term and need to be paid for through revenue increases, but the long-term benefits would make it worth it. It would help bring medical costs down, which is one of the constant reasons (constant =/= war) we're running a deficit.
The biggest hurdles to becoming a doctor is the retarded amount of work involved in becoming one and practicing, and, perhaps more importantly, education costs.
There is no scientific evidence that I'm aware of that says that the shortage of doctors (by the way its a shortage of general practitioners, not doctors as a whole) will get worse under single payer. Single payer could actually be more attractive to doctors, since they can then challenge insurance decisions in public, since they would be governed by public laws not secret deals that are trade secrets of the health insurance companies. In fact, that transparency has been one of the major factors that has improved the world's single payer systems so much from the 80s when conservatives were first arguing that they didn't work (turns out they were wrong). You are arguing on old invalid data that was questionable when the arguments first were formulated in the 80s, which has now plainly been demonstrated incorrect by all reasonable measures.
I fail to see why one massive government bureaucracy is better than 10-20 corporations competing against each other, or why for profit is a problem.
I fail to see how 20 people rowing in the same direction under the direction of a single captain will bring you to your destination faster than 10-20 individual captains rowing in competing directions.
I fail to see how one ship that will continue to sail no matter what happens, will get me anywhere faster than 10-20 ships all fighting for who can get me their the fastest. If an insurance company doesn't make money, it folds. If the government doesn't make budget it borrows.
Wasn't one of the problems with Health Care in the US due to health insurance providers telling people they couldn't get insurance due to pre-existing conditions, and using that excuse (among others) to tell people with claims "tough shit"?
Sounds like most or all of those 10-20 ships aren't fighting for shit if they're telling a whole lot of potential passengers to fuck off because they're heavier or carrying more baggage than some of their passengers.
They had their chance, and rather than try to work out systems that could cover just about everyone affordably, they rode those who could pay (or who couldn't afford not to pay) all the way to the bank instead.
Forar on
First they came for the Muslims, and we said NOT TODAY, MOTHERFUCKER!
That's not new. Doctors can already do that. They already do that.
Why do some lawyers cost more money than other lawyers?
Why do some basketball players earn more per year than others?
Why do some bands get paid more for a show than others?
Why does fancy sushi cost more than ramen?
Why do some things cost different amounts of money?
This is not a bug, it is a feature.
Its also almost entirely irrelevant when talking about the debt ceiling and deficit. There's a health care thread, and insofar as single payer can reduce the deficit, let's talk about it. Whether single payer would provide better care and whether single payer is more or less ethical than the current system are all interesting but not really related to the deficit.
Reality, where some of us live and some of us occasionally visit. Quick easy example. You are a doctor. You will see 100 patients in a day. Now you are a good doctor, and thanks to the doctor shortage have no problem scheduling those 100 patients a day.
Now imagine you have two insurance companies who will pay you. The first is Brand X, they will pay you 100 dollars a visit. The second is Brand O, they will pay you 10 dollars a visit. Since you are free to chose which patients you wish to see and given the doctor shortage you are capable of seeing 100 Brand X patients a day, why do you see any with Brand O? The answer is you don't unless you are feeling charitable.
You realize that if anything you said was even remotely plausible as a scenario, we would already be seeing it, yes?
Yes, we do have a shortage of doctors. But it's not to the point where we only have enough doctors to cover the millionaires, and no one else.
Single payer has been proven to work in Canada, Australia, the UK, Germany, France, Japan, and Sweden, all of which have higher life expectancy, lower infant mortality, and spend less per capita on healthcare than we do.
These things have nothing to do with how we pay for our health care. The differences tend to disappear once you account for demographic differences between the US and those countries, much like our crime rate.
This is a canard that pro-single-payer proponents throw around as they pretend comparing the US to Japan or Sweden is anything other than apples and oranges.
Modern Man on
Aetian Jupiter - 41 Gunslinger - The Old Republic
Rigorous Scholarship
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adventfallsWhy would you wish to know?Registered Userregular
That's not new. Doctors can already do that. They already do that.
Why do some lawyers cost more money than other lawyers?
Why do some basketball players earn more per year than others?
Why do some bands get paid more for a show than others?
Why does fancy sushi cost more than ramen?
Why do some things cost different amounts of money?
This is not a bug, it is a feature.
Its also almost entirely irrelevant when talking about the debt ceiling and deficit. There's a health care thread, and insofar as single payer can reduce the deficit, let's talk about it. Whether single payer would provide better care and whether single payer is more or less ethical than the current system are all interesting but not really related to the deficit.
Bolded for emphasis. While I like that we have a debate on single-payer going on, we need to keep it focused on the economic (debts/finances/debt ceiling) side of it.
Single payer has been proven to work in Canada, Australia, the UK, Germany, France, Japan, and Sweden, all of which have higher life expectancy, lower infant mortality, and spend less per capita on healthcare than we do.
These things have nothing to do with how we pay for our health care. The differences tend to disappear once you account for demographic differences between the US and those countries, much like our crime rate.
This is a canard that pro-single-payer proponents throw around as they pretend comparing the US to Japan or Sweden is anything other than apples and oranges.
They spend less per capita
They spend less as a percentage of GDP
They spend less as a percentage of government revenue
They pay a higher percentage of healthcare costs per patient.
No see, it really hasn't. Tossing out some random pro single payer talking points and ignoring the reality of just how screwed up our system is is not debunking. Our system is really, really broken. Waving the magic wand of single payer does not solve our problems, merely changes them to different ones.
Claiming it will all work out ok with no consequences because the government will fix everything with a vague plan of "taxing people" and "negotiation" does nothing to address doctor shortages, nurse shortages, or how we ration health care.
It does not even address the fact that health insurance is not health care, and does nothing to address the fact you will be taxing the middle class for health insurance they will likely never use because if they want to actual see a good doctor they will need to buy into the second tier because nobody who can get away with it will actually want to deal with the lower everyone has it insurance tier. Which means only the newest, or shittiest doctors will take it.
Single payer is not Gandalf, Erasmus, or Merlin. It does not solve our problems.
The bolded part is simultaneously true and not true.
Health insurance is not actually health care, but it does determine one's accessibility to health care. If I have a shit policy, I'm going to get access to shit medical care. If I shell out for better policies, it's more likely I'll get access to better care.
A private insurance company and a government health care provider (Tricare, Medicare, Medicad et all) are functionally going to provide the same services- help you pay for your medical bills.
In terms of government spending, yes- a single-payer system will initially cost the government more. But this is one of the big advantages of a government-run health care provider- they're not in it for the money. They're going to try to provide you health care of pretty good quality as cheap as they can. So while it does cost money to the government, programs like this (Medicare, Medicaid) are known to be highly efficient in their current form.
A private insurance company is beholden to its stockholders, meaning they need to turn a profit.
tl;dnr: A government-run health care option or a single payer system will obviously cost the government more in the short term and need to be paid for through revenue increases, but the long-term benefits would make it worth it. It would help bring medical costs down, which is one of the constant reasons (constant =/= war) we're running a deficit.
If the profit motivation of health insurance companies is the driving factor behind costs, why is it that the large not-for-profit health insurance companies aren't beating the pants off of all of the for profit companies in terms of subscribers?
Let's just say that health care may be/is related in important ways to national debt and if people want to get into the nitty gritty the actual medical care thread is missing the strident voice of conservatives. So feel free to get involved over there.
Also, how long before this becomes an issue again? 60 days or something right?
hanskey on
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adventfallsWhy would you wish to know?Registered Userregular
I fail to see why one massive government bureaucracy is better than 10-20 corporations competing against each other, or why for profit is a problem.
I fail to see how 20 people rowing in the same direction under the direction of a single captain will bring you to your destination faster than 10-20 individual captains rowing in competing directions.
I fail to see how one ship that will continue to sail no matter what happens, will get me anywhere faster than 10-20 ships all fighting for who can get me their the fastest. If an insurance company doesn't make money, it folds. If the government doesn't make budget it borrows.
Because insurance companies aren't in the business of getting to my destination the fastest, unless by "fastest" you mean "final destination of death, so that there are no longer any new medical bills." They're in the business of making money.
How do they make money? By winning over as much customers as they possibly can, pressuring their customers to spend as much as they can afford, and spending as little as they can get away with.
Winning over customers requires ad time and marketing. 20 companies who have to constantly spend huge chunks of their profits on ad space will be less efficient than a single government that only needs a very small ad budget. Moreover, 20 companies will buy ad space in the form of "branding." Where as government tends to buy ads in the form of PSAs. Which means that government ad time is more informative than corporate ad time. It also means that corporations don't need to waste resources offering a better product, when they can simply use resources on building a more popular brand.
Pressuring customers as much as they can afford is easy, since they are literally holding the customer's health at hostage. Government doesn't have the same motive to charge people as much as possible.
Spending as little as they can get away with is also encouraged more for corporations, since the corporation can simply shrug and say that it's an industry wide practice. Where as if the government started dropping coverage for cancer patients, it would be a single entity for all people to target.
Anyway, please explain to us how having a profit motive automatically makes health care cheaper.
If you replaced one tax payer funded bridge with 20 toll bridges, would the competing bridge system be cheaper?
Also, how long before they start waving their dicks ... the debt ceiling in our faces again? 60 days or something, right?
Dunno- memory's a bit fuzzy if they've actually raised it yet.
I thought I heard yesterday on NPR or CNN that they won't have to raise the debt ceiling after all because they got more revenue than they thought they would, and the next likely time for a vote to be needed would be in like a month or two?
I'm actually growing to like this idea of "debts to yourself don't count."
I have a credit card, and its in my name, so that's a debt to myself, obviously. It doesn't count. I'll just take a cash advance from my own credit card and put all that money into my bank account, spend it on videogames, and then not pay the credit card because its a debt to myself so therefore it isn't real.
Maybe I'll get some advance pay from work, that's just an IOU from my future self to my current self, so also not real. I'll set up two credit cards and put all the debt from one into the other, and then decide that one is no longer real.
This is a brave new frontier in finance. IOU's no longer matter, time to get some fucking shopping done.
This is a retarded strawman and you know it, and it has nothing to do with what I was saying.
When the government issues bonds to fund a project, does it suddenly invent free money? "Okay, we're going to write out ten billion in bonds, WOO FREE MONEY, okay, we never have to worry about that ten billion again." Is that how you imagine it works?
No, what happens is the government sells a bunch of bonds, takes the money, and then has to spend the next couple decades making payments on it.
That is what the SS fund is. The government created a legal obligation to pay itself a bunch of money in the future. So yeah, legally the money exists. Yay, whatever. But the government still has to pay that money to itself. Where is going to get the money to pay this back? Well, with tax revenue. From... somewhere. We don't fucking know. It can pay it back with payroll taxes, or it can pay it back with income taxes, or any other form of taxes, but it is not money that is sitting around waiting to be spent.
If you want to define the IOUs the government wrote as real money, great, but the fact remains that the money it is paying to itself has to come from somewhere, and that money is going to be money that it can't spend on other things, unless it wants to borrow more and add more to the debt.
I mean, I'm sure you know how bonds work. So I don't get why you keep willfully ignoring the part where the government has to actually pay that money back.
ElJeffe on
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adventfallsWhy would you wish to know?Registered Userregular
Also, how long before they start waving their dicks ... the debt ceiling in our faces again? 60 days or something, right?
Dunno- memory's a bit fuzzy if they've actually raised it yet.
I thought I heard yesterday on NPR or CNN that they won't have to raise the debt ceiling after all because they got more revenue than they thought they would, and the next likely time for a vote to be needed would be in like a month or two?
Can you cite that for me? I spend all of yesterday cramming for an exam.
If the profit motivation of health insurance companies is the driving factor behind costs, why is it that the large not-for-profit health insurance companies aren't beating the pants off of all of the for profit companies in terms of subscribers?
Lack of access to the not-for-profits plans, thanks to lobbying by the for-profit health insurers.
If the profit motivation of health insurance companies is the driving factor behind costs, why is it that the large not-for-profit health insurance companies aren't beating the pants off of all of the for profit companies in terms of subscribers?
Of the 138 health plans in the United States with at least 100,000 medical enrollees,
84 or 61% are nonprofit.
Of the 203,203,306 total medical enrollees of these 138 health plans, 97,931,924 or
48% are in nonprofit health plans.
[/quote]
Customers are always 100% rational. That's why most tea party members are absolutely convinced that taxes went up after Obama, even though taxes actually went down.
I'm actually growing to like this idea of "debts to yourself don't count."
I have a credit card, and its in my name, so that's a debt to myself, obviously. It doesn't count. I'll just take a cash advance from my own credit card and put all that money into my bank account, spend it on videogames, and then not pay the credit card because its a debt to myself so therefore it isn't real.
Maybe I'll get some advance pay from work, that's just an IOU from my future self to my current self, so also not real. I'll set up two credit cards and put all the debt from one into the other, and then decide that one is no longer real.
This is a brave new frontier in finance. IOU's no longer matter, time to get some fucking shopping done.
This is a retarded strawman and you know it, and it has nothing to do with what I was saying.
When the government issues bonds to fund a project, does it suddenly invent free money? "Okay, we're going to write out ten billion in bonds, WOO FREE MONEY, okay, we never have to worry about that ten billion again." Is that how you imagine it works?
No, what happens is the government sells a bunch of bonds, takes the money, and then has to spend the next couple decades making payments on it.
That is what the SS fund is. The government created a legal obligation to pay itself a bunch of money in the future. So yeah, legally the money exists. Yay, whatever. But the government still has to pay that money to itself. Where is going to get the money to pay this back? Well, with tax revenue. From... somewhere. We don't fucking know. It can pay it back with payroll taxes, or it can pay it back with income taxes, or any other form of taxes, but it is not money that is sitting around waiting to be spent.
If you want to define the IOUs the government wrote as real money, great, but the fact remains that the money it is paying to itself has to come from somewhere, and that money is going to be money that it can't spend on other things, unless it wants to borrow more and add more to the debt.
I mean, I'm sure you know how bonds work. So I don't get why you keep willfully ignoring the part where the government has to actually pay that money back.
Except by that logic:
1) SS has nothing to do with the government debt or deficit
2) the US government has been running absolutely massive deficits for decades now
I'm actually growing to like this idea of "debts to yourself don't count."
I have a credit card, and its in my name, so that's a debt to myself, obviously. It doesn't count. I'll just take a cash advance from my own credit card and put all that money into my bank account, spend it on videogames, and then not pay the credit card because its a debt to myself so therefore it isn't real.
Maybe I'll get some advance pay from work, that's just an IOU from my future self to my current self, so also not real. I'll set up two credit cards and put all the debt from one into the other, and then decide that one is no longer real.
This is a brave new frontier in finance. IOU's no longer matter, time to get some fucking shopping done.
This is a retarded strawman and you know it, and it has nothing to do with what I was saying.
Oh that's only half true, its a retarded strawman that has EVERYTHING to do with what you were saying (but more to do with what others were saying, but you responded so here we are).
*snip* (bonds are irrelevant here, as printing money and issuing bonds are different)
That is what the SS fund is. The government created a legal obligation to pay itself a bunch of money in the future. So yeah, legally the money exists. Yay, whatever. But the government still has to pay that money to itself.
]
I'm glad we're in agreement on the bolded, although "itself" is kind of a curious definition. The government owes money to retirees and uses the social security fund to pay that, is that money owed to retirees or to the government? If the government creates a new account, say "military funding" account, and puts all the money due to outside contractors in there, is money owed to Xe now "money it owes to itself?"
Where is going to get the money to pay this back? Well, with tax revenue. From... somewhere. We don't fucking know.
How is this different than any other debt currently carried by the government?
I haven't seen you making any posts about how nobody should buy bonds from the government because "THOSE ARE JUST IOU's!"
So why is one bond, one IOU, one debt, valid and one imaginary?
It can pay it back with payroll taxes, or it can pay it back with income taxes, or any other form of taxes, but it is not money that is sitting around waiting to be spent.
Arguably it can also increase the debt limit or print money, although the actual process for doing either of those would obviously be more complicated. But generally, the government can borrow, print, or tax in order to increase income and pay debts.
It can also default, of course, but nobody wants the government to default. In fact, the concept of the government defaulting on any debt is crazy, as it would undermine the entire U.S. economy. For some inexplicable reason, some people think the government should default on the debt owed to social security because its a special magical debt that is ok to default on. Its "just a bunch of IOUs!"
If you want to define the IOUs the government wrote as real money, great, but the fact remains that the money it is paying to itself has to come from somewhere, and that money is going to be money that it can't spend on other things, unless it wants to borrow more and add more to the debt.
I mean, I'm sure you know how bonds work. So I don't get why you keep willfully ignoring the part where the government has to actually pay that money back.
I completely understand how bonds work. Why do you think bonds and social security are different? Why is it ok to default on one but not the other? Why not keep social security solvent and just tell every outside investor and agent owed a bond to get fucked? How about the government just decides, one day, to not pay any employees. Ever again. Nobody who works for the government ever gets paid. Its all just IOUs, all owed by the government to the government, right?
No, that's obviously not a good idea, but neither is pretending that the social security fund is "just an IOU" without understanding that all money is "just an IOU" as well.
Also, how long before they start waving their dicks ... the debt ceiling in our faces again? 60 days or something, right?
Dunno- memory's a bit fuzzy if they've actually raised it yet.
I thought I heard yesterday on NPR or CNN that they won't have to raise the debt ceiling after all because they got more revenue than they thought they would, and the next likely time for a vote to be needed would be in like a month or two?
Can you cite that for me? I spend all of yesterday cramming for an exam.
The absolute final date for raising the debt limit on federal borrowing has been pushed back by three weeks, to Aug. 2. Weeks ago, the ceiling was expected to be reached sometime in May.
Secretary of the Treasury Tim Geithner said in a letter he sent to lawmakers on Monday that higher than expected tax receipts will carry the current debt load of approximately $14.2 trillion a little longer than previously anticipated. He will also begin a series of financial maneuvers to avoid breaching the current limit of $14.294 trillion.
I'm actually growing to like this idea of "debts to yourself don't count."
I have a credit card, and its in my name, so that's a debt to myself, obviously. It doesn't count. I'll just take a cash advance from my own credit card and put all that money into my bank account, spend it on videogames, and then not pay the credit card because its a debt to myself so therefore it isn't real.
Maybe I'll get some advance pay from work, that's just an IOU from my future self to my current self, so also not real. I'll set up two credit cards and put all the debt from one into the other, and then decide that one is no longer real.
This is a brave new frontier in finance. IOU's no longer matter, time to get some fucking shopping done.
This is a retarded strawman and you know it, and it has nothing to do with what I was saying.
When the government issues bonds to fund a project, does it suddenly invent free money? "Okay, we're going to write out ten billion in bonds, WOO FREE MONEY, okay, we never have to worry about that ten billion again." Is that how you imagine it works?
No, what happens is the government sells a bunch of bonds, takes the money, and then has to spend the next couple decades making payments on it.
That is what the SS fund is. The government created a legal obligation to pay itself a bunch of money in the future. So yeah, legally the money exists. Yay, whatever. But the government still has to pay that money to itself. Where is going to get the money to pay this back? Well, with tax revenue. From... somewhere. We don't fucking know. It can pay it back with payroll taxes, or it can pay it back with income taxes, or any other form of taxes, but it is not money that is sitting around waiting to be spent.
If you want to define the IOUs the government wrote as real money, great, but the fact remains that the money it is paying to itself has to come from somewhere, and that money is going to be money that it can't spend on other things, unless it wants to borrow more and add more to the debt.
I mean, I'm sure you know how bonds work. So I don't get why you keep willfully ignoring the part where the government has to actually pay that money back.
The government pays for it by selling securities to other individuals, which converts part of the public debt from the "Intragovernmental Holdings" category to the "Debt Held By the Public" category. What exactly is the problem here?
If the profit motivation of health insurance companies is the driving factor behind costs, why is it that the large not-for-profit health insurance companies aren't beating the pants off of all of the for profit companies in terms of subscribers?
Of the 138 health plans in the United States with at least 100,000 medical enrollees,
84 or 61% are nonprofit.
Of the 203,203,306 total medical enrollees of these 138 health plans, 97,931,924 or
48% are in nonprofit health plans.
Customers are always 100% rational. That's why most tea party members are absolutely convinced that taxes went up after Obama, even though taxes actually went down.
I'm not sure I understand your suggestion. Customers (in this case very large organizations) are so irrational that they're ignoring the (assumed, since profit was listed as a driving force in the high costs of health insurance companies in the post I responded to) lower premiums offered by the health insurance companies that don't have a profit motivation?
The problem is we have no guarantee that it will in fact bring costs down especially since you will be talking about giving more people "subsidized" or free insurance paid for by increases in taxes on the middle class. Especially considering when it comes to just having to pay for people with their insurance the average profit margin of an insurance company is around 3.7%. These companies, already dumping the burden of the uninsured on hospitals who rarely make any money already are not raking in the cash here.
Which means taking every single person currently with insurance, and ignoring all the messed up things insurance companies due to maximize profits you are still only walking away with less than 4% more than you take in. Now let us remove all those messed up ways in which they increase profits. Now let us dump in 46 million more people who currently lack insurance. Now you are losing even more money. You are not making a profit any more.
Trying to bring costs down is great, except the only people actually making any money are pharmaceuticals and largely we as a country are subsidizing the worlds cheap drugs.
However thankfully Massachusetts was nice enough to pass a mandatory insurance bill so we can get a sneak preview of how that might work out. Instead of cutting costs it has instead seen costs rise. We complain that the US has the highest cost of health care per capita in the world, and yet Massachusetts has the highest costs per capita in the US.
I'm not sure I understand your suggestion. Customers (in this case very large organizations) are so irrational that they're ignoring the (assumed, since profit was listed as a driving force in the high costs of health insurance companies in the post I responded to) lower premiums offered by the health insurance companies that don't have a profit motivation?
Do a blind taste test, and consumers overwhelmingly choose Pepsi over Coke. Then do another taste test where they see the labels, and the results are reversed. It turns out that people are willing to pay for an inferior brand name product simply because they like the brand name better.
The problem is we have no guarantee that it will in fact bring costs down especially since you will be talking about giving more people "subsidized" or free insurance paid for by increases in taxes on the middle class. Especially considering when it comes to just having to pay for people with their insurance the average profit margin of an insurance company is around 3.7%. These companies, already dumping the burden of the uninsured on hospitals who rarely make any money already are not raking in the cash here.
Which means taking every single person currently with insurance, and ignoring all the messed up things insurance companies due to maximize profits you are still only walking away with less than 4% more than you take in. Now let us remove all those messed up ways in which they increase profits. Now let us dump in 46 million more people who currently lack insurance. Now you are losing even more money. You are not making a profit any more.
Trying to bring costs down is great, except the only people actually making any money are pharmaceuticals and largely we as a country are subsidizing the worlds cheap drugs.
However thankfully Massachusetts was nice enough to pass a mandatory insurance bill so we can get a sneak preview of how that might work out. Instead of cutting costs it has instead seen costs rise. We complain that the US has the highest cost of health care per capita in the world, and yet Massachusetts has the highest costs per capita in the US.
The profit margin and the waste margin are completely different. Also, I for one think that health care for people who currently can't afford it is a good thing.
The problem is we have no guarantee that it will in fact bring costs down especially since you will be talking about giving more people "subsidized" or free insurance paid for by increases in taxes on the middle class. Especially considering when it comes to just having to pay for people with their insurance the average profit margin of an insurance company is around 3.7%. These companies, already dumping the burden of the uninsured on hospitals who rarely make any money already are not raking in the cash here.
And how much of that revenue is spent on actually providing health care?
If you pay your CEO $100 million for hookers and your lawyers $50 million to find ways to cut services, it's going to cut into your profit margin. But it's not necessarily efficient.
We have as much guarentee as you have for anything that works the same way every time somebody else has done it.
I'm glad we've decided to reiterate the "America is a Unique Snowflake" argument all over again though.
I am sure things will work exactly the same here as they do in a country a 1/10th our size with a population that expects something completely different from their government and is willing to pay for it. Disregarding the problems other countries have with their systems, causing anyone with any money to come here for treatment oddly enough, discounting all constitutional and legal issues, discounting how it will interact with the other problems we already have, discounting that there is absolutely no guarantee it will fix anything, then yes we could potentially hack into place a flawed system that would never work like we intend, cause more problems than we have now, and cost us progressively more money each year.
Oh the usual definition. Making enough to actually have to pay taxes, but not enough you can dodge most of it or get the Republicans throwing a hissy fit when anyone threatens your particular bracket.
I'm not laughing about dead babies, I'm laughing about you.
Yes, the US is so different and unique that, unlike nations that clawed themselves out from under the heel of monarchy or fascism, there's no way the US could possibly refine it's laws and regulations to the point where it could approximate single payer health care that works for millions of people all over the world (edit: so as to save money!), at every range of population density compared to the US.
I swear, I know of no other nation so convinced that it is incapable of doing anything competently. For all the talk, a remarkable number of Americans have no faith in their nation.
Ego on
Erik
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We have as much guarentee as you have for anything that works the same way every time somebody else has done it.
I'm glad we've decided to reiterate the "America is a Unique Snowflake" argument all over again though.
I am sure things will work exactly the same here as they do in a country a 1/10th our size with a population that expects something completely different from their government and is willing to pay for it. Disregarding the problems other countries have with their systems, causing anyone with any money to come here for treatment oddly enough, discounting all constitutional and legal issues, discounting how it will interact with the other problems we already have, discounting that there is absolutely no guarantee it will fix anything, then yes we could potentially hack into place a flawed system that would never work like we intend, cause more problems than we have now, and cost us progressively more money each year.
Deth, it's fairly clear that you're coming in with a bias against a government health system.
>I am sure things will work exactly the same here as they do in a country a 1/10th our size with a population that expects something completely different from their government and is willing to pay for it.
Sarcasm aside, these smaller countries have populations that expect if they pay for their government to pay for something, they should get a service they are happy with.
>Disregarding the problems other countries have with their systems
There is no such thing as a perfect system. Attempting to disparage the 'good' in pursuit of the 'perfect' (this is not unique to health care, this is just in general) never works.
>causing anyone with any money to come here for treatment oddly enough
The United States has the best tech on the planet when it comes to health care. So *if* you have the money, of course you're going to spring for the best possible equipment- meaning you go to the US.
>discounting all constitutional and legal issues
This one's obviously up for interpretation. Congress certainly has the power to spend money to improve the general welfare of US citizens. Even Obama's health care reform (which is projected to decrease the deficit) has survived most of its challenges, and the one challenge it's lost is being appealed.
>discounting how it will interact with the other problems we already have, discounting that there is absolutely no guarantee it will fix anything
There is *never* going to be a 100% in anything. Never. Is a new weather prediction system going to be 100% accurate? Do patches for Windows fix 100% of all user issues? I know those are examples in different areas, but you cannot possibly please everyone, you cannot possibly fix everything with a single attempt. You fix problems as you come across them in order to create a better system.
>then yes we could potentially hack into place a flawed system that would never work like we intend
Let's put aside your clear disdain for the idea of a single-payer system for a moment. This is the same kind of argument conservatives in other countries used when their single-payer (or something akin to thereof) were being implemented. They were ultimately proven wrong.
>cause more problems than we have now
In our current system, you could be denied coverage by just about everyone if you got sick as a kid. Ex: I had asthma as a kid. This is a condition I had before I could get onto a private plan. An attempt to get onto a private plan (before Obama health care reform) wouldn't be guaranteed, because I had a 'pre-existing condition'.
California has seen double-digit increases in premiums at least two years in a row now. In many states, one or two insurance companies hold a near-monopoly.
I find it difficult to comprehend that attempting to institute a new system could create problems worse than these.
>and cost us progressively more money each year.
This is probably the only point that I think is worthy of a frank discussion. And that's really a discussion more for the Health Care thread, though I'm not the authority on that call.
Either way, can we stop having a back and forth with Detharin on health care and focus more on the financial side of things?
I'm not laughing about dead babies, I'm laughing about you.
Yes, the US is so different and unique that, unlike nations that clawed themselves out from under the heel of monarchy or fascism, there's no way the US could possibly refine it's laws and regulations to the point where it could approximate single payer health care that works for millions of people all over the world (edit: so as to save money!), at every range of population density compared to the US.
I swear, I know of no other nation so convinced that it is incapable of doing anything competently. For all the talk, a remarkable number of Americans have no faith in their nation.
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Single payer has been proven to work in Canada, Australia, the UK, Germany, France, Japan, and Sweden, all of which have higher life expectancy, lower infant mortality, and spend less per capita on healthcare than we do.
twitch.tv/Taramoor
@TaramoorPlays
Taramoor on Youtube
Rigorous Scholarship
http://en.wikipedia.org/wiki/Neofeudalism
Reality, where some of us live and some of us occasionally visit. Quick easy example. You are a doctor. You will see 100 patients in a day. Now you are a good doctor, and thanks to the doctor shortage have no problem scheduling those 100 patients a day.
Now imagine you have two insurance companies who will pay you. The first is Brand X, they will pay you 100 dollars a visit. The second is Brand O, they will pay you 10 dollars a visit. Since you are free to chose which patients you wish to see and given the doctor shortage you are capable of seeing 100 Brand X patients a day, why do you see any with Brand O? The answer is you don't unless you are feeling charitable.
so why is this not happening in every other country that has single player systems
is this american exceptionalism that this is something that will only happen in america
or are you just making up your own reality
PSN/Steam/NNID: SyphonBlue | BNet: SyphonBlue#1126
The bolded part is simultaneously true and not true.
Health insurance is not actually health care, but it does determine one's accessibility to health care. If I have a shit policy, I'm going to get access to shit medical care. If I shell out for better policies, it's more likely I'll get access to better care.
A private insurance company and a government health care provider (Tricare, Medicare, Medicad et all) are functionally going to provide the same services- help you pay for your medical bills.
In terms of government spending, yes- a single-payer system will initially cost the government more. But this is one of the big advantages of a government-run health care provider- they're not in it for the money. They're going to try to provide you health care of pretty good quality as cheap as they can. So while it does cost money to the government, programs like this (Medicare, Medicaid) are known to be highly efficient in their current form.
A private insurance company is beholden to its stockholders, meaning they need to turn a profit.
tl;dnr: A government-run health care option or a single payer system will obviously cost the government more in the short term and need to be paid for through revenue increases, but the long-term benefits would make it worth it. It would help bring medical costs down, which is one of the constant reasons (constant =/= war) we're running a deficit.
There is no scientific evidence that I'm aware of that says that the shortage of doctors (by the way its a shortage of general practitioners, not doctors as a whole) will get worse under single payer. Single payer could actually be more attractive to doctors, since they can then challenge insurance decisions in public, since they would be governed by public laws not secret deals that are trade secrets of the health insurance companies. In fact, that transparency has been one of the major factors that has improved the world's single payer systems so much from the 80s when conservatives were first arguing that they didn't work (turns out they were wrong). You are arguing on old invalid data that was questionable when the arguments first were formulated in the 80s, which has now plainly been demonstrated incorrect by all reasonable measures.
Wasn't one of the problems with Health Care in the US due to health insurance providers telling people they couldn't get insurance due to pre-existing conditions, and using that excuse (among others) to tell people with claims "tough shit"?
Sounds like most or all of those 10-20 ships aren't fighting for shit if they're telling a whole lot of potential passengers to fuck off because they're heavier or carrying more baggage than some of their passengers.
They had their chance, and rather than try to work out systems that could cover just about everyone affordably, they rode those who could pay (or who couldn't afford not to pay) all the way to the bank instead.
Why do some lawyers cost more money than other lawyers?
Why do some basketball players earn more per year than others?
Why do some bands get paid more for a show than others?
Why does fancy sushi cost more than ramen?
Why do some things cost different amounts of money?
This is not a bug, it is a feature.
Its also almost entirely irrelevant when talking about the debt ceiling and deficit. There's a health care thread, and insofar as single payer can reduce the deficit, let's talk about it. Whether single payer would provide better care and whether single payer is more or less ethical than the current system are all interesting but not really related to the deficit.
You realize that if anything you said was even remotely plausible as a scenario, we would already be seeing it, yes?
Yes, we do have a shortage of doctors. But it's not to the point where we only have enough doctors to cover the millionaires, and no one else.
This is a canard that pro-single-payer proponents throw around as they pretend comparing the US to Japan or Sweden is anything other than apples and oranges.
Rigorous Scholarship
Bolded for emphasis. While I like that we have a debate on single-payer going on, we need to keep it focused on the economic (debts/finances/debt ceiling) side of it.
They spend less per capita
They spend less as a percentage of GDP
They spend less as a percentage of government revenue
They pay a higher percentage of healthcare costs per patient.
All of them.
twitch.tv/Taramoor
@TaramoorPlays
Taramoor on Youtube
If the profit motivation of health insurance companies is the driving factor behind costs, why is it that the large not-for-profit health insurance companies aren't beating the pants off of all of the for profit companies in terms of subscribers?
edited for reference:
Also, how long before this becomes an issue again? 60 days or something right?
Dunno- memory's a bit fuzzy if they've actually raised it yet.
Because insurance companies aren't in the business of getting to my destination the fastest, unless by "fastest" you mean "final destination of death, so that there are no longer any new medical bills." They're in the business of making money.
How do they make money? By winning over as much customers as they possibly can, pressuring their customers to spend as much as they can afford, and spending as little as they can get away with.
Winning over customers requires ad time and marketing. 20 companies who have to constantly spend huge chunks of their profits on ad space will be less efficient than a single government that only needs a very small ad budget. Moreover, 20 companies will buy ad space in the form of "branding." Where as government tends to buy ads in the form of PSAs. Which means that government ad time is more informative than corporate ad time. It also means that corporations don't need to waste resources offering a better product, when they can simply use resources on building a more popular brand.
Pressuring customers as much as they can afford is easy, since they are literally holding the customer's health at hostage. Government doesn't have the same motive to charge people as much as possible.
Spending as little as they can get away with is also encouraged more for corporations, since the corporation can simply shrug and say that it's an industry wide practice. Where as if the government started dropping coverage for cancer patients, it would be a single entity for all people to target.
Anyway, please explain to us how having a profit motive automatically makes health care cheaper.
If you replaced one tax payer funded bridge with 20 toll bridges, would the competing bridge system be cheaper?
This is a retarded strawman and you know it, and it has nothing to do with what I was saying.
When the government issues bonds to fund a project, does it suddenly invent free money? "Okay, we're going to write out ten billion in bonds, WOO FREE MONEY, okay, we never have to worry about that ten billion again." Is that how you imagine it works?
No, what happens is the government sells a bunch of bonds, takes the money, and then has to spend the next couple decades making payments on it.
That is what the SS fund is. The government created a legal obligation to pay itself a bunch of money in the future. So yeah, legally the money exists. Yay, whatever. But the government still has to pay that money to itself. Where is going to get the money to pay this back? Well, with tax revenue. From... somewhere. We don't fucking know. It can pay it back with payroll taxes, or it can pay it back with income taxes, or any other form of taxes, but it is not money that is sitting around waiting to be spent.
If you want to define the IOUs the government wrote as real money, great, but the fact remains that the money it is paying to itself has to come from somewhere, and that money is going to be money that it can't spend on other things, unless it wants to borrow more and add more to the debt.
I mean, I'm sure you know how bonds work. So I don't get why you keep willfully ignoring the part where the government has to actually pay that money back.
Can you cite that for me? I spend all of yesterday cramming for an exam.
So when's the new date for the debt ceiling vote?
Customers are always 100% rational. That's why most tea party members are absolutely convinced that taxes went up after Obama, even though taxes actually went down.
Except by that logic:
1) SS has nothing to do with the government debt or deficit
2) the US government has been running absolutely massive deficits for decades now
Oh that's only half true, its a retarded strawman that has EVERYTHING to do with what you were saying (but more to do with what others were saying, but you responded so here we are).
]
I'm glad we're in agreement on the bolded, although "itself" is kind of a curious definition. The government owes money to retirees and uses the social security fund to pay that, is that money owed to retirees or to the government? If the government creates a new account, say "military funding" account, and puts all the money due to outside contractors in there, is money owed to Xe now "money it owes to itself?"
How is this different than any other debt currently carried by the government?
I haven't seen you making any posts about how nobody should buy bonds from the government because "THOSE ARE JUST IOU's!"
So why is one bond, one IOU, one debt, valid and one imaginary?
Arguably it can also increase the debt limit or print money, although the actual process for doing either of those would obviously be more complicated. But generally, the government can borrow, print, or tax in order to increase income and pay debts.
It can also default, of course, but nobody wants the government to default. In fact, the concept of the government defaulting on any debt is crazy, as it would undermine the entire U.S. economy. For some inexplicable reason, some people think the government should default on the debt owed to social security because its a special magical debt that is ok to default on. Its "just a bunch of IOUs!"
I completely understand how bonds work. Why do you think bonds and social security are different? Why is it ok to default on one but not the other? Why not keep social security solvent and just tell every outside investor and agent owed a bond to get fucked? How about the government just decides, one day, to not pay any employees. Ever again. Nobody who works for the government ever gets paid. Its all just IOUs, all owed by the government to the government, right?
No, that's obviously not a good idea, but neither is pretending that the social security fund is "just an IOU" without understanding that all money is "just an IOU" as well.
The government pays for it by selling securities to other individuals, which converts part of the public debt from the "Intragovernmental Holdings" category to the "Debt Held By the Public" category. What exactly is the problem here?
I'm not sure I understand your suggestion. Customers (in this case very large organizations) are so irrational that they're ignoring the (assumed, since profit was listed as a driving force in the high costs of health insurance companies in the post I responded to) lower premiums offered by the health insurance companies that don't have a profit motivation?
Could you be more specific? What lobbying is keeping private not-for-profit health insurance plans from being utilized by customers?
Which means taking every single person currently with insurance, and ignoring all the messed up things insurance companies due to maximize profits you are still only walking away with less than 4% more than you take in. Now let us remove all those messed up ways in which they increase profits. Now let us dump in 46 million more people who currently lack insurance. Now you are losing even more money. You are not making a profit any more.
Trying to bring costs down is great, except the only people actually making any money are pharmaceuticals and largely we as a country are subsidizing the worlds cheap drugs.
However thankfully Massachusetts was nice enough to pass a mandatory insurance bill so we can get a sneak preview of how that might work out. Instead of cutting costs it has instead seen costs rise. We complain that the US has the highest cost of health care per capita in the world, and yet Massachusetts has the highest costs per capita in the US.
I'm glad we've decided to reiterate the "America is a Unique Snowflake" argument all over again though.
Do a blind taste test, and consumers overwhelmingly choose Pepsi over Coke. Then do another taste test where they see the labels, and the results are reversed. It turns out that people are willing to pay for an inferior brand name product simply because they like the brand name better.
The profit margin and the waste margin are completely different. Also, I for one think that health care for people who currently can't afford it is a good thing.
And how much of that revenue is spent on actually providing health care?
If you pay your CEO $100 million for hookers and your lawyers $50 million to find ways to cut services, it's going to cut into your profit margin. But it's not necessarily efficient.
I am sure things will work exactly the same here as they do in a country a 1/10th our size with a population that expects something completely different from their government and is willing to pay for it. Disregarding the problems other countries have with their systems, causing anyone with any money to come here for treatment oddly enough, discounting all constitutional and legal issues, discounting how it will interact with the other problems we already have, discounting that there is absolutely no guarantee it will fix anything, then yes we could potentially hack into place a flawed system that would never work like we intend, cause more problems than we have now, and cost us progressively more money each year.
Oh the usual definition. Making enough to actually have to pay taxes, but not enough you can dodge most of it or get the Republicans throwing a hissy fit when anyone threatens your particular bracket.
Yeah, you wouldn't want to have one of those.
Hahaha.
*goes and looks up infant mortality and life expectancy between the US, Canada, and Western/Northern Europe*
Hahahahahaha.
You monster.
Yes, the US is so different and unique that, unlike nations that clawed themselves out from under the heel of monarchy or fascism, there's no way the US could possibly refine it's laws and regulations to the point where it could approximate single payer health care that works for millions of people all over the world (edit: so as to save money!), at every range of population density compared to the US.
I swear, I know of no other nation so convinced that it is incapable of doing anything competently. For all the talk, a remarkable number of Americans have no faith in their nation.
Deth, it's fairly clear that you're coming in with a bias against a government health system.
>I am sure things will work exactly the same here as they do in a country a 1/10th our size with a population that expects something completely different from their government and is willing to pay for it.
Sarcasm aside, these smaller countries have populations that expect if they pay for their government to pay for something, they should get a service they are happy with.
>Disregarding the problems other countries have with their systems
There is no such thing as a perfect system. Attempting to disparage the 'good' in pursuit of the 'perfect' (this is not unique to health care, this is just in general) never works.
>causing anyone with any money to come here for treatment oddly enough
The United States has the best tech on the planet when it comes to health care. So *if* you have the money, of course you're going to spring for the best possible equipment- meaning you go to the US.
>discounting all constitutional and legal issues
This one's obviously up for interpretation. Congress certainly has the power to spend money to improve the general welfare of US citizens. Even Obama's health care reform (which is projected to decrease the deficit) has survived most of its challenges, and the one challenge it's lost is being appealed.
>discounting how it will interact with the other problems we already have, discounting that there is absolutely no guarantee it will fix anything
There is *never* going to be a 100% in anything. Never. Is a new weather prediction system going to be 100% accurate? Do patches for Windows fix 100% of all user issues? I know those are examples in different areas, but you cannot possibly please everyone, you cannot possibly fix everything with a single attempt. You fix problems as you come across them in order to create a better system.
>then yes we could potentially hack into place a flawed system that would never work like we intend
Let's put aside your clear disdain for the idea of a single-payer system for a moment. This is the same kind of argument conservatives in other countries used when their single-payer (or something akin to thereof) were being implemented. They were ultimately proven wrong.
>cause more problems than we have now
In our current system, you could be denied coverage by just about everyone if you got sick as a kid. Ex: I had asthma as a kid. This is a condition I had before I could get onto a private plan. An attempt to get onto a private plan (before Obama health care reform) wouldn't be guaranteed, because I had a 'pre-existing condition'.
California has seen double-digit increases in premiums at least two years in a row now. In many states, one or two insurance companies hold a near-monopoly.
I find it difficult to comprehend that attempting to institute a new system could create problems worse than these.
>and cost us progressively more money each year.
This is probably the only point that I think is worthy of a frank discussion. And that's really a discussion more for the Health Care thread, though I'm not the authority on that call.
Either way, can we stop having a back and forth with Detharin on health care and focus more on the financial side of things?
American has turned into American't.
Quite sad, actually.