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Thread: Serious Healthcare Thread

  1. #21
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    Quote Originally Posted by Keorythe View Post
    The "old document" is the basis for most rights in the US. Social values change from decade to decade, rights do not.
    Some 3/5 persons would no doubt like to have a word on that statement.
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  2. #22
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    I consider that access to healthcare should be a right, not a privilege. Rights are (in my opinion) posited, so its up for individual jurisdictions to grant that right to its people.

    Living in fear of being bankrupted by getting ill through no fault of your own is ridiculous. Illness and disability is unpleasant enough without the added stress of the cost to worry about.

    Many countries around the world have demonstrated that single-payer free at the point of delivery or similar systems can work, can be efficient and can provide a high level of care cost effectively. The burden on taxpayers is not infrequently far less than the cost of health insurance would be individually in the US.

    It therefore stands to reason that a national universal healthcare system is a moral imperative.

  3. #23
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    Quote Originally Posted by Lallante View Post
    It therefore stands to reason that a national universal healthcare system is a moral imperative.

    This. Add good and clean water to that. Apart from a moral perspective, it is also cheaper to have a conscience where people go to doctors and get treatment without worry since medical cost rise exponentialy the later the treatment starts.

  4. #24
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    Quote Originally Posted by Lallante View Post
    It therefore stands to reason that a national universal healthcare system is a moral imperative.
    In my opinion, I think you'd find most Americans, even on the right, agree.......when discussing the poor, the disabled, veterans, etc.

    The disagreement, in my experience, is the concept of paying for able-bodied people who should (as the argument goes) be working and paying for this service themselves.

    Many Americans do not see it as a moral imperative to provide free healthcare for the able bodied non-poor, anymore than they see it as a moral imperative to provide food stamps, free housing, free cellphones, free cars, etc, etc, etc.

    Food and housing are two key items on that list, given that life cannot survive without food and water, or without shelter from the elements. There is no percieved moral imperative in the United States that we should have a national system of food distribution, or a national system of housing, even if it may be cheaper when taken as a whole, or more fair (as some define it) when taken as a whole, or more effective when taken as a whole. We provide aid in aquiring both to those in need, i.e. the poor (with the expectation they'll try and work their way out of it) and the disabled/retired/veterans/etc. on a more permanent basis. We also provide aid in healthcare to those same groups in the same way.

    It's a fundamental viewpoint difference between a meaningful portion of U.S. voters, and how Europe et al. feels. There is a distinction made between what moral imperative exists and to whom that imperitive applies. Put simply, a majority (thus far) of American taxpayers and voters do not believe they should be required to pay for basic needs if the person is able-bodied beyond the short-term aid offered specificly to those living below the poverty line.

    Please note (before someone gets all spergy and ad hom. again) that I'm not taking a side on the issue here, I am relaying the position and issues that bar a Universal System in the United States, based on my experience discussing and debating the issue with other "regular" Americans, right and left.


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    Indeed. A good chunk of our country still believes that the poor should simply get jobs and stop being poor, ignoring the fact that so much of our system is rigged to keep this from ever happening. Effective marginal tax rates exceeding 100% are great for discouraging people from wanting to earn more money.

    And the unaffordability of healthcare is part of that system that keeps them poor. TBH, we'd probably be better off helping pay for it with the hopes that they could then get out of the poverty trap and start earning enough money to pay meaningful taxes. But that logic applies to a lot of things, like paying for better schools and kids programs, etc.

  6. #26
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    Quote Originally Posted by Victoria Steckersaurus View Post
    Indeed. A good chunk of our country still believes that the poor should simply get jobs and stop being poor, ignoring the fact that so much of our system is rigged to keep this from ever happening. Effective marginal tax rates exceeding 100% are great for discouraging people from wanting to earn more money.

    And the unaffordability of healthcare is part of that system that keeps them poor. TBH, we'd probably be better off helping pay for it with the hopes that they could then get out of the poverty trap and start earning enough money to pay meaningful taxes. But that logic applies to a lot of things, like paying for better schools and kids programs, etc.
    How much do you make, ballpark, Victoria? How much of it are you willing to offer up to help them?

    50% perhaps? 75%?

    It is VERY easy to say "we should help". It is far harder for many to actually do it, when they see their paycheck get cut, and can no longer live their own life in the comfort they have come to expect, and feel they've earned with their labor.

    It's very easy to say "do these things, and it'll be cheaper!", except when one looks at how the U.S. Federal Govt. operates fiscally, it is never, ever cheaper. The Feds never spend less, they always spend more. There is no reason to have faith that, if implemented, a Universal healthcare system in the U.S. will result in any lowered burden to taxpayers, quite the contrary. The fact that it is cheaper elsewhere does not mean it will be cheaper here.

    In my own view, I'd be far more supportive of this aim IF alongside it's creation, we took a cold hard look at what our Government is currently spending it's money on, and cut the ever loving fuck out quite a large portion of it. Including defense and foreign interventionism. Especially defense as it related to places like Europe, Japan and Korea and the middle east.

    Reallocate existing federal revenues from these wastes, and put them to expanding/building an efficient national Federal Healthcare option (at least to start) citizens can choose, and fund real science to start the shift from oil-based to green-energy-based, and to rebuild our own infrastructure of roads, bridges, rail, mass transit, internet, etc.

    As a finance guy, I have absolute faith we can have so much of what we want.....with the money we taxpayers already pay in. But some VERY sacred cows will ahve to be butchered in the process.


  7. #27

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    Quote Originally Posted by Alistair View Post
    How much do you make, ballpark, Victoria? How much of it are you willing to offer up to help them?

    50% perhaps? 75%?

    It is VERY easy to say "we should help". It is far harder for many to actually do it, when they see their paycheck get cut, and can no longer live their own life in the comfort they have come to expect, and feel they've earned with their labor.
    Are you trying to argue that implementing a decent healthcare system would increase costs? Because you'd be wrong. Period. Our current system inflates costs massively, and the savings from putting in something effective (Israel is a good model) would be enough that we could provide decent healthcare for the poor and still be coming out ahead.

    I think the piece you're missing is that your insurance already comes out of your paycheck - you just don't see it. If you have employer-backed health insurance, your employer is paying a large amount of money for your insurance. So yes, taxes would probably need to go up for a government run system, but the cost savings to your employer is going to massively outweigh your increased taxes. Hopefully you're working for a company with a soul and they raise your salary by a reasonable amount as a result.

    The only argument against it boils down to "The poor don't deserve the help, therefore I'll pay more money for my broken system that doesn't help them than implement one that saves both of us money."

    It's like after school and community programs for at-risk youth. People say they don't want to pay for them, without realizing that they are actually a massive savings because of the reduced rate of incarceration. So you choose not to pay for the program because you don't think they deserve the help (or your budget is simply tight), and instead you pay even more money to keep them in prison.

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    Allistair did you read the posts earlier in this thread that showed that the US spends MORE of its GDP, MORE per capita per year on healthcare than any other country in the world?

    Those darn liberal hippies with universal healthcare are spending LESS than you are. Also they are far healthier and live longer.

    My point is that if the US moved to an efficient (lol) universal healthcare system it would save costs while vastly improving the quality of life of the whole population. It's not some tradoff like you describe, where the rich must help the poor by paying extra.
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  9. #29
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    Quote Originally Posted by Alistair View Post
    Quote Originally Posted by Lallante View Post
    It therefore stands to reason that a national universal healthcare system is a moral imperative.
    In my opinion, I think you'd find most Americans, even on the right, agree.......when discussing the poor, the disabled, veterans, etc.

    The disagreement, in my experience, is the concept of paying for able-bodied people who should (as the argument goes) be working and paying for this service themselves.
    If you need healthcare, you by definition are not "able bodied".


    Many Americans do not see it as a moral imperative to provide free healthcare for the able bodied non-poor, anymore than they see it as a moral imperative to provide food stamps, free housing, free cellphones, free cars, etc, etc, etc.
    Right, which is why fuck america tbh.
    Food and housing are two key items on that list, given that life cannot survive without food and water, or without shelter from the elements. There is no percieved moral imperative in the United States that we should have a national system of food distribution, or a national system of housing, even if it may be cheaper when taken as a whole, or more fair (as some define it) when taken as a whole, or more effective when taken as a whole.
    right, which is why the USA is a terrible place. The whole "if you cant afford it, die" attitude is horribly wrong and the fact that its mainstream is terrifying.
    It's a fundamental viewpoint difference between a meaningful portion of U.S. voters, and how Europe et al. feels. There is a distinction made between what moral imperative exists and to whom that imperitive applies. Put simply, a majority (thus far) of American taxpayers and voters do not believe they should be required to pay for basic needs if the person is able-bodied beyond the short-term aid offered specificly to those living below the poverty line.
    I agree. I'd rather live in a world where people help you up when you fall rather than counting to 5 and then standing on your head.

  10. #30
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    Quote Originally Posted by Victoria Steckersaurus View Post
    Are you trying to argue.....
    I'm not trying to argue. Given that you've just demonized every possible opponent or objection as coming exclusively from someone who hates poor people and is too stupid to understand their own budgets vs. tax budens. I don't see much room for argueing with you.

    Suffice it to say, you have far more faith in the abillity of the U.S. Federal Govt. to operate an efficent cost-effective, spending-appropriate, equivalent-to-current-quality single-payor Universal Healthcare system than many Americans do, you have more faith that such a system will translate from Israel-sized to U.S.-sized without considerable problems and additional costs or adverse economic impacts, and you have far more faith that the result wouldn't be either either raised levels of Federal debt and/ or increased taxation to fund it all.

    These are the concerns (in part) you'll need to overcome to get such a system passed into Law in the United States. Even if the concerns are all based in stupidity and ignorence and hatred of poor people, they will still need overcome.

    Quote Originally Posted by Lallante View Post
    Right, which is why fuck america tbh.

    right, which is why the USA is a terrible place.
    Ok.
    Last edited by Alistair; March 1 2013 at 03:42:49 PM.


  11. #31
    Movember '12 Best Facial Hair Movember 2012Donor Lallante's Avatar
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    Quote Originally Posted by Alistair View Post
    Quote Originally Posted by Victoria Steckersaurus View Post
    Are you trying to argue.....
    I'm not trying to argue. Given that you've just demonized every possible opponent or objection as coming exclusively from someone who hates poor people and is too stupid to understand their own budgets vs. tax budens. I don't see much room for argueing with you.

    Suffice it to say, you have far more faith in the abillity of the U.S. Federal Govt. to operate an efficent cost-effective, spending-appropriate, equivalent-to-current-quality single-payor Universal Healthcare system than many Americans do, you have more faith that such a system will translate from Israel-sized to U.S.-sized without considerable problems and additional costs or adverse economic impacts, and you have far more faith that the result wouldn't be either either raised levels of Federal debt and/ or increased taxation to fund it all.

    These are the concerns (in part) you'll need to overcome to get such a system passed into Law in the United States. Even if the concerns are all based in stupidity and ignorence and hatred of poor people, they will still need overcome.
    Why not state run, federally mandated minimum standard schemes paid for by a federal grant distributed by population?

  12. #32
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    Quote Originally Posted by Lallante View Post
    Quote Originally Posted by Alistair View Post
    Quote Originally Posted by Victoria Steckersaurus View Post
    Are you trying to argue.....
    I'm not trying to argue. Given that you've just demonized every possible opponent or objection as coming exclusively from someone who hates poor people and is too stupid to understand their own budgets vs. tax budens. I don't see much room for argueing with you.

    Suffice it to say, you have far more faith in the abillity of the U.S. Federal Govt. to operate an efficent cost-effective, spending-appropriate, equivalent-to-current-quality single-payor Universal Healthcare system than many Americans do, you have more faith that such a system will translate from Israel-sized to U.S.-sized without considerable problems and additional costs or adverse economic impacts, and you have far more faith that the result wouldn't be either either raised levels of Federal debt and/ or increased taxation to fund it all.

    These are the concerns (in part) you'll need to overcome to get such a system passed into Law in the United States. Even if the concerns are all based in stupidity and ignorence and hatred of poor people, they will still need overcome.
    Why not state run, federally mandated minimum standard schemes paid for by a federal grant distributed by population?
    Given how existing Federal healthcare programs work, this is very likely the way any such system would be implemented. State run, funded partially via Federal subsidy (i.e. grant) with some form of state match requirements, with Federally imposed standards.

    Population basis would certainly be a part of the calculation for funding, but only a part, other factors would be included as well I'd venture.


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    Quote Originally Posted by Alistair View Post
    Quote Originally Posted by Victoria Steckersaurus View Post
    Are you trying to argue.....
    I'm not trying to argue. Given that you've just demonized every possible opponent or objection as coming exclusively from someone who hates poor people and is too stupid to understand their own budgets vs. tax budens. I don't see much room for argueing with you.

    Suffice it to say, you have far more faith in the abillity of the U.S. Federal Govt. to operate an efficent cost-effective, spending-appropriate, equivalent-to-current-quality single-payor Universal Healthcare system than many Americans do, you have more faith that such a system will translate from Israel-sized to U.S.-sized without considerable problems and additional costs or adverse economic impacts, and you have far more faith that the result wouldn't be either either raised levels of Federal debt and/ or increased taxation to fund it all.

    These are the concerns (in part) you'll need to overcome to get such a system passed into Law in the United States. Even if the concerns are all based in stupidity and ignorence and hatred of poor people, they will still need overcome.
    If you start with a statement like this:

    How much do you make, ballpark, Victoria? How much of it are you willing to offer up to help them?

    50% perhaps? 75%?
    It looks like you're trying to argue. Just FYI.

    And actually, I don't think every objection comes from people who (in lesser terms) hate the poor - although politicians have done an excellent job of encouraging it. Most objections come from people who are ignorant - specifically, ignorant of how much money their employer wastes on their insurance. Because they don't tell us.

    Do I think the Israeli system will scale perfectly from a country their size to ours? Probably not. But our current system spends 18% GDP on mediocre to poor healthcare, and theirs spends 8% on very good healthcare. That's such a massive gulf it's absurd.

    And of course taxes are going to go up, I mentioned that in my post. But compared to the amount we currently waste on private insurance companies, the tax increase should be less than the savings.

    Does the Federal Gov. waste money? Sure. Do we have some bloated programs that need to be cut? Absolutely. Most of that is due to congressmen doing their best to bring federal money back to their states to help get themselves elected again. Is there a risk that healthcare could end up the same way? Certainly. But most every country that has universal healthcare has implemented ways to keep costs in line. I don't think it's impossible.


    And even if the FedGov does continue to waste money, it would still likely be less than the amount we currently overpay for healthcare. They have some form of oversight, which private insurance has successfully removed from the system.

  14. #34
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    Quote Originally Posted by Victoria Steckersaurus View Post
    If you start with a statement like this:

    How much do you make, ballpark, Victoria? How much of it are you willing to offer up to help them?

    50% perhaps? 75%?
    It looks like you're trying to argue. Just FYI.
    It's fair to ask what level of overall taxation you're personally comfortable with accepting to achieve the aims your promote, is it not?

    Do I think the Israeli system will scale perfectly from a country their size to ours? Probably not. But our current system spends 18% GDP on mediocre to poor healthcare, and theirs spends 8% on very good healthcare. That's such a massive gulf it's absurd.
    So, your position (if I understand it) is that we're going to add full coverage to something like ~100,000,000 new people (non- and underinsured currently) reaching 100% coverage, at a superior level of service to that enjoyed by the average privately insured person, with the same level of technology and pharmacopia access, the same level of investment in advancement, and we're going to save ~10% of our GDP doing it.

    And it's going to be run by the Federal Govt. and administered by the 50 States (following on Lall's quite astute point above).

    I have trouble believing that.

    So lets be objective. Can you provide an example of any other servidce that the Federal Government does that was taken away from the private sector competition where the Govt. service was a marked increase in service, at a marked descrease in costs, to the previous private version?

    As I am sure you understand, if you can promise me we can cover everyone, at current levels of service or better, and my paycheck will be bigger each week net take-home (higher taxes but no insurance costs), it would be a very difficult issue to oppose except from an ultra-libertarian individualist position (whcih is in truth a very small minority, most voters still vote out of personal self-interest above all else).

    The hurdle is showing that this is actually how it would work. Proof of concept here in the U.S. Do we have an example that could be used to prove it?


  15. #35
    Movember '12 Best Facial Hair Movember 2012Donor Lallante's Avatar
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    In answer to your question I'm happy to pay 50% overall in taxation. Potentially more if the additional tax comes from spending on luxuries.

    An example of nationalisation that caused an improvement in services is Railtrack in the UK, which was pseudo nationalised (it was liquidated and its assets were given to its government backed successor, Network Rail). Network Rail is safer and better run than Railtrack (though not without its own problems).

    The US doesnt nationalise because its so right-wing.
    Last edited by Lallante; March 1 2013 at 04:27:05 PM.

  16. #36
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    Quote Originally Posted by Lallante View Post
    An example of nationalisation that caused an improvement in services is Railtrack in the UK, which was pseudo nationalised (it was liquidated and its assets were given to its government backed successor, Network Rail). Network Rail is safer and better run than Railtrack (though not without its own problems).

    The US doesnt nationalise because its so right-wing.
    An interesting example, as the U.S. nationalized it's long-distance passenger rail services, in the form of Amtrak, in the 1970's. In this case, however, it's a difficult example to use as proof-of-case, as passenger rail in the United States has never been a profitable venture (unlike healthcare), and never will be.

    The private freight-rail companies were quite eager to dump their service requirements on the Federal Govt. Service did not improve (but it was generally maintained) and costs have risen substantially from before the mid-70's nationalization to after.

    I will agree with the last, the U.S. in general (very general) belives in private-for-profit ownership of industries, not collectivised nationalization of industries. Something I believe is changing and will continue to change over time.


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    Quote Originally Posted by Alistair View Post

    So, your position (if I understand it) is that we're going to add full coverage to something like ~100,000,000 new people (non- and underinsured currently) reaching 100% coverage, at a superior level of service to that enjoyed by the average privately insured person, with the same level of technology and pharmacopia access, the same level of investment in advancement, and we're going to save ~10% of our GDP doing it.

    And it's going to be run by the Federal Govt. and administered by the 50 States (following on Lall's quite astute point above).

    I have trouble believing that.
    You could probably save that by just implementing a bit system for government as single purchaser of medicine tbh. And no, that does not mean less choice for consumers, in fact a system where patients asks the doctor for specific brands of drugs is frankly retarded.


    Quote Originally Posted by Alistair View Post
    So lets be objective. Can you provide an example of any other servidce that the Federal Government does that was taken away from the private sector competition where the Govt. service was a marked increase in service, at a marked descrease in costs, to the previous private version?

    As I am sure you understand, if you can promise me we can cover everyone, at current levels of service or better, and my paycheck will be bigger each week net take-home (higher taxes but no insurance costs), it would be a very difficult issue to oppose except from an ultra-libertarian individualist position (whcih is in truth a very small minority, most voters still vote out of personal self-interest above all else).

    The hurdle is showing that this is actually how it would work. Proof of concept here in the U.S. Do we have an example that could be used to prove it?
    This is not us being objective FYI.

    And the rest of the western world is a brilliant proof of concept.

    Sent from my Nexus 7 using Tapatalk HD

  18. #38
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    The affordable health care act is a pretty intresting thing, and there is soo much mis-information surrounding it. If you were to ask what the primary purpose of the legislation was, most people would tell you its either to provide healthcare to those who cannot afford it, or to bring down said costs. Both would be wrong. The goal of the affordable health care act is the abolition of "pre-existing" conditions. This is certainly a goal that is worth pursuing as having a lapse in health insurance should not prevent you from being able to get it affordably ever again.

    This is why there is the requirement for everyone to have health insurance, as if you were not required to from the get go, people would abuse the system and only purchase healthcare when the need arose. Its to make it as fair as possible for both the insurance companies & the people. This way everyone has health coverage, and skin in the game from the get go, and insurance companies do not have to suffer massive losses from people who would only purchase health care when they needed it, and stop it as soon as no longer do. Its not fair to expect an insurance company to shell out 100's of thousands of dollars for cancer treatment, when the person only acquired it only after they were diagnosed, and cancelled it as soon as treatments were done & they were given a clean bill of health.

    I also think its worth mentioning that, atleast IMO, part of the huge rises in healthcare has been that people go to the hospitals now adays for things that do not neccesitate it. When I was growing up, if you went to the hospital, it was an emergency, something was broken, or someone was in bad shape and need immediate medical attention. Now adays people take their kids to the emergency room for colds, minor infections, or many other things that simply do not represent a medical emergency, and would be the type of thing you would see your GP about. I understand that when it comes to your kids everything is serious & that people want the best care possible for them, but alot of people need a fucking reality check. For an example of how messed up this shit is; A few weeks ago my friend took her 7 year old son to the hospital because his throat was sore, he has strept throat. This is something that in no way shape or form requires a hospital visit. Its one thing if your getting recuring strept as that can be a sign of appendix or immune problems, but an isolated case of it is not a medical emergency. Do you want to know why she went to the hospital? Because she cancelled her health private insurance policy because most hospitals in NJ will provide free healthcare to individuals under 26 y/o with no health insurance. She currently has no incentive to carry health insurance because she can game the system. And this is far from rare occurance. Any american can likely tell you stories of sitting in a waiting room with people legitamately needing medical care & they are having to wait for because so many people with inane, non-emergency issues got there before them. And by law the hospital cannot turn them away, even if its just little timmy broke his pinky toe.

  19. #39
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    Quote Originally Posted by Alistair View Post
    Given how existing Federal healthcare programs work, this is very likely the way any such system would be implemented. State run, funded partially via Federal subsidy (i.e. grant) with some form of state match requirements, with Federally imposed standards.

    Population basis would certainly be a part of the calculation for funding, but only a part, other factors would be included as well I'd venture.
    Needs to be mandatory spending if this happens. The federal government has a long track record of making mandatory programs where States match federal funds. But federal funding cuts off after a few years and the State governments are stuck with the program which they can't control and can't remove.

    What you're describing is a healthcare exchange sort of like the ones in Obamacare but with the roles reversed. And just like previous federal implemented programs, this is funded by the State but the State really has no control over it. The likelihood of subsidies being yanked in the future are pretty high and this is a REALLY expensive program. This scares the crap out of a number of States since they tried this long before and failed due to cherry picking and a market only within the State itself.

    EU countries get the luxury of lower prices through price controlling. We could do the same here in the US but you could just see the lawyers prepping for the future Supreme Court battles. We could institute regulations about pricing, drug licensing, and other items to reduce costs. Again, read the OP article. Yes, it's fucking long but it's a darn good read. The major issue of pricing is the key here. If it were normalized and if there was some real competition between companies rather than the stranglehold they have over patents then prices would drop like a rock.

    Gotta run, Blue Cross meeting for my company insurance in an hour. Ironic isn't it? Wondering if I should skip the dental plan.

  20. #40
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    Quote Originally Posted by Keorythe View Post
    Quote Originally Posted by Alistair View Post
    Given how existing Federal healthcare programs work, this is very likely the way any such system would be implemented. State run, funded partially via Federal subsidy (i.e. grant) with some form of state match requirements, with Federally imposed standards.

    Population basis would certainly be a part of the calculation for funding, but only a part, other factors would be included as well I'd venture.
    Needs to be mandatory spending if this happens. The federal government has a long track record of making mandatory programs where States match federal funds. But federal funding cuts off after a few years and the State governments are stuck with the program which they can't control and can't remove.

    What you're describing is a healthcare exchange sort of like the ones in Obamacare but with the roles reversed. And just like previous federal implemented programs, this is funded by the State but the State really has no control over it. The likelihood of subsidies being yanked in the future are pretty high and this is a REALLY expensive program. This scares the crap out of a number of States since they tried this long before and failed due to cherry picking and a market only within the State itself.

    EU countries get the luxury of lower prices through price controlling. We could do the same here in the US but you could just see the lawyers prepping for the future Supreme Court battles. We could institute regulations about pricing, drug licensing, and other items to reduce costs. Again, read the OP article. Yes, it's fucking long but it's a darn good read. The major issue of pricing is the key here. If it were normalized and if there was some real competition between companies rather than the stranglehold they have over patents then prices would drop like a rock.

    Gotta run, Blue Cross meeting for my company insurance in an hour. Ironic isn't it? Wondering if I should skip the dental plan.
    Aye, good post.
    And as one who recently had all four wisdom teeth yanked......don't skip the dental.


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