Single-Payer Health Care Dies in Vermont

[AlucardNatasrd]

Ya'll muricans need to get on the Australian/UK health system. Who needs universal health care when you can build aircraft carriers instead?

You're welcome.

 

[Glokta]

Ya'll muricans need to get on the Australian/UK health system. Who needs universal health care when you can build aircraft carriers instead?

The Aus/Uk systems are nearly half the cost per head of the US so universal healthcare = more aircraft carriers.

 

[dza76wutang]

The Aus/Uk systems are nearly half the cost per head of the US so universal healthcare = more aircraft carriers.

Joe Abercrombie fan?

 

[Deleted member 159002]

Payroll is one of the most regressive of all taxes, too. It primarily hurts the working poor who get their paycheck slashed.

A better method of paying for a single payer system would have to be less regressive than that.

Agreed. Capital gains would be the way to go.

 

[lfd0311]

From 60 minutes..

"Brill takes a comprehensive look at what what the new law does and doesn't do. Brill argues that obamacare is the product of what he calls an orgy of lobbying and backroom deals in which just about everyone with a stake in the 3 trillion dollar health industry came out ahead, except the tax payers."

http://www.cbsnews.com/videos/topics/60-minutes/

Listen to the family in the video said, they had to go out of network and pay 48 thousand dollars out of pocket before they even received services. Now they blame that on a bad policy and say, they are now covered with a good obamacare plan 100% subsidized by tax payers. The fact of the matter is if you're paying for insurance and you seek this type treatment in an out of network provider you have just about the same exposure.

This is a call out thread to all of you talking shit when I gave my personal experience with health-care this year. There are no cost controls in the law, gruber himself admitted as much. This scam has tentacles that can grab you from anywhere.

I mentioned before my family's premiums are 24k per year, for the very best policy available, MD Anderson is not in my network, so if I went there to be treated I would be responsible for the 24k in premiums plus 15k out of network deductible plus medicine and who knows what else. Thats over 40k out of pocket for the very best plan available and then add another 15k, pushing it to 55 thousand dollars if two people in my family had serious health issues.

For a bronze plan (the bottom one) it's 15k for my family with a $6,000.00 per person or a $12,000.00 per family deductible (in network, it jumps way up out of network) I would have to pay 100% of everything until the deductibles are met. That means at minimum, I pay $21,000.00 fucking dollars every year before I see a single penny out of this so called insurance.

You all laugh now because you get subsidized but look at the first article I posted this will eventually crash on you to.

How many kids do you have?

 

[second sight]

three

 

[Anung Un Rama]

Single payer is Best payer.

Getting it to work in America would be a painful transition that would require great minds and non-partisanship, and sacrifices from the American People.

1. Raise taxes.
2. Create a national formulary
3. Negotiate pricing with the pharmaceutical industry ( 340b pricing across the country would save billions).

Now it gets complicated:
1. Reducing compensation. Hospitals, pharmacies, and clinics are built on the current structure. I doubt many could survive even the smallest change in compensation. How do we taper out the roll out to keep these businesses from tanking?
2. Individual Healthcare Professionals (HCP) Current HCPs will need some type of loan forgiveness to keep them from being slaves.
3. Universities. Are going to drop their tuition prices to keep the industry from collapsing.
4. Bad Habits - people are going to have to drastically change their unhealthy habits as part of an individual commitment as well as a patriotic one. Relying 100% on HCPs for all your ills, as many Americans do, can't continue.
4. The insurance industry: how much of our economy is 8%. How do you handle that?

All in all I think it would be better for America, but it might take a full generation before that would be realized. That is a huge commitment/ gamble, especially when you are at the mercy of the stooges we elect to run this country.

 

[Gunny]

So Vermont found out that trying to pay everyone's healthcare costs is really expensive. And Vermont residents found out that single payer healthcare means much higher taxes (just like it does in Europe). Then Vermont residents decided that they didn't really want much higher taxes and the state nixed the expensive single payer plan.

Fascinating. If only people had told them beforehand that it's expensive and the Europe can only afford it through a combination of high taxes, caps on the types of service/drugs available and limitations on healthcare worker compensation then this whole fiasco could have been avoided. If only.

As I've mentioned before, I own manufacturing business in VT that employs about a hundred people. Also my own sister was a legislator that was a major driver of this disaster of an attempt at single payer. My perspective on this is that the governor overstated the costs in order to explain why he was sinking his own law. Sounds crazy right? Well the aspect of this that these clowns never legitimately considered (insane as that sounds) is that any socialized healthcare system depends on closed and secure borders. The trans state implications were what really sunk this law (which is absurdly self-evident to me so I won't go into it unless asked.) They aren't saying this was the reason for pulling the plug because it would mean admitting that the entire mess was a fools errand costing the state millions. Instead they're pretending to kick the can down the road so Shumlin can save some amount of face while he's still in office.

 

[panamaican]

I find it very hard to believe single payer can only be brought about via what amounts to crushing increases in taxes. VT basically raised the shit out of taxes AND cut reimbursements to doctors and it was still going to be insolvent? Something doesn't seem right.

No offense but that paragraph is the crux of the problem. Vermont committed to the program and then realized that funding it was really, really expensive. Prior to this, many people simply assumed that finding the money would be the lowest hurdle. It's not, it's the biggest hurdle. Even when the numbers are right in our faces, you're still questioning the validity of their attempt.

The better option is to look at the reality of what Vermont has shown us and then adjust our expectations. I've always been against it because I think it's too expensive. But if you want to support it, the responsible thing is to come to grips with the cost and devise arguments for why you think the cost (and cut reimbursements) is justified.

At least on a national scale you'd get maximum risk pooling. States like Colorado would offset states like Texas, for example. When you consider risk pools like United Health or Blue Cross it makes VT look tiny. Something like 80% of cost is generated by 20% of patients, in some populations it can be 1-5% generating 30-50%. Those are extraordinarily sick people, however, even on a national scale you can probably get enough volume to drop prices, in theory. Plus you'd have collected premium from the 80% who barely consume. One purchaser telling Pfizer, Merck, etc that all of the $500K per dose drugs were being bought by this one buyer at $450K (conservative) per dose represents a material savings, and Pfizer, Merck etc would eat that up since the drug game is HUGE on volume. This is just one example of what a theoretical 300M life "insurance plan" could do.

Health care needs better price discovery for common/basic care, even intermediate care, better shock loss elimination to prevent bankruptcies from unforeseeable events, and better moral hazard control to help contain costs. Problem, as I see it, is a failure to adequately balance across these and more priorities. If I had my druthers we'd spend more on keeping healthy people healthy which would probably be the single most impactful thing we could do as a nation when it comes to cost containment and ROI.

After typing this post, it sounds like VT tried to force single payer into an ecosystem that wasn't re-engineered around it.

Maximum risk pooling isn't necessarily better on a national scale (Vermont ranks 25th in income and they're average in terms of their resident's health profile). You're increasing your percentage of catastrophic risk as well. It's not just more healthy people, it's a shit ton more unhealthy people, more low income people, etc.

You can discuss restructuring the ecosystem, which is fine. However, this is where plenty of people come to realize that making single payer cost effective requires significant changes to many things Americans take for granted in our current system.

I'm not claiming this is you but most people haven't really done an in-depth analysis of how most single payer countries manage their costs and the associated increases. It's not our system just with more transparency and single payer rather than private insurance. There are numerous restrictions on drugs, equipment, compensation, procedure availability, etc. It's a completely different system, not just in the payment model.

One notable trend is the rapid increase in the need for supplemental private insurance for things not covered under the single payer system. It should be informative that single payer residents feel that private insurance has any value at all, given the significant taxes they already pay under that model.

Lastly, I don't think Vermont's tax increases or pay cuts were unreasonable. I think they were fair, given what was being received in exchange. The problem Vermont ran into is that most people don't want to pay it, fairly priced or not.

 

[panamaican]

As I've mentioned before, I own manufacturing business in VT that employs about a hundred people. Also my own sister was a legislator that was a major driver of this disaster of an attempt at single payer. My perspective on this is that the governor overstated the costs in order to explain why he was sinking his own law. Sounds crazy right? Well the aspect of this that these clowns never legitimately considered (insane as that sounds) is that any socialized healthcare system depends on closed and secure borders. The trans state implications were what really sunk this law (which is absurdly self-evident to me so I won't go into it unless asked.) They aren't saying this was the reason for pulling the plug because it would mean admitting that the entire mess was a fools errand costing the state millions. Instead they're pretending to kick the can down the road so Shumlin can save some amount of face while he's still in office.

Yeah, I mentioned that in another post as well. If they could magically prevent people, businesses and/or capital from leaving the state then they might have had a chance.

It's very similar to many of the tax based conversations related to other issues. Some people propose these ideas and then dismiss the risk of capital flight.

 

[Glokta]

Joe Abercrombie fan?

Does it show?