Is the American healthcare system really so broken?

Originally posted by Melanerpes
the individual mandate seems like a very hard sell - especially if it means it requires you to spend something like $10,000 or more per year, when a healthy person or family might only expect to spend a few $1000 at worst in any given year. People just don't like the idea of being forced to buy something they don't need.

Now if they put all of the chro ...[text shortened]... buying insurance to cover only the truly catastrophic costs, that might be politically doable.

No proposal that included an individual mandate would have forced anyone to pay $10,000 a year. There would either be; A) A low cost public option; or B) Generous government subsidies to help people pay private premiums; or C) Both.

The polling suggests that individual mandates are not anathema to the public as you seem to think: Public support for such an individual mandate ranges from 49 to 56% if no mention is made of subsidies for people who cannot afford insurance (ABC June 18; Gallup July 10). If a mandate were to include such subsidies, support ranges from 53 to 70% (CBS July 24; ABC June 18; KFF July 7; Pew July 22). On the other hand, when people are told about penalties that people would have to pay for not having coverage, support drops to 44% (ABC June 18).

Originally posted by no1marauder
No proposal that included an individual mandate would have forced anyone to pay $10,000 a year. There would either be; A) A low cost public option; or B) Generous government subsidies to help people pay private premiums; or C) Both.

Okay; so:

1) The government gives out low cost insurance or pays people the money to buy their own insurance

2) Nobody pays for it


So, where does the money come from?

Originally posted by sh76
Okay; so:

1) The government gives out low cost insurance or pays people the money to buy their own insurance

2) Nobody pays for it


So, where does the money come from?

Rich b*stards!

In terms of paying for reform, 58 to 68% of Americans support raising taxes on people with higher incomes (in some polls, those earning more than $250,000 a year) (Pew July 22; Gallup July 10; KFF June 1); 30% support taxing all employer-provided health insurance benefits (QU June 23), with 25 to 43% in support of taxing only more expensive health plans (Pew July 22; Gallup July 10; KFF June 1); and 33 to 38% support using savings from Medicare to help pay for reform (Pew July 22; Gallup July 10). Support for the use of Medicare savings, however, rises to 53% when the savings come from limiting increases in payments to physicians and hospitals (KFF June 1). Only 32% support increasing the deficit to help pay for health care reform (KFF Dec. 4).

http://healthcarereform.nejm.org/?p=1424&query=home

Of course, neither of your statements are accurate; in both cases some part of the insurance premiums would be paid by the purchasers.

Originally posted by no1marauder
On the other hand, when people are told about penalties that people would have to pay for not having coverage, support drops to 44% (ABC June 18).

in other words, when people were told that a "mandate" to buy coverage really was a mandate, the support dropped significantly -- and this was back in June.

Originally posted by Melanerpes
in other words, when people were told that a "mandate" to buy coverage really was a mandate, the support dropped significantly -- and this was back in June.

So what? 44% is still significant support. Reduce the penalties and you'd easily get a majority.

Originally posted by no1marauder
So what? 44% is still significant support. Reduce the penalties and you'd easily get a majority.

Of course, people will support a mandate if the penalty is really small. No one fears a dog without any teeth.

The only way to make something mandatory is to have a penalty that's strong enough to force people to do what they normally wouldn't want to do.

Originally posted by Melanerpes
Of course, people will support a mandate if the penalty is really small. No one fears a dog without any teeth.

The only way to make something mandatory is to have a penalty that's strong enough to force people to do what they normally wouldn't want to do.

Either way, it's hardly "politically impossible" as you assert if 44% support it even with substantial penalties.

Of course, an affordable public option would cut down the number of people who would want to avoid paying for health insurance altogether as would subsidies for private insurance.

Originally posted by no1marauder
Either way, it's hardly "politically impossible" as you assert if 44% support it even with substantial penalties.

Of course, an affordable public option would cut down the number of people who would want to avoid paying for health insurance altogether as would subsidies for private insurance.

remember - that 44% was during a point when the overall opinions regarding healthcare reform were much more favorable. I'm sure that 44% drops to 35% very quickly after a couple weeks of attack ads by the opposition.

But you are correct - the keystone is having the public option in there (which is essentially the same as expanding Medicare and-or Medicaid in some way). The real purpose of having it is to cover all the chronically ill people that the private insurance industry really isn't structured to handle. How do you run a profitable business covering people who require, say, $100,000-yr for their healthcare?

Once you get all of those people out of the pool, you're left with relatively healthy people whose main worry is the rare catastrophic event. This is precisely the sort of thing the private insurance industry is structured to handle. It shouldn't be that expensive to get universal coverage for this sort of thing.

But thanks to Lieberman (who clearly has some axes to grind with the Dems), all talk of a public option was tossed out -- and all those chronically sick people were now tossed into the pool. And making this work for the insurance industry means requiring everyone to buy an expensive insurance plan that most people don't want.

Originally posted by Melanerpes
remember - that 44% was during a point when the overall opinions regarding healthcare reform were much more favorable. I'm sure that 44% drops to 35% very quickly after a couple weeks of attack ads by the opposition.

But you are correct - the keystone is having the public option in there (which is essentially the same as expanding Medicare and-or Medic ...[text shortened]... ry means requiring everyone to buy an expensive insurance plan that most people don't want.

Liberman, Nelson and a few other conservative Dems have been shills for decades for the insurance industry. That industry didn't want the competition of a public option while insisting on an individual mandate for the reasons you have discussed.

Originally posted by no1marauder
Liberman, Nelson and a few other conservative Dems have been shills for decades for the insurance industry. That industry didn't want the competition of a public option while insisting on an individual mandate for the reasons you have discussed.

And you know the last thing the insurance industry wants is for everyone to set up their own savings accounts and pay out of pocket for their routine expenses. There's only so much money to be made if the insurance industry was limited to doing what insurance companies are supposed to do -- protect people against rare catastrophic events.

And the other thing the insurance industry doesn't want is real competition - whether it be from a public option or from a truly competitive marketplace in every part of the country.

On the other hand, where are all the other interest groups? Surely there are a lot of healthcare providers who would benefit from making coverage available to more people. Surely there are a lot of employers and unions who don't relish the prospect of having to deal with skyrocketing premiums to cover workers - especially during a recession when everyone's trying to cut costs. Why aren't these interest groups weighing in more on the debate?

Originally posted by no1marauder
In terms of paying for reform, 58 to 68% of Americans support raising taxes on people with higher incomes

http://www.theonion.com/content/news/report_98_percent_of_u_s_commuters

Originally posted by sh76
Okay; so:

1) The government gives out low cost insurance or pays people the money to buy their own insurance

2) Nobody pays for it


So, where does the money come from?

I would like to know why every single country who has universal healthcare pays far less than we do (even per capita) and covers everyone. And to top it off the US doesn't even rank among the top as far as quality care goes.

Starting from scratch I would say universal healthcare is the way to go. For now what do you think about a government medical insurance program that is not for profit? Premiums are set to break even instead of maximizing quarterly reports for shareholders.

Originally posted by USArmyParatrooper
I would like to know why every single country who has universal healthcare pays far less than we do (even per capita) and covers everyone. And to top it off the US doesn't even rank among the top as far as quality care goes.

Starting from scratch I would say universal healthcare is the way to go. For now what do you think about a government med ...[text shortened]... rofit? Premiums are set to break even instead of maximizing quarterly reports for shareholders.

I'm in favor of a three pronged system:

1) Public option with market rate premiums, reduced on a sliding scale based on income/resource ability to pay standard

2) Increase of 1 or 2 points in the Medicare tax to pay for (1)

3) Deregulation of private insurers and removal of their liability shield. They can deny for pre-existing conditions; sell across state lines. Whatever they want. They can also be sued for breach of contract to failing to pay for a procedure that they should have.

This way you get competition, efficiency, solvency and universal coverage.

Single payer systems are too bureaucracy laden. Open market brings the best results.

Originally posted by sh76
I'm in favor of a three pronged system:

1) Public option with market rate premiums, reduced on a sliding scale based on income/resource ability to pay standard

2) Increase of 1 or 2 points in the Medicare tax to pay for (1)

3) Deregulation of private insurers and removal of their liability shield. They can deny for pre-existing conditions; sell across ...[text shortened]... verage.

Single payer systems are too bureaucracy laden. Open market brings the best results.

I actually like your ideas but I disagree about the open market bringing the best results. Do you have an example of this? Certainly the US isn't one of them.

Originally posted by USArmyParatrooper
I actually like your ideas but I disagree about the open market bringing the best results. Do you have an example of this? Certainly the US isn't one of them.

How about other markets? Computer technology. Communications technology; even pharmaceutical development. The free market (regulated smartly of course) produces the best and most innovative environment.