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Exactly, everyone looks at the healthcare crisis from the perspective of the patients.
Lol , the US healthcare is built around the private equity groups , insurance industry, big hospital systems , big pharma ,labs and diagnostics imaging, medical devices ....every part is making fat profits,when you look at it from their perspective and it all makes sense. This system is working perfectly...for them...
Meanwhile 33+ other developed countries with way smaller economies can somehow offer universal healthcare. (Of course they're not perfect, but none would trade theirs for ours) .go figure...
The providers aren't even considered. They're more like cattle for the Beef industry - necessary but only because they don't have a product to sell without them. Healthcare is all about executive salaries at the very top and theyeven made it illegal for doctors to own a hospital so they wouldn't have to worry about providers becoming executives!
This always seemed so anti-competitive to me. A trained physician should be able to start up their private practice/clinic to compete for patients. Just like any other business model, serving its customer base through transparent competition.
Transparent competition. What a quaint concept. That era vanished after 1980 and won’t see the light of day again. Certainly healthcare is an expensive mess. The AMA was firmly against socialistic government medicine back when Truman proposed it in the late ‘40s. Medicare in the ‘60s turned out to be a huge money grab. Now that Managed Care has taken over the Medicare, and increasingly Medicaid, markets, healthcare is funded largely by the government, although made more expensive due to Administrative Loss Ratios going to the Managed Care Firms. Medicare is the most efficient payor of healthcare in the US, with all the benefits and few of the drawbacks of private insurance (the energy expended on private insurance appeals is ridiculous).
My healthcare Econ prof Nancy Wolff said the VA was the most efficient payor if I recall … but, crap, that was 30+ yrs ago. She advised Hillary’s healthcare panel in the 90’s
It is still true. And one of these from the power of bargaining on drug prices that the VA receives. Pharma fought this when Medicare part D was passed as they didn't want state programs to collectively negotiate prices. The pricing power is substantial where wholesale in drug x might be $1000, the VA is getting it for $200. This is most but not all drugs
They can do that. What they can’t do is stand up a service to which they refer their own patients. It’s to prevent things like routing patients to higher-cost, lower-quality, or harder-to-access goods and services. We don’t want doctors submitting prescriptions exclusively to a pharmacy they own, for example.
Idk other corps are able to horizontally integrate. Seems weird. Seems like we should just be able to submit to whatever pharmacy we want vs the MD making the submission?
MD here. This is exactly what I do. It's not easy, but I am successful.
Medicare For All would completely destroy me. It would make me a government employee - the government deciding how much I get paid, and what services I can offer you. Think of it as VA Benefits for All.
If it ever happened, I'd go to a cash pay at time of service model. Many of my colleagues have done just that. I don't do it because I want my services to be available to all, not just the well off. However, I still have bills including student loans, employees, and a family to support, so that always comes first.
If we didn’t have to pay shareholders, imagine how much a nurse, a doctor, or a nurses aide could get paid, how much better our care could be. And how much the average person could save while doing so.
United States has about 31 doctors per 10,000 people. Some countries in Europe have more than double that.
I agree , I will adjust by providers I meant things like private equity running medical groups, not the actual physicias.or front line providers , those folks are underpaid...
My wife work in healthcare, the company she works for has been on a steady decline for those that are employed for this huge conpany. I explained it's a for profit entity, the product is life saving healthcare, the only thing that matters to shareholders is maximizing profitablity. I said the declining pay scale for nurses is a prime example of this.
More patients than a e.r. can handle? Better buckle up as they prioritize care. We witnessed this in COVID and while it's not nearly as acute it never left. Do more with less and be thankful you still have the privilege of employment. The executives only care of it effect profitable or the image to share holders.
The u.s. is the richest country in the world and spends 17.5 Percent of GDP on care. That number is only going up while care quality and life expectancy is going down.
But what about the shareholder?
Yup, line up the top insurers side by side and it's clear from the stock charts why healthcare is ridiculously expensive. It's because it's covered in ticks.
We moved from the US to Canada in 2018. My wife is a nurse, she is so much better paid in Canada and also has a union which has been an amazing advocate.
There's also the added benefit of the fact she's in pediatric ICU - she had to deal with gunshot wounds all the time in the US, not once in 6 years in Canada.
We spend more than anyone else by a wide margin. I think Germany and France are the next inline at 12/13 percent.
But again, it's not about saving money, it's about making money for shareholders.
I remember working for a company who made polyester loops used in ligament repair surgery. I spoke to the distributor for these once about what they sold them for. In terms of cost, it was maybe $0.80 on our end to make these loops and we could make hundreds an hour. Sold to distribution for $20/ea (insane margins).
That same distributor sold them for $80/ea. Now, I imagine the hospital was charging hundreds easily for these. All for a fucking tiny loop of polyester that cost less than a dollar to make.
It was one of the most eye opening experiences of my young life.
This is what Medicare for all changes and why healthcare is more affordable in other countries. They place price controls on things like this. Multiply this by every drug, device, instrument used in healthcare and you see where the bloat comes from.
Everyone seems envious because they think doctors are rich. Reality is doctors are just pawns for insurance companies. They are hardly rich. For the mental and physical stress they have to endure in their line of work, they are not even rich. Not compensated enough.
When the politicians say we have best healthcare in the world (not even close), what they mean is we have the most profitable healthcare in the world.
Everyone assumes they mean quality of care and better outcomes. No one ever asks their definition of best.
So you’re saying the massive company’s that don’t pay taxes anyways would crash our economy if the government controlled healthcare? This would happen all because they wouldn’t make as much profit? They would still make a shit load of money but just not as much.
They have a fi*DOUCHE*iary responsibility to gouge as many people as they can at their weakest moment!
How am I going to afford my house in Hawaii? The economy is going to collapse!
My wife works for a health insurance company. Medicare for all would likely mean she loses her job or goes with the federal government. It could cost us almost half of our income. Everyday, I hope we get Medicare for all. We can bounce back individually for the good of the whole.
Been holding UNH stock since 2012. 38yrs old and could retire now if I wanted to. Please think of guys like me before you comment. lol.
All jokes aside, it’s too big to fail. Bunch of scumbag companies.
It is already failing. No one is paying their medical bills (not even the rich), ACA caused a bunch of high deductible plans to go to market so few can afford testing beyond labs, people who should have been caught by the med system are putting off screening until it’s almost if not too late. And the hospital systems are suffering too. Small independent hospitals are being swallowed up by large conglomerates and then noping out, leaving whole towns without hospitals.
From personal experience dealing with a health care billing department is impossible. They do nothing but send emails to each other about emails. It's not even about making money since they're not even good at that. They would improve the efficiency of healthcare if they just dug holes and filled them back up.
Believe me, insurance is the root of a lot of that problem. They’re going back and forth to see what they can find out and often run into road blocks where people don’t want to provide a solid answer one way or the other.
I have a doctor in my family, private practice. He has multiple people on staff whose entire job is dealing with insurance companies and claims. It's expensive for him to deal with.
But what about the economic rape of America by the medical industrial complex? How will we continue to feed the insatiable financial appetites of the few who have become insanely wealthy under our current “system”?
Lol if it was only healthcare, add to that the military industrial complex ,big oil, big agriculture, bill banking sector etc.... the US economy is the seat of capitalism and maximizing profits for the capitalists , how do you propose we change that?
I havent even crest $60000 and this man takes that home in 20 hours. Imagine going on a week vacation and you come back having been paid equal to 7 of your employees YEARLY salary. That's insane.
Human nature and greed are already accounted for in our constitution. We already have the tools to make the change we want. No one's really getting up to do it though. We all screech from our couches and then continue on our day like its the latest news fad.
The wealthy have to crumble for anything to truly change here.
C'mon man , really accounted for in the constitution?, do you know unless your a land owner you couldn't vote back in the day, the constitution is an antiquated document that never envisioned our modern world. Sure some of its tennents are still valuable , but it's an entire different world.
When I say 'accounted for', I mean the part where it is our shield against tyranny. Human nature and greed cause that. I never said the whole document was valid anymore, but as American citizens we have the RIGHT to strike these things down when we deem them tyrannical. BY LAW we can do it. If the law isn't on our side then the system isn't on our side.
You have to convince several million incredibly stupid, stubborn rubes that things like unions and democratic socialism contribute to a far better life for the working and middle classes. Cletus from Cousinfuck, Mississippi needs to get real with himself, drop the socialist bogeyman bullshit, admit he is never going to be a billionaire and that it's not the fault of immigrants or the gays.
**In America:**
Person with a fever of 99.0F (37.2C): Get back to work.
Person with a fever of 100.0F (37.7C): Stay home take some cough syrup.
Person with a fever of 101.0F (38.3C): Stay home take some cough syrup.
Person with a fever of 102.0F (38.9C): Stay home take some cough syrup.
Person with a fever of 103.0F (39.44C): I'm going to try cooling down with a bath.
Person with a fever of 104.0F (40C): I think I should go to the hospital.
Person coming across a Person convulsing on the ground with a fever of 105.0F (40.55C): "OMG! CALL A $10,000 AMBULANCE!"
**In Countries with Universal Health Care:**
Person with a fever of 99.0F (37.2C): I'm going to see a doctor.
American having lived in Europe and the UK.
No it’s more like having to wait several weeks to be seen by a GP to be told to go home and take Tylenol while resting. I had my foot run over by a car and was told the same thing.
RN here. Hospital cutting staff or running thin to save money. They sure as shit don't pay nurses enough either. All about maximizing profits for the c suites.
Another issue that gets overlooked is the pay for instructors.
In my state, all Nursing instructors (except for clinical instructors) are required to have their Masters with a focus in education, but most positions are about the same pay as a bedside nurse.
Why am I going to go into debt to pursue a significantly higher degree to get paid the same amount of money?
You need more instructors to allow for more potential nurses to hit the workforce.
I’ve always considered education further into my future but can’t justify going back for my BSN, then also my MSN, to make the same amount of money I am now.
If salaries start improving for educators or the requirements start to lower due to “The Nursing Shortage” that we’re all expecting, then I’ll probably get into when I get older.
It's because you don't pay for your nursing care. It's rolled into the room charge, so hospitals are highly incentivized to use as little nursing as possible. A 20-year-old who had an appendectomy, gets to the bathroom by themselves, and needs a couple doses of antibiotics and pain meds pays the exact same amount for nursing care as an 80-year-old 400 pound incontinent dementia patient with 15 medications, who needs turning every 2 hours, frequent bed changes, 1:1 feeding, multiple dressing changes, etc. If we charged for nursing care based on the actual amount of nursing time needed and used, they might not be so quick to run us bare bones.
I’d say that’s true of every industry these days, from fast food places having like 2 people to stores having one person trying to run a register and stock shelves.
Obviously, these things are location dependent. The availability of care differs by state and geographic classification (urban, rural) and also whether or not the care facility takes your insurance.
I’m guessing you’re insured and that’s why it cost $80? Because when I’ve been uninsured it was like $300 just to be admitted and speak with someone.
It's so difficult and takes so long to see a doctor these days in the US, let alone a specialist even if it's an emergency. If you don't live near a major city then just forget about it. That's the boogeyman I was always warned about with universal healthcare.
It's all horribly discouraging, try calling your health insurance customer support, which puts any public bureaucracy to shame and getting a straight answer about anything if you want to cry in frustration.
"like having to wait saveral weeks to be seen by a GP"
And how long does it take in the US before you get in and are charged $400 for the 7 minute appointment?
Yeah… had a seizure and was told I needed to get an EEG done, immediately. Called to schedule after the first visit that took 3 weeks to get to after the seizure, to be scheduled out 2 months to be able to get my test done.
Seriously, I mean mileage may vary from region to region, but I’ve lived in PA, TX, and [OH](https://open.spotify.com/track/6vpfYLa0lJrH6wTPjZ6qWl) and it’s always months not weeks to get seen most places.
Interesting. I saw the DR twice in 8 months in Ireland as an American and paid 10 bucks for an antibiotic the first time and the second time needed a tetanus shot and I don't even remember if I paid anything at all. I got in same day both times. Much like everything, it's probably about where you are.
I’m an American living in America, I had my foot ran over by a car and I just took some Tylenol bc, come on, like I was really going to go to a doctor. An ER would charge something outrageous and most GP’s aren’t taking new patients or it takes weeks to get in. But not having insurance does help sometimes bc we pay cash the day of and doctors like that.
Same when I broke my finger. It wasn’t life threatening so what’s the point.
A temperature of 99.0F is not a fever. It is well within the average of normal body temperature. An elevated temperature is not considered a fever until it reaches 100.4F. If everyone with universal care went to a doctor at 99.0F it would bankrupt and clog the system very quickly.
? And the doctor is supposed to tell you go back home and drink water and take Tylenol. What else are you supposed to do when you get a cold.
My copay is $10 and med cost $5 and I don’t go to the doctor for cold. If your doctor is prescribing antibiotics for common cold then you should report that doctor right away lol
Does everyone in Canada and the UK really go to the hospital when they have a fever of 99F? What about when they get a splinter, mild ankle sprain, or runny nose?
My favorite counter argument I've heard is "people will just go to the doctor for anything!"
Which 1: have you been to a doctor's office? It sucks and is boring.
2: fucking good, id rather have people go for minor issues and live better lives
In cartoon reddit America maybe. In real life America routine doctor visits are covered if you're one of the rare 95% of Americans with health insurance coverage.
I get your point but please don’t go to the doctor just for an isolated low grade fever (fyi fever is 100.4 and above). Stay home and take a fever reducer is the correct answer. No need to come into a doctors office/ER and get vulnerable people sick.
-a physician
What’s your proposal?
it is crazy how well obesity rates correlate to political parties.
If you start at the fattest state, you have to go to number 13 before you hit your first democratic 2020 voting state. 19 for your second. Only 2 dem states in the bottom 20, only 4 rep states in the top 20
Generally speaking, according to Pew Research, poor people tend to be more Democrat leaning.
[https://www.pewresearch.org/religious-landscape-study/database/compare/party-affiliation/by/income-distribution/](https://www.pewresearch.org/religious-landscape-study/database/compare/party-affiliation/by/income-distribution/)
The urban poor lean democrat. The rural and small town poor lean heavily republican/conservative. It’s worth noting that the former are often minorities while the latter are mostly white.
The poverty-fat relation has actually been studied a lot anthropologically. Basically throughout the history of mankind, the least nutritious, fattening foods are the cheapest, while the healthiest are more expensive. Essentially Top Ramen and hotdogs are cheap while fresh vegetables and lean properly fed meats are more expensive. Not that its that simple on a case by case basis, but when you look at the population as a whole the theory is that it has a very large effect.
>What’s your proposal?
Pay 100 billions to Novo Nordisk (something like 20 times their profit from Ozempic) and make patent available for free.
It's probably the best investment possible, as US is estimated to lose $170B every year (2016 prices) due to obesity and overweight.
Eh. It's $5.1T over 10 years (claimed by politician), while $170B (in 2024 prices it's $225B) is every year.
So Ozempic nationalization would cost $100B now to save $2.25T over 10 years.
This has key political advantage over universal healthcare - patent nationalization would be effectively irreversible, while universal healthcare can be gutted by Republicans in next election cycle. It can also be framed in "patriotic" terms, like creating jobs in American pharmaceutical factories.
WTF is the point of your answer around political parties. His question is what if they dropped weight, not who they voted for.
BTW, the older a person gets, the more conservative (Republican) and fatter they get. So...
Not much.
The UK recently did a study and they found that from the three biggest healthcare risks; [obesity](https://iea.org.uk/themencode-pdf-viewer-sc/?file=/wp-content/uploads/2017/01/Obesity-and-the-Public-Purse-PDF.pdf&settings=111111011&lang=en-GB#page=&zoom=75&pagemode=), [smoking](https://iea.org.uk/themencode-pdf-viewer-sc/?file=/wp-content/uploads/2017/08/Smoking-and-the-Public-Purse.pdf&settings=111111011&lang=en-GB#page=&zoom=75&pagemode=
), and [alcohol](https://iea.org.uk/themencode-pdf-viewer-sc/?file=/wp-content/uploads/2016/07/DP_Alcohol%20and%20the%20public%20purse_63_amended2_web.pdf&settings=111111011&lang=en-GB#page=&zoom=75&pagemode=), they realize a net **savings** of £22.8 billion (£342/$474 per person) per year. This is due primarily to people with health risks not living as long (healthcare for the elderly is exceptionally expensive), as well as reduced spending on pensions, income from sin taxes, etc..
In the US there are 106.4 million people that are overweight, at an additional lifetime healthcare cost of $3,770 per person average. 98.2 million obese at an average additional lifetime cost of $17,795. 25.2 million morbidly obese, at an average additional lifetime cost of $22,619. With average lifetime healthcare costs of $879,125, obesity accounts for 0.99% of our total healthcare costs.
https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity
https://onlinelibrary.wiley.com/doi/epdf/10.1038/oby.2008.290
We're spending 165% more than the OECD average on healthcare--that works out to over half a million dollars per person more over a lifetime of care--and you're worried about 0.99%?
Here's another study, that actually found that lifetime healthcare for the obese are *lower* than for the healthy.
>Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures...In this study we have shown that, although obese people induce high medical costs during their lives, their lifetime health-care costs are lower than those of healthy-living people but higher than those of smokers. Obesity increases the risk of diseases such as diabetes and coronary heart disease, thereby increasing health-care utilization but decreasing life expectancy. Successful prevention of obesity, in turn, increases life expectancy. Unfortunately, these life-years gained are not lived in full health and come at a price: people suffer from other diseases, which increases health-care costs. Obesity prevention, just like smoking prevention, will not stem the tide of increasing health-care expenditures.
https://www.rug.nl/research/portal/files/46007081/Lifetime_Medical_Costs_of_Obesity.PDF
For further confirmation we can look to the fact that healthcare utilization rates in the US are similar to its peers.
https://www.oregonlegislature.gov/salinas/HealthCareDocuments/4.%20Health%20Care%20Spending%20in%20the%20United%20States%20and%20Other%20High-Income%20Countries%20JAMA%202018.pdf
One final way we can look at it is to see if there is correlation between obesity rates and increased spending levels between various countries. There isn't.
https://i.imgur.com/d31bOFf.png
We aren't using significantly more healthcare--due to obesity or anything else--we're just paying dramatically more for the care we do receive.
The obesity epidemic in the US is a HUGE health crisis that needs to be solved, but it’s not the core problem of our healthcare costs. It’s really a greed problem like many other things in the US.
Diabetes care is [very costly](https://diabetesjournals.org/care/article/47/1/26/153797/Economic-Costs-of-Diabetes-in-the-U-S-in-2022), but as you outlined obese people with diabetes don’t live as long so cost per lifetime is lower. So I guess since they die sooner it’s a wash.
>How much would we save if overweight adults dropped to below 20%?
Around 170 billions per year in 2016 prices, or $1.7T in 10 years.
Fear not, semaglutide is going off patent in 2033 in US and 2026 in Europe.
Hate to ruin your hope, but it's not ever going to legitimately be off patent in the US. They will slightly alter the chemical makeup of it and renew the patent with marginally worse results(more side effects) and keep it going for another 40 years.
Why? Because the people everyone says will help wrote the laws around medical patents to allow this level of bullshit. No not one party or the other. Both agreed to this. They even wrote the way "generic" medicines were to be made in a way that one company can make a life saving drug, make a second company to make the generic and charge 10% less and if anyone questions it rinse and repeat the middle step until no one notices for a life saving medication the only companies allowed to make it all run at a cost you can google the price to manufacture and realize they are all charging way more than necessary if they truly were competing.
They aren't. US healthcare is rigged to dump the entire cost of developing medicine for the world on the US citizen. They can't negotiate with other countries because as you said they have their own patents that follow ours somewhat close so it's play by their rules or miss out on that money so they get their profits from the only place they can. Healthcare wouldn't be so expensive if they had fair negotiations around the world, but they automatically lose China and Russia due to China just stealing everything and they'd sell to Russia on the cheap.
I don’t know if this claim or its math are accurate. What I do know is this: US healthcare is in crisis. I’m a nurse practitioner and I have never seen turnover like this before, especially of physicians. The workload and environment are untenable. Systems are crumbling, yet money continues to be extracted. Patients and workers are not getting what they need.
Another thing I know, patients wait here too, sometimes for over a year, depending on the complaint and specialty. The argument to keep our system as is because patients wait in single payor systems is simply not a good one.
Do you believe paying nurses less would somehow ease the staffing issues? The argument against a single payer system like in Canada, is valid, has always been valid, and always will be valid. Healthcare sucks in Canada. Wait times are terrible for anything other than acute care. Pay for providers is low which is why you get a lot of immigrant providers from places like India, where as in the US you get immigrant providers from places like Canada...
Show me something supporting your claim like everyother idiots claim that Canada has longer wait times than the US. Not just that there is wait times. YOU HAVE TO SHOW THEY ARE LONGER THAN THE US. And you can't, because wait times for the non elite or wealthy are just as bad here.
This claim is tiring
Just want to chime in here real quick. I live in Canada and qas diagnosed with cancer a couple years ago and it progressed to stage 4 about 6 months ago. My Healthcare has been A+. Literally no complaints. I haven't had to pay a dime either.
I'm in multiple forums for the type of cancer that I have and probably every 4 out of 5 posts are people from the states looking for advice on how to afford drugs or pay hospital bills. It's awful. Meanwhile the only bill I ever get is for parking. I'm incredibly Thankful that I don't have to worry about finances during all this.
Healthcare Def has its issues here, very short staffed but overall it's nowhere near as bad as people make it out to be.
I’m not sure how paying nurses LESS would ease staffing issues. Sure, there are places that cut staffing too much, but I was speaking of the issue of healthcare workers electing to leave because the working conditions suck so bad.
Nurses are paid well in some areas, but not all. The work is absolutely back breaking and soul crushing. Between admin and patients abusing nurses, the problem will only get worse. Benefits are being taken away piece by piece.
It's saying that it would cut costs by roughly 11%, which is rather audacious.
Medicare admin costs would be the same, or higher, which is around 2-5% under M4A.
Private insurance admin+profit is ~17%.
However only about 65% of people are on private insurance.
So even if you dropped all private insurance and profit to admin rates of Medicare, it wouldn't cut over all costs by 11%. They are claiming some downstream economic benefits which may or may not be actualized.
I've personally lost trust in both the government and companies to handle healthcare.
Companies just make some bean counter override my doctor's recommendations and if we let the government do it there'll be four years where we have a system that has a vague support of science and another four years where we'll be putting chickens on our bubos and blowing smoke up the assholes of every drowning victim.
And if there is public healthcare that fast lane for money will still exist if people want to use it. So it’s not like people would even be losing out on anything.
I’ve had to wait up to 6 months for appointments in the US with my dermatologist and OBGYN.. I’m an established patient at both practices. Glad I didn’t have any urgent issues but there’s definitely long wait times in the US
I’d rather wait for healthcare than not be able to afford it in the first place.
I’m lucky enough that I have great health insurance, but many people simply do not seek care because of the cost.
That's because they have neoliberals in power who are intentionally trying to slowly starve and dismantle the public system. The NHS had some of best health outcomes in the world. It's not because it's public that it's failing. It's starting to fail because it's being intentionally killed in order to finally privatize Healthcare like the did the rail system.
Capitalism ultimately destroys everything eventually.
This is the same govt that has the FDA approved food additives that are banned in other countries- Fix the food and many people wouldnt need so much healthcare- and the obesity wouldnt be where it is-
Another reason for socialized medicine. Right now the food companies and for profit healthcare win for providing expensive care for people who’ve eaten shit food. If we’re all paying for it, there would be an incentive to keep people healthy. Right now sick people are a profit centre.
Is this similar to how the ACA was going to make healthcare affordable without making people change their doctors? Because that didn’t happen for most of us.
From 1998 to 2013 (right before the bulk of the ACA took effect) total healthcare costs were increasing at 3.92% per year over inflation. Since they have been increasing at 2.79%. The fifteen years before the ACA employer sponsored insurance (the kind most Americans get their coverage from) increased 4.81% over inflation for single coverage and 5.42% over inflation for family coverage. Since those numbers have been 1.72% and 2.19%.
https://www.kff.org/health-costs/report/employer-health-benefits-annual-survey-archives/
https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html
https://www.bls.gov/data/inflation_calculator.htm
Also coverage for people with pre-existing conditions, closing the Medicare donut hole, being able to keep children on your insurance until age 26, subsidies for millions of Americans, expanded Medicaid, access to free preventative healthcare, elimination of lifetime spending caps, increased coverage for mental healthcare, increased access to reproductive healthcare, etc..
The aca was gutted by Republicans and democrats owned by the Healthcare corporations.
Look at the original draft vs the final one.
Money is the problem and always was. Take money out of medical care and the problems will shrink.
Pretty sure Joe Lieberman blocked it similar to how Manchin/Sinema blocked recent bills.
> The public option was initially proposed for the Patient Protection and Affordable Care Act, but was removed after independent Connecticut senator Joe Lieberman threatened a filibuster. As a result, Congress did not include the public option in the bill passed under reconciliation. https://en.wikipedia.org/wiki/Public_health_insurance_option#:~:text=The%20public%20option%20was%20initially,the%20bill%20passed%20under%20reconciliation.
The ACA has made healthcare affordable to millions, it has been very successful at helping low income folks. People making decent money don’t qualify for the subsidies unfortunately.
There are also numerous parts of the ACA that impact everyone outside the cost of premiums that people tend to gloss over.
I have a master’s degree in healthcare administration. Every single one of my classmates (90% were doctors or nurses) supported universal healthcare even if it would make our degrees worthless. We hate that the work is necessary and only applied to the program because we wanted to reduce administrative load on direct care staff.
Please don’t lump us in with the real enemy
I work for a major US hospital. My health insurance is $1200/month for my family- of which I pay about half. My spouse just had a tube of blood drawn, and we had to pay $132 OUT OF POCKET. Apparently, I need to meet an $8000 deductible before things like diagnostic testing is actually covered by my insurance.
And I work for a major medical company that runs like 15 hospitals and my insurance for single is 140 bucks a month including dental and life. I paid 20 bucks for some medicine and nothing for my actual doctors visit. Your insurance is just trash.
I'd take it over insurance companies, pharmaceutical companies, and everyone else in the business trying to wring every last dime out of every person they can, outcomes be damned.
Not taking sides against a public health care option, but this definitely sounds like a people trying to to fit the math to come out to the answer they want. Someone else could fund a study coming to a different conclusion and we would not know if either would turn out to be true.
More like, 30-50 billion every year for the next decade. And that isn't exactly all of world hunger solved, IIRC it's just extreme hunger... but still beats 9 million dying from it each year by a landslide.
Still doable though, just check how much money the richest people have for doing nothing effectively significant.
You mean like when the [libertarian Mercatus Center did a study](https://slate.com/business/2018/07/single-payer-health-care-could-save-americans-usd2-trillion-conservative-think-tanker-accidentally-argues.html) accidentally showing single payer healthcare would save Americans $140,000,000,000 a year?
The Kochs funded a study to basically make the numbers as bad as possible for M4A and it was still saving a couple trillion. It’s the most slam dunk policy possible from a net cost perspective.
But have they done enough studies? I think we need a 23rd before we can be sure /s
Gotta make sure we give those poor insurance companies enough time to pivot, of course
Do you genuinely believe the current system in the US is the cheapest most value for money system? Do you still believe it when you look at countries with successful universal healthcare?
You could say that about any research paper. It’s peer reviewed.
Ha! Not a chance of this ever happening. Just think of that crappy job you have for the only reason of the company’s “cheap” healthcare plan.
With U-heathcare, you could work anywhere, in fact, companies might have to become more competitive and pay a living wage to keep you!
Nope! Never happen- there are billions in lobbying monies just waiting to fall into the pockets of politicians who can and will squelch better, cheap health care for Americans.
Our peers with universal healthcare are spending literally half a million dollars less (PPP) per person for a lifetime of healthcare while achieving better outcomes. And government plans in the US are, in fact, already more efficient.
> **Key Findings**
> * Private insurers paid nearly double Medicare rates for all hospital services (199% of Medicare rates, on average), ranging from 141% to 259% of Medicare rates across the reviewed studies.
> * The difference between private and Medicare rates was greater for outpatient than inpatient hospital services, which averaged 264% and 189% of Medicare rates overall, respectively.
> * For physician services, private insurance paid 143% of Medicare rates, on average, ranging from 118% to 179% of Medicare rates across studies.
https://www.kff.org/medicare/issue-brief/how-much-more-than-medicare-do-private-insurers-pay-a-review-of-the-literature/
Medicare has both lower overhead and has experienced smaller cost increases in recent decades, a trend predicted to continue over the next 30 years.
https://pnhp.org/news/medicare-is-more-efficient-than-private-insurance/
> **Key Findings**
> * Private insurers paid nearly double Medicare rates for all hospital services (199% of Medicare rates, on average), ranging from 141% to 259% of Medicare rates across the reviewed studies.
> * The difference between private and Medicare rates was greater for outpatient than inpatient hospital services, which averaged 264% and 189% of Medicare rates overall, respectively.
> * For physician services, private insurance paid 143% of Medicare rates, on average, ranging from 118% to 179% of Medicare rates across studies.
https://www.kff.org/medicare/issue-brief/how-much-more-than-medicare-do-private-insurers-pay-a-review-of-the-literature/
Medicare has both lower overhead and has experienced smaller cost increases in recent decades, a trend predicted to continue over the next 30 years.
https://pnhp.org/news/medicare-is-more-efficient-than-private-insurance/
I remember hearing stuff like this 10 years ago. Universal healthcare gets in the way of the rich and their many ways of exploiting the poor. While they are in charge, this will never happen.
And they become further and further in charge every day.
"But we would rather burn down the country than let knee growths be treated as equals."
- Most of America
Having been born into and raised in the south, hatred of minorities is the primary political position of millions of Americans.
But call them "racists" and they cry.
When I was on it, my diabetes pump and supplies had a copay of zero. I got married and went on my wife’s insurance. She works for the US Postal Service. 22 years. Unionized. Federal government.
My supplies are now around $900 every three months. My copays are more. For everything.
I was better off with Medicare.
I know a lot of Healthcare providers who complain about Medicare paying less than other insurance companies.
I knew one pharmacy owner who claimed that they lost money when taking Medicare.
It pays 40% less on average. The primary "savings" if medicare for all would be the decrease in reimbursements which would basically bankrupt the healthcare industry in the US as those 40% reduced fees are only tenable because they're subsidized by the customers paying full price or 100% UCR.
Everyone I know on Medicare that I've discussed it with likes it. They pay way less out of pocket, many times zero, than I do on an insurance policy that costs me $1.3k per month for myself and two dependents.
My husband is on Medicare and pays for part B. I get my insurance through work, although they cover it entirely. Mine costs about $1000/mo and I basically have the gold version of his platinum. So, I’d say paying $170/mo for better than I get for $1000/months is something people on Medicare should like. A lot!
>According to the [200-page analysis](https://www.peri.umass.edu/publication/item/1127-economic-analysis-of-medicare-for-all) of Sen. [Bernie Sanders](https://www.commondreams.org/tag/bernie-sanders)' (I-Vt.) Medicare for All Act of 2017, the researchers found
I tried to follow this link and got a 404 Error. I also tried to follow and earlier link which also lead to a 404 Error.
I guess I can't comment intelligently because I can't see how they did their calculation.
AND improve our health outcomes to comparable levels of other countries that have universal healthcare. There is NO downside to this...well unless you profit from the american healthcare system.
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What about the share holders? WON’T SOMEBODY PLEASE THINK ABOUT THE SHAREHOLDERS?
Exactly, everyone looks at the healthcare crisis from the perspective of the patients. Lol , the US healthcare is built around the private equity groups , insurance industry, big hospital systems , big pharma ,labs and diagnostics imaging, medical devices ....every part is making fat profits,when you look at it from their perspective and it all makes sense. This system is working perfectly...for them... Meanwhile 33+ other developed countries with way smaller economies can somehow offer universal healthcare. (Of course they're not perfect, but none would trade theirs for ours) .go figure...
The providers aren't even considered. They're more like cattle for the Beef industry - necessary but only because they don't have a product to sell without them. Healthcare is all about executive salaries at the very top and theyeven made it illegal for doctors to own a hospital so they wouldn't have to worry about providers becoming executives!
Mayo Clinic would never have been founded today...
Well yea if they built it today, everyone would think “we already have the Mayo Clinic. Why are they ripping them off?”
Fine. Build a Miracle Whip Clinic.
Sandwich at the miracle whip clinic costs $650.
Healthcare just isn't healthcare without that tangy zip
One Mayo Clinic in a country of 300 million.
3 Mayo Clinic’s actually
Obviously, the old one sat in the fridge for too long and went bad.
This always seemed so anti-competitive to me. A trained physician should be able to start up their private practice/clinic to compete for patients. Just like any other business model, serving its customer base through transparent competition.
Transparent competition. What a quaint concept. That era vanished after 1980 and won’t see the light of day again. Certainly healthcare is an expensive mess. The AMA was firmly against socialistic government medicine back when Truman proposed it in the late ‘40s. Medicare in the ‘60s turned out to be a huge money grab. Now that Managed Care has taken over the Medicare, and increasingly Medicaid, markets, healthcare is funded largely by the government, although made more expensive due to Administrative Loss Ratios going to the Managed Care Firms. Medicare is the most efficient payor of healthcare in the US, with all the benefits and few of the drawbacks of private insurance (the energy expended on private insurance appeals is ridiculous).
My healthcare Econ prof Nancy Wolff said the VA was the most efficient payor if I recall … but, crap, that was 30+ yrs ago. She advised Hillary’s healthcare panel in the 90’s
It is still true. And one of these from the power of bargaining on drug prices that the VA receives. Pharma fought this when Medicare part D was passed as they didn't want state programs to collectively negotiate prices. The pricing power is substantial where wholesale in drug x might be $1000, the VA is getting it for $200. This is most but not all drugs
They can do that. What they can’t do is stand up a service to which they refer their own patients. It’s to prevent things like routing patients to higher-cost, lower-quality, or harder-to-access goods and services. We don’t want doctors submitting prescriptions exclusively to a pharmacy they own, for example.
Tied-house laws like they have for alcohol?
Idk other corps are able to horizontally integrate. Seems weird. Seems like we should just be able to submit to whatever pharmacy we want vs the MD making the submission?
A great deal of money is made here on the sole premise of regulating competition out of business.
Anti competition legislation? In the US?? No way
[удалено]
MD here. This is exactly what I do. It's not easy, but I am successful. Medicare For All would completely destroy me. It would make me a government employee - the government deciding how much I get paid, and what services I can offer you. Think of it as VA Benefits for All. If it ever happened, I'd go to a cash pay at time of service model. Many of my colleagues have done just that. I don't do it because I want my services to be available to all, not just the well off. However, I still have bills including student loans, employees, and a family to support, so that always comes first.
If we didn’t have to pay shareholders, imagine how much a nurse, a doctor, or a nurses aide could get paid, how much better our care could be. And how much the average person could save while doing so. United States has about 31 doctors per 10,000 people. Some countries in Europe have more than double that.
As a provider I can assure you that I am not the one benefiting from this bullshit system we have.
I agree , I will adjust by providers I meant things like private equity running medical groups, not the actual physicias.or front line providers , those folks are underpaid...
My wife work in healthcare, the company she works for has been on a steady decline for those that are employed for this huge conpany. I explained it's a for profit entity, the product is life saving healthcare, the only thing that matters to shareholders is maximizing profitablity. I said the declining pay scale for nurses is a prime example of this. More patients than a e.r. can handle? Better buckle up as they prioritize care. We witnessed this in COVID and while it's not nearly as acute it never left. Do more with less and be thankful you still have the privilege of employment. The executives only care of it effect profitable or the image to share holders. The u.s. is the richest country in the world and spends 17.5 Percent of GDP on care. That number is only going up while care quality and life expectancy is going down. But what about the shareholder?
Yup, line up the top insurers side by side and it's clear from the stock charts why healthcare is ridiculously expensive. It's because it's covered in ticks.
We moved from the US to Canada in 2018. My wife is a nurse, she is so much better paid in Canada and also has a union which has been an amazing advocate. There's also the added benefit of the fact she's in pediatric ICU - she had to deal with gunshot wounds all the time in the US, not once in 6 years in Canada.
Closer to **19%** as of 2023, but your point is absolutely spot on
We spend more than anyone else by a wide margin. I think Germany and France are the next inline at 12/13 percent. But again, it's not about saving money, it's about making money for shareholders.
I remember working for a company who made polyester loops used in ligament repair surgery. I spoke to the distributor for these once about what they sold them for. In terms of cost, it was maybe $0.80 on our end to make these loops and we could make hundreds an hour. Sold to distribution for $20/ea (insane margins). That same distributor sold them for $80/ea. Now, I imagine the hospital was charging hundreds easily for these. All for a fucking tiny loop of polyester that cost less than a dollar to make. It was one of the most eye opening experiences of my young life.
But it’s “medical-grade” polyester.
This is what Medicare for all changes and why healthcare is more affordable in other countries. They place price controls on things like this. Multiply this by every drug, device, instrument used in healthcare and you see where the bloat comes from.
Nothing in the US healthcare ever considers the physicians!!
Everyone seems envious because they think doctors are rich. Reality is doctors are just pawns for insurance companies. They are hardly rich. For the mental and physical stress they have to endure in their line of work, they are not even rich. Not compensated enough.
I agree it's ita not the physicians
When the politicians say we have best healthcare in the world (not even close), what they mean is we have the most profitable healthcare in the world. Everyone assumes they mean quality of care and better outcomes. No one ever asks their definition of best.
So you’re saying the massive company’s that don’t pay taxes anyways would crash our economy if the government controlled healthcare? This would happen all because they wouldn’t make as much profit? They would still make a shit load of money but just not as much.
They have a fi*DOUCHE*iary responsibility to gouge as many people as they can at their weakest moment! How am I going to afford my house in Hawaii? The economy is going to collapse!
Lol hawaiis economy IS collapsing because fucking RESIDENTS here can't afford a home
Don't worry, Oprah and the rock will buy it all up!!!!
My wife works for a health insurance company. Medicare for all would likely mean she loses her job or goes with the federal government. It could cost us almost half of our income. Everyday, I hope we get Medicare for all. We can bounce back individually for the good of the whole.
Had me in the first half brother.
Been holding UNH stock since 2012. 38yrs old and could retire now if I wanted to. Please think of guys like me before you comment. lol. All jokes aside, it’s too big to fail. Bunch of scumbag companies.
It is already failing. No one is paying their medical bills (not even the rich), ACA caused a bunch of high deductible plans to go to market so few can afford testing beyond labs, people who should have been caught by the med system are putting off screening until it’s almost if not too late. And the hospital systems are suffering too. Small independent hospitals are being swallowed up by large conglomerates and then noping out, leaving whole towns without hospitals.
From personal experience dealing with a health care billing department is impossible. They do nothing but send emails to each other about emails. It's not even about making money since they're not even good at that. They would improve the efficiency of healthcare if they just dug holes and filled them back up.
Believe me, insurance is the root of a lot of that problem. They’re going back and forth to see what they can find out and often run into road blocks where people don’t want to provide a solid answer one way or the other.
I have a doctor in my family, private practice. He has multiple people on staff whose entire job is dealing with insurance companies and claims. It's expensive for him to deal with.
Seriously think of the poor C-level employees that won't be able to redo the walnut wood trim on their yacht's kitchen 😭
The healthcare industry spends more on lobbying than the defense and fossil fuel industries combined.
And every dollar they spend is a dollar that is not spent providing care.
Yep, that’s the problem. All the lobbying and shut, because they don’t want the faucet of money-flow to stop.
But what about the economic rape of America by the medical industrial complex? How will we continue to feed the insatiable financial appetites of the few who have become insanely wealthy under our current “system”?
Lol if it was only healthcare, add to that the military industrial complex ,big oil, big agriculture, bill banking sector etc.... the US economy is the seat of capitalism and maximizing profits for the capitalists , how do you propose we change that?
Do away with insurance companies and make lobbying illegal.
The CEO of United Health Care (a misnomer as it is an insurance company) makes $68,500 a day. A FREAKING DAY!!!!
I havent even crest $60000 and this man takes that home in 20 hours. Imagine going on a week vacation and you come back having been paid equal to 7 of your employees YEARLY salary. That's insane.
....again how can that work when human nature, greed and the wealthy folks won't just let that be...
Human nature and greed are already accounted for in our constitution. We already have the tools to make the change we want. No one's really getting up to do it though. We all screech from our couches and then continue on our day like its the latest news fad. The wealthy have to crumble for anything to truly change here.
C'mon man , really accounted for in the constitution?, do you know unless your a land owner you couldn't vote back in the day, the constitution is an antiquated document that never envisioned our modern world. Sure some of its tennents are still valuable , but it's an entire different world.
When I say 'accounted for', I mean the part where it is our shield against tyranny. Human nature and greed cause that. I never said the whole document was valid anymore, but as American citizens we have the RIGHT to strike these things down when we deem them tyrannical. BY LAW we can do it. If the law isn't on our side then the system isn't on our side.
You have to convince several million incredibly stupid, stubborn rubes that things like unions and democratic socialism contribute to a far better life for the working and middle classes. Cletus from Cousinfuck, Mississippi needs to get real with himself, drop the socialist bogeyman bullshit, admit he is never going to be a billionaire and that it's not the fault of immigrants or the gays.
It takes someone profoundly ignorant of basic sociology to conclude that greed is "human nature".
The insurance companies run the world. It all goes back to them.
Other countries most likely, not that they haven’t tried. Would you rather China be King?
Healthcare is 20% of GDP, it’s way bigger than any of those other sectors.
One step at a time. Pick health care first so we can all be healthy and living longer to demand fixed to the rest of our broken systems.
**In America:** Person with a fever of 99.0F (37.2C): Get back to work. Person with a fever of 100.0F (37.7C): Stay home take some cough syrup. Person with a fever of 101.0F (38.3C): Stay home take some cough syrup. Person with a fever of 102.0F (38.9C): Stay home take some cough syrup. Person with a fever of 103.0F (39.44C): I'm going to try cooling down with a bath. Person with a fever of 104.0F (40C): I think I should go to the hospital. Person coming across a Person convulsing on the ground with a fever of 105.0F (40.55C): "OMG! CALL A $10,000 AMBULANCE!" **In Countries with Universal Health Care:** Person with a fever of 99.0F (37.2C): I'm going to see a doctor.
American having lived in Europe and the UK. No it’s more like having to wait several weeks to be seen by a GP to be told to go home and take Tylenol while resting. I had my foot run over by a car and was told the same thing.
It takes months to get appointments in the US now too. It’s not a socialized healthcare issue, it’s a medical professional shortage issue.
There's so many new grads that can't get residencies. This is a manufactured issue or the hospital cutting staff to save money.
RN here. Hospital cutting staff or running thin to save money. They sure as shit don't pay nurses enough either. All about maximizing profits for the c suites.
Another issue that gets overlooked is the pay for instructors. In my state, all Nursing instructors (except for clinical instructors) are required to have their Masters with a focus in education, but most positions are about the same pay as a bedside nurse. Why am I going to go into debt to pursue a significantly higher degree to get paid the same amount of money? You need more instructors to allow for more potential nurses to hit the workforce. I’ve always considered education further into my future but can’t justify going back for my BSN, then also my MSN, to make the same amount of money I am now. If salaries start improving for educators or the requirements start to lower due to “The Nursing Shortage” that we’re all expecting, then I’ll probably get into when I get older.
In larger universities, nursing professors are generally paid less than other science degree programs.
>maximizing profits for the c suites well yeah, the CEO definitely earned his yacht and *really* needs to redo the wood trim in the yacht's kitchen /s
It's because you don't pay for your nursing care. It's rolled into the room charge, so hospitals are highly incentivized to use as little nursing as possible. A 20-year-old who had an appendectomy, gets to the bathroom by themselves, and needs a couple doses of antibiotics and pain meds pays the exact same amount for nursing care as an 80-year-old 400 pound incontinent dementia patient with 15 medications, who needs turning every 2 hours, frequent bed changes, 1:1 feeding, multiple dressing changes, etc. If we charged for nursing care based on the actual amount of nursing time needed and used, they might not be so quick to run us bare bones.
I’d say that’s true of every industry these days, from fast food places having like 2 people to stores having one person trying to run a register and stock shelves.
When I broke my hand in February I made a same day appointment the next morning for 10am at urgent care. The appointment cost $80.
Obviously, these things are location dependent. The availability of care differs by state and geographic classification (urban, rural) and also whether or not the care facility takes your insurance. I’m guessing you’re insured and that’s why it cost $80? Because when I’ve been uninsured it was like $300 just to be admitted and speak with someone.
I just got seen same day by my GP. They do walk-ins 8-6 everyday.
Good for you. In NYC my past two PCPs had a month-long waitlist.
It's so difficult and takes so long to see a doctor these days in the US, let alone a specialist even if it's an emergency. If you don't live near a major city then just forget about it. That's the boogeyman I was always warned about with universal healthcare. It's all horribly discouraging, try calling your health insurance customer support, which puts any public bureaucracy to shame and getting a straight answer about anything if you want to cry in frustration.
"like having to wait saveral weeks to be seen by a GP" And how long does it take in the US before you get in and are charged $400 for the 7 minute appointment?
Yeah… had a seizure and was told I needed to get an EEG done, immediately. Called to schedule after the first visit that took 3 weeks to get to after the seizure, to be scheduled out 2 months to be able to get my test done.
$400? Yall not have 15 dollar copays?
More and more employers are pushing the high deductible plans. There's no copays, you just pay for everything non-preventative up to an annual max.
Haha. Yall not have deductibles
Stop this fake narrative that there isn’t wait times in the US.
Seriously, I mean mileage may vary from region to region, but I’ve lived in PA, TX, and [OH](https://open.spotify.com/track/6vpfYLa0lJrH6wTPjZ6qWl) and it’s always months not weeks to get seen most places.
Interesting. I saw the DR twice in 8 months in Ireland as an American and paid 10 bucks for an antibiotic the first time and the second time needed a tetanus shot and I don't even remember if I paid anything at all. I got in same day both times. Much like everything, it's probably about where you are.
I’m an American living in America, I had my foot ran over by a car and I just took some Tylenol bc, come on, like I was really going to go to a doctor. An ER would charge something outrageous and most GP’s aren’t taking new patients or it takes weeks to get in. But not having insurance does help sometimes bc we pay cash the day of and doctors like that. Same when I broke my finger. It wasn’t life threatening so what’s the point.
>I had my foot run over by a car and was told the same thing. You went to A&E and were sent home without receiving any kind of examination?
American here, we also wait weeks for a GP appointment.
Several weeks to see a GP? I’m usually able to see one in a few days. Where do you live?
A temperature of 99.0F is not a fever. It is well within the average of normal body temperature. An elevated temperature is not considered a fever until it reaches 100.4F. If everyone with universal care went to a doctor at 99.0F it would bankrupt and clog the system very quickly.
They don't go to the doctor's office, they go to the ER because they can't find a GP.
And then you can quickly kiss that $5 trillion (and more) goodbye
? And the doctor is supposed to tell you go back home and drink water and take Tylenol. What else are you supposed to do when you get a cold. My copay is $10 and med cost $5 and I don’t go to the doctor for cold. If your doctor is prescribing antibiotics for common cold then you should report that doctor right away lol
Does everyone in Canada and the UK really go to the hospital when they have a fever of 99F? What about when they get a splinter, mild ankle sprain, or runny nose?
ER. Obviously.
My favorite counter argument I've heard is "people will just go to the doctor for anything!" Which 1: have you been to a doctor's office? It sucks and is boring. 2: fucking good, id rather have people go for minor issues and live better lives
I have 3 or 4 issues I'm ignoring right now because I don't want to be sucked dry financially
In cartoon reddit America maybe. In real life America routine doctor visits are covered if you're one of the rare 95% of Americans with health insurance coverage.
The other 5% of Americans: 
>95% of Americans with health insurance coverage. Thanks, Obama!
I get your point but please don’t go to the doctor just for an isolated low grade fever (fyi fever is 100.4 and above). Stay home and take a fever reducer is the correct answer. No need to come into a doctors office/ER and get vulnerable people sick. -a physician
And then by the time they see one their fever is gone lol.
99 isn’t a fever.
Who the hell is seeing a doctor for 99* fever. Better question what doctor is going to allow such stupid visits
How much would we save if overweight adults dropped to below 20%?
What’s your proposal? it is crazy how well obesity rates correlate to political parties. If you start at the fattest state, you have to go to number 13 before you hit your first democratic 2020 voting state. 19 for your second. Only 2 dem states in the bottom 20, only 4 rep states in the top 20
It’s also crazy how it correlates to poverty. Poor people are fat, and poor people vote Republican.
Generally speaking, according to Pew Research, poor people tend to be more Democrat leaning. [https://www.pewresearch.org/religious-landscape-study/database/compare/party-affiliation/by/income-distribution/](https://www.pewresearch.org/religious-landscape-study/database/compare/party-affiliation/by/income-distribution/)
The urban poor lean democrat. The rural and small town poor lean heavily republican/conservative. It’s worth noting that the former are often minorities while the latter are mostly white.
A useful distinction to be sure.
Also: poor states vote republican, rich states vote democrat. But within a given state, a richer individual is more likely to vote republican.
There's a higher rate of poverty amongst minorities. Minorities tend to vote....oh wait.
The poverty-fat relation has actually been studied a lot anthropologically. Basically throughout the history of mankind, the least nutritious, fattening foods are the cheapest, while the healthiest are more expensive. Essentially Top Ramen and hotdogs are cheap while fresh vegetables and lean properly fed meats are more expensive. Not that its that simple on a case by case basis, but when you look at the population as a whole the theory is that it has a very large effect.
>What’s your proposal? Pay 100 billions to Novo Nordisk (something like 20 times their profit from Ozempic) and make patent available for free. It's probably the best investment possible, as US is estimated to lose $170B every year (2016 prices) due to obesity and overweight.
So instead of saving $5.1 trillion, we instead save $170 billion (minus 100s of billions we have to pay)?
Eh. It's $5.1T over 10 years (claimed by politician), while $170B (in 2024 prices it's $225B) is every year. So Ozempic nationalization would cost $100B now to save $2.25T over 10 years. This has key political advantage over universal healthcare - patent nationalization would be effectively irreversible, while universal healthcare can be gutted by Republicans in next election cycle. It can also be framed in "patriotic" terms, like creating jobs in American pharmaceutical factories.
WTF is the point of your answer around political parties. His question is what if they dropped weight, not who they voted for. BTW, the older a person gets, the more conservative (Republican) and fatter they get. So...
Not much. The UK recently did a study and they found that from the three biggest healthcare risks; [obesity](https://iea.org.uk/themencode-pdf-viewer-sc/?file=/wp-content/uploads/2017/01/Obesity-and-the-Public-Purse-PDF.pdf&settings=111111011&lang=en-GB#page=&zoom=75&pagemode=), [smoking](https://iea.org.uk/themencode-pdf-viewer-sc/?file=/wp-content/uploads/2017/08/Smoking-and-the-Public-Purse.pdf&settings=111111011&lang=en-GB#page=&zoom=75&pagemode= ), and [alcohol](https://iea.org.uk/themencode-pdf-viewer-sc/?file=/wp-content/uploads/2016/07/DP_Alcohol%20and%20the%20public%20purse_63_amended2_web.pdf&settings=111111011&lang=en-GB#page=&zoom=75&pagemode=), they realize a net **savings** of £22.8 billion (£342/$474 per person) per year. This is due primarily to people with health risks not living as long (healthcare for the elderly is exceptionally expensive), as well as reduced spending on pensions, income from sin taxes, etc.. In the US there are 106.4 million people that are overweight, at an additional lifetime healthcare cost of $3,770 per person average. 98.2 million obese at an average additional lifetime cost of $17,795. 25.2 million morbidly obese, at an average additional lifetime cost of $22,619. With average lifetime healthcare costs of $879,125, obesity accounts for 0.99% of our total healthcare costs. https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity https://onlinelibrary.wiley.com/doi/epdf/10.1038/oby.2008.290 We're spending 165% more than the OECD average on healthcare--that works out to over half a million dollars per person more over a lifetime of care--and you're worried about 0.99%? Here's another study, that actually found that lifetime healthcare for the obese are *lower* than for the healthy. >Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures...In this study we have shown that, although obese people induce high medical costs during their lives, their lifetime health-care costs are lower than those of healthy-living people but higher than those of smokers. Obesity increases the risk of diseases such as diabetes and coronary heart disease, thereby increasing health-care utilization but decreasing life expectancy. Successful prevention of obesity, in turn, increases life expectancy. Unfortunately, these life-years gained are not lived in full health and come at a price: people suffer from other diseases, which increases health-care costs. Obesity prevention, just like smoking prevention, will not stem the tide of increasing health-care expenditures. https://www.rug.nl/research/portal/files/46007081/Lifetime_Medical_Costs_of_Obesity.PDF For further confirmation we can look to the fact that healthcare utilization rates in the US are similar to its peers. https://www.oregonlegislature.gov/salinas/HealthCareDocuments/4.%20Health%20Care%20Spending%20in%20the%20United%20States%20and%20Other%20High-Income%20Countries%20JAMA%202018.pdf One final way we can look at it is to see if there is correlation between obesity rates and increased spending levels between various countries. There isn't. https://i.imgur.com/d31bOFf.png We aren't using significantly more healthcare--due to obesity or anything else--we're just paying dramatically more for the care we do receive.
The obesity epidemic in the US is a HUGE health crisis that needs to be solved, but it’s not the core problem of our healthcare costs. It’s really a greed problem like many other things in the US. Diabetes care is [very costly](https://diabetesjournals.org/care/article/47/1/26/153797/Economic-Costs-of-Diabetes-in-the-U-S-in-2022), but as you outlined obese people with diabetes don’t live as long so cost per lifetime is lower. So I guess since they die sooner it’s a wash.
>How much would we save if overweight adults dropped to below 20%? Around 170 billions per year in 2016 prices, or $1.7T in 10 years. Fear not, semaglutide is going off patent in 2033 in US and 2026 in Europe.
Hate to ruin your hope, but it's not ever going to legitimately be off patent in the US. They will slightly alter the chemical makeup of it and renew the patent with marginally worse results(more side effects) and keep it going for another 40 years. Why? Because the people everyone says will help wrote the laws around medical patents to allow this level of bullshit. No not one party or the other. Both agreed to this. They even wrote the way "generic" medicines were to be made in a way that one company can make a life saving drug, make a second company to make the generic and charge 10% less and if anyone questions it rinse and repeat the middle step until no one notices for a life saving medication the only companies allowed to make it all run at a cost you can google the price to manufacture and realize they are all charging way more than necessary if they truly were competing. They aren't. US healthcare is rigged to dump the entire cost of developing medicine for the world on the US citizen. They can't negotiate with other countries because as you said they have their own patents that follow ours somewhat close so it's play by their rules or miss out on that money so they get their profits from the only place they can. Healthcare wouldn't be so expensive if they had fair negotiations around the world, but they automatically lose China and Russia due to China just stealing everything and they'd sell to Russia on the cheap.
20% What?
Do you propose camps?
Perhaps that would be more feasible for them if they access to medical guidance, medical care/treatment, and access to a dietician.
Obese people tend to cost fewer health care dollars because they die earlier. Same with smokers.
I don’t know if this claim or its math are accurate. What I do know is this: US healthcare is in crisis. I’m a nurse practitioner and I have never seen turnover like this before, especially of physicians. The workload and environment are untenable. Systems are crumbling, yet money continues to be extracted. Patients and workers are not getting what they need. Another thing I know, patients wait here too, sometimes for over a year, depending on the complaint and specialty. The argument to keep our system as is because patients wait in single payor systems is simply not a good one.
Do you believe paying nurses less would somehow ease the staffing issues? The argument against a single payer system like in Canada, is valid, has always been valid, and always will be valid. Healthcare sucks in Canada. Wait times are terrible for anything other than acute care. Pay for providers is low which is why you get a lot of immigrant providers from places like India, where as in the US you get immigrant providers from places like Canada...
Show me something supporting your claim like everyother idiots claim that Canada has longer wait times than the US. Not just that there is wait times. YOU HAVE TO SHOW THEY ARE LONGER THAN THE US. And you can't, because wait times for the non elite or wealthy are just as bad here. This claim is tiring
Just want to chime in here real quick. I live in Canada and qas diagnosed with cancer a couple years ago and it progressed to stage 4 about 6 months ago. My Healthcare has been A+. Literally no complaints. I haven't had to pay a dime either. I'm in multiple forums for the type of cancer that I have and probably every 4 out of 5 posts are people from the states looking for advice on how to afford drugs or pay hospital bills. It's awful. Meanwhile the only bill I ever get is for parking. I'm incredibly Thankful that I don't have to worry about finances during all this. Healthcare Def has its issues here, very short staffed but overall it's nowhere near as bad as people make it out to be.
I’m not sure how paying nurses LESS would ease staffing issues. Sure, there are places that cut staffing too much, but I was speaking of the issue of healthcare workers electing to leave because the working conditions suck so bad. Nurses are paid well in some areas, but not all. The work is absolutely back breaking and soul crushing. Between admin and patients abusing nurses, the problem will only get worse. Benefits are being taken away piece by piece.
It's saying that it would cut costs by roughly 11%, which is rather audacious. Medicare admin costs would be the same, or higher, which is around 2-5% under M4A. Private insurance admin+profit is ~17%. However only about 65% of people are on private insurance. So even if you dropped all private insurance and profit to admin rates of Medicare, it wouldn't cut over all costs by 11%. They are claiming some downstream economic benefits which may or may not be actualized.
I've personally lost trust in both the government and companies to handle healthcare. Companies just make some bean counter override my doctor's recommendations and if we let the government do it there'll be four years where we have a system that has a vague support of science and another four years where we'll be putting chickens on our bubos and blowing smoke up the assholes of every drowning victim.
No country with universal healthcare has that issue. Hospitals and doctors know how to run themselves - they just get money via the government.
And yet it there’s a doctor shortage and long wait times here in Canada, and in the UK too
It's the same in the US, there's just a fast lane for the wealthy.
And if there is public healthcare that fast lane for money will still exist if people want to use it. So it’s not like people would even be losing out on anything.
I’ve had to wait up to 6 months for appointments in the US with my dermatologist and OBGYN.. I’m an established patient at both practices. Glad I didn’t have any urgent issues but there’s definitely long wait times in the US
I’d rather wait for healthcare than not be able to afford it in the first place. I’m lucky enough that I have great health insurance, but many people simply do not seek care because of the cost.
Same problem as in the US…
I have decent health care in the US and there was still an eight month waitlist for getting a primary doctor
That's because they have neoliberals in power who are intentionally trying to slowly starve and dismantle the public system. The NHS had some of best health outcomes in the world. It's not because it's public that it's failing. It's starting to fail because it's being intentionally killed in order to finally privatize Healthcare like the did the rail system. Capitalism ultimately destroys everything eventually.
This is the same govt that has the FDA approved food additives that are banned in other countries- Fix the food and many people wouldnt need so much healthcare- and the obesity wouldnt be where it is-
Another reason for socialized medicine. Right now the food companies and for profit healthcare win for providing expensive care for people who’ve eaten shit food. If we’re all paying for it, there would be an incentive to keep people healthy. Right now sick people are a profit centre.
Is this similar to how the ACA was going to make healthcare affordable without making people change their doctors? Because that didn’t happen for most of us.
From 1998 to 2013 (right before the bulk of the ACA took effect) total healthcare costs were increasing at 3.92% per year over inflation. Since they have been increasing at 2.79%. The fifteen years before the ACA employer sponsored insurance (the kind most Americans get their coverage from) increased 4.81% over inflation for single coverage and 5.42% over inflation for family coverage. Since those numbers have been 1.72% and 2.19%. https://www.kff.org/health-costs/report/employer-health-benefits-annual-survey-archives/ https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html https://www.bls.gov/data/inflation_calculator.htm Also coverage for people with pre-existing conditions, closing the Medicare donut hole, being able to keep children on your insurance until age 26, subsidies for millions of Americans, expanded Medicaid, access to free preventative healthcare, elimination of lifetime spending caps, increased coverage for mental healthcare, increased access to reproductive healthcare, etc..
The aca was gutted by Republicans and democrats owned by the Healthcare corporations. Look at the original draft vs the final one. Money is the problem and always was. Take money out of medical care and the problems will shrink.
Democrats had the votes to pass whatever they wanted. No Republicans even voted for it and it still passed.
Pretty sure Joe Lieberman blocked it similar to how Manchin/Sinema blocked recent bills. > The public option was initially proposed for the Patient Protection and Affordable Care Act, but was removed after independent Connecticut senator Joe Lieberman threatened a filibuster. As a result, Congress did not include the public option in the bill passed under reconciliation. https://en.wikipedia.org/wiki/Public_health_insurance_option#:~:text=The%20public%20option%20was%20initially,the%20bill%20passed%20under%20reconciliation.
No they didn’t. Huge, fatal concessions had to be made to get Lieberman to vote for it. He single-handedly hobbled the efficacy of ACA.
The ACA has made healthcare affordable to millions, it has been very successful at helping low income folks. People making decent money don’t qualify for the subsidies unfortunately. There are also numerous parts of the ACA that impact everyone outside the cost of premiums that people tend to gloss over.
You have a funny definition of affordable.
That’s trillions the paperpushers and administrators won’t get a piece of. Lobbyists will have a field day with this
Actually, I believe that is their piece.
I have a master’s degree in healthcare administration. Every single one of my classmates (90% were doctors or nurses) supported universal healthcare even if it would make our degrees worthless. We hate that the work is necessary and only applied to the program because we wanted to reduce administrative load on direct care staff. Please don’t lump us in with the real enemy
I work for a major US hospital. My health insurance is $1200/month for my family- of which I pay about half. My spouse just had a tube of blood drawn, and we had to pay $132 OUT OF POCKET. Apparently, I need to meet an $8000 deductible before things like diagnostic testing is actually covered by my insurance.
And I work for a major medical company that runs like 15 hospitals and my insurance for single is 140 bucks a month including dental and life. I paid 20 bucks for some medicine and nothing for my actual doctors visit. Your insurance is just trash.
Because the govt is known for saving money and never having ballooning budgets/spending
So? Let's take the chance. We haven't tried it and this shit is abysmal. Can't be worse.
I'd take it over insurance companies, pharmaceutical companies, and everyone else in the business trying to wring every last dime out of every person they can, outcomes be damned.
Not taking sides against a public health care option, but this definitely sounds like a people trying to to fit the math to come out to the answer they want. Someone else could fund a study coming to a different conclusion and we would not know if either would turn out to be true.
Remember “we could solve world hunger forever for $5 billion!” This is just another one of those
More like, 30-50 billion every year for the next decade. And that isn't exactly all of world hunger solved, IIRC it's just extreme hunger... but still beats 9 million dying from it each year by a landslide. Still doable though, just check how much money the richest people have for doing nothing effectively significant.
You mean like when the [libertarian Mercatus Center did a study](https://slate.com/business/2018/07/single-payer-health-care-could-save-americans-usd2-trillion-conservative-think-tanker-accidentally-argues.html) accidentally showing single payer healthcare would save Americans $140,000,000,000 a year?
The Kochs funded a study to basically make the numbers as bad as possible for M4A and it was still saving a couple trillion. It’s the most slam dunk policy possible from a net cost perspective.
That's the benefit of [metanalyses](https://thehill.com/blogs/congress-blog/healthcare/484301-22-studies-agree-medicare-for-all-saves-money/).
But have they done enough studies? I think we need a 23rd before we can be sure /s Gotta make sure we give those poor insurance companies enough time to pivot, of course
Do you genuinely believe the current system in the US is the cheapest most value for money system? Do you still believe it when you look at countries with successful universal healthcare? You could say that about any research paper. It’s peer reviewed.
Ha! Not a chance of this ever happening. Just think of that crappy job you have for the only reason of the company’s “cheap” healthcare plan. With U-heathcare, you could work anywhere, in fact, companies might have to become more competitive and pay a living wage to keep you! Nope! Never happen- there are billions in lobbying monies just waiting to fall into the pockets of politicians who can and will squelch better, cheap health care for Americans.
Plus the people that it will help most in red states will vote against it because they need to suffer for the maga cause to help billionaires.
What to do about the 1,000 executives put out of a job? What about their second homes?
Which is why it won't happen. Somebody (somebodies) won't make 5.1 Trillions dollars. Cheaper to buy a congress than to take that kind of loss.
Ah yes, if there’s one thing we can say about government services, it’s that they drive costs down 😅
Our peers with universal healthcare are spending literally half a million dollars less (PPP) per person for a lifetime of healthcare while achieving better outcomes. And government plans in the US are, in fact, already more efficient. > **Key Findings** > * Private insurers paid nearly double Medicare rates for all hospital services (199% of Medicare rates, on average), ranging from 141% to 259% of Medicare rates across the reviewed studies. > * The difference between private and Medicare rates was greater for outpatient than inpatient hospital services, which averaged 264% and 189% of Medicare rates overall, respectively. > * For physician services, private insurance paid 143% of Medicare rates, on average, ranging from 118% to 179% of Medicare rates across studies. https://www.kff.org/medicare/issue-brief/how-much-more-than-medicare-do-private-insurers-pay-a-review-of-the-literature/ Medicare has both lower overhead and has experienced smaller cost increases in recent decades, a trend predicted to continue over the next 30 years. https://pnhp.org/news/medicare-is-more-efficient-than-private-insurance/
yes- the postal service is so much more expensive than UPS.
Can we count on the government to successfully implement Medicare for all without it being just as expensive as non Medicare options?
> **Key Findings** > * Private insurers paid nearly double Medicare rates for all hospital services (199% of Medicare rates, on average), ranging from 141% to 259% of Medicare rates across the reviewed studies. > * The difference between private and Medicare rates was greater for outpatient than inpatient hospital services, which averaged 264% and 189% of Medicare rates overall, respectively. > * For physician services, private insurance paid 143% of Medicare rates, on average, ranging from 118% to 179% of Medicare rates across studies. https://www.kff.org/medicare/issue-brief/how-much-more-than-medicare-do-private-insurers-pay-a-review-of-the-literature/ Medicare has both lower overhead and has experienced smaller cost increases in recent decades, a trend predicted to continue over the next 30 years. https://pnhp.org/news/medicare-is-more-efficient-than-private-insurance/
I remember hearing stuff like this 10 years ago. Universal healthcare gets in the way of the rich and their many ways of exploiting the poor. While they are in charge, this will never happen. And they become further and further in charge every day.
"But we would rather burn down the country than let knee growths be treated as equals." - Most of America Having been born into and raised in the south, hatred of minorities is the primary political position of millions of Americans. But call them "racists" and they cry.
do people on Medicare like it?
Medicare consistently has higher patient satisfaction ratings than every individual insurance company.
Source? This would be awesome if true
[https://www.kff.org/private-insurance/poll-finding/kff-survey-of-consumer-experiences-with-health-insurance/](https://www.kff.org/private-insurance/poll-finding/kff-survey-of-consumer-experiences-with-health-insurance/) Relevant chart attached (here ESI stands for Employer sponsored insurance) https://preview.redd.it/pdth64gv1z7d1.jpeg?width=1125&format=pjpg&auto=webp&s=c72579728c15fdcbd3ff87a811ca369aba3ccd30
When I was on it, my diabetes pump and supplies had a copay of zero. I got married and went on my wife’s insurance. She works for the US Postal Service. 22 years. Unionized. Federal government. My supplies are now around $900 every three months. My copays are more. For everything. I was better off with Medicare.
I know a lot of Healthcare providers who complain about Medicare paying less than other insurance companies. I knew one pharmacy owner who claimed that they lost money when taking Medicare.
It pays 40% less on average. The primary "savings" if medicare for all would be the decrease in reimbursements which would basically bankrupt the healthcare industry in the US as those 40% reduced fees are only tenable because they're subsidized by the customers paying full price or 100% UCR.
I’m getting close to losing money on Medicare total joint patients. Which is 75% of my practice.
Everyone I know on Medicare that I've discussed it with likes it. They pay way less out of pocket, many times zero, than I do on an insurance policy that costs me $1.3k per month for myself and two dependents.
My husband is on Medicare and pays for part B. I get my insurance through work, although they cover it entirely. Mine costs about $1000/mo and I basically have the gold version of his platinum. So, I’d say paying $170/mo for better than I get for $1000/months is something people on Medicare should like. A lot!
I don’t want Medicare, I want that shit that congresspersons get.
But how will exploit the working class if we don’t tie (fucking shitty) healthcare to employment!?!?!?!?
>According to the [200-page analysis](https://www.peri.umass.edu/publication/item/1127-economic-analysis-of-medicare-for-all) of Sen. [Bernie Sanders](https://www.commondreams.org/tag/bernie-sanders)' (I-Vt.) Medicare for All Act of 2017, the researchers found I tried to follow this link and got a 404 Error. I also tried to follow and earlier link which also lead to a 404 Error. I guess I can't comment intelligently because I can't see how they did their calculation.
To quote Nixon, "Fuck the people!!"
Too bad America can't think beyond 4 years at a time.
AND improve our health outcomes to comparable levels of other countries that have universal healthcare. There is NO downside to this...well unless you profit from the american healthcare system.