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peter45

There are probably thousannds of reasons why Medicare for All could not pass.

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There are probably thousands of reasons why Medicare for All won't pass.

 

There are probably thousands of companies that sell health insurance to their employees.

And, there are probably thousands of them that make money selling that health insurance.

Meaning, that those companies are not going to want to lose the profits that they are getting by selling that insurance, so they will be fighting Medicare For All, for all their might.

 

There was a local Chicago story recently, about a medium size company that had gone bankrupt, and was not paying the health claims of their employees, even though the employees had been insured when the claims were made.

The trick is called "self insurance".

The employer pays the employee, but then charges the employee for the health insurance.

But, there is no separate insurance company.

The "premiums" go right back to the employer.

 

It is all perfectly legal, of course.

It is "conservatism".

 

https://chicago.cbslocal.com/2019/01/29/hobo-closing-bankruptcy-medical-bills-unpaid-insurance/

 

 

 

Edited by peter45
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https://www.umass.edu/newsoffice/article/depth-analysis-team-umass-amherst

 

yes, the biggest most important reason why we may never have single payer insurance that covers all is not because it cost too much. It's political.

Actually a good slice of the healthcare out there is delivered by public means already through the VA, another large group through medicare and medicare which 

is orchestrated by the CMS, or the Centers for Medicare and Medicaid Services, which btw instituted CLIA or the Clinical Laboratory Amendment which took affect in 1988

that regulated a systematic approach to ensure that laboratory testing systems were accurate.

 

You take into account people who work for the federal government and people who work for state government who get their health care paid for by government tax dollars and that is in fact already a big slice of the pie regarding total health care cost.

 

The problem with Medicare is that it covers people who are elderly, not all of them are unhealthy but the older they get the more healthcare cost they incur eventually.

Private healthcare insurance is different. Most people if they are lucky that is, get their health insurance through their employer. They get a good rate, yet they still see their deductions for healthcare rising due to pharmaceutical costs that are sky rocketing and indigent care which causes hospital rates to go up up up, and up.

Before the ACA, healthcare insurance companies could pick and choose who they gave coverage to. They could offer really thin coverage at a very cheap rate, because it would only cover the worst outcome, so you had to pay if you were young and healthy a lot up front for most healthcare needs. If you were at risk, you could not get any coverage at all, unless you paid through the nose.

 

And yes, it's not a market whereby people can pick and choose.

You won't hear much about the economics by most news sources because the truth is it is a system that holds a whole lot of political sway regarding extravagant profits. 

 

These days hospitals utilize purchasing power by corporations that buy up supplies and try to deliver better rates, and this has created hospital systems, large hospital systems that utilize 

purchasing industries that specialize in buying required diagnostic machines, syringes, sutures, hospital beds, gurneys, in bulk to lower cost etc. etc. etc.. - sort of like Walmart. 

 

And the more you have people who don't have any insurance at all, the more you have emergency rooms fill with indigent folks taking up space. And hospital administrators justify incredibly high cost by simply saying that they have to have all these medical supplies on hand, whatever the circumstance, just in case and that also is as they say in the business world stock.

First in first out, you know, the way  you run a smooth manufacturing plant simply does not have anything to do with how you deliver first rate care to a patient who is sick.

 

It's more than crazy, kind of letting some folks claim profits while at the same time never achieving any real rational healthcare goal.

 

Could you have single payer, or Medicare for all? Yes, you could, and if you did you would be able to insure all people universally, and it would benefit all, the corporations, and all their workers, and at a lower cost overall.

 

But hey, politically it seems like a non-starter these days.

 

Peace!

 

 

 

 

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Heard a Democratic Representative on Morning Joe talking about attempting to pass the Public Option.

I believe that would be the option to buy health insurance from the government. The idea that Obama needed to drop from the ACA, because he knew it would never pass with it included.

As I think about it, it could be the idea THAT MIGHT WORK.

No, not the best idea, but with so many special interests lined up against Medicare For All, and the unfathomable stupidity of "conservatives", it could pass.

 

The Public Option would probably lead to the slow death of For Profit Health Insurance.

The million dollar CEOs would be given time to slowly rape their companies for everything that they could,

while the cement brains slowly realized that non-profit insurance is cheaper than for-profit insurance.

The employers who are raping their employees by making a profit on the health insurance "benefit" that they provide,

would be able to slowly extricate themselves from the situation. They would need to give up the profit that they make on the insurance, but would not need to explain that they had been scamming their employees for years.

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15 hours ago, peter45 said:

 

There are probably thousands of companies that sell health insurance to their employees.

And, there are probably thousands of them that make money selling that health insurance.

Meaning, that those companies are not going to want to lose the profits that they are getting by selling that insurance, so they will be fighting Medicare For All, for all their might.

 

The trick is called "self insurance".

The employer pays the employee, but then charges the employee for the health insurance.

But, there is no separate insurance company.

The "premiums" go right back to the employer.

 

The employer charges the employee, typically, 25% of the cost of insurance, and pays 75% of it. This isn't a moneymaker.

 

The company for which I work does this, almost.

 

It is self insurance for something like 2000 employees across the US (over 400 in Tampa). But it's administered by Cigna, with Cigna paying the bills. At pre-determined times of the year the company pays Cigna for both the healthcare costs and the price of administering the program.

 

When I compared the price and cost of other HMO and PPO programs, it's competitive, and it really is a deluxe plan.

 

Paying 75% of the cost, the company will not make a profit on it. Cigna will profit for sure, because they're just providing a service and have no risk.

 

Still, single payer comprehensive health care would be better, and I think the company would prefer not to have that overhead and bureaucracy either. They hired Cigna because managing healthcare isn't what they're good at.

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5 hours ago, peter45 said:

The employers who are raping their employees by making a profit on the health insurance "benefit" that they provide,

would be able to slowly extricate themselves from the situation. They would need to give up the profit that they make on the insurance, but would not need to explain that they had been scamming their employees for years.

 

Thus us just inflammatory and moreover untrue. See my previous post. Employers typically pay 75% of the cost of this insurance. That's a real benefit. It's not a moneymaker for them.

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3 hours ago, laripu said:

 

Thus us just inflammatory and moreover untrue. See my previous post. Employers typically pay 75% of the cost of this insurance. That's a real benefit. It's not a moneymaker for them.

Thousands of companies provide healthcare insurance to employees.

 

Are you really comfortable stating that the example that you state applies across the board?

 

Have you never worked for a company that played it a little differently?

 

Have you never worked for a company that limited the claims that it would pay?

 

As I stated,

there may be thousands of companies that may not like Medicare For All, for reasons that they may not want to reveal to their employees.

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4 hours ago, laripu said:

 

Thus us just inflammatory and moreover untrue. See my previous post. Employers typically pay 75% of the cost of this insurance. That's a real benefit. It's not a moneymaker for them.

You do realize that it is a businessman's job to CUT COST.

If MOST employers paid 75% of the cost of insurance,

wouldn't there be clamoring BY THE CORPORATIONS,

IN FAVOR OF Medicare For All?

 

Wouldn't Medicare For All make American companies,

MUCH MORE COMPETITIVE WITH COUNTRIES THAT HAVE NATIONALIZED HEALTHCARE?

 

Don't you suspect that there is something completely rotten,

but it is probably not in Denmark?

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1 hour ago, peter45 said:

 

If MOST employers paid 75% of the cost of insurance,

wouldn't there be clamoring BY THE CORPORATIONS,

IN FAVOR OF Medicare For All?

 

Must corporations don't clamor for anything, when being vocal might hurt their main business. Most companies are not in the health insurance business. On the other hand, health insurance companies are vocally against single payer healthcare.

 

The company for which I work has government contracts. They will never speak out about any political issue, because it would hurt them with one party or the other. On the other hand, they're inclusive, having people working there of all religions, races, and sexual orientations. Their emphasis is on talent, which is hard to get, expensive to train, and makes them huge profits. Nickle and diming employees for $1 million (e.g. 2000 employees * $500/ year) doesn't make sense, if you alienate important employees that make you $1 billion every year.

 

On the contrary, they work very hard to figure out ways to keep employees healthy and happy. That increases their bottom line much more than cheating. The company for which I work asked software engineers for at least 5 hours per week of mandatory paid overtime, for the last 9 weeks. We grumbled, but we did it. This is my first weekend not working for a while.

 

Treating employees well, keeping them healthy and happy is good business.

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29 minutes ago, laripu said:

 

Must corporations don't clamor for anything, when being vocal might hurt their main business. Most companies are not in the health insurance business. On the other hand, health insurance companies are vocally against single payer healthcare.

 

The company for which I work has government contracts. They will never speak out about any political issue, because it would hurt them with one party or the other. On the other hand, they're inclusive, having people working there of all religions, races, and sexual orientations. Their emphasis is on talent, which is hard to get, expensive to train, and makes them huge profits. Nickle and diming employees for $1 million (e.g. 2000 employees * $500/ year) doesn't make sense, if you alienate important employees that make you $1 billion every year.

 

On the contrary, they work very hard to figure out ways to keep employees healthy and happy. That increases their bottom line much more than cheating. The company for which I work asked software engineers for at least 5 hours per week of mandatory paid overtime, for the last 9 weeks. We grumbled, but we did it. This is my first weekend not working for a while.

 

Treating employees well, keeping them healthy and happy is good business.

Nope,

if you are trying to sell whatever,

competing against foreign competition,

that does not have costs burdened with healthcare insurance costs,

because they have nationalized healthcare,

you attempt to shed the cost.

 

Something is wrong with the picture.

 

Of course,

the "conservatives" who claim to know just SO MUCH about business,

don't seem to get it either.

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31 minutes ago, peter45 said:

Nope,

if you are trying to sell whatever,

competing against foreign competition,

that does not have costs burdened with healthcare insurance costs,

because they have nationalized healthcare,

you attempt to shed the cost.

 

 

They are burdened with healthcare costs. In Canada, for example, which I know pretty well, healthcare costs are supported by 1) income taxes of people and 2) corporate taxes.

 

Healthcare costs are kept down because provincial governments limit how much they'll pay for services, but doctors are still very well paid.

 

Hospitals, however, are not that well maintained compared to what I've seen in Tampa, and their diagnostic machines are considerably older.

 

All in all, they produce better healthcare outcomes for less societal cost, which is why I'm in favor of single payer government healthcare.

 

But ... it's completely wrong to say that Canadian healthcare is free for people, or that Canadian companies have no burden of cost. High taxes to both businesses and individuals support healthcare.

 

How high?

 

Here in Tampa, I pay under 20% in federal income tax, regular payroll tax (7.65%), and about $5000/ year in PPO premiums. I'm nearing the end of my career, and therefore the high point of my career income.

 

Twenty two years ago, I made 40% of what I make now, numerically (in Canadian funds). My taxes in Canada then were about 52%. I still wasn't poor, but my tax burden was high.

 

I'm in favor of single payer healthcare because it will be much better for poor people, and because overall it will be better for everyone, and because it will limit overall costs over time and be much simpler. But for me it will be a very expensive change.

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42 minutes ago, laripu said:

 

Here in Tampa, I pay under 20% in federal income tax, regular payroll tax (7.65%)

 

 

Recalculation: including both income tax and payroll taxes, I pay under 20% in taxes. Add $5000 in healthcare premiums and maybe another $1000 in copays and co-insurance and deductibles.

 

Much much much cheaper (and better too) for me in the US than in Canada.

 

However, it sucks big-time for poor people.

 

And it's much more complicated and requires more user involvement and intelligence to navigate the hateful insurance companies. It takes your time and energy, and sometimes you give up.

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Some years ago, I was on a team that set up an American subsidiary in the Czech Republic in Europe.

A new factory, to produce an American product that was much too bulky to make in America, and then ship to Europe for the European market.

(Shipping mostly air, is just not economical.)

The taxes in Czech were a flat 37% of the workers pay.

 

During the course of the project (about 2 years), one of the Czechs got hurt, the British guy, and the Swiss guy had children who suffered from non-average maladies. You know, the poor kids had things that show up in 1 in a few hundred kids. The kids were treated in their home countries, while the dads were on the job in Czech.

Because it was a "hot" subject, even 10 years ago, I spent a lot of time talking to the Europeans about healthcare and politics.

(When you are living in a hotel for years, working a job in a foreign country, you have a lot of time to talk to most anybody who is patient enough to listen to you.)

A few things that I picked up on;

1. Europeans are happy with their health care.

2. Europeans are afraid of American politics.

3. Europeans think that Americans are loudmouths, and not generally too bright.

 

Of course, when I told the Czechs that my grandparents on my mother's side were born in Czech,

I became an honorary Czech, and could do no wrong.

They always came by to say hello when in Chicago, until I finally officially retired, quite a few years after I turned 67.

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4 hours ago, peter45 said:

(When you are living in a hotel for years, working a job in a foreign country, you have a lot of time to talk to most anybody who is patient enough to listen to you.)

A few things that I picked up on;

1. Europeans are happy with their health care.

2. Europeans are afraid of American politics.

3. Europeans think that Americans are loudmouths, and not generally too bright.

 

 

Yup, that's pretty much what I encounter. I haven't been to Europe for quite a while, but I know plenty of Germans through my wife. That's pretty much spot on.

 

On the other hand, the Europeans aren't too bright either. They're better organized, for sure, and they've had plenty of discord from which to learn. But they're falling for right wing populists too. It's a dangerous time.

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On 3/29/2019 at 10:48 PM, peter45 said:

There are probably thousands of reasons why Medicare for All won't pass.

 

There are probably thousands of companies that sell health insurance to their employees.

And, there are probably thousands of them that make money selling that health insurance.

Meaning, that those companies are not going to want to lose the profits that they are getting by selling that insurance, so they will be fighting Medicare For All, for all their might.

 

There was a local Chicago story recently, about a medium size company that had gone bankrupt, and was not paying the health claims of their employees, even though the employees had been insured when the claims were made.

The trick is called "self insurance".

The employer pays the employee, but then charges the employee for the health insurance.

But, there is no separate insurance company.

The "premiums" go right back to the employer.

 

It is all perfectly legal, of course.

It is "conservatism".

 

https://chicago.cbslocal.com/2019/01/29/hobo-closing-bankruptcy-medical-bills-unpaid-insurance/

 

 

 

 

The battle like everything else comes down to the lowest common denominator which is money but the MAGAts may lose this one. Employers don't want to have to pay for health care and I don't blame them. The American Medical Mafia is nearly 20% of the GDP and they own EVERY Republican lock stock and barrel. 

 

Other corporate employers want universal health care so I think that will be the battle ground.  As you know the corporations own our government so it is only a matter of other industries bribing politician more than the medical industry. The way Americans can help is by urging the pigs on congress to pass universal health care

 

Universal health care will be better than the overpriced crap we have now because if the government is footing the bill there can be proper regulations on the medical gangsters regarding cost an quality. Italy is ranked number 2 in the world for health care quality and Italy provides the health care at 1/3 the cost of the US. 

 

My plan would be more aggressive. I would confiscate wealth from all the trash who is currently involved in health care and then ship a lot of them to Gitmo for medical experimentation and attitude adjustments.  Any person who would exploit human suffering for obscene profits or holds back lifesaving cures should be executed in the most gruesome ways IMO.

 

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On 3/31/2019 at 4:25 PM, BlueDoggL said:

Employers don't want to have to pay for health care and I don't blame them.

 

Employers don't want the bureaucracy, but they'll still have to pay, via taxes, for universal single payer healthcare.

 

Healthcare is expensive unless you cut the profits out of every part of it. See my post above about Canada, where I'm from. Doctors work harder and make a lot less money (but are still rich). Hospitals don't get the latest greatest machines. And they don't take as good care of the physical attributes like paint and cleaning. That makes the process much less expensive.

 

The important thing is: when they do that, the outcomes are not worse than what we have in the US.

 

But even with all that, both employer and citizen taxes go up a lot. It will be better for poor people and lower middle class. It will be more expensive for upper middle class people, and up.

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11 minutes ago, laripu said:

 

Employers don't want the bureaucracy, but they'll still have to pay, via taxes, for universal single payer healthcare.

They will pay 2/3 less because they will set the price instead of the American Medical Mafia price gouging. That will create real competition and with regulation their were be higher quality standards.

11 minutes ago, laripu said:

 

Healthcare is expensive unless you cut the profits out of every part of it. See my post above about Canada, where I'm from. Doctors work harder and make a lot less money (but are still rich). Hospitals don't get the latest greatest machines. And they don't take as good care of the physical attributes like paint and cleaning. That makes the process much less expensive.

If things sucked so bad for MDs in Canada they would be coming here in droves. Health care quality in Canada is rated far above the US. 

11 minutes ago, laripu said:

 

The important thing is: when they do that, the outcomes are not worse than what we have in the US.

 

But even with all that, both employer and citizen taxes go up a lot. It will be better for poor people and lower middle class. It will be more expensive for upper middle class people, and up.

Either way the people pay the price. If the American drug companies, hospitals and MDs were not allowed to price gouge and if the billing fraud here was stopped we could paying 2/3 less than we are for them same thing. There is probably more medical fraud in Canada than there is in France, Italy and Japan.  

 

There is actually a doctor shortage in the US compared to other countries in spite of the fact that American MDs are the highest paid in the world. In the US if you have rich parents you can go to medical school. In France medical school is free and the only way to get into medical school there is by having the best grades. France has the best health care in the world and they do it for half the cost on the US. There is no way the US can't do that. 

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On 3/30/2019 at 5:13 AM, peter45 said:

Heard a Democratic Representative on Morning Joe talking about attempting to pass the Public Option.

I believe that would be the option to buy health insurance from the government. The idea that Obama needed to drop from the ACA, because he knew it would never pass with it included.

As I think about it, it could be the idea THAT MIGHT WORK.

No, not the best idea, but with so many special interests lined up against Medicare For All, and the unfathomable stupidity of "conservatives", it could pass.

 

The Public Option would probably lead to the slow death of For Profit Health Insurance.

The million dollar CEOs would be given time to slowly rape their companies for everything that they could,

while the cement brains slowly realized that non-profit insurance is cheaper than for-profit insurance.

The employers who are raping their employees by making a profit on the health insurance "benefit" that they provide,

would be able to slowly extricate themselves from the situation. They would need to give up the profit that they make on the insurance, but would not need to explain that they had been scamming their employees for years.

I am starting to rethink what you say here and I think it holds merit. You do have to face the fact going to Medicare for all would seem to many as an assault on what they currently have, and then you really do need to consider the political campaigning that you would have to go up against - the ACA fight was nothing, compared to what the Medicare for All campaign would hold.

 

In essence, Medicare for All, actually saves us all a significant amount of money and would allow for universal healthcare which does hold a great amount value to just about anyone when they truly stop and consider it, truth be told. But what a political fight it would take.  
And meanwhile, yes, dealing with Climate change is big time important here in the US and everywhere else.

 

Think about the ACA a bit. If it had been instituted correctly a lot more people today would have coverage. Also, if there was a public offering, think about a lot of people being able to retire a little bit sooner. Healthy people of older age, being able to retire a bit sooner, paying into a public system that supports others - doesn't that make sense?

 

We also quite rightly need to think about the system that currently operates. You can't just cut off all the people who currently work for private insurance companies and think that that will not have an impact on our economy. 

 

So in spirit, Medicare for all, or single payer is best, but how do we get there, yes, that is the question. How do you get people to believe in something, and then, how do you get your Congress to Act?

 

Nothing happens all at once, we are told. We experience this during our lifetimes. I wish it was an ebb and flow sort of thing, but sometimes we take two steps forwards and then three steps back again. 

 

Climate change is critical. Jobs and the economy are critical as well. How does it feel to be someone who is left behind, and what is it like to be turned away when you are sick and have no insurance at all? Let's say you have someone in your family who you can't take care of anymore who has none, or let's say it's even you, the breadwinner, who just goes on without because you know the economic harm it will cause those you support.

 

Difficult choices for sure must be made anyway we slice and dice this issue. I wish it was simpler, I wish we did not have to deal with mental disease, I wish people ate the right kinds of foods and exercised more, and I wish, more and more that people took the time to explore all the problems we face in a more sensible way.

That's the Me Too Movement I want, and I'm not poking any fun at the women's abuse movement when I say as such. Because after all, we are all human and we all do deserve respect. It's a long time overdue!

 

 

 

Peace!

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On 3/31/2019 at 5:09 AM, peter45 said:

Some years ago, I was on a team that set up an American subsidiary in the Czech Republic in Europe.

A new factory, to produce an American product that was much too bulky to make in America, and then ship to Europe for the European market.

(Shipping mostly air, is just not economical.)

The taxes in Czech were a flat 37% of the workers pay.

 

During the course of the project (about 2 years), one of the Czechs got hurt, the British guy, and the Swiss guy had children who suffered from non-average maladies. You know, the poor kids had things that show up in 1 in a few hundred kids. The kids were treated in their home countries, while the dads were on the job in Czech.

Because it was a "hot" subject, even 10 years ago, I spent a lot of time talking to the Europeans about healthcare and politics.

(When you are living in a hotel for years, working a job in a foreign country, you have a lot of time to talk to most anybody who is patient enough to listen to you.)

A few things that I picked up on;

1. Europeans are happy with their health care.

2. Europeans are afraid of American politics.

3. Europeans think that Americans are loudmouths, and not generally too bright.

 

Of course, when I told the Czechs that my grandparents on my mother's side were born in Czech,

I became an honorary Czech, and could do no wrong.

They always came by to say hello when in Chicago, until I finally officially retired, quite a few years after I turned 67.

Thanks for sharing this story about living overseas long enough to capture an understanding of what the Czech's live with each and every day! Some of us have been abroad and some of us correspond with coworkers daily overseas by the telephone or through emails gathering insight about what might work regarding a better health care and social order, as well as some of the wrinkles people in different countries have to contend with since you and they both know, nothing is exactly perfect...

 

This is information that most people in the US unfortunately know not too much about. There aren't enough people like you peter45, so thank you!

The important point here is that there is a choice that can be made. The more we know about different systems, the more chance we have to find a better plan. Corporations utilizing Human Resource Executives, call it benchmarking - of course you know they only half-heartedly use it as a competitive mark to attract a more qualified workforce. I'm laughing out loud at that last sentence. If they did it well we would have seen wages grow more inline with productivity at some point in the last three decades.

 

But now,  I'm feeling it, what it might be like to retire I  guess. The stiff arm, the stiff arm they say is this poor fellow who is just about to retire, and then he or she gets the Axe, or the corporate speak for downsizing, or the euphemism they use for reorganization, and then he or she just dies from a sudden heart attack right there in front of all their colleagues. I guess they could say, it saves a lot of money. The Benchmarking / a scary movie playing in neighborhood Theaters near you?

 

Peace!

 

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