Medicare fix ideas- long term

PS wrote:

The point I was attempting to make, which it sounds like you are in agreement with, is that the chemo wouldn't cost $10K a month under such a scenario because most people couldn't afford to pay that much. If no one is purchasing the product or service because the cost is too high, the cost comes down to a point where it will be purchased. That is simply the way that a free market works.

Not necessarily true. They could stop producing the chemo product.

archer wrote: You won't like this one, only liberals do, but a nationwide single payer system, or medicare for all, is what I would like to see. Then, like many other nations, one payer would have the clout to negotiate drug prices, medical costs, and medical coverage.

It may be heading that way when the current system ultimately fails, which is where we are heading. I'm not sure if I would like it (single payer), depends on if its successful. Its a big gamble. Most nations with single payer have a dual system where people buy added coverage and get to the front of the line if they have the bucks. I could see that happening here, unless you could make it illegal for a doc to accept cash payment from an individual who can afford it. So you still have an unequal system don't you?

Thanks for the honest answer though. Doesn't sound like you think medicare can be fixed standalone?

Joe wrote:

archer wrote: You won't like this one, only liberals do, but a nationwide single payer system, or medicare for all, is what I would like to see. Then, like many other nations, one payer would have the clout to negotiate drug prices, medical costs, and medical coverage.

It may be heading that way when the current system ultimately fails, which is where we are heading. I'm not sure if I would like it (single payer), depends on if its successful. Its a big gamble. Most nations with single payer have a dual system where people buy added coverage and get to the front of the line if they have the bucks. I could see that happening here, unless you could make it illegal for a doc to accept cash payment from an individual who can afford it. So you still have an unequal system don't you?

Thanks for the honest answer though. Doesn't sound like you think medicare can be fixed standalone?

As it stands alone now...probably not, it's hard to sustain a medical system only for those who are at the highest risk, require the most medical care, and use the system the most often. It only becomes cost effective when everyone is in the pool, the healthy and those at risk.

archer wrote:

Joe wrote: So back on topic, what are the actual fixes?
So far we have raise the payroll tax 0.7%, negotiate drug prices, turn medicare over to the states. Is that the best you got? I'm not optimistic.

You won't like this one, only liberals do, but a nationwide single payer system, or medicare for all, is what I would like to see. Then, like many other nations, one payer would have the clout to negotiate drug prices, medical costs, and medical coverage.

Why not simply nationalize the health care system and make all the hospitals, doctors, nurses and everyone associated with providing health care a federal employee? Then the only negotiating you have to do concerns the union pension, benefit and compensation contract with the workers. If you leave the hospitals, doctors and nurses in the private sector, you have failed to accomplish anything because they could simply refuse the insurance and require everyone pay for everything out of pocket, right? We already have a large number of doctors who refuse Medicaid insurance, why wouldn't they do the same for Medicare under single payer?

PrintSmith wrote:

archer wrote:

Joe wrote: So back on topic, what are the actual fixes?
So far we have raise the payroll tax 0.7%, negotiate drug prices, turn medicare over to the states. Is that the best you got? I'm not optimistic.

You won't like this one, only liberals do, but a nationwide single payer system, or medicare for all, is what I would like to see. Then, like many other nations, one payer would have the clout to negotiate drug prices, medical costs, and medical coverage.

Why not simply nationalize the health care system and make all the hospitals, doctors, nurses and everyone associated with providing health care a federal employee? Then the only negotiating you have to do concerns the union pension, benefit and compensation contract with the workers. If you leave the hospitals, doctors and nurses in the private sector, you have failed to accomplish anything because they could simply refuse the insurance and require everyone pay for everything out of pocket, right? We already have a large number of doctors who refuse Medicaid insurance, why wouldn't they do the same for Medicare under single payer?

It would be interesting to know how many more or less people would be willing to go through 12 years of schooling to be a doctor knowing they would be put into a government machine that would have control over their income and possibly fields of expertise. I know I would think twice about it.

That was a concern when Canada went to universal healthcare
Fears of a doctor shortage were just that.... fears
It didn't happen.

Actually, archer, it depends on the specialty as to whether there is a doctor shortage.

2wlady wrote: Actually, archer, it depends on the specialty as to whether there is a doctor shortage.

same here 2wlady

Yes, I know. The closest specialist for my cancer is in Iowa. The best place for certain surgeries is New Orleans. The best place for another set of procedures is three cities in Europe.

Two cities in the US are just starting the procedures that have been done in Europe for over 20 years. The cost in the US is the same as going to Europe and paying out of pocket for living expenses. But in Europe you have the advantage of experience.

Still costs thousands, however.

When the supply of something is low and demand is high, the cost is also high. That's simply economics 101. Right now there are very few doctors here that do the procedures you speak of 2w - and in addition to the supply part of the equation you have to remember the litigation risks the doctors doing a recently approved procedure are taking on. That risk is what currently reduces the number of specialists that practice in this country. My take on the low number of specialists in Canada is the compensation levels those specialists receive. There may be a low number of specialists in both instances, but the reasons for that low number are not necessarily the same from my perspective.

Of course, making our system the same as the one in Canada would certainly cure the dichotomy of the reasons. Doesn't necessarily fix the problem of too few specialists, but in addition to sharing the problem, at least the reason would be shared as well.