Medicare for All Would Abolish Private Insurance. ‘There’s No Precedent’
nytimes.com
nytimes.com
And I am (still) baffled that the starting viewpoint from the American side is that with single payer health care private insurance would be 'abolished' or otherwise become unavailable and/or illegal. Huh? Of course not. It's simply a base level of care given to everyone. If you have the money and desire then why wouldn't you pay for private insurance, or cash out of pocket for a private hospital?
And better yet, that private insurance will become cheaper: it can exclude the rare, chronic and expensive diseases you probably won't get. (As if you ever do, you could rely on the base single payer coverage.)
It’s amazing how many states are passing laws that are pro Medicare expansion now that it doesn’t mean supporting Obama.
On top of that, they don’t want “them” to have health insurance.
Let’s call “patriotic” what it is - racism.
Seriously?Plenty of precedent in the rest of the world ... In fact, you'll have to go looking to find western countries that don't have universal public healthcare.
An American friend told me that the US health care system will never be fixed. There is no way it can. That there are too many people with too much power getting filthy rich through it.
That's the key point. Of course there are many precedents, all over the world, and especially in all Western countries other than the US: the public and private healthcare systems happily coexist. But in the US there is so much money to be made on all components of the current complex system it's simply impossible the people involved give up without fight and agree to make it sane like everywhere else in the civilized world.
This article is about the Sanders plan, which is radical (in the non-judgmental sense). It is more generous/costly than typical non-US single-payer systems, such as Canada's. Even Medicare itself incorporates private insurance, via "Medicare Plus".
So "abolish private insurance" is actually an outlier position among the Democratic field and is not implied by a naive interpretation of "Medicare for All".
https://en.m.wikipedia.org/wiki/Kela_(Finnish_institution)
I am an expat from the U.S. living in Finland on a work permit and still qualify for Kela support.
Voluntary health insurance does exist here, e.g. employee health benefit, but plays a small role compared with the National Health Insurance.
More info:
https://www.infofinland.fi/en/living-in-finland/health/healt...
Is this common vernacular now, or is the author letting their hacker show?
The US spends around $3.6 trillion per year on healthcare now (approximately 18% of GDP). Matching with other elite, developed nation healthcare expenditures, it should be closer to $2.3 trillion. Even after accounting for the higher US wages. 10% to 12% of the economy going to healthcare should produce a system that is competitive with the top dozen systems (whether France, Canada, Britain or Switzerland).
What would cutting $1.3 trillion from the system do for the the US? It'd be a boon for unleashing an extraordinary amount of capital for productive use. Capital that's currently being vaporized as the greatest worker welfare subsidy in world history, exceeding the over-spending on the military industrial complex by a laughable sum ($200b-$250b in over-spending on military, versus $1.3 trillion in over-spending on the healthcare industrial complex).
At the center of all of the problems with US healtchare, including doing a proper socialized system, is cost. No matter the angle, no matter the argument, it's all back to the problem of how much the US spends per capita on healthcare. There is no scenario where the US can implement a universal / socialized medicine approach without dramatically cutting spending. The question is: who's going to take the hits (on higher taxes, and lost jobs / lost income). The US middle class pays very low effective income tax rates. Other developed nations tend to have far higher tax rates on their middle classes, which goes to pay for healthcare and other social safety nets. Somebody has to tell the middle class their tax rates are going to double at a minimum.
Doctors, nurses, admin, scientists, pharma reps, insurance industry employees, etc. Overwhelmingly people in the top 40% of the economic bracket. That's where that $1.3 trillion in welfare subsidies is going. Instead, it should be going toward expanding the economy, funding business formation, investing into productive companies, boosting household savings (including dramatically reducing bankruptcies), and so on. I find that nobody ever wants to talk about how so many people in the US healthcare system will need to take a huge pay cut to get our costs down to sane levels. US doctors and nurses are considerably overpaid versus other comparable nations (as one example, compare what US radiologists make versus France or Germany, it's typically two to four times higher depending on the market).
People often think the over-cost in the system is all in pharma + insurance, which isn't the case. The over-cost in pharma is about $100 to $125 billion per year, it's less than 10% of the cost problem in the US healthcare system.
Doctors at my local ER, in a rural market, charge about $1400+ per hour for their time. Step foot into that ER for any reason, and it's $500+ as a minimum charge from the hospital (doesn't count the physician fee). Doctors here commonly earn ~$300,000 to ~$500,000 depending on specialty. Roughly 11 to 17 times the median income.
That all has to be wiped out, it's entirely non-functional and non-sustainable. It's one of the great economically exploitive systems ever invented, fiercely protected by very powerful guilds.
If we make our healthcare cost effective, you can increase taxation on business (a tax to help pay for universal coverage) at zero net additional cost to the businesses versus what they're paying now to cover employees with health insurance. Each dollar directed at the healthcare system ends up going a lot further in other words.
Short term there would be considerable pain for anyone working in healthcare, unless it's phased in quite slowly. Even if it's phased in slowly, there will be massive strikes and protests as wages either stagnate at a minimum or are slashed. Every nurse in America will go on strike if you freeze their wages for even a few years, forget about cutting their wages by 1/4 as should occur to bring them into line with other developed nations.