Anonymous
01/20/2016 14:52
Subject: Insurance and Pharma Companies under Single Payer System?
No health care bill will ever pass Congress without some concessions to the insurance industry. The reason we have Medicare and Medicaid in the first place is because insurers only want to cover young healthy people with jobs and leave the rest to the government. But over time the insurers have figured out how to get pieces of Medicare and Medicaid subsidies while still cherry-picking to avoid taking the risk of taking care of the old, the chronically ill, or the poor. So we have Medicare Advantage, Medicare Part D, Medicaid Managed Care, and similar programs that contract with insurance companies at higher costs. Obamacare is the government overpaying insurance companies to cover the people they don't want to cover. Also, unwinding employer provided health insurance would be political heavy lifting because most companies and employees would see it as a tax increase. The tax code and public opinion heavily favor paying premiums for employer provided care than paying taxes for government provided care.
Anonymous
01/20/2016 14:44
Subject: Insurance and Pharma Companies under Single Payer System?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Doctors don't get paid enough and in a timely manner by govt. sorry
you're full of it. they get paid much more quickly from the government and in some cases more.
Definitely get paid more quickly (usually). I don't know any instance where they pay more, maybe some HMOs. I don't have a single contract below Medicare allowable. A lot of strings attached to Medicare reimbursement as well. Also potential for criminal prosecution for charting errors. I try to limit Medicare to 30% of my practice. I will go to cash only or retire if single payer happens
Would you have agreed to single-payer if it meant Uncle Sam picked up 100% of your medical school costs?
I'm willing to be 90% of kids currently in medical school would take that deal. $300K+ in student loans is not sustainable. I think this will eventually be the grand bargain one day in exchange for single-payer coverage.
Well mine are paid off but even so I would say no. If I were in medical school looking at single payer I would look at other career paths.
The rising cost of education in general and medical school specifically is a topic in and of itself, but yes the inflationary costs are not sustainable. In your scenario the new doctors are basically indentured servants to the govt. I would imagine at the very least the govt would want to dictate where you practice for a set number of years (the way current federal forgiveness/payback program works), and for that kind of money most likely will want to direct your specialty training as well (how military medical "scholarships" work).
There is also the lost time away from family and deferring/foregoing pursuit of avocations that medical training requires that really has no dollar cost, but 80-100k per year beginning at 30 to 32 years of age won't cover it for many of the best and brightest when they are looking at options.
If your fearmongering were true, there would be no doctors in uk, france, or germany.
I never said *no one* would become doctors, just that many of the best candidates would be open to pursuing less strenuous professions
Again, for another thread, the healthcare systems in all three of those countries have separate issues, but briefly:
Training is not nearly as lengthy in terms of formal education, and residencies and fellowships not nearly as grueling.
Malpractice suits are almost nonexistent in terms of the physician's liability.
European physicians stick to bankers' hours except for life and limb threatening conditions.
I honestly don't know how other fields such as IB, law, etc pay in Europe compared to the US, but I would suspect many people here with options would look at other jobs in the high 5 to low 6 figure range that didn't require the number of years medicine does. Hell, if I were starting out and looking at a government run system I would consider going to nursing school and then CRNA or NP school rather than medical school if I really wanted to be in the medical field. Get out quicker, less liability/responsibility, and much better hours for close to the same pay.
We are already looking at a projected shortfall in physicians even without govt run healthcare; but maybe you are right, maybe all those young men and women will still flock to the profession.
Anonymous
01/20/2016 13:03
Subject: Insurance and Pharma Companies under Single Payer System?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Doctors don't get paid enough and in a timely manner by govt. sorry
you're full of it. they get paid much more quickly from the government and in some cases more.
Definitely get paid more quickly (usually). I don't know any instance where they pay more, maybe some HMOs. I don't have a single contract below Medicare allowable. A lot of strings attached to Medicare reimbursement as well. Also potential for criminal prosecution for charting errors. I try to limit Medicare to 30% of my practice. I will go to cash only or retire if single payer happens
Would you have agreed to single-payer if it meant Uncle Sam picked up 100% of your medical school costs?
I'm willing to be 90% of kids currently in medical school would take that deal. $300K+ in student loans is not sustainable. I think this will eventually be the grand bargain one day in exchange for single-payer coverage.
Well mine are paid off but even so I would say no. If I were in medical school looking at single payer I would look at other career paths.
The rising cost of education in general and medical school specifically is a topic in and of itself, but yes the inflationary costs are not sustainable. In your scenario the new doctors are basically indentured servants to the govt. I would imagine at the very least the govt would want to dictate where you practice for a set number of years (the way current federal forgiveness/payback program works), and for that kind of money most likely will want to direct your specialty training as well (how military medical "scholarships" work).
There is also the lost time away from family and deferring/foregoing pursuit of avocations that medical training requires that really has no dollar cost, but 80-100k per year beginning at 30 to 32 years of age won't cover it for many of the best and brightest when they are looking at options.
If your fearmongering were true, there would be no doctors in uk, france, or germany.
Anonymous
01/20/2016 12:57
Subject: Insurance and Pharma Companies under Single Payer System?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Doctors don't get paid enough and in a timely manner by govt. sorry
you're full of it. they get paid much more quickly from the government and in some cases more.
Definitely get paid more quickly (usually). I don't know any instance where they pay more, maybe some HMOs. I don't have a single contract below Medicare allowable. A lot of strings attached to Medicare reimbursement as well. Also potential for criminal prosecution for charting errors. I try to limit Medicare to 30% of my practice. I will go to cash only or retire if single payer happens
Would you have agreed to single-payer if it meant Uncle Sam picked up 100% of your medical school costs?
I'm willing to be 90% of kids currently in medical school would take that deal. $300K+ in student loans is not sustainable. I think this will eventually be the grand bargain one day in exchange for single-payer coverage.
Well mine are paid off but even so I would say no. If I were in medical school looking at single payer I would look at other career paths.
The rising cost of education in general and medical school specifically is a topic in and of itself, but yes the inflationary costs are not sustainable. In your scenario the new doctors are basically indentured servants to the govt. I would imagine at the very least the govt would want to dictate where you practice for a set number of years (the way current federal forgiveness/payback program works), and for that kind of money most likely will want to direct your specialty training as well (how military medical "scholarships" work).
There is also the lost time away from family and deferring/foregoing pursuit of avocations that medical training requires that really has no dollar cost, but 80-100k per year beginning at 30 to 32 years of age won't cover it for many of the best and brightest when they are looking at options.
Anonymous
01/19/2016 19:52
Subject: Insurance and Pharma Companies under Single Payer System?
Anonymous wrote:No need to worry about this since there's no way in hell he can get this through Congress.
+1 yup - insurance industry has too strong of a lobby.
Remember Hillarycare that went up in a fireball Bill's first year in office?
Anonymous
01/19/2016 19:51
Subject: Insurance and Pharma Companies under Single Payer System?
Anonymous wrote:No need to worry about this since there's no way in hell he can get this through Congress.
All depends on if he would be successful at rallying the general public and in turn putting real pressure on Congress.
Anonymous
01/19/2016 19:46
Subject: Insurance and Pharma Companies under Single Payer System?
No need to worry about this since there's no way in hell he can get this through Congress.
Anonymous
01/19/2016 19:45
Subject: Insurance and Pharma Companies under Single Payer System?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Didn't single payer fail in VT?
Yes, because it's too expensive. When asked about it the debate, Bernie basically blamed the governor. He gets very pissy about people who endorsed Hillary. Hell, Martin O'Malley has more congressional endorsements than Bernie.
It couldn't be done in a state with 90% liberals and a homogeneous population of 500,000 people and 750,000 cows. How can ANYONE believe Bernie, who is so inconsequential in the Senate for 25 years could actually roll out government run health care?
I'm sure in a federal universal system there would be some subsidizing going on between states. High income states would be generating more funds then they need, unless there's a cap on the tax. And healthier states would probably also be generating more funds then they need. But that's the benefit of a universal system and why it works.
Anonymous
01/19/2016 19:17
Subject: Insurance and Pharma Companies under Single Payer System?
Anonymous wrote:Anonymous wrote:Didn't single payer fail in VT?
Yes, because it's too expensive. When asked about it the debate, Bernie basically blamed the governor. He gets very pissy about people who endorsed Hillary. Hell, Martin O'Malley has more congressional endorsements than Bernie.
It couldn't be done in a state with 90% liberals and a homogeneous population of 500,000 people and 750,000 cows. How can ANYONE believe Bernie, who is so inconsequential in the Senate for 25 years could actually roll out government run health care?
Anonymous
01/19/2016 19:13
Subject: Insurance and Pharma Companies under Single Payer System?
Anonymous wrote:Didn't single payer fail in VT?
Yes, because it's too expensive. When asked about it the debate, Bernie basically blamed the governor. He gets very pissy about people who endorsed Hillary. Hell, Martin O'Malley has more congressional endorsements than Bernie.
Anonymous
01/19/2016 19:10
Subject: Insurance and Pharma Companies under Single Payer System?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Doctors don't get paid enough and in a timely manner by govt. sorry
you're full of it. they get paid much more quickly from the government and in some cases more.
Definitely get paid more quickly (usually). I don't know any instance where they pay more, maybe some HMOs. I don't have a single contract below Medicare allowable. A lot of strings attached to Medicare reimbursement as well. Also potential for criminal prosecution for charting errors. I try to limit Medicare to 30% of my practice. I will go to cash only or retire if single payer happens
Would you have agreed to single-payer if it meant Uncle Sam picked up 100% of your medical school costs?
I'm willing to be 90% of kids currently in medical school would take that deal. $300K+ in student loans is not sustainable. I think this will eventually be the grand bargain one day in exchange for single-payer coverage.
Anonymous
01/19/2016 18:39
Subject: Insurance and Pharma Companies under Single Payer System?
Anonymous wrote:Anonymous wrote:Doctors don't get paid enough and in a timely manner by govt. sorry
you're full of it. they get paid much more quickly from the government and in some cases more.
Definitely get paid more quickly (usually). I don't know any instance where they pay more, maybe some HMOs. I don't have a single contract below Medicare allowable. A lot of strings attached to Medicare reimbursement as well. Also potential for criminal prosecution for charting errors. I try to limit Medicare to 30% of my practice. I will go to cash only or retire if single payer happens
Anonymous
01/19/2016 18:29
Subject: Insurance and Pharma Companies under Single Payer System?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Just been reading about Sanders' plan and it doesn't say anything about what will happen to all the insurance companies if we switch to a single payer system. So what would happen? Would it ruin the economy?
If it's Medicare for All, then there would still be optional supplemental insurance plans/companies. Keeping in mind that Medicare is an 80/20 insurance with co-pays and deductibles. Medicare also doesn't fully cover prescription drugs
If it is really full coverage for everything then the government would have two options. Keep them as silent partners or let them die. Either way, it would not ruin the economy.
Outside of a hospital stay Medicare doesn't cover prescriptions.
I worked for Microsoft during the years we paid $0 for our health care costs.
$0 co-pays
$0 for both pregnancies
$0 premiums
$0 for brand drugs
$0 for broken arm
$0 for speech therapy
$0 for physical therapy
ahhhhh.....
those were the days
Even Microsoft, with $60B in the bank could not sustain that. People took advantage of the system right and left.
Under government control, costs will be even worse.
Yep, even my former little software company had full coverage for everything. But most the employees were in their 20's and 30's and hardly ever used health insurance. Babies were probably the biggest usage. Now there isn't full coverage but everyone is in their 50's and use health care much more frequently. That is one of the bigger advantages of a single payer system, you have a much more diversified group.
I would imagine for a big company like Microsoft it would be even tougher especially since they have employees in pretty much every state. They have to negotiate different insurance policies for every state they have employees in. So even a big company like Microsoft loses some of it's negotiating power. Centralizing it under the federal government allows for a better negotiating position.
No, they self insured. Premera just handled the paper work processing claims.
Anonymous
01/19/2016 17:43
Subject: Insurance and Pharma Companies under Single Payer System?
Anonymous wrote:Doctors don't get paid enough and in a timely manner by govt. sorry
you're full of it. they get paid much more quickly from the government and in some cases more.
Anonymous
01/19/2016 17:39
Subject: Insurance and Pharma Companies under Single Payer System?
Didn't single payer fail in VT?