medicare for all is nocare? better than what we have now

Post #406,655 by boxley 12/1/15 11:39:51 PM Reply	medicare for all is nocare? better than what we have now instead of putting a 3% penalty tax for people without health insurance put a 3% tax on everyone with no ceiling and let everyone have a medicare card. If you want better care than that buy additional health insurance. you can kill people for America at age 18 but need to be 21 to buy a beer
Post #406,657 by mmoffitt 12/2/15 7:38:08 AM Reply	But we don't have the votes in the Senate!
Post #406,669 by boxley 12/2/15 12:43:32 PM Reply	sometimes it takes a republican president to get social shit done, re nixon you can kill people for America at age 18 but need to be 21 to buy a beer
Post #406,665 by malraux 12/2/15 10:22:11 AM Reply	Based on other countries that have made it work We'd need to hit about 10% of GDP worth of tax, whatever that translates into as an tax on individuals. In the US right now it's considerably higher, but presumably a single payer would be able to bring that down. Regards, -scott Welcome to Rivendell, Mr. Anderson.
Post #406,667 by mmoffitt 12/2/15 11:38:39 AM Reply	But don't forget to subtract ... what we pay private health insurers now. "My" part of my health insurance premium is $500.00/month. If you'd increase my taxes $5,000.00 per year and gave me Single Payer, I'd still be better off by $1,000.00 per year. And that doesn't count the 6K per year my employer pays a private health insurance company, nor the broker they hire to "find us the best plan at the best price." Also, factor in the overwhelming advantage Medicare has in efficiency over private health insurers (along with no profit incentive) and the overall costs to society are dramatically lower with Single Payer than what we have today.
Post #406,668 by malraux 12/2/15 12:02:19 PM Reply	That does "subtract" it. If the total cost is X% of GDP, then the tax needs to hit that number irrespective of what anyone may have paid before that point. The Nordics all run around 10% of GDP with better health care, while the US is about 17%. I can definitely see a big portion of that difference coming from Medicare efficiencies, but I suspect there is also a large component of unnecessary care in there as well (both fraud and CYA). We will need to incentivize preventative care as well. Doing so isn't simply "here it is, now you can go see the doctor before it becomes a problem." There's also a large education component and changing behavior will take some time. Regards, -scott Welcome to Rivendell, Mr. Anderson.
Post #406,671 by mmoffitt 12/2/15 3:57:10 PM 12/2/15 4:18:27 PM Reply	Interesting "We need 10%" is an interesting hypothesis that holds, I think, only if you consider Norway, Sweden and Finland combined. Some Per capita GDP numbers Norway 76,266 ( x 5.10 million ~ 388,956,600,000) Sweden 48,966 ( x 9.53 million ~ 466,645,980,000) Finland 42,159 ( x 5.44 million ~ 229,344,960,000) United States 55,904 ( x 318.9 million ~ 17.8 trillion) Total GDP for those three countries combined is a little over 1 trillion. If you're right about "10% for healthcare" in those countries, then that would be 110 billion for healthcare for all three countries combined. That would translate to about 110 billion for a little over 20 million people or about 5,480 per head per year for healthcare. 10% of our GDP would yield a number slightly higher than that. But the 10% doesn't appear to hold for the countries individually. Something screwy with flat 10% mark. If they all do spend 5500 per capita, then the individual countries spend the below percentages of their total GDP: Norway 7.2% Finland 11.2% Sweden 13.0% So, are we more like Norway or Sweden? And why is healthcare twice as large a burden on GDP in Sweden as it is in Norway? Is that in fact the case? I don't know. I didn't look for actual per capita expenditures for healthcare in those countries, I only looked at GDP and population. Comparing single-payer around the world to GDP doesn't seem to be a useful method to me. Now, my math could be way off - I've been futzing around doing a lot of things and only sporadically put this post together. But if I've made a big blunder, I don't see it. Fortunately, if there is a big error, I'm confident somebody will point it out to me (maybe even rub my nose in it). ;0) Aside: It's "preventive" btw. Update: (So I got out of a meeting and looked up the healthcare costs). Finland 4,449 (10.5%) Sweden 5,680 (11.6%) Norway 9,715 (12.7%) US 9,146 (16.3%) That is something new for me. I had no idea Norway spent more per capita than we do. Curiouser and curiouser. http://www.marketwatch.com/story/10-countries-that-spend-the-most-on-health-care-2013-07-30 I know it's two years old, but Norway is listed at number 2. Edited by mmoffitt Dec. 2, 2015, 04:07:54 PM EST Edited by mmoffitt Dec. 2, 2015, 04:18:27 PM EST Expand All History
Post #406,672 by malraux 12/2/15 4:23:02 PM Reply	That is very interesting I hadn't done the actual monetary calculations either... I had just read about the %GDP previously. Norway doesn't (IIRC) have substantially different health outcomes than Finland, Sweden, or Denmark (don't forget to include them in the Scandic model). Regards, -scott Welcome to Rivendell, Mr. Anderson.
Post #406,673 by boxley 12/2/15 4:54:25 PM Reply	Also note savings could be made by using Nurse Practisioners and Physician Assistants more than now I don't need someone with years of medical school and residency to tell me when I have strep or an ear infection, just need someone who can write a scrip and notice if there is anything badly wrong that need a doc's attention you can kill people for America at age 18 but need to be 21 to buy a beer
Post #406,676 by scoenye 12/2/15 7:08:24 PM Reply	Watch what you wish for... Most of the money goes to specialists, not the GPs. Specialists already make heavy use of NPs/PAs. And there, things tend to go off the rails, at least for my data point. Every time I've run into an NP/PA, the end result was ineffective at best. That was not because the operators were incompetent, not by a long shot. It's just that the situation was outside their scope. So in the end, we ended up paying twice plus dragged things out for weeks until the MD can find a free spot.
Post #406,681 by boxley 12/2/15 10:51:08 PM Reply	true, I have heard in holland you get a nurse to birth at home, no docs involved you can kill people for America at age 18 but need to be 21 to buy a beer
Post #406,691 by mmoffitt 12/3/15 8:03:34 AM Reply	You can do that here, too, with an OB NP.
Post #406,690 by mmoffitt 12/3/15 8:03:00 AM Reply	There is a material difference between them as well. Only 10% of NP charts require MD review. 100% of PA charts require MD review. That's typically why specialists prefer PA's over NP's. They get a cha-ching for every patient a PA sees, but only 1 in 10 that an NP sees.
Post #406,694 by boxley 12/3/15 9:09:11 AM Reply	did not know that, thank you you can kill people for America at age 18 but need to be 21 to buy a beer

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