Medicare-For-All

[Subduction Zone]

As far as I know, single payer elsewhere as well as Medicare significantly determines how much doctors get paid for their services.

Yes, it does. That does not change anything in my post.

 

[esmith]

Where did you get that figure from? They do get paid less, but it is closer to 2/3 than 1/2:

How Much Do Doctors in Other Countries Make?

Some of that difference may be cultural, it is not really possible to say that it is all due to a different healthcare system.

Suggest you look at what it cost for a medical degree in the U.S. vs other countries.
For example two articles for the U.S.
$2.6 million: Is the cost of becoming a doctor worth it?
Is Medical School Worth it Financially? – BestMedicalDegrees.com

For example one article for Great Britain
What does it take to become a doctor?

For example Germany
https://college.lovetoknow.com/cost-medical-degree-germany

For example Canada
Facts - The Cost of Becoming a Doctor

 

[Salvador]

Bottom line is that our outdated healthcare system needs an overhaul and Republicans have shown that their only goal in that aim has been to get in the way. They have left us with no other choice but to rely on the Democrats for this much needed change.

Republicans like Dr. Rand Paul have proposed health care reform that'd make health care more affordable for many hard working class Americans.

 

[Subduction Zone]

Suggest you look at what it cost for a medical degree in the U.S. vs other countries.
For example two articles for the U.S.
$2.6 million: Is the cost of becoming a doctor worth it?
Is Medical School Worth it Financially? – BestMedicalDegrees.com

For example one article for Great Britain
What does it take to become a doctor?

For example Germany
https://college.lovetoknow.com/cost-medical-degree-germany

For example Canada
Facts - The Cost of Becoming a Doctor

And that supports my cultural difference claim. Education is more expensive here resulting in a need to pay doctors more. If there was education reform along with medical reform that would lower the pay needed for doctors.

 

[Valjean]

Actually, 'go out of business' is the only answer.

OK....I am not going to give anybody statistics here, just very personal experience.

I lived for a year and a half in England, where I watched what a young Englishman had to go through to get his deviated septum fixed. Mind you, he was nineteen years old and had literally spent most of his life sleeping sitting up. He could NOT lie down, or he could not breathe. Perfectly healthy, very athletic and fit (as long as none of his exercising was done in a prone position). He had been waiting for three years to get this simple out patient procedure OK'd....

One day he was knocked off his bicycle onto his back, and even though there were no injuries, he nearly died. His church stepped in and paid for the procedure. He was in business in less than a week.

National health care.

Several years ago (about 12)...a friend of mine and I were going through the same problems with our knees, and were both told we needed knee replacements. We were also both told that the sooner those operations were done, the better the results and the more range of motion we would have. I had Kaiser Permanente ...which is an HMO and at the time was really hard to get stuff qualified through. She is Canadian. It took me six months to get my knee replacement authorized and done, and three years later I had the other one done. If I'd had private insurance with my choice of physician, I'm told I would have had them both done within three months of being told I needed the one done.

I have a better range of motion in both knees than many people who haven't had replacements; I can, and do, sit fully cross-legged on the floor, quite often. My Canadian friend?

Had to wait for six years to get her first knee done and is still waiting for authorization for the second. She's lucky she can bend her knee far enough to sit in a chair at all.

I have Multiple Myeloma. It's a very expensive cancer to treat, and I have had two, count 'em, TWO, bone marrow transplants through this US based HMO in the six years since I was diagnosed. I belong to a group that has members from many different nations who have nationalized health care....

Nationalized health care is not popular among those who really need health care.

Just thought I'd drop that one in the mix.

There are lots of anecdotal shortcomings to all systems, everywhere, but no people would be willing to trade their system for the American, out-of-pocket system.

 

[Valjean]

What subject matter did the "experts" contribute to Obamacare...
Answer: Bean Counting.

Obamacare began as a compromise. It was assembled by dozens of different designers, after which it was sabotaged by the Anti-Obama powers.

Oh by the way you still haven't answered my question:
I'm just asking if you are willing to pay what I'm paying for and getting just what I'm getting. Also you say healthcare would be overhauled. Do you think the cost of procedures would be lowered in the "overhaul".

The costs could be reduced. Everywhere else in the world they seem to make a profit at half our price.

 

[Valjean]

that is correct, no argument there. No matter what system is devised you will still have to have private insurance companies to cover the shortfall

Why? What shortfall? Other countries manage to cover everyone with no shortfalls.

The only way a single payer system could be less costly than insurance provided by private insurance companies, is if medical providers are forced to take a significant reduction in pay. How would you like it if you were a doctor whose salary was reduced from $500,000 to less than $350,000?

No. If insurance costs were zero, copays zero, out-of-pocket charges zero, drug prices cut, medical billing departments reduced to one or two people, and the dozens of ancillary 'services' eliminated, wouldn't that reduce costs?
Medicare operates on between two and three percent overhead. No insurance company can even approach that.
Wholesale is always cheaper than retail, for-profit always more expensive than non-profit.

As for doctors, I don't really want people going into the business as businessmen, to make big profits.
Other developed countries manage to keep physicians without the fantastic potential salaries of American doctors.

Medicare compensates doctors at two-thirds what they could otherwise earn, this is the main reason why Medicare is less expensive than other forms of health insurance. The annual $240 billion of health care savings from Medicare-for-all would mostly be at the expense of health care providers. If Medicare-for-all were to be enacted, there'd be significantly fewer doctors.

That hasn't been the experience elsewhere in the world. Money isn't the primary motivator for scientists, physicians, &c. Medicare is non-profit and operates efficiently on a shoestring.

The US restricts medical school admissions to keep profits up. There's no reason we couldn't open the system up. There would be more doctors, no matter what the salaries.[/QUOTE]

 

[averageJOE]

Are you aware there are multiple forms of Medicare for all?

 

[Salvador]

Why? What shortfall? Other countries manage to cover everyone with no shortfalls.
No. If insurance costs were zero, copays zero, out-of-pocket charges zero, drug prices cut, medical billing departments reduced to one or two people, and the dozens of ancillary 'services' eliminated, wouldn't that reduce costs?
Medicare operates on between two and three percent overhead. No insurance company can even approach that.
Wholesale is always cheaper than retail, for-profit always more expensive than non-profit.

As for doctors, I don't really want people going into the business as businessmen, to make big profits.
Other developed countries manage to keep physicians without the fantastic potential salaries of American doctors.
That hasn't been the experience elsewhere in the world. Money isn't the primary motivator for scientists, physicians, &c. Medicare is non-profit and operates efficiently on a shoestring.

The US restricts medical school admissions to keep profits up. There's no reason we couldn't open the system up. There would be more doctors, no matter what the salaries.

Medicare Administrative Costs Are Higher, Not Lower, Than for Private Insurance

"Medicare’s administrative costs amounted to about $509 per primary beneficiary, and private plan administrative costs were about $453 per beneficiary. That means, in effect, that private health plans’ administrative costs were about 10 percent lower than Medicare’s."

Medicare-For-All Would Increase, Not Save, Administrative Costs

 

[Valjean]

As far as I know, single payer elsewhere as well as Medicare significantly determines how much doctors get paid for their services.

So? Are you arguing some sort of save our salaries position?

 

[Salvador]

So? Are you arguing some sort of save our salaries position?

Medicare pays doctors less than what private insurance companies pay them.

See here: Medicare pays doctors less than private insurance

How would you feel if you were a typical physician whose annual salary were to be reduced from $300,000 to $200,000 due to getting reimbursed a lesser amount of money from medicare/medicare-for-all for medical services rendered to medicare/(medicare-for-all) patients compared to getting reimbursed a higher amount of money from private insurance companies for medical services rendered to patients who had medical insurance from a private insurance company?

If I were a doctor, for economic reasons, I'd be against Medicare-for-all.

 

[youknowme]

Medicare pays doctors less than what private insurance companies pay them.

See here: Medicare pays doctors less than private insurance

How would you feel if you were a typical physician whose annual salary were to be reduced from $300,000 to $200,000 due to getting reimbursed a lesser amount of money from medicare/medicare-for-all for medical services rendered to medicare/(medicare-for-all) patients compared to getting reimbursed a higher amount of money from private insurance companies for medical services rendered to patients who had medical insurance from a private insurance company?

If I were a doctor, for economic reasons, I'd be against Medicare-for-all.

O noes! Only 200k a year?

 

[youknowme]

Btw, the median income of physicians was 187,200 in 2015.

 

[dianaiad]

There are lots of anecdotal shortcomings to all systems, everywhere, but no people would be willing to trade their system for the American, out-of-pocket system.

"out of pocket?" No.

Better insurance? Yes. the problem here is that, when I look at the nations which have nationalized health care, there is one thing that seems consistent: the smaller the nation the better it works, and the larger (more people) the nation the worse it works. I can see the US coming up with something on a state by state basis that might work. ...but the sort of bureaucracy required for the nation as a whole?

Have you taken a good look at the VA lately?

We are talking about a 'fail' of gigantic proportions, and nothing anybody has come up with so far looks any better.

I know that my son, for instance, doesn't think that SS will be there for him when he retires, and he certainly isn't counting on health care for his family from the government. He's not QUITE a "prepper," but he's not exactly optimistic, either.

 

[Salvador]

O noes! Only 200k a year?

Physicians have lots of student debt and medical malpractice liability insurance bills to pay; they would be hard pressed to live a very luxurious life style on 200k a year.

 

[youknowme]

Physicians have lots of student debt and medical malpractice liability insurance bills to pay; they would be hard pressed to live a very luxurious life style on 200k a year.

At 200k they could be debt free in under two years.

 

[dianaiad]

O noes! Only 200k a year?

Do you have any idea how expensive it is to become a doctor, how long it takes the average physician to pay back his or her student loans, and how much of that vaunted income...if he is in private practice...goes TO his practice...and, er, insurance? As it happens, it is not at all uncommon for a doctor to owe over half a million bucks when s/he finishes his/her residencies and fellowships....when s/he is in his/her mid thirties.

I have two sons who have just hit their forties. They drive trucks and deal with hazardous waste clean up. Neither one went to college, but right at the moment, if you add up their annual income and compare it to the annual income of a doctor their age? The truck driver wins every time....and the truck driver doesn't have half a million bucks of student loans to pay back.

I suggest that ONE way to lower the cost of medical care in the USA is to lower the cost of making doctors. There are programs that try to do that, but not enough of them.

 

[youknowme]

Do you have any idea how expensive it is to become a doctor, how long it takes the average physician to pay back his or her student loans, and how much of that vaunted income...if he is in private practice...goes TO his practice...and, er, insurance? As it happens, it is not at all uncommon for a doctor to owe over half a million bucks when s/he finishes his/her residencies and fellowships....when s/he is in his/her mid thirties.

I have two sons who have just hit their forties. They drive trucks and deal with hazardous waste clean up. Neither one went to college, but right at the moment, if you add up their annual income and compare it to the annual income of a doctor their age? The truck driver wins every time....and the truck driver doesn't have half a million bucks of student loans to pay back.

I suggest that ONE way to lower the cost of medical care in the USA is to lower the cost of making doctors. There are programs that try to do that, but not enough of them.

Spare me the sob story, if truck driving was so much more lucrative than being a doctors, we'd have a lot of doctors wearing trucker caps.

 

[sayak83]

I'm just asking if you are willing to pay what I'm paying for and getting just what I'm getting. Also you say healthcare would be overhauled. Do you think the cost of procedures would be lowered in the "overhaul".

Yes. Medicare is currently only for older people. A universal healthcare will cover everyone, including the young who get sick less. So premiums will fall significantly.

 

[sayak83]

Do you have any idea how expensive it is to become a doctor, how long it takes the average physician to pay back his or her student loans, and how much of that vaunted income...if he is in private practice...goes TO his practice...and, er, insurance? As it happens, it is not at all uncommon for a doctor to owe over half a million bucks when s/he finishes his/her residencies and fellowships....when s/he is in his/her mid thirties.

I have two sons who have just hit their forties. They drive trucks and deal with hazardous waste clean up. Neither one went to college, but right at the moment, if you add up their annual income and compare it to the annual income of a doctor their age? The truck driver wins every time....and the truck driver doesn't have half a million bucks of student loans to pay back.

I suggest that ONE way to lower the cost of medical care in the USA is to lower the cost of making doctors. There are programs that try to do that, but not enough of them.

Free college.