Medicare for all — net costs

[GeezerSteve]

Regardless, with the Canadian system the option to trade money for time is available; you can wait and get it done for free or if you have the means you are free to travel the US or elsewhere and get it done ASAP. That choice is not available in the US.

By god, we don't want choices! We want freedom! #MAGAmotherfucker!

[evdog]

I think you are reading that wrong. Total cost billed was at least $13k. It's not like the insurance company is just paying the extra $9k out of the goodness of their hearts, you pay that, plus their profit margin. Just not all at once.

Original bills from providers came out to $59k. Actual cost after factoring in discounts negotiated by insurance was $13k. My share of that $13k was $4k. So insurance paid net of $9k. And yes insurance premiums are on top of that.

A torn ACL also generally doesn't impede basic mobility much, and if your job depends on it or there are other extenuating circumstances you will generally get treated more quickly. Regardless, with the Canadian system the option to trade money for time is available; you can wait and get it done for free or if you have the means you are free to travel the US or elsewhere and get it done ASAP. That choice is not available in the US.

When I tore ACL the first time the actual time from injury to surgery was over 2 years. Didn't realize it was torn for a few months. Once I saw a doc it was 9mos to get a referral. Then I picked a surgery date in low season for biking which was another 7 months out. I was riding Whistler and the shore every weekend most of those two years, and probably riding better than I ever have after that surgery. The wait wasn't a big deal at all though there was some risk of blowing the rest of the knee out. It would have been a bigger deal if I was waiting on knee or hip replacement, something that did inhibit mobility. No system is perfect. But you might trade 9 months of wait time dealing with some pain for nine months of fighting it out with providers and insurance companies over bills. Pick your poison.

I would gladly pay $3967 extra dollars to not give up the better part of a year of my life waiting to get an ACL fixed. Combine that with Iceman's comments on the lack of motivation to innovate, upgrade equipment etc and you know exactly why universal isn't coming to the USA.

Universal health care isn't coming to the US because there are too many people making way too much money off the system as it is now. Providers, corporate providers, insurance companies, middle-men, pharma, private equity, institutional investors.

[Buster Highmen]

Universal health care isn't coming to the US because there are too many people making way too much money off the system as it is now. Providers, corporate providers, insurance companies, middle-men, pharma, private equity, institutional investors.

dingdingding.
It's also the misinformation spread by these profiteers and so readily consumed and regurgitated by regressives.

[dunfree]

I think you are reading that wrong. Total cost billed was at least $13k. It's not like the insurance company is just paying the extra $9k out of the goodness of their hearts, you pay that, plus their profit margin. Just not all at once.

He's unintentionally showcasing why the US system as it is is doomed to failure. Everyone cares about out of pocket which is only tangentially related to the actual cost of healthcare and so there is no market incentive for individuals to make decisions that reduce their heathcare consumption. Individuals get really angry in the US if they actually have to have free market healthcare in my experience. They also often make more rational decisions.

[AdironRider]

How I read it was 56->13k was the dance. Insurance covered 9k and he paid 4. But that 9k isn’t just free money. That cost and more gets passed on to you by the insurance company through premiums and other fees. So the true cost is at least the 13k that was finally billed.

Yeah I get all that, but 99% of America doesn't. At the end of the day, I'll pay to play if it means I get a year of my prime physical years back, and most of America would as well.

Most of that cost is falling on your employer most likely, or like 80% of it or so on average.

Cost is not the end all be all in healthcare. Americans wouldn't play that 9 month waiting game unless they are forced.

I'm not saying it is a better system, I'm saying you aren't going to get the US to move backwards in terms of quality of care (as illustrated by others or even just in perception) or service time.

[GeezerSteve]

Universal health care isn't coming to the US because there are too many people making way too much money off the system as it is now. Providers, corporate providers, insurance companies, middle-men, pharma, private equity, institutional investors.

You conflate the concept of single payer with universal coverage. Universal coverage can be mulit-payer. Germany's multi-payer universal coverage system involves a blend of private insurance carriers and public option on the coverage side. Most HC services are provided by private HC providers.

[dunfree]

Most of that cost is falling on your employer most likely, or like 80% of it or so on average.

so it's part of your compensation and you are paying for it.

I'm not saying it is a better system, I'm saying you aren't going to get the US to move backwards in terms of quality of care (as illustrated by others or even just in perception) or service time.

Again - there are many "socialist" systems that provide better outcomes and better outcomes per $ spent. You aren't moving backwards.

[Buster Highmen]

All this completely overlooks the article and how the information has been spun to reach an opposite conclusion.

[bodywhomper]

a handful of years ago, my company broadcasted an email to all employees in the US informing us that, collectively, we had overused our insurance well beyond the calculated expectation, and, as a result, all options were going to cost much more $$. That sucked and issued in the new norm for all. At one point, when my wife was pregnant, our local hospital was in a contracting dispute with our health provided and was determined to be out of network until further notice. that cost would have been something like a $9k deductible, followed by 30% co-pay to a max $60k out-of-pocket. "Luckily," we made it to an in-network hospital about 2 hour drive from our house with a high risk pregnancy ward and the babies got to spend a few weeks in their NICU while we lived in the nearby ronald mcdonald house, which was a $9k expense (out of pocket and not including premium) in total.

something i check every year is whether my insurance covers (as in-network) helicopter evacuation. life flight is very common where i live in the sticks

[AdironRider]

so it's part of your compensation and you are paying for it.



Again - there are many "socialist" systems that provide better outcomes and better outcomes per $ spent. You aren't moving backwards.

Did you even read where I said it could just be perception? Anyways...

Tell that to the US electorate. Regardless of the merit of the legislation, US politics is what it is because of a strong reaction to health care and its effects. Did you see the bloodbath dems took after Obamacare? There aren't enough racists to unseat 1000+ democratic leaders exclusively because they hate brown people.

[Supermoon]

New poll has 70% approval for MFA. I think Americans are listening.

[yeahman]

New poll has 70% approval for MFA. I think Americans are listening.

I do think more Americans are starting to realize it's not sustainable the way it is now. Despite all the money being made by the big players in the U.S. healthcare industry, just about every other business in the country is getting creamed by rising costs for employee health insurance. Eventually you would think that collective pressure will increase to the point of superseding the lobbying power of the healthcare industries, strong as it is. Might be five years, might be fifteen or twenty, but it's going to kill business in the U.S. if some sort of national program isn't put into place. I mean the whole idea of employers paying for employee health insurance is just past its time. It doesn't make any real sense anymore because it creates such a discombobulated system.

[AdironRider]

Trump literally got elected on a 50/50 platform of overturning Obamacare and illegal immigration.

America's view on the matter is so strong they put the Cheeto in office, less than two years ago. Americans aren't coming around on the matter, they'd rather burn it all to the ground.

[Supermoon]

I do think more Americans are starting to realize it's not sustainable the way it is now. Despite all the money being made by the big players in the U.S. healthcare industry, just about every other business in the country is getting creamed by rising costs for employee health insurance. Eventually you would think that collective pressure will increase to the point of superseding the lobbying power of the healthcare industries, strong as it is. Might be five years, might be fifteen or twenty, but it's going to kill business in the U.S. if some sort of national program isn't put into place. I mean the whole idea of employers paying for employee health insurance is just past its time. It doesn't make any real sense anymore because it creates such a discombobulated system.

I work for myself, and healthcare costs are the biggest thing I had to worry about when deciding to leave my corporate gig. It's basically a $20k/yr tax on my business to get insurance for me and my wife.

Trump literally got elected on a 50/50 platform of overturning Obamacare and illegal immigration.

America's view on the matter is so strong they put the Cheeto in office, less than two years ago. Americans aren't coming around on the matter, they'd rather burn it all to the ground.

I mean, who needs data when we can just pontificate wildly, right?

[AdironRider]

Polls all had Hillary winning the Presidency. The end result was the exact opposite.

I just don't see it happening, the past 8 or so years have shown the exact opposite position than you think the majority of the electorate has turned to.

[Harry]

Polls all had Hillary winning the Presidency. The end result was the exact opposite.

I just don't see it happening, the past 8 or so years have shown the exact opposite position than you think the majority of the electorate has turned to.

The "majority of the electorate" voted for Hillary. Trump got his ass kicked in the popular vote.

[dunfree]

Ah yes Obamacare, the name people love to hate, but they actually like what's in the law for the most part. So much so that the Republicans who'd campaigned against it for years couldn't actually repeal it because they lacked the votes.

In the current environment rural, or more rural, hospitals and healthcare providers are going to continue to close. Eventually that might produce pressure upon rural congresspeople to change things. Or not.

[Self Jupiter]

flyover voters count double*

*source: Fox News

All those illegals voting on the coasts... something had to be done

[Self Jupiter]

.

[GeezerSteve]

New poll has 70% approval for MFA.

But only 44% support socialized medicine. Remember that some people operate with the misconception that the government has nothing to do with Medicare. See, e.g., Tea Party signs "Keep Government Away From My Medicare."

[AdironRider]

The "majority of the electorate" voted for Hillary. Trump got his ass kicked in the popular vote.

Those aren't the rules of the game man.

I'd be more open to thinking it would be possible if 1000+ other elections didn't show the exact same thing.

Again, my point has nothing to do with the merits of either system, just whether it could become reality in the US.

[skaredshtles]

The "majority of the electorate" voted for Hillary. Trump got his ass kicked in the popular vote.

[iceman]

Somebody explain to me where Mass. health fits on the universal care/single payer/etc. spectrum please.

[Supermoon]

Somebody explain to me where Mass. health fits on the universal care/single payer/etc. spectrum please.

Has is changed substantially since Romneycare? If not, it would be universal, but not single-payer. Universal in that everyone has to have insurnance and there are subsidies to help people afford it. Much like Obamacare before the Supreme Court and Congress started slowly gutting it.

[iceman]

It's been tweaked some since Romney to comply with ACA stuff but is still substantially the same is my understanding. I just read the wiki and got kinda lost, it's long and complicated.