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We have multiple insurance programs – based on age and income, there are differences among the states, who pays how much is a mess – many seniors pay more than younger Americans at the same income level.
Enrollment periods and rules differ by type of coverage. Out of pocket costs frequently ignore ability to pay. Employers try to mask costs via FSAs, HSAs and HRAs – if you can afford to contribute. Trying to deal with out-of-pocket costs jeopardizes the ability to save for retirement.
We allow drug companies to market directly to consumers driving demand and costs and perhaps creating health risks.
Allowable fees paid to providers for the same service vary greatly depending on the source of payment – Medicaid, Medicare, employer coverage, private pay – thus causing cost shifting and an unfair distribution of costs to patients.
Employers continue to shift costs to workers sometimes offsetting raises.
We make our disconnected approach so confusing few can figure it out.
Make an attempt at change and we hear the cry “socialized medicine” which is nonsense as we are talking about a payment system not health care delivery system.
I hear people from other countries talk about their much better “free” healthcare system. Of course, it is not free, but the very fact they feel that way tells us the perceived value of paying via taxes and not at the point of service. Everyone is in the same risk pool.
Why can’t America do better? I don’t expect to see significant change in my lifetime, but someday we may see the light.
Sorry, there is no valid argument against a universal USA health insurance system. We have tinkered with our system since the 1960s and I was involved in trying change after change to manage costs, nothing has worked. Nothing has assured universal coverage.
I once lobbied Congress against the Clinton health care plan, I was wrong. Will any universal system be perfect? Certainly not. Will there be tradeoffs? Absolutely!
But if our system works fine for people like me – aside from premiums over $2,000 a month for us – it doesn’t for tens of millions of others young and old and the cost shifting to the middle class is getting worse.
Our goals should be universal insurance coverage, uniform management of costs, fair distribution of costs and no variations based on where you live.
I would like to see serious tuition help for medical students as the debt where I live is preventing them from buying into practices. Our PCP is overloaded with patients. Also, raises in Medicare should be included in the Social Security COLA, rather than erasing the small increases we get. We are anxiously awaiting the promised 2025 cap on Part D of Medicare, as it runs us about $8K/year and we have good insurance!
to understand how convoluted and “weird” our healthcare system is in terms of who and how we pay listen to the podcast an arm and a leg. It’s surreal at times what people have to go through. One hint is clear there are profits being earned by big corporations that are not adding a penny to the quality of healthcare. I’m not sure what the answer is since to change anything you have to pass laws but these corporations make huge political contributions.
Keep in mind that in places where there are perceived
long waits for health care services as in Canada and the UK there is budgeting intended to manage costs, but which also limits available services in some cases. Medicare does not do that, but attempts to manage cost by limiting payable fees.
No matter what, the open access and generally readily availability of healthcare resources Americans want and expect will always be expensive.
For example the US has 38 MRIs per million population, Canada has 10. The UK 8.6 Only Japan has more than the US.
So easier access, more spending. Also, scanners are expensive so to pay for them they have to be used – who creates the demand?
No valid argument against universal health insurance, huh? I admire your confidence. You may find of interest a concept called “steel-manning,” where instead of exposing the weakest possible argument against your position, you deliberately discuss the opposing side’s strongest case.
My dad’s from a communist country that has universal health insurance and their health care is terrible. Have you ever wondered why the richest people from all over the world come to the US for care? They don’t go to Canada or UK. They come here because you can pay for the best care possible.
I, for one, love it when my doctors get rich. It means they’re providing a valuable service to many people who reward them for their skill with certificates of appreciation with presidents faces on them. This is the same reason I love it when my lawyer, accountant, plumber, and car mechanic get rich. If they profit it is because they delivered a good or service that the market found valuable.
Just in case you think I’m the Monopoly Guy, I grew up poor in this country. My mother died of cancer with no health insurance. That sucked, but that doesn’t change the fact that free enterprise is the answer, and “universalizing” (socialism) is not. Never has been. Once “universal” heath care comes to the US our system will be just as dreadful as all of the other countries that have it.
I can’t think of any reason a brilliant, skilled person would go into medicine to become a doctor just to be paid like a government employee. Instead our best and brightest will go into non-“Universalized” fields…until those are “universalized” too.
I completely agree.
The most successful health care systems in the world are hybrids, where universal coverage is buttressed by the availability of private insurance. They are not “dreadful” — they are vastly superior to the US, which has the best physicians, best hospitals, best new medical devices, and worst outcomes.
The universal measuring stick for the effectiveness of a nation’s health care is how they care for babies and new mothers. The US infant mortality rate is 49th in the world. It’s more than double that of Slovenia, Cyprus, Belarus and Montenegro. Our maternal mortality rate is 21 per 100,000 births which is 65th in the world. That’s obscene. Israel and Australia have a rate of 3 per 100,000. Germany and France are 5 and 8 respectively. We are killing our new mothers with neglect.
Fewer than half of US physicians are self-employed and that number is only 32% for those under the age of 45 (a 13 percentage point drop in the past 10 years).
It appears you have not read the research which has demonstrated repeatedly that US health care, compared to all other developed countries, costs twice as much per person for results that are on average worse. Yes, if you are very rich you can get excellent care, but that’s not true of most people.
it wouldn’t be quite so bad if all that excess spending went to the doctors, but in general it does not. It goes to administrators and middle men and insurance companies. Not to mention professions other countries don’t need, like medical coders.
i don’t know which country your father grew up in, but France is held by experts to have the best medical system in the world. But they understand the difference between Communism and Socialism.
Nope, no reason and if you have a better idea that meets the criteria of universal coverage, fair income based costs to individuals and open access to care with reasonable cost management I am open to hear it.
Keep in mind we have Medicare as an example. It’s not perfect as is, but it does the job very well for 20% of Americans today.
Medicare is not even close to socialism, There’s no government ownership of healthcare at all. People who falsely claim a Medicare for all type approach is