5f13389fd6ea4b6de49bacec84ed7d8f

Why don't we have a reasoned discussion about the pros and cons of a single payer system. It could be an exclusive mandatory model. Or simply an option that would give consumers a choice.

jc @ 3 months ago

Comments (45)

0eda15e8a4a685a0722949782c90e863

I'm a proponent of single payer basic health care with different copay tiers based on income and age. Discounts are available to those who practice a healthy lifestyle. Then allow individuals to purchase upgrade plans direct from their medical

AMi @ 3 months ago

Port Washington, WI, USA

0eda15e8a4a685a0722949782c90e863

provider. I believe this would achieve a good balance of encouraging improvement in national health and competition in the medical field.

AMi @ 3 months ago

Port Washington, WI, USA

7feb020fb3d3aa6cf2752031cf61da89

who controls the, (annual), cost increases? . Who determines, or what is, "basic" healthcare? . is a kidney transplant a basic healthcare item? .

H2O @ 3 months ago

2901 Sorano Ct, Pleasanton, CA 94566, USA

7feb020fb3d3aa6cf2752031cf61da89

I can see groups & unions negotiating with doctors for "enhanced" plans. . ooooohhhhhj .

H2O @ 3 months ago

2901 Sorano Ct, Pleasanton, CA 94566, USA

B35527b232c45def78db4f6949419182

@h2o - if only there were other systems in the world who've already wrestled with these questions, maybe we'd have some guidance. If only...

Tjaden Froyda @ 3 months ago

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One of the things I find intriguing is that a SP system may be a way to break the employer/healthcare connection.

jc @ 3 months ago

Yellow Springs, OH 45387, USA

5f13389fd6ea4b6de49bacec84ed7d8f

Let's say that a universal tax based sytem is passed. The employer then calculates your current healthcare cost, converts it into salary, then is forever rid of the hassle of trying to guess what next years increase will be.

jc @ 3 months ago

Yellow Springs, OH 45387, USA

5f13389fd6ea4b6de49bacec84ed7d8f

You get to pay more income tax, SS, and medicare unless these are inapplicable. The end result should result in a revenue neutral conversion for you and your employer. Wouldn't that be sweet?

jc @ 3 months ago

Yellow Springs, OH 45387, USA

5f13389fd6ea4b6de49bacec84ed7d8f

H2O,, Your concern regarding the double digit increases may be valid. Maybe not. From what I've read, the cost increases in countries with universal coverage tend to be equal to or less than ours. It makes sense. Markets are supposed to be driven

jc @ 3 months ago

Yellow Springs, OH 45387, USA

5f13389fd6ea4b6de49bacec84ed7d8f

by the buyer. A drug company intent on entering a market would necessarily have to negotiate a reasonable price. Even patented drugs only enjoy a brief period before a copycat is on the market. Viagra is still stupid expensive, but Cialis took some

jc @ 3 months ago

Yellow Springs, OH 45387, USA

5f13389fd6ea4b6de49bacec84ed7d8f

of their market share. Just one more competitor will change the picture entirely.

jc @ 3 months ago

Yellow Springs, OH 45387, USA

7feb020fb3d3aa6cf2752031cf61da89

drugs aren't the only thing increasing medical costs. . You seem pretty confident an employer would give the employee the healthcare share the employer has been paying. I wouldn't...

H2O @ 3 months ago

2901 Sorano Ct, Pleasanton, CA 94566, USA

7feb020fb3d3aa6cf2752031cf61da89

do we take employers out of the healthcare picture?

H2O @ 3 months ago

2901 Sorano Ct, Pleasanton, CA 94566, USA

5f13389fd6ea4b6de49bacec84ed7d8f

I don't see why any employer would balk at the chance to be rid of the health care burden. If a national tax based system were implemented, it could be an option to either convert the current cost to salary or simply pay the tax bill. There would be

jc @ 3 months ago

Yellow Springs, OH 45387, USA

5f13389fd6ea4b6de49bacec84ed7d8f

benefits to the employer under either model. But the simplest would be to sever the healthcare connection.

jc @ 3 months ago

Yellow Springs, OH 45387, USA

5f13389fd6ea4b6de49bacec84ed7d8f

Then, yes, employers would be out of the picture. Employees would consider that cost when negotiating their salary for future employment.

jc @ 3 months ago

Yellow Springs, OH 45387, USA

5f13389fd6ea4b6de49bacec84ed7d8f

You say you wouldn't give the employee the healthcare cost. That would be the equivalent of giving them a healthy pay cut. Try it. Let me know how that works out for you.

jc @ 3 months ago

Yellow Springs, OH 45387, USA

5f13389fd6ea4b6de49bacec84ed7d8f

And understand this. No one other than myself has proposed this type of solution. It's just a thought. One option. There are unlimited possibilities.

jc @ 3 months ago

Yellow Springs, OH 45387, USA

7feb020fb3d3aa6cf2752031cf61da89

I just don't see employers giving employees the employer's share of healthcare, especially if you're promising to cut costs

H2O @ 3 months ago

Pleasanton, CA, USA

5f13389fd6ea4b6de49bacec84ed7d8f

If it was a one time conversion it could be a big savings. Break even the first year. Never worry about health care costs again. Hopefully the tax rate would remain static. The normal employee raises would provide a growing income for healthcare.

jc @ 3 months ago

Yellow Springs, OH 45387, USA

B35527b232c45def78db4f6949419182

@H20 - one of the big things keeping people in specific jobs (that they hate) right now is healthcare benefits. If the employer doesn't give a bump in pay to compensate, the employee has much more freedom to leave

Tjaden Froyda @ 3 months ago

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I just think you're making a huge assumption that employers would give up the entire employer healthcare contribution, ($500-$1000 / month) and raises to continued increases. Especially when they don't control the plan. .

H2O @ 3 months ago

Pleasanton, CA, USA

7feb020fb3d3aa6cf2752031cf61da89

How's that competitive mindset working with minimum wage increases?

H2O @ 3 months ago

Pleasanton, CA, USA

5f13389fd6ea4b6de49bacec84ed7d8f

Around here, pretty well. The only minimum wage jobs are servers who also get tips. Fast food jobs are starting well above minimum wage. Still constantly looking for help.

jc @ 3 months ago

Yellow Springs, OH 45387, USA

5f13389fd6ea4b6de49bacec84ed7d8f

But that's not the point. It may come down to a flat amount of compensation per employee. Or a percentage of salary. Whatever works. I guess it would be somewhat dependent on the anticipated cost to the employee.

jc @ 3 months ago

Yellow Springs, OH 45387, USA

5f13389fd6ea4b6de49bacec84ed7d8f

To be honest, I have no idea how it is structured elsewhere. I assume the tax would be the same for single, married, with or without kids, multiple incomes, earned and unearned income.

jc @ 3 months ago

Yellow Springs, OH 45387, USA

5f13389fd6ea4b6de49bacec84ed7d8f

H2O,, Do you really feel that it would be beneficial to nationalize the entire healthcare industry?

jc @ 3 months ago

Yellow Springs, OH 45387, USA

7feb020fb3d3aa6cf2752031cf61da89

Yes, from the perspective of cost. I don't see how you control cost by continually paying increased premiums/taxes. . Nationalized healthcare controls the premiums, the doctors, the hospitals, the drugs, & the patient's. .

H2O @ 3 months ago

2901 Sorano Ct, Pleasanton, CA 94566, USA

B35527b232c45def78db4f6949419182

Is cost the only consideration?

Tjaden Froyda @ 3 months ago

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7feb020fb3d3aa6cf2752031cf61da89

at this point, yes. . We have the capabilities, the equipment and the technology. . if you can't afford it, you have ZERO access.

H2O @ 3 months ago

2901 Sorano Ct, Pleasanton, CA 94566, USA

B35527b232c45def78db4f6949419182

Why the sudden 180? What flipped you?

Tjaden Froyda @ 3 months ago

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7feb020fb3d3aa6cf2752031cf61da89

I figure it's inevitable for single payer. . So given that, federalized healthcare is the only realistic way for the government to control costs, versus annual tax hikes to cover increases. .

H2O @ 3 months ago

Pleasanton, CA, USA

7feb020fb3d3aa6cf2752031cf61da89

the only real issue is what to cover, at the basic levels and what to limit patients access to. . ie. a smoker wouldn't be eligible for a transplant,, a couch potato would have no access to a heart transplant.... . to me, that's reasonable .

H2O @ 3 months ago

Pleasanton, CA, USA

B35527b232c45def78db4f6949419182

If you're bad enough to need a heart transplant, you're kinda a couch potato by definition... I love how you approach this from a punitive standpoint. /S

Tjaden Froyda @ 3 months ago

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5f13389fd6ea4b6de49bacec84ed7d8f

Just did a little research. In Germany the public option tax is about 14.5% of wages. Half paid by the employer. Hospitals, doctors, clinics etc are private, for profit, entities.

jc @ 3 months ago

Miami Township, OH, USA

5f13389fd6ea4b6de49bacec84ed7d8f

Higher earners may decide that private insurance is the way to go. Depending on age, and level of risk, it could be much cheaper. Employer pays one half of premiums. But as you age your premium may skyrocket. Switching to the public option is not

jc @ 3 months ago

Miami Township, OH, USA

5f13389fd6ea4b6de49bacec84ed7d8f

easily or cheaply done.

jc @ 3 months ago

Miami Township, OH, USA

7feb020fb3d3aa6cf2752031cf61da89

mandate single payer, 1st. I thought you guys where taking the employer out of the picture. . some things take more time then others skal . couch potato, my intended def., someone who refuses to exercise, obese, insists on being waited on, etc

H2O @ 3 months ago

Pleasanton, CA, USA

7feb020fb3d3aa6cf2752031cf61da89

yea know, like the fat kid calling grandma for a grape soda.

H2O @ 3 months ago

Pleasanton, CA, USA

B35527b232c45def78db4f6949419182

How the hell would that be operationalized?

Tjaden Froyda @ 3 months ago

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5f13389fd6ea4b6de49bacec84ed7d8f

The employer out plan was just my idea. I don't know if it's even practical.

jc @ 3 months ago

Yellow Springs, OH 45387, USA

5f13389fd6ea4b6de49bacec84ed7d8f

The German public option offers a choice of over 100 insurers. Each has its own menu of coverages. In many ways their system is more complicated than ours.

jc @ 3 months ago

Yellow Springs, OH 45387, USA

B35527b232c45def78db4f6949419182

Since we are into penalizing life choices now, why stop at just transplants? Eat unhealthy? Overweight? no stent.

Tjaden Froyda @ 3 months ago

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Or Viagra.

Tjaden Froyda @ 3 months ago

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7feb020fb3d3aa6cf2752031cf61da89

I'm okay with those.. . would help cut costs, for a bit ... Single Payer w/baseline care for Everyone Single Provider for EVERYONE ... If you want additional insurance add a 50% surcharge (limit rich advantage)

H2O @ 3 months ago

Pleasanton, CA, USA

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