Politics Thread

Xville · 08-02-2018, 08:35 PM

Originally Posted by boozehound

Medicare is in the Red in a large part because we have basically enacted a single payer system that kicks in when people hit 65 without any offsetting premiums from younger, healthier, people (outside of the Medicare tax, which is relatively minimal at 1.45%). That's not how risk pools work. It's fundamentally unsound mathematically. That's not an opinion - it's a verifiable fact. Even in cases where people have retiree healthcare benefits from a large corporation those benefits typically subordinate to Medicare, further adding to the cost.

Explain to me using facts, not talking points, how the concept of pooled risk somehow only applies in a private free market system. That is an insane thing to say.

Furthermore - in a version of a 'Medicare for all' type of scenario, let's look at the average American family:

The average American family makes $56K per year. They pay a 1.45% Medicare payroll tax which is $812 per year. Let's assume that they carry health insurance for the family at a cost of $600 per month (which is probably on the low side of average for decent coverage). They are paying $7200 per year in insurance premiums, not including the ubiquitous co-pays and deductibles. So they are paying 12.5% of their income for insurance. You could raise taxes, or simply charge a premium for single-payer healthcare, that would generate a significant amount of the revenue needed to fund it. I'm not even sure how much deficit expansion would be necessary, if any at all. If we want to talk about deficit reduction let's talk about military spending, and reducing some of that while spending more on healthcare and infrastructure.

It's also pretty universally regarded that preventative care reduces costs overall, which single payer would theoretically encourage.

This is generally how I feel - we can't simply just remove the profit motive from healthcare. It should still exist. I would, however, like to remove the profit the insurance companies (middlemen) make from the equation and use that savings to offset overall healthcare costs. Doctors, hospitals, and drug companies should still be profitable, and significantly so. The other challenge with comparing our outcomes to a lot of European countries is that we are so much unhealthier than they are, which has to have an impact on outcomes.

You are forgetting the fact that your job pays a significant portion of your premium, that won't be the case in single payer....better increase that percentage...by a lot.

In regards to the pool statement, we shall see...I'm skeptical when its controlled by one entity.

Strange Brew · 08-02-2018, 08:37 PM

Originally Posted by Xville

You think a 40 trillion deficit in funding is a red herring? That's interesting...guess the money will just fall from the money tree to fund it.

Here in Colorado people were all for govt run Colocare until they realized it would require an additional 10% increase in the state income tax. That’s a big price and it failed miserably at the ballot box. Marxist policies sound great until the bill comes and it is spread equally (not really, high earners still pay more in nominal terms) among the persons.

**X-man** · 08-03-2018, 06:26 AM

Originally Posted by Xville

You are forgetting the fact that your job pays a significant portion of your premium, that won't be the case in single payer....better increase that percentage...by a lot.

In regards to the pool statement, we shall see...I'm skeptical when its controlled by one entity.

I'm trying to understand here. Does the fact that "your job pays" mean that the insurance or healthcare covered has no cost? In addition if you understood how elasticities affect cost shares (for taxes, health insurance, etc.) in the labor market works, you would never confuse statutory cost shares with actual cost shares. But more to the point: when you add up the total cost (regardless of who is paying it) of healthcare and health insurance, it is higher in the US on a per capita basis than it is in other countries with single payer systems. End of story.

**boozehound** · 08-03-2018, 06:47 AM

Originally Posted by Xville

You are forgetting the fact that your job pays a significant portion of your premium, that won't be the case in single payer....better increase that percentage...by a lot.

In regards to the pool statement, we shall see...I'm skeptical when its controlled by one entity.

Somebody is still paying it, it's not free money. Imagine the burden that the small business owner bears in terms of healthcare costs? Do you know any small business owners that provide insurance for their employees? It's very difficult to do, and generally you are one major medical event for one of your employees away from not being able to provide insurance. It is a significant built-in disadvantage for small business in terms of both profit and the labor market.

I'm not sure that we ever will 'see' even though the majority of Americans at this point support some form of single payer. The insurance industry is massive and spends a tremendous amount of money lobbying to ensure that it doesn't happen.

Originally Posted by X-man

I'm trying to understand here. Does the fact that "your job pays" mean that the insurance or healthcare covered has no cost? In addition if you understood how elasticities affect cost shares (for taxes, health insurance, etc.) in the labor market works, you would never confuse statutory cost shares with actual cost shares. But more to the point: when you add up the total cost (regardless of who is paying it) of healthcare and health insurance, it is higher in the US on a per capita basis than it is in other countries with single payer systems. End of story.

Yes. Somebody is paying. If you add the employer subsidy in to the mix I (and my employer on my behalf) am paying closer to $1400 per month, or $16,800 per year. That is a LOT of money to the average American family making ~$56K per year.

Xville · 08-03-2018, 06:54 AM

Originally Posted by X-man

I'm trying to understand here. Does the fact that "your job pays" mean that the insurance or healthcare covered has no cost? In addition if you understood how elasticities affect cost shares (for taxes, health insurance, etc.) in the labor market works, you would never confuse statutory cost shares with actual cost shares. But more to the point: when you add up the total cost (regardless of who is paying it) of healthcare and health insurance, it is higher in the US on a per capita basis than it is in other countries with single payer systems. End of story.

My point was that in single payer, your job isnt going to cover half or heck I have been offered some jobs recently where my medical, dental would be covered 100%. That wont happen in single payer...you will be fully responsible for it thru taxes or otherwise.

Boozehound was saying avg American pays 12.5% of income, my contention is that it could be more than that in single payer due to job not paying for a portion of it etc. No one knows this one way or the other until it's actually enacted.

Your last statement...yeah I'm not arguing that and never did but way to put the hammer down with your "end of story." My contention is that just because it works in other countries doesnt mean it would work here..period end of story.

Xville · 08-03-2018, 06:58 AM

Originally Posted by boozehound

Somebody is still paying it, it's not free money. Imagine the burden that the small business owner bears in terms of healthcare costs? Do you know any small business owners that provide insurance for their employees? It's very difficult to do, and generally you are one major medical event for one of your employees away from not being able to provide insurance. It is a significant built-in disadvantage for small business in terms of both profit and the labor market.

I'm not sure that we ever will 'see' even though the majority of Americans at this point support some form of single payer. The insurance industry is massive and spends a tremendous amount of money lobbying to ensure that it doesn't happen.

Yes. Somebody is paying. If you add the employer subsidy in to the mix I (and my employer on my behalf) am paying closer to $1400 per month, or $16,800 per year. That is a LOT of money to the average American family making ~$56K per year.

I agree with most of this. My father is a small business owner and has been for 30+ years and is a veterinarian so you can imagine the insurance he pays not only to his employees but jaut to practice medicine. I do think the whole notion of a job paying for half of insurance was just an attempt to put a band aid on something. We do that a crap ton in our country, just like tuition reimbursement companies are now paying for again.

I'm not against single payer necessarily, I'm just not convinced that it would work here or cost less just because it works in Iceland.

**paulxu** · 08-03-2018, 07:47 AM

Originally Posted by Xville

My point was that in single payer, your job isnt going to cover half or heck I have been offered some jobs recently where my medical, dental would be covered 100%. That wont happen in single payer...you will be fully responsible for it thru taxes or otherwise.

You need to study how universal health care works in some of the European countries. The employers very often do pay into the system on behalf of their employees. In other areas, the amount your employer pays in the US for health is in the employee's wage, so it is paid in taxes.

That's why "per capita" is so important to understand. Their health systems deliver good car to ALL their citizens, and about 1/2 the total cost of ours. For a variety of reasons, not the least of which is covering everyone provides primary care to reduce emergency room costs for uninsured who wait late for diagnosis and treatment.

**boozehound** · 08-03-2018, 07:58 AM

Originally Posted by Xville

I agree with most of this. My father is a small business owner and has been for 30+ years and is a veterinarian so you can imagine the insurance he pays not only to his employees but jaut to practice medicine. I do think the whole notion of a job paying for half of insurance was just an attempt to put a band aid on something. We do that a crap ton in our country, just like tuition reimbursement companies are now paying for again.

I'm not against single payer necessarily, I'm just not convinced that it would work here or cost less just because it works in Iceland.

Oh, I'm far from convinced that single payer will work here. The devil will be in the details and execution. I also don't think the current system really 'works', and is on an unsustainable trajectory. I think moving toward single payer is probably our least worst option.