Elizabeth Warren's 52 Trillion dollar health plan

[BobTheCoward]

The basic structure of Medicare is that patients choose their own providers, and doctors and hospitals run their own businesses. Medicare is a single-payer insurance program that covers all Medicare patients and pays all Medicare providers. Expanding who is covered and what is covered wouldn't need to alter the basic framework, unlike, say, trying to copy the UK's NHS. And creating a Medicare-for-All-Who-Want-It public option would allow patients to compare Medicare with whatever other insurance is available. This just doesn't seem impossible.

Who is covered and what is covered sounds like the basic framework.

 

[acbytesla]

No country provides what Sanders proposed.

You're wrong.

 

[Giordano]

Medicare focuses on an elderly population often with chronic or acute disease. Expanding this to the general, younger, generally healthier population represents lower costs on average per person.

 

[BobTheCoward]

You're wrong.

Name the country.

 

[xjx388]

Your initial claims are wrong. You don't have to introduce copays...they are already introduced.



It is designed to cover old and young, healthy and sick, male and female.

Like I said, whether there are copays or not depends on the State. Texas does not have Medicaid plans with copays.

What and who it’s designed to cover also varies by State. What they all have in common is that they are designed to cover vulnerable populations; people living at or near the poverty line. That population has unique needs that the rest of the population does not.

For example, in Texas, Medicaid covers things like home care providers (assistance with cleaning, cooking and housework) that are not covered by any other insurance plans. It picks up a portion of the Medicare deductibles, but not copays; doctors who take Medicare and Medicaid have to write-off whatever Medicaid doesn’t cover. It mandates many more well-child services than commercial insurance does. It covers over-the-counter meds if a doctor prescribes them. It covers in-office education. It covers rides to the doctor.

The benefits are much more comprehensive than any commercial insurance. However, it doesn’t cover men unless they meet very specific conditions: mostly disability or if they care for a child. Single women without children also have reduced, women’s health benefits. Texas has a Buy-In program but only for people and children with disabilities.

Expanding Texas Medicaid to all would require much alteration of benefits so much so that it wouldn’t resemble Medicaid anymore.

 

[xjx388]

Medicare focuses on an elderly population often with chronic or acute disease. Expanding this to the general, younger, generally healthier population represents lower costs on average per person.

How so? Medicare doesn’t cover things that would be required for the general younger healthy population.

 

[mgidm86]

This is a "we're not ready for it" fail. Let a candidate who advocates for "keep your private insurance but here's Medicare if you need it" proceed and let people gradually conclude Medicare for all is better. Maybe we will adopt a system like most of Western Europe. Just don't risk four more years of Trump over it.

This seems like a wise approach, just in terms of logistics and ease of implementation.

I think so too.

There's also a trust issue. Every time a politician has a great plan for something it never really pans out, or the details change after election.

Last time health care was fiddled with, not only could I not "keep my doctor" but my rates went up 90 percent. Guess who pays for my health care now? And it isn't nearly as good. I'm not happy about that and I don't forget easy.

Just because Warren or anyone else says it's true doesn't make it so. When I see a plan like this I assume that it will be completely different come time to implement it, and much more expensive.

52 Trillion will become something more, just like the bullet train here in Cali with its ever-increasing price tag. Just like everything.

We definitely need health care reform but politicians are known for either lying or not knowing what they are talking about, or both.

 

[Bob001]

I think so too.

There's also a trust issue. Every time a politician has a great plan for something it never really pans out, or the details change after election.

Last time health care was fiddled with, not only could I not "keep my doctor" but my rates went up 90 percent. Guess who pays for my health care now? And it isn't nearly as good. I'm not happy about that and I don't forget easy.
.....

Details, please. Who paid previously, who pays now, and what makes it "not as good?" Maybe you switched jobs? Maybe your employer cut the percentage he paid? That was not the common experience, and under the ACA 20+ million people got insurance that they couldn't get before. I doubt they're sorry about it.

 

[Silly Green Monkey]

Last time health care was 'fiddled with', I was put on Medicaid just in time to be diagnosed with cancer. Tests and treatment were fully paid for (though I may not ever be able to get private insurance). I don't forget easy either.

 

[Bob001]

Last time health care was 'fiddled with', I was put on Medicaid just in time to be diagnosed with cancer. Tests and treatment were fully paid for (though I may not ever be able to get private insurance). I don't forget easy either.

Note that under the ACA you can't be turned down for a pre-existing condition. Dear Leader wants to restore your freedom to not be able to buy insurance.

 

[Bob001]

Name the country.

France, for one.

In its 2000 assessment of world health care systems, the World Health Organization found that France provided the "close to best overall health care" in the world.[

https://en.wikipedia.org/wiki/Health_care_in_France

Probably Germany, too.

According to the Euro health consumer index, which placed it in seventh position in its 2015 survey, Germany has long had the most restriction-free and consumer-oriented healthcare system in Europe. Patients are allowed to seek almost any type of care they wish whenever they want it.

https://en.wikipedia.org/wiki/Healthcare_in_Germany

 

[Bob001]

....
Expanding Texas Medicaid to all would require much alteration of benefits so much so that it wouldn’t resemble Medicaid anymore.

Maybe it would resemble Medicaid as it's provided in some other states.

Here's the question: Do you accept the premise that everybody -- rich or poor, employed or not, healthy or sick -- should have access to health care? If so, how would you provide it?

If not, who would you leave out?

 

[Puppycow]

I think it would be a mistake to eliminate co-pays altogether.

In Japan, where everyone is covered by one of two national health insurance schemes, you still pay a modest fee when you visit a doctor. The fee is very reasonable: the equivalent of a few dollars in most cases, but it isn't free. Make it free and that's going to be a recipe for people going to the doctor when they don't even need to.

 

[Bob001]

I think it would be a mistake to eliminate co-pays altogether.

In Japan, where everyone is covered by one of two national health insurance schemes, you still pay a modest fee when you visit a doctor. The fee is very reasonable: the equivalent of a few dollars in most cases, but it isn't free. Make it free and that's going to be a recipe for people going to the doctor when they don't even need to.

Is the fee means-tested? If somebody doesn't have any money does he still get to see the doc?

 

[Silly Green Monkey]

I think it would be a mistake to eliminate co-pays altogether.

In Japan, where everyone is covered by one of two national health insurance schemes, you still pay a modest fee when you visit a doctor. The fee is very reasonable: the equivalent of a few dollars in most cases, but it isn't free. Make it free and that's going to be a recipe for people going to the doctor when they don't even need to.

That will never happen. Going to a doctor is time not spent doing anything else. No one goes "huh, nothing to do for a few hours. Well, lets go to the doctor!" Just as no one goes "huh, nothing to do for a few hours. Why not take the car to the dealership?" We go to places because we need to go to them or want to be there, not because they're free.

 

[BobTheCoward]

France, for one.

https://en.wikipedia.org/wiki/Health_care_in_France

Probably Germany, too.

https://en.wikipedia.org/wiki/Healthcare_in_Germany

Both have copays making them less generous than Sanders's plan.

 

[TragicMonkey]

That will never happen. Going to a doctor is time not spent doing anything else. No one goes "huh, nothing to do for a few hours. Well, lets go to the doctor!" Just as no one goes "huh, nothing to do for a few hours. Why not take the car to the dealership?" We go to places because we need to go to them or want to be there, not because they're free.

Some people do go to the doctor a lot, unnecessarily. There are hypochondriacs and also people who just panic over what turns out to be nothing. In olden times you'd find "FF" in some patient medical records, short for "frequent flyer". At least a nominal copay does serve to curb some of this behavior.

People go look at cars for fun and out of boredom as well.

I don't go to doctors or dealerships for no reason myself, but I have frequently gone into stores and not purchased anything. From their POV I am just as bad.

 

[Venom]

No country provides what Sanders proposed.

BobTheCoward is right, actually.

Sanders' proposal is more generous than any healthcare system on the planet. That's the super high bar I'm afraid progressives will stick too hard to.

 

[llwyd]

BobTheCoward is right, actually.

Sanders' proposal is more generous than any healthcare system on the planet. That's the super high bar I'm afraid progressives will stick too hard to.

Well, the Republicans might be better off in the sense that their incredibly impossible and destructive proposals are put in so vague terms and vast holes are explained away by magical thinking that no-one really bothers to take them seriously. And so something bit less awful ends up being enacted. Being detailed and serious might not be a bonus (though I think it makes sense, now, for Warren to release this plan).

Anyway, maybe it's a good tactic to go whole hog with healthcare and end up with something less. And these Democratic plans are quite different in the sense that they really would hugely help the country and save waste and produce way better care than under the current system

 

[Puppycow]

That will never happen. Going to a doctor is time not spent doing anything else. No one goes "huh, nothing to do for a few hours. Well, lets go to the doctor!" Just as no one goes "huh, nothing to do for a few hours. Why not take the car to the dealership?" We go to places because we need to go to them or want to be there, not because they're free.

Have you heard of hypochondriacs or Munchausen Syndrome? Malingering? It happens.