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Kamala Harris wants to end private health insurance, a new Democratic litmus test

  

Category:  News & Politics

Via:  vic-eldred  •  2 months ago  •  61 comments

By:   Hillary Clinton (NBC News)

Kamala Harris wants to end private health insurance, a new Democratic litmus test
Sen. Kamala Harris, D-Calif., came out for a Medicare For All plan on Monday that would replace private insurance. Expect it to be one of the biggest debates of 2020.

S E E D E D   C O N T E N T


WASHINGTON — When 2020 presidential hopeful Kamala Harris came out for single-payer health care that would replace private insurance, she took a side in what is emerging as one of the sharpest fault lines in the Democratic field.

"The idea is that everyone gets access to medical care, and you don't have to go through the process of going through an insurance company, having them give you approval, going through the paperwork, all of the delay that may require," Harris said in a town hall in Iowa on Monday on CNN.

Led by Sen. Bernie Sanders, I-Vt. and energized by his 2016 campaign, one set of Democrats see "Medicare For All" as a necessary all-encompassing overhaul of the health care system.

Medicare For All supporters celebrated Harris' comments as further evidence that their position had taken hold of the party's mainstream after being dismissed in 2016 by Hillary Clinton as "a theoretical debate about some better idea that will never, ever come to pass."

"There is no viable path to the Democratic nomination for someone who does not support single-payer health care," Sean McElwee, founder of Data For Progress, told NBC News. "It's done."

Under legislation proposed by Sanders, Americans covered by private insurance or government programs would instead get their care through a new version of Medicare with more generous benefits, including dental coverage, and no premiums or deductibles.

Supporters of single-payer argue it's necessary to replace the entire system of financing health care, which spends far more per patient than other developed nations, in order to achieve maximum coverage and deliver the most cost-efficient care.

The Sanders' bill is co-sponsored by Harris along with other presidential contenders or potential candidates Elizabeth Warren, D-Mass., Kirsten Gillibrand, D-N.Y. .and Cory Booker, D-N.J., among others.

But then there's the other side of the party, which favors a more incremental approach that typically expands public coverage without eliminating private plans. And it can be difficult to tell the sides apart sometimes.

One notable 2020 name in the incrementalist camp is Sen. Sherrod Brown, D-Ohio, who didn't sign onto the Sanders bill and has proposed allowing more people to buy into Medicare instead.

Former New York Mayor Michael Bloomberg, another potential candidate, criticized Medicare For All in New Hampshire on Tuesday, but suggested he also might support a more limited public plan.

"You can have 'Medicare-for-all' for people who are uncovered," he said, according to The Hill. "But...to replace the entire private system where companies provide healthcare for their employees would bankrupt us for a very long time."

But even some of the same senators backing the Sanders bill, including Harris, have also signed on to legislation that expands a Medicare or Medicare-like option to more people without ending employer-based insurance.

This created some confusion on Tuesday after a CNN report quoted a Harris aide who noted that she also supported the more moderate plans. That led to a wave of speculation that Harris was backtracking on her Monday town hall comments, which her campaign denied.

"Her preferred plan, as we have always said, is Medicare For All," Lily Adams, a spokeswoman for Harris, told NBC News in an email. "That's her plan. She has cosponsored other bills to expand coverage, which is good."

The CHOICE Act by Sen. Sheldon Whitehouse, D-R.I., and co-sponsored by Harris, Booker, Warren and Brown, among others, would create a public insurance option on Obamacare's exchanges. The State Public Option Act, by Sen. Brian Schatz, D-Hawaii, and Rep. Ben Ray Lujan, D-N.M., would allow Americans to buy into a Medicaid plan and is sponsored by Harris, Booker and Warren, as well as Sanders. There are several other Democratic bills floating around that are centered on a public option as well.

While less far-reaching than Medicare For All, the various proposals are less disruptive and require fewer new taxes. If implemented, most Americans who get insurance through their job might notice anything had changed, at least at first.

By backing multiple approaches at once, Democrats showed a united front in favor of expanded public health coverage and against Republican efforts to repeal Obamacare and cut Medicaid. But it's harder to suss out their individual voices when everyone is singing together.

This ambiguity helps explain why Harris' comments were so notable even though she's already signed onto Sanders' bill and already endorsed the concept in her recent book. It's one thing to say you support Medicare For All, it's another thing to talk up one of its most controversial provisions rather than vague goals of universal coverage or your fallback plan if there aren't votes for single-payer.

Republican attacks on Medicare For All did little discernible damage in the midterms, but there are signs that the approach Harris outlined could become a liability if proponents aren't careful in selling it.

A recent poll by the Kaiser Family Foundation found that 56 percent of respondents were favorable toward Medicare For All, but also unsure what it entailed, with more than half saying they assumed they would be able to keep their existing coverage. When told that a plan would eliminate existing insurance, respondents moved form supporting it by a 14-point margin to opposing it by a 21-point margin.

Benjy Sarlin

Benjy Sarlin is policy editor for NBC News.


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Vic Eldred
Professor Principal
1  seeder  Vic Eldred    2 months ago

From Jan 2019.

She went into the DNC primary with that.

 
 
 
devangelical
Professor Principal
1.1  devangelical  replied to  Vic Eldred @1    2 months ago

lucky for us we've all had that better and cheaper health insurance trump promised us 7 years ago... ... oh wait...

 
 
 
JohnRussell
Professor Principal
1.1.1  JohnRussell  replied to  devangelical @1.1    2 months ago

He couldnt organize his thoughts long enough to come up with something

 
 
 
devangelical
Professor Principal
1.1.2  devangelical  replied to  JohnRussell @1.1.1    2 months ago

he's a 1 trick pony and that trick is blatant racism...

 
 
 
Hal A. Lujah
Professor Guide
1.1.3  Hal A. Lujah  replied to  devangelical @1.1    2 months ago

He was too busy with infrastructure week.

 
 
 
Greg Jones
Professor Participates
1.2  Greg Jones  replied to  Vic Eldred @1    2 months ago

When the Dems say Medicare for everyone, they are including illegal aliens 

 
 
 
Vic Eldred
Professor Principal
2  seeder  Vic Eldred    2 months ago

I think everyone already knows that private insurance is the thing you buy if you can afford it and hope you never need it.

There is no equitable way the government can do it all.

 
 
 
Ozzwald
Professor Quiet
2.1  Ozzwald  replied to  Vic Eldred @2    2 months ago
There is no equitable way the government can do it all.

Other than the fact that every other non 3rd world country has done it?

 
 
 
Vic Eldred
Professor Principal
2.1.1  seeder  Vic Eldred  replied to  Ozzwald @2.1    2 months ago

You mean Socialist nations who don't pay for their own defense.

 
 
 
Snuffy
Professor Participates
2.1.2  Snuffy  replied to  Ozzwald @2.1    2 months ago

So how about providing some sort of ideas on how the country could move to such a system. You can't just pick a day and proclaim that it's Medicare for all now. We saw that during the early years of COVID. Don't just toss crap about how other countries can do it, provide some ideas. That is after all how conversation works, with the exchange of ideas.

 
 
 
TᵢG
Professor Principal
2.1.3  TᵢG  replied to  Snuffy @2.1.2    2 months ago

I would say that the very first step is to standardize.   Pick a national ID (social security number of something else) that serves as the unique identifier for authorized medical professional to access medical records across the nation.   Then develop a standard protocol that enables the various medical systems to literally access these records as if they were local.   This is standard techy stuff nowadays but still is not-trivial when dealing with the myriad disparate systems, security, etc.

Also upfront, establish a mechanism for sharing medical equipment and to acquire/retire same.   Medical equipment such as MRIs are expensive.   A sharing system allows the leading edge facilities to retire old equipment when they upgrade and make said equipment available for others to use.   Much like a library, resource sharing provides great economies of scale and enables more effective use of equipment.  

In addition, the groundwork for prescription drugs would fall naturally under a national system.   The purchasing power becomes substantial and the distribution can be made with an efficient on-demand system.  

Meanwhile work can proceed on delivery systems.   It makes sense (to me) to have a stratified system where there are layers of care.   The lower layers staffed by PAs and RNs (and LPNs) can handle the more routine care like is done in other nations.   Broken arms, minor stitches, flu, pink-eye, etc. can be handled efficiently and with reasonable cost.   Centers for these more routines items are easily distributed and we see similar capabilities with the 'Urgent Care' type businesses that have emerged over the last decade.   Devising these layers is a smart way to allocate resources and deal with low hanging fruit while the higher layers deal with the more complex (and more expensive) medical care.

Then we have the general management / sharing of medical personnel.   We can maintain a national database of skills, locations, availability, etc. to use as a basis for myriad programs designed to get the right care to the right people and to enable medical personnel more freedom of location and specialization.

This and more can all be done upfront.   It is building a technical and logistics infrastructure that would be the backbone of a national system delivered by a regulated private sector.

Much more to talk about, but in terms of where do we start, I would say the above.

 
 
 
sandy-2021492
Professor Expert
2.1.4  sandy-2021492  replied to  TᵢG @2.1.3    2 months ago
Then we have the general management / sharing of medical personnel.   We can maintain a national database of skills, locations, availability, etc. to use as a basis for myriad programs designed to get the right care to the right people and to enable medical personnel more freedom of location and specialization.

I think the private sector is doing a fairly good job of this with travel medical personnel.  My sis works as a PA for a company that hires both mid-level providers and MDs, and sends them where they're needed, with an eye to their specialized area of practice.  She prefers to work in gastroenterology, so she is regularly dispatched to GI offices nationwide, for either short-term or long-term assignments.

They're pretty good at the logistics of getting people where they're needed, too.  They do a lot of the legwork of finding her a place to live, and work with the offices where she's assigned to help her settle into the community easily.  Things like finding the most popular grocery stores and restaurants, leisure activities, and so forth.  If their providers have pets, they look for pet-friendly apartments.  If they have family that can't or doesn't want to move to the assignment, they try to arrange a schedule that allows for frequent visits, like alternating weeks on and weeks off.

Licensure in some states can be a bitch, though.  Some states have a lot of red tape, and employees who slow-walk licensure for new providers.  Some use antiquated record-keeping, like requring ink fingerprinting (digital not accepted, looking at you, New Mexico) for ID and background checks.  In Indiana, her application for licensure sat on the desk of an employee who was on long-term leave for some reason or other, with no arrangements made to cover that job.  This should be the easiest thing for government to fix, considering that government is the only entity with power over licensure.

 
 
 
Ozzwald
Professor Quiet
2.1.5  Ozzwald  replied to  Snuffy @2.1.2    2 months ago
So how about providing some sort of ideas on how the country could move to such a system.

Step 1 would be offering a public option for health insurance.  Let the general public opt in to Medicare at the going cost + 10%.  This would provide health insurance and a much lower cost than private insurance and give the government time to grow the administrative side to support the new customers.

This would accomplish two major things.  It would force private insurance to compete by lowering their prices to a more acceptable level, and either show that more steps are necessary or show that this has accomplished affordable healthcare and no further steps are necessary. 

 
 
 
Snuffy
Professor Participates
2.1.6  Snuffy  replied to  TᵢG @2.1.3    2 months ago
I would say that the very first step is to standardize.   Pick a national ID (social security number of something else) that serves as the unique identifier for authorized medical professional to access medical records across the nation.   Then develop a standard protocol that enables the various medical systems to literally access these records as if they were local.   This is standard techy stuff nowadays but still is not-trivial when dealing with the myriad disparate systems, security, etc.

Doable. Medicare (for those on Medicare, we already know) does have a national ID system, our individual medicare ID number can be used anywhere in the US by healthcare providers so this sort of system already exists. The bigger issue is health care records. Several years back there was all sorts of excitement about a national system for health care records using block-chain technology but that never materialized. Whatever is built up for this needs to be very secure and robust to protect those records. Would probably require some modification to HIPPA laws as well. Again, can be done but tough. Would probably require the federal government to set up and to be honest I don't really trust them to see and protect all the issues before hand as they really don't have a good track record.

Also upfront, establish a mechanism for sharing medical equipment and to acquire/retire same.   Medical equipment such as MRIs are expensive.   A sharing system allows the leading edge facilities to retire old equipment when they upgrade and make said equipment available for others to use.   Much like a library, resource sharing provides great economies of scale and enables more effective use of equipment.  

Less unsure how this would work. Medical equipment like you said is very expensive so private businesses (and lets face it, hospitals and the like regardless of their tax status are private businesses) would need to be reimbursed in order to place the equipment into such a system. That would be very expensive to set up. And there is the cost for operations as well as maintenance. Again doable, but would require negotiations between a lot of areas,

In addition, the groundwork for prescription drugs would fall naturally under a national system.   The purchasing power becomes substantial and the distribution can be made with an efficient on-demand system.  

Would love to see this but I think you would first need to get the politics out of the way. Politicians are the worst enemy in this due to the money spent by lobbyists who work to maintain their share of the pie.

Then we have the general management / sharing of medical personnel.   We can maintain a national database of skills, locations, availability, etc. to use as a basis for myriad programs designed to get the right care to the right people and to enable medical personnel more freedom of location and specialization.

This is the biggest expense in the system as these people spend a lot of money to get the training so they can be in those skill positions and they spend years paying off that debt. They have built their lives around that money. I worked for the largest health insurance company in the US and we saw one issue around this back when the medicare-for-all model was being pushed hard in Washington. A lot of providers (doctors, nurses, etc) stated that they would just retire / quit rather than accept the money that Medicare allowed as they could not afford to cover their bills. During the Covid emergency when hospitals stopped all elective care, the only money coming in was Medicare levels for treatment of the Covid cases and we had many rural hospitals close their doors as the money coming in was not sufficient to meet their bills. There were also many nurses who were laid off as hospitals closed entire floors. 

Looking at how other countries handle this. England's National Health Care System has doctors and nurses who are employees of the crown and are paid accordingly, but their training is covered by the crown as well. Canada allows the doctors to work private practice as the salaries offered for the doctors in the system is rather low. But they also know up front how this works, getting the doctors and nurses in the US to change to such a system would be a hard sell.

Meanwhile work can proceed on delivery systems.   It makes sense (to me) to have a stratified system where there are layers of care.   The lower layers staffed by PAs and RNs (and LPNs) can handle the more routine care like is done in other nations.   Broken arms, minor stitches, flu, pink-eye, etc. can be handled efficiently and with reasonable cost.   Centers for these more routines items are easily distributed and we see similar capabilities with the 'Urgent Care' type businesses that have emerged over the last decade.   Devising these layers is a smart way to allocate resources and deal with low hanging fruit while the higher layers deal with the more complex (and more expensive) medical care.

IMO this is one area where a Medicare-for-all system would help the best in controlling costs. Emergency rooms across the country are flooded with those without any healthcare insurance for all sorts of minor issues. If they could be treated at an urgent care center, costs could much better controlled. Perhaps if hospitals could be set up to better triage issues in the ER and shunt these types of cases to an on-site urgent care facility which would also help to control costs. But I think we also need to get Washington to work on tort laws as it's way too easy to sue a facility for "perceived" bad care. I know only too well, I had an issue with a minor medical issue years ago (infection) and the first questions they asked me was if I was considering legal actions rather than getting me antibiotics for the infection. It's crazy but tort laws must be worked on for this to happen.

There's much more that needs to be looked at for this to happen. IMO it will require a lot of bravery out of our leaders in Washington as there will be tremendous outcry over any such action. Medicine is a multi-billion dollar industry and any changes to that will have to overcome a lot of resistance. I remember the outcry over the change from ICD-9 to ICD-10 codes and that was really very simple compared to this.

 
 
 
Snuffy
Professor Participates
2.1.7  Snuffy  replied to  sandy-2021492 @2.1.4    2 months ago
I think the private sector is doing a fairly good job of this with travel medical personnel. 

Traveling Nurses is also very expensive, don't know that the federal government could compete with the money offered. My daughter did it for a while, loved seeing new areas of the country at no expense for herself. But anybody who's worked as a consultant can tell you it's not for everybody. We seem to be driven to have a "home" and uprooting yourself every few months to move to a new city can be difficult for a lot of people to handle. Perhaps a system where they are assigned in an area. That would work in the larger cities, not so much in rural areas. But that's also an issue with the lack of healthcare facilities in rural areas. There are too many reports where hospitals closed their doors leaving patients having to travel up to 100 miles to get to the next closest facility. 

It's an idea but I think it would require more work out of our "leaders" in Washington. 

 
 
 
TᵢG
Professor Principal
2.1.8  TᵢG  replied to  Snuffy @2.1.6    2 months ago

In general, at the highest level, an effective system IMO would be one that imposes a standard infrastructure and thus enables the economies of scale of sharing coupled with local optimization.   Local optimization means that there are freedoms to adjust processes (sticking with the standards and guidelines) at each level.   Thus, as a simple example, we have national standardization.   But we may have different processes in different geographical regions based upon supply chain factors, climate, differing medical needs, population, etc.   At the next level, states can impose different processes for their particular needs.    All the way down to townships (especially rural).

National standardization and economies of scale coupled with the ability to dynamically optimize processes so that they best conform to and support the particular needs of a domain.

This is an abstract notion that, if it were me, would be the core blueprint for a national healthcare system which involves both public and private sectors working together in areas where they are best suited.

 
 
 
Snuffy
Professor Participates
2.1.9  Snuffy  replied to  Ozzwald @2.1.5    2 months ago
Step 1 would be offering a public option for health insurance.  Let the general public opt in to Medicare at the going cost + 10%.  This would provide health insurance and a much lower cost than private insurance and give the government time to grow the administrative side to support the new customers.

That's an interesting thought. I don't know that the government has every calculated a "monthly premium" for part A & B, are you aware of any such estimates? We know what the Part B premium is, but that's only what we pay and is not the total cost per person. 

We know in 2021 the total Medicare benefits paid out was $829 Billion.  In 2023 the total number of people receiving Medicare benefits was 65,748,297. To that works out to $12,609 in benefits paid per person. So just to break even that would work out to a monthly premium of $1050 per person. And that's only for parts A and B which only cover 80% of costs.

That's not a dollar amount that's going to work for people who currently don't have any health insurance. So we'll need to raise taxes to help cover that cost. I'm not against that. Don't know if you remember, a while back I proposed some simple changes to help Social Security due to it's shortfall in money. I believe we could do the same here. The current Medicare tax rate is 1.45%. If we were to double that to 3%, the impact to most working people would be minimal and would bring a lot more money into the system to offset the costs of adding the 26 million people in the US who currently do not have health insurance. I didn't do any real math to determine if 3% would cover all of it, and I don't know what the premiums would need to be set at to cover the people but still not bankrupt the system. But I think this is a starting point for discussion.

And FYI, the government does not administrate billing on Medicare. All they do is set payment amounts for procedures (ICD-10) and use private companies to manage the billing. I worked in the largest health insurance company in the US for 22 years, all of it in the Medicaid billing section. We worked hand in hand with the Medicare group and all had the same processes. It was simply the number of claims daily that had the two groups separate. The federal government (and state governments for Medicaid) allowed for a 2% profit to the company for their work. It's doable but costs must be carefully managed and I doubt that the federal government could do it better.

I still think the biggest roadblock to this will be Washington. There's too much money paid by lobbyists to congressmen and Congress IMO doesn't have enough members with the bravery to work for the American people for something like this.

 
 
 
Snuffy
Professor Participates
2.1.10  Snuffy  replied to  TᵢG @2.1.8    2 months ago

This is gonna require more than just 2 cups of coffee to wrap my brain around. I can kind of see it but can also see a lot of problem around jealousy from various regions as well as the usual government overreach. I think for this to be an effective blueprint, we would definitely need people to bring their 'better angels' and not the normal crap that people usually bring. 

Yeah, definitely more coffee... 

 
 
 
TᵢG
Professor Principal
2.1.11  TᵢG  replied to  Snuffy @2.1.10    2 months ago

I fully agree that any solution will be challenged by the flaws of human nature.   Politics will certainly mess with it.   And thus another key factor in the design and implementation of such a system is to mitigate politics ... we might want to turn to the checks & balances concepts of our constitution for ideas.

 
 
 
sandy-2021492
Professor Expert
2.1.12  sandy-2021492  replied to  Snuffy @2.1.7    2 months ago

Yes, I have a patient who is a travelling nurse.  She makes enough in a few months to take the rest of the year off.  I think she's currently in South America for travel, not work, for quite a while.

I guess my thought is that these companies could put their expertise to use in recruiting longer-term providers.  Help people find jobs, help hospitals find employees, and help those providers be happy in place by doing some of the relocation work that they likely don't have time to do themselves. 

 
 
 
Greg Jones
Professor Participates
2.1.13  Greg Jones  replied to  TᵢG @2.1.3    2 months ago

What you're essentially saying, is that you support socialized medicine....healthcare managed and run by the "government". How long before the rationing and cost cutting begin, or decisions made by nameless, faceless bureaucrats in windowless rooms as to whether you need such and such a treatment or procedure. How many weeks or months to get office visit, or even longer to see a specialist! 

 
 
 
TᵢG
Professor Principal
2.1.14  TᵢG  replied to  Greg Jones @2.1.13    2 months ago
What you're essentially saying, is that you support socialized medicine....

You clearly did not read what I wrote.   Since my comment is still there, go ahead and actually read it.   Read it carefully.

 
 
 
JohnRussell
Professor Principal
2.1.15  JohnRussell  replied to  sandy-2021492 @2.1.12    2 months ago

I have a niece who is a traveling nurse. So far she has worked in Austin, San Diego , Los Angeles, San Francisco and Boston. Three months at a time. The money is better.   This summer she took a job at a hospital in Hyannis Port Ma. 

She turned 30 this year and met a guy in Boston so she may be ready to settle down.  She loves traveling though and in the first couple years between college and nursing school she lived in Madrid Spain for two years teaching English to children. She has visited over 20 countries in Europe and North Africa, including Iceland.  I have to say I envy her a little , even though even though I have never felt a great urge to travel like that. 

 
 
 
Snuffy
Professor Participates
2.1.16  Snuffy  replied to  Greg Jones @2.1.13    2 months ago

Actually, Ozzwald was the only one who was talking for it. The rest of the discussion was about ways it could be implemented. While TiG and I do have our differences, nowhere in our discussion was support for the idea. It was just how it could possibly be set up and what issues can arise. And that was just touching the surface as there are a lot of issues around how it could work.

I don't know about you but are you retired and on Medicare? A lot of us are on Medicare and that system is set up very similar to socialized medicine. Advantage plans even more so. God, I would not recommend an Advantage plan to anybody. They have way too many issues that are going to get worse in the next few years.

There's nothing wrong with socialized medicine. Where it tends to go wrong is when people get involved cuz you know, people.

 
 
 
Snuffy
Professor Participates
2.1.17  Snuffy  replied to  JohnRussell @2.1.15    2 months ago

Yeah, my daughter did the traveling nurse gig for a few years. She loved it, spending three months in different areas of the country. Then she also decided it was time to get married and settle down. But she sure enjoyed her time. It was very different then how my computer consulting gigs were as she would go to an area, they would set up housing and she would stay in that area for the three months. When I was consulting, I would fly out on Sunday to be ready for Monday morning and fly back home either Thursday or Friday to enjoy a weekend with the family. I did that for a few years but living out of a suitcase just isn't a fun gig for me.

 
 
 
sandy-2021492
Professor Expert
2.1.18  sandy-2021492  replied to  JohnRussell @2.1.15    2 months ago

My sis has worked in Indiana, New Mexico, and Wisconsin.  The NM and WI assignments were supposed to be short term, but kept getting extended.  She flatly refuses to return to the hospital where she worked in Indiana, and will only go back to the one in Wisconsin if they find her different accommodations.  Every hospital to which she's been assigned has offered her a permanent position, but she has turned them all down for one reason or another.

She is currently taking some time off to be treated for breast cancer, and will return to NM in September.  She was able to save enough money as a travel PA that she could take a leave of absence, pay her COBRA payments, and live with our parents for a few months.  She sold her house, since she wasn't there very often and her renters moved out, so she has that money to live on, too, if she has to.  She hasn't had to.

 
 
 
Ozzwald
Professor Quiet
2.1.19  Ozzwald  replied to  Snuffy @2.1.9    2 months ago
I don't know that the government has every calculated a "monthly premium" for part A & B, are you aware of any such estimates?

Now why would they even bother coming up with such estimates when there is nobody even trying to push the policy currently?

So just to break even that would work out to a monthly premium of $1050 per person.

Did you read the part where I said cost + 10%?  You seem to have missed that.

And it is not that I am questioning your math skills or anything, but.......

The cost of a public healthcare option, such as a government-backed health insurance plan, can vary. For example, in 2022, a public option plan in one state had premiums of around $400 per month before subsidies. 

New health care study: public option would generate more benefits, savings than projected

4 Myths About the Public Option

 
 
 
Ozzwald
Professor Quiet
2.1.20  Ozzwald  replied to  Greg Jones @2.1.13    2 months ago
What you're essentially saying, is that you support socialized medicine

Are you opposed to the government controlling your healthcare decisions?

 
 
 
sandy-2021492
Professor Expert
2.1.21  sandy-2021492  replied to  TᵢG @2.1.3    2 months ago
Then develop a standard protocol that enables the various medical systems to literally access these records as if they were local.   This is standard techy stuff nowadays but still is not-trivial when dealing with the myriad disparate systems, security,

From what I hear from providers, and what I've seen as a patient, electronic medical records software is a mess.  Too clicky, too hard to get to information that should be prominent on a patient's record (like allergies, for example), too hard to share with other providers.  When my son had his appendix out years ago, our PCP only got the last page of the report.  When he was in for his physical, she asked if there were any changes since last year.  I told her about the appendectomy, and she looked for reports sent from the hospital.  All she could find were his dishcarge instructions - no report as to why he wasn't allowed to lift more than 10 pounds.

Every doctor, nurse, PA, and NP I've met has complained about how clunky EMR software is.  Too many clicks to get to needed information, too hard to write a narrative when something doesn't fit the progam's templates for notes.  Too hard to access info from other hospitals, even when they use the same software.  Too much time spent typing instead of providing patient care.

The standard techy stuff isn't nearly standard enough between institutions, and needs improvement.  I don't know how much input providers have when this software is developed, but it doesn't seem to be enough.

 
 
 
TᵢG
Professor Principal
2.1.22  TᵢG  replied to  sandy-2021492 @2.1.21    2 months ago

The natural order is disorder.

I have no doubt that our national system (looking at all of our systems in aggregate) is a mess.   Which is why I suggested that we could start (immediately really) devising a scheme for standardization.   This is basic IT work at this point and all sorts of talented people are available to work with medical professionals, healthcare provider businesses, etc. to formulate a sensible architecture for a national infrastructure.

 
 
 
Snuffy
Professor Participates
2.1.23  Snuffy  replied to  Ozzwald @2.1.19    2 months ago
I don't know that the government has every calculated a "monthly premium" for part A & B, are you aware of any such estimates?
Now why would they even bother coming up with such estimates when there is nobody even trying to push the policy currently?
So just to break even that would work out to a monthly premium of $1050 per person.

Did you read the part where I said cost + 10%?  You seem to have missed that.

And it is not that I am questioning your math skills or anything, but.......

I was trying to continue an actual conversation, seems that's not very likely.

The cost of a public healthcare option, such as a government-backed health insurance plan, can vary. For example, in 2022, a public option plan in one state had premiums of around $400 per month before subsidies. 

But to determine how the government can back health insurance premiums for all non-insurred, they do need to have an idea what the costs will be. We cannot just continue to borrow more money to do so. Again, was trying to get an actual conversation.

 
 
 
Ozzwald
Professor Quiet
2.1.24  Ozzwald  replied to  Snuffy @2.1.23    2 months ago
I was trying to continue an actual conversation, seems that's not very likely.

You pulled some numbers out of the air (or some body part), and wanted to continue the conversation with those?  It wouldn't have been an honest conversation then would it?

 
 
 
Thomas
Masters Guide
2.1.25  Thomas  replied to  Snuffy @2.1.6    2 months ago
There's much more that needs to be looked at for this to happen. IMO it will require a lot of bravery out of our leaders in Washington as there will be tremendous outcry over any such action. Medicine is a multi-billion dollar industry and any changes to that will have to overcome a lot of resistance.

Bravery out of our leaders? Eesh. I am not going to hold my breath.

 
 
 
Snuffy
Professor Participates
2.1.26  Snuffy  replied to  Ozzwald @2.1.24    2 months ago

The numbers are easily searchable via Google. You just have a nice day. As you don't seem to want a conversation, I'll just ignore you moving forward.

 
 
 
Snuffy
Professor Participates
2.1.27  Snuffy  replied to  Thomas @2.1.25    2 months ago
Bravery out of our leaders? Eesh. I am not going to hold my breath.

Yeah, me neither. There was IMO a good article on Fox News this morning just about this. Wasn't the normal partisan ranting, but an article about how leadership should take responsibility and own up when they make a mistake. But for too many years now, it's been normal to just blame the other side for issues rather than admit they made a mistake. Does not bode will for the continuation of our Republic.

In 1958, the National Election Study began surveying   Americans' trust in government , revealing that approximately 75% believed the federal government would do the right thing almost always or most of the time. However, according to Pew Research in 2023, this trust has plummeted to a seven-decade low of merely 16%. 

Alarmingly, only 2% of Americans now believe that the government consistently acts correctly, and confidence in elected officials continues to erode. The primary reason for this decline is clear: our government leaders   no longer take responsibility   for their decisions.

True leadership   is challenging and often solitary. It requires making tough decisions and, more importantly, acknowledging both successes and failures. Unfortunately, our politicians no longer engage in this level of honesty, contributing significantly to the diminishing trust in the federal government. People understand that no one can be right all the time… we are only human.

During this election season, you will also witness both sides of the political spectrum engaging in the blame game. Whether through television soundbites, newspaper columns or social media, it is common to see one side blaming the other for current issues, including the economy, immigration, crime, abortion or climate change.

When   leaders resort to blaming others , it sets a precedent that if we cannot solve our problems, we are justified in blaming someone else for the difficulties or inaction. 

In any leadership role, be it in corporate America or a family-run business,  making wrong choices is inevitable . However, confidence is instilled by leader.s who can persist in their vision despite setbacks. 

It's time for our leaders to rebuild our trust, starting with three simple words: "I was wrong." 

Why don’t we trust the government anymore? | Fox News

We're all human and we all make mistakes. But when leadership is more interested in blaming the other side than admitting to their own failures we all suffer. 

 
 
 
Drinker of the Wry
Senior Expert
2.1.28  Drinker of the Wry  replied to  TᵢG @2.1.22    2 months ago

I don't know what MyCharts is like from a provider's perspective,  but from this patients' view it is a great tool.  I have all of my records, appointments, test and visit results and multiple  healthcare providers in one place.  It is easily accessible and useable.  When I was in the military, I had to hand carry a growing stack of paperwork with every move.

 
 
 
Ozzwald
Professor Quiet
2.1.29  Ozzwald  replied to  Snuffy @2.1.26    2 months ago
The numbers are easily searchable via Google.

Yet, you decided not to include any links to their source?  Very questionable, which is why I question them.  You may have noticed that I did include links to show where I got my information.

 
 
 
Thomas
Masters Guide
2.1.30  Thomas  replied to  Snuffy @2.1.27    2 months ago

We're all human and we all make mistakes. But when leadership is more interested in blaming the other side than admitting to their own failures we all suffer. 

Even the tacit admission of,"Well, that didn't work like we thought," would be refreshing. 

In this country I feel the need for renewal of dialog, actual talking, between the supposedly "different" camps of people. Reduce the hyperbole to somewhere around zero and have discussions instead of flaming wars of words. This level of discourse will not be achieved if we continue to elect leaders based on how much they are going to raze the opposition.  

 
 
 
evilone
Professor Guide
3  evilone    2 months ago

This crops up all the time, but it's not going to happen. At least it wouldn't be something that would happen in a 4 year term. There would have to be a large majority consensus (there isn't one) and a generational phase shift to the new system. There are enough issues with Medicare as it is, expanding that without addressing the deficiencies will only make things worse. This year's Medicare Annual Enrollment Period is going to be nuts with all the Part D changes the Dems forced though already. 

 
 
 
Vic Eldred
Professor Principal
3.1  seeder  Vic Eldred  replied to  evilone @3    2 months ago

You said quite a bit there.

At least we know where Kamala's heart is.

 
 
 
evilone
Professor Guide
3.1.1  evilone  replied to  Vic Eldred @3.1    2 months ago

Making overbroad platform statements is what politicians do. It's like Trump saying he'd do a mass round up and deportation of undocumented immigrants. These things sound good to people who are more impressed with Duck Dynasty and Real Housewives than policy, but the nuts and bolts of these things is often unworkable.

 
 
 
Vic Eldred
Professor Principal
3.1.2  seeder  Vic Eldred  replied to  evilone @3.1.1    2 months ago
Making overbroad platform statements is what politicians do.

That's a new angle.

Last night we heard that she was simply compassionate about poor students.

 
 
 
evilone
Professor Guide
3.1.3  evilone  replied to  Vic Eldred @3.1.2    2 months ago
That's a new angle.

Really? 

Last night we heard that she was simply compassionate about poor students.

We all should be. 

 
 
 
Sean Treacy
Professor Principal
4  Sean Treacy    2 months ago

Let's massively raise taxes on everyone and receive  shittier care!  YAY

 
 
 
Vic Eldred
Professor Principal
4.1  seeder  Vic Eldred  replied to  Sean Treacy @4    2 months ago

It is really an affliction that some come down with in college.

That is the place where both teacher & student fantasizes about being the planners in a planned economy.

 
 
 
Dismayed Patriot
Professor Quiet
4.2  Dismayed Patriot  replied to  Sean Treacy @4    2 months ago
Let's massively raise taxes on everyone and receive  shittier care!

Let's create a bullshit narrative and whine and cry about it for weeks and months hoping no one notices we're full of shit!

 
 
 
George
Junior Expert
4.2.1  George  replied to  Dismayed Patriot @4.2    2 months ago

You summed up the TDS crowd perfectly! Well done!

 
 
 
Thomas
Masters Guide
4.2.2  Thomas  replied to  George @4.2.1    2 months ago

Nice to see you are finally admitting it. 

Remember, acceptance of reality is the first step towards healing! 

Congratulations! Good luck on your journey.

 
 
 
JBB
Professor Principal
5  JBB    2 months ago

Medicare Supplement Policies are private insurance...

 
 
 
Dismayed Patriot
Professor Quiet
5.1  Dismayed Patriot  replied to  JBB @5    2 months ago

Shhhh! Don't go ruining their false narrative, it's all these sad conservative sycophants have left!

Also, it sure seems like an awful lot of Trump supporters are freaking out about Biden dropping out, almost as if they're not all that confident the lump of gold painted poo they nominated can win without Biden being its opponent.

 
 
 
Sean Treacy
Professor Principal
5.1.1  Sean Treacy  replied to  Dismayed Patriot @5.1    2 months ago
Shhhh! Don't go ruining their false narrative

Shhh! Harris wasn't proposing Medicare supplemental policies for all. 

 
 
 
Dismayed Patriot
Professor Quiet
5.1.2  Dismayed Patriot  replied to  Sean Treacy @5.1.1    2 months ago
Harris wasn't proposing Medicare supplemental policies for all.

That's the point. What was proposed in 2019 was "Medicare for all" which is NOT a comprehensive health insurance policy that covers all medical costs which is why there is a full range of Medicare Supplement policies that Americans purchase through private insurers to cover additional expenses and fill the gaps in the bare bones Medicare that is provided by the government for seniors. I work for an insurer that sells Medicare supplement policies and there are at least 10 different supplement plan options ranging from very minimal at a low cost to very comprehensive at a high cost. That's capitalism, not socialism, but no one would know that by the way conservatives constantly try and falsely frame the debate which could mean they're just misinformed or they're intentionally lying because they know the truth doesn't fit in their attack narrative.

 
 
 
evilone
Professor Guide
5.1.3  evilone  replied to  Dismayed Patriot @5.1.2    2 months ago
I work for an insurer that sells Medicare supplement policies...

As do I. They are freaking out over PDPs for this upcoming AEP that are changing because of the Inflation Reduction Act. Carriers will be raising rates and dropping drugs off the formularies next year.

 
 
 
Drinker of the Wry
Senior Expert
5.2  Drinker of the Wry  replied to  JBB @5    2 months ago

Heavily subsidized by the government.

 
 
 
JohnRussell
Professor Principal
6  JohnRussell    2 months ago

Owning an assault rifle is a "god given right" but health care is not. 

I think Jesus is sad. 

 
 
 
JohnRussell
Professor Principal
7  JohnRussell    2 months ago

I was going to wonder why we are looking at a five year old article, but what is the point ? 

 
 
 
devangelical
Professor Principal
7.1  devangelical  replied to  JohnRussell @7    2 months ago

trumpsters will be reaching back decades for kamala shit to throw, when all she just has to do is remind voters of all the shit trump pumps out of his mouth from yesterday...

 
 
 
Snuffy
Professor Participates
7.2  Snuffy  replied to  JohnRussell @7    2 months ago

Maybe because it was only since she started her campaign for President that they have been cleaning up all the old bullshit she tossed around. Until 11 days ago, as far as we can research, she was still in favor of Medicare for All.

 
 
 
TᵢG
Professor Principal
8  TᵢG    2 months ago

The details matter, but the USA should look for ways to improve our system.   For years I have been in favor of a system that is standardized and enjoys economies of scale but uses a regulated private sector for delivery.   The role of government is oversight, regulation and standardization.   While I am not at all comfortable that our government is capable of doing that with today's clowns in Congress, that is logically (to me) the right way to go.   It uses government in its proper role and uses the private sector in its proper role (playing to each of their strengths).

The problem of covering costs (and gaining approval) remains.   The motivation for the funding source is always to keep costs low and that always means being restrictive in coverage.    I would love to consider clever ways of maintaining a balance so that frivolous and unnecessary costs are mitigated while providimg good coverage for all who really need it.   A very difficult problem to solve.

Private insurers in any industry, healthcare, real estate, etc. are beyond frustrating.   They wear people down to drive them to give up trying to get claims covered.   There are better systems and I am confident the USA is quite capable of devising one that is particular to our needs and works better than what we have today.   But I have no confidence that our current Congress has the will or the ability to lead the development of such a program.   

Hopefully they can prove me wrong.

 
 
 
devangelical
Professor Principal
8.1  devangelical  replied to  TᵢG @8    2 months ago

I wouldn't expect much in the terms of progress from most of congress when their main priorities are grandstanding, stuffing lobbyist cash into both pockets, and getting re-elected to highly paid no work jobs...

 
 
 
Hal A. Lujah
Professor Guide
9  Hal A. Lujah    2 months ago

The American healthcare system doesn’t lend itself to human empathy.  The fox will always be guarding the henhouse, and the prospect of death will always be used as profiteering leverage.

 
 

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