Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Fully agree about the need to severely trim the healthcare bureaucracy. Regarding statistical parameters, you are talking about Bell curve, ie, a normal distribution. But the population of seniors starting from the age 50, plotted with the age on x axis and morbidity/health services use (per 1000 people of each age) on the y axis, does not follow normal distribution. The bulk of morbidity is skewed heavily to the right. Fifty five year olds are on average nowhere near as sick as 85 year olds, plus my guess is that there are many more 55 year olds than 85 year olds.
You are correct, of course; I chose a normal distribution or "bell curve" as a simple way to make my point. Once you get to the generalized method of moments, people's eyes glaze over (except for, perhaps, Lars Peter Hansen).
One alternative is already here. Medicare pays in full for the Cologuard DNA test every 3 years between the ages of 50 and 85. I had one the first year I was on Medicare and will be getting it every 3 years after.
The test kit actually contains two tests: they do the DNA test and also the typical traditional FIT test as a backup/control. The two tests have different strengths and weaknesses (one is more sensitive but the other is more specific) and so taking the results of the two together produces the best chance of an accurate diagnosis.
Medicare doesn't pay for it until age 65 as was pointed out. Only people on some types of disability and End Stage Renal Disease get Medicare before age 65. In addition, Cologard is only for people at normal risk, IOW, not for those who have "conditions that increase the risk, such as a personal history of polyps, inflammatory bowel disease, chronic ulcerative colitis, Crohn’s disease, or familial adenomatous polyposis; or a family history of colorectal cancer or polyps." That is in point of fact, most of us.
Every one of us who has undergone colonoscopy prep knows what I'm talking about - being tethered to a toilet for hours on end. Indeed, it is a common joke and topic of endless internet memes.
Decaf, Katarina. Try switching to decaf.
Yes, I'm aware, as are you. You know you'll have it every 10 years (or 5) so that is a perfect thing for you to plan for years in advance.
Are you aware that a typical asphalt shingle roof on a house has a life expectancy of 20 years? And that the homeowner has 20 years to accrue for its replacement?
I'm probably older than you, have had several colonoscopies as has my husband who has a big-time family history of colon cancer, and I've never heard these jokes. Must be the crowd I hang with. BTW, I'm an RN and I'm familiar with a lot of sick medical humor. You are aware that usually after age 65 and almost totally after 70, people are not working, at least not full time, so "saving" for these fun colonsocopies has to come out of previous savings and/or SS payments.
Insulting. "Rite of passage" includes privileges after passage. Here is a good article on "Rite of Passage". See particularly sections on "Life-cycle ceremonies" and "Ceremonies of social transformation". https://www.britannica.com/topic/rite-of-passage
I'm well aware of the longevity of roofs. That you think I'm ignorant is not helpful in this discussion.
Quote:
Originally Posted by WestieJeff
Indeed medical treatment is a commodity. So is police protection, fire protection, and education, but we choose to accept those cost societally.
Ultimately anyone who doesn't "contribute to the collection" is going to end up in the emergency room , where they are guaranteed treatment and the rest of us pay anyways. Might as well setup a system where they pay something towards their treatment and we have the opportunity to offload that person's care to a less expensive provider than the emergency room.
No, you are erroneously conflating the cost of something versus how it is paid. The other countries are cheaper because they have various forms of cost controls in place. How they choose to pay for it is a separate topic. If you and your friends go for lunch, does the total price of the bill change if you pay for it alone or if you split the bill amongst everyone?
The populace that pays no income tax still pays medicare tax, social security tax, sales tax, gas tax, property tax, and a host of other taxes. There are plenty of opportunities to configure single payer in a way that everyone chips in.
Indeed medical treatment is a commodity. So is police protection, fire protection, and education, but we choose to accept those cost societally.
Ultimately anyone who doesn't "contribute to the collection" is going to end up in the emergency room , where they are guaranteed treatment and the rest of us pay anyways. Might as well setup a system where they pay something towards their treatment and we have the opportunity to offload that person's care to a less expensive provider than the emergency room.
No, you are erroneously conflating the cost of something versus how it is paid. The other countries are cheaper because they have various forms of cost controls in place. How they choose to pay for it is a separate topic. If you and your friends go for lunch, does the total price of the bill change if you pay for it alone or if you split the bill amongst everyone?
The populace that pays no income tax still pays medicare tax, social security tax, sales tax, gas tax, property tax, and a host of other taxes. There are plenty of opportunities to configure single payer in a way that everyone chips in.
1. Who is "we" that accept the situation in which medical treatment or municipal services are subsidized by 47% of people for the benefit of 100% of people? You can speak for yourself, but not for me (or for Mitt Romney :-). The situation is far from acceptable to every US citizen, and the last election (of a president whose manners and rhetoric are a bit extreme even for my stomach :-), although I have mostly agreed with the policies that he has passed), so, the last election suggests that the majority of "us" probably does not choose to accept Robin Hood taxation.
2. There is already a health service (ie, Medicaid) that provides funding for people unable to pay any amount healthcare premium. People on Medicaid should receive care only at designated Medicaid facilities, and the spectrum of care should be limited only to bare essentials that the society can reasonably afford to give as a charity. Other ERs should not be required to admit Medicaid or non-paying uninsured patients.
3. How health insurance is paid has a major effect on the cost of health insurance. How else do you explain the fairly low cost of my health insurance in Boston MA ($396 per month, age 59) except with the fact that every household in my zip code pays health insurance premium? Prices of medical services are surely not lower in Boston than in the rest of the nation.
4. The welfare class is not chipping in when it comes to their own housing or food. How do you envision configuring a single payer system where they will be chipping in to contribute to funding of healthcare?
Medicare:
as the Jacksons said....
ABC, Easy as 123. Ah, simple as do re.
bottom line:
NOthing is Simple
after the Feds get their
Do-Re-Mi around this idea.
I vote with this. Quite simply, the bureaucracy isn't ready for this. They can't even handle the new cases of Boomers signing up for Medicare at 65, from what I've seen. I know people who went through, or are still going through, hell, just to get signed up and stay signed up. One person keeps getting their Part B cancelled due to errors by the Social Sec. admin, a lost check, clerical errors by SS that the Medicare side can do nothing about; the customer is told they have to get SS to fix it, but no one at their local SS office knows what to do, and so on. I've known people who have had access to Part B cut off for 6 months or more, due to bureaucratic bumbling.
Anyone who thinks they want to buy into that system has no idea what they'd be up against. Half the people working for SS should be fired, going by the stories I hear. It's a real-life bureaucratic nightmare, when co-ordinating between two gov't agencies: SS and Medicare.
Medicare doesn't pay for it until age 65 as was pointed out. Only people on some types of disability and End Stage Renal Disease get Medicare before age 65. In addition, Cologard is only for people at normal risk, IOW, not for those who have "conditions that increase the risk, such as a personal history of polyps, inflammatory bowel disease, chronic ulcerative colitis, Crohn’s disease, or familial adenomatous polyposis; or a family history of colorectal cancer or polyps." That is in point of fact, most of us.
I'm probably older than you, have had several colonoscopies as has my husband who has a big-time family history of colon cancer, and I've never heard these jokes. Must be the crowd I hang with. BTW, I'm an RN and I'm familiar with a lot of sick medical humor. You are aware that usually after age 65 and almost totally after 70, people are not working, at least not full time, so "saving" for these fun colonsocopies has to come out of previous savings and/or SS payments.
Insulting. "Rite of passage" includes privileges after passage. Here is a good article on "Rite of Passage". See particularly sections on "Life-cycle ceremonies" and "Ceremonies of social transformation". https://www.britannica.com/topic/rite-of-passage
I'm well aware of the longevity of roofs. That you think I'm ignorant is not helpful in this discussion.
My guess is that 50 - 85 is the age that Cologard is approved for.
The population on the dole is not that large in the UK - as you can see from your article, more than 40% of the recipients are seniors, and most other long-term recipients are disabled. About 80% of the unemployed find employment in less than 6 months, there are only 15k households (in the country with a population of almost 67 million) where there was unemployment in two generations, and the researchers were unable to find any family on generational welfare across 3 generations. This is about what I would have expected. Able-bodied adult people are on the dole in the UK very briefly, are generally deeply ashamed of being on the dole, and typically try to get off it any way possible.
There are counties in certain states in the US where being employed is almost unheard of, and nobody in the known history of any of the families has ever worked. I would not have believed it had I not seen it with my two eyes. The most popular activity in these counties seems to be consumption of crystal meth, relatively closely followed by the second most popular activity, ie, childbearing.
Yes it is a retirement concern. Many on this forum have retired prior to 65 and struggle with the cost of health care until medicare kicks in. Many of us take Social Security at 62, but cannot get Medicare until 65. Some retire even earlier... sometimes not by choice. It is very much a retirement issue.
The politics is something else.
Below is one link that talks about the various Medicare proposals which include two buy-in options for people who have retired but are not yet eligible for the program. The other six proposals are some form of a pitch for Medicare for all. So I concede it is a retirement issue in part, but the proposals are largely a set of blueprints to hand over the American healthcare economy to the USG. I absolutely do not support that political outcome.
There is all this talk about healthcare being everybody's natural right... but in fact, it isn't. It is a commodity. Professional skills are not easy for a doctor to attain, taking care of a patient consumes tremendous amount of time and is stressful, new procedures are not easy to figure out, medications are not easy to discover and sometimes make, same with medical devices. Health care is exactly what you called it: a product. Nobody of course forces you to buy that product, but nobody should also be forced to give you that product if you did not buy it.
It is fine if you do not wish to be forced into paying a guaranteed treatment for certain diseases by splitting the cost of the risk with a few million other people, but then you should be prepared to either pay the full cost of treatment of the actual illness if you get it (say, up to $100,000 for cardiac stents, something that many of us will need sooner or later), or be prepared to die of, say, heart attack.
If a group of people simply cannot collect among themselves enough money to pay for everybody's stents (because too many people are not contributing to the collection), and nobody can afford to pay for them out of pocket, then some people in that group will have to die of heart attack, and the only fair thing is that it should be those people who did not contribute to the collection of money. Sorry.
I "repped" you for your first paragraph alone. I absolutely agree.
I disagree with your second and third paragraphs. We have Children's hospitals and cancer centers and St Jude Medical Centers that cost patients and families nary a cent and are sustained by grants and contributions alone. Americans are generous, compassionate, and willfully contribute money for causes that touch their hearts. We have telethons to raise money for disease research and treatment. We have a Make-a-wish foundation whose sole purpose is to give really sick people an amazing experience and some good memories. Go Fund Me accounts are filled to the brim when some injustice or heroic action has resulted in a tragic loss. Americans aid and supplies paid for by all of us show up at every natural disaster across the globe. But the benefactors of these programs have not demanded these services be provided to them. They just ask and it is all given.
I buy insurance willingly. I pay my part for the scope and type of coverage I need. Before the ACA debacle, people could buy catastrophic, high-deductible insurance policies fairly cheap. Many people who did not have insurance chose not to have it and when they needed treatment, they got it anyway, and the cost of that was passed onto other consumers. Compassionate, but not very cost-effective. Fast forward to Obamacare, people were mandated to buy insurance that was unaffordable to the middle class and included welfare for pre-existing conditions. It was promoted on lies and some people think it was designed to fail in order to usher in socialized medicine. No thanks.
Have you heard of the Liverpool Care Pathway? Check it out. The UK government, which lots of people think they mean so much to, rewarded hospitals and doctors to deny food and water to elderly people whose treatments and continued existence were deemed liabilities by nameless, faceless, bureaucratic bean counters. They did this without the family's consent. Where's Grandpa? I'm sorry son, they cancelled Grandpa. No thanks. I'll pass.
The population on the dole is not that large in the UK - as you can see from your article, more than 40% of the recipients are seniors, and most other long-term recipients are disabled. About 80% of the unemployed find employment in less than 6 months, there are only 15k households (in the country with a population of almost 67 million) where there was unemployment in two generations, and the researchers were unable to find any family on generational welfare across 3 generations. This is about what I would have expected. Able-bodied adult people are on the dole in the UK very briefly, are generally deeply ashamed of being on the dole, and typically try to get off it any way possible.
There are counties in certain states in the US where being employed is almost unheard of, and nobody in the known history of any of the families has ever worked. I would not have believed it had I not seen it with my two eyes. The most popular activity in these counties seems to be consumption of crystal meth, relatively closely followed by the second most popular activity, ie, childbearing.
Yes, indeed, obviously everyone is not in favor of single payer. You obviously don't want anyone receiving any benefit from your personal dime. Apparently you feel police, fire, and ability to attend school should be paid for individually too. I feel differently, nothing wrong with that. We'll see how society shakes out. And remember, DT won the electorate but not the majority vote. Reality is the younger generations are heavily in favor of single payer and as the baby boomers age out, unless there is a significant shift in the millennial's view (which is possible), single payer is inevitable.
Quote:
Originally Posted by elnrgby
1. Who is "we" that accept the situation in which medical treatment or municipal services are subsidized by 47% of people for the benefit of 100% of people? You can speak for yourself, but not for me (or for Mitt Romney :-). The situation is far from acceptable to every US citizen, and the last election (of a president whose manners and rhetoric are a bit extreme even for my stomach :-), although I have mostly agreed with the policies that he has passed), so, the last election suggests that the majority of "us" probably does not choose to accept Robin Hood taxation.
"People on Medicaid should".. there's that should word again.. the one that doesn't match reality. It doesn't really matter would should be the case. The reality is people on medicaid, and off medicaid, show up in the emergency room and receive treatment. The law that allows that was passed by Ronald Reagan and no republican or democrat politicians are looking to change it.
Quote:
Originally Posted by elnrgby
2. There is already a health service (ie, Medicaid) that provides funding for people unable to pay any amount healthcare premium. People on Medicaid should receive care only at designated Medicaid facilities, and the spectrum of care should be limited only to bare essentials that the society can reasonably afford to give as a charity. Other ERs should not be required to admit Medicaid or non-paying uninsured patients.
Cost of insurance is one thing, cost of underlying care is another. I was asserting that the cost of underlying medical care under single payer is cheaper, plain and simple.
Quote:
Originally Posted by elnrgby
3. How health insurance is paid has a major effect on the cost of health insurance. How else do you explain the fairly low cost of my health insurance in Boston MA ($396 per month, age 59) except with the fact that every household in my zip code pays health insurance premium? Prices of medical services are surely not lower in Boston than in the rest of the nation.
This argument is reductio ad absurdum. Not many in the "welfare" class get 100% of their housing and food paid for. And there is huge swath of people in the 50% who do not pay federal income tax and are not in your purported welfare class.
Quote:
Originally Posted by elnrgby
4. The welfare class is not chipping in when it comes to their own housing or food. How do you envision configuring a single payer system where they will be chipping in to contribute to funding of healthcare?
How dare those people expect medical coverage for pre-existing conditions!
Quote:
Originally Posted by ncguy50
Compassionate, but not very cost-effective. Fast forward to Obamacare, people were mandated to buy insurance that was unaffordable to the middle class and included welfare for pre-existing conditions. It was promoted on lies and some people think it was designed to fail in order to usher in socialized medicine. No thanks.
How dare those people expect medical coverage for pre-existing conditions!
How dare people speak poorly of the compassionate chains of socialism.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
