The most important change we need to make - M4A or something like that

[mark46]

You just need single payer. when the federal government negotiates on behalf of literally everyone at once, they have a lot of leverage to prevent overpricing.

then why mention the EU?

BTW, single payer doesn't mean no insurance companies. Medicare is single payer, and has many opportunities for improved efficeincy.

 

[MorkandMindy]

You can continue to advocate for a UK system. There is little interest here. We will continue to have a mixed system as does much of Europe. What we need is to have universal access and for the system to run better. Does it run better in various countries in Europe? yes. We can learn from them.

No. The US system is not like much of Europe, the UK system is like much of Europe, it is in the middle of the pack, so decry the UK system if you like, it makes no difference, there are a whole bunch of other examples.

I mention the UK system because it is the one I know from living there 42 years.

 

[mark46]

My point was not that the US system was best. I was merely pointing out that many of the European systems rely on private insurance. I'm sure that many don't have their government operating 1200 hospitals.
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I'm fine with Medicare for elders.

I'm fine with a combination of employer, private insurance, and government for those under 65.

There are many ways to improve our systems. I strongly suspect that California can do fine with a choice between a couple of insurance companies, Kaiser and a public option.

 

[comana]

My point was not that the US system was best. I was merely pointing out that many of the European systems rely on private insurance. I'm sure that many don't have their government operating 1200 hospitals.
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I'm fine with Medicare for elders.

I'm fine with a combination of employer, private insurance, and government for those under 65.

There are many ways to improve our systems. I strongly suspect that California can do fine with a choice between a couple of insurance companies, Kaiser and a public option.

I think if we are going to keep private insurance it needs a huge overhaul. It needs to be sold to individuals/families and not offered through employers the way it is now. One shouldn’t lose their insurance because they leave an employer. Also, employer provided takes away competition that improves a service. Employees get what the employer chooses, it should be more like choosing car insurance where the various companies have to complete for customers.

 

[mark46]

I think if we are going to keep private insurance it needs a huge overhaul. It needs to be sold to individuals/families and not offered through employers the way it is now. One shouldn’t lose their insurance because they leave an employer. Also, employer provided takes away competition that improves a service. Employees get what the employer chooses, it should be more like choosing car insurance where the various companies have to complete for customers.

In may experience, unions through employers negotiate much better than individuals. Also, managers then get those very good plans.

 

[comana]

In may experience, unions through employers negotiate much better than individuals. Also, managers then get those very good plans.

But it is still tied to employment and union jobs are not the majority anymore. It needs to change so that individuals have the power rather than unions and employers. Personally I am for a Medicare for all type deal with private insurance working like it does with Medicare now if we must keep any form of private insurance.

 

[MorkandMindy]

As you say it needs a huge overhaul. It is far more complicated than car insurance and the part of the private health insurance I've been involved with changes almost every year and is pretty tricky.

So who's going to be the overseer.

And there's another problem, some, fortunately not all that many, doctors decide what to do partly on the basis of how much they will profit from it, and there are complications on top of all that on the basis of referrals, not being able to do things in an efficient sequence and so on, and demarcations. A neighbor here got ripped off big time.

Private insurance is there for no other reason than to make a profit, take it from the horse's mouth Milton Friedman.

It is like keeping venomous sea snakes in your swimming pool.

 

[MorkandMindy]

The Friedman Doctrine:

Friedman introduced the theory in a 1970 essay for The New York Times titled "A Friedman Doctrine: The Social Responsibility of Business is to Increase Its Profits.

I'm sure that includes health insurance companies, and they do make huge profits.

 

[mark46]

But it is still tied to employment and union jobs are not the majority anymore. It needs to change so that individuals have the power rather than unions and employers. Personally I am for a Medicare for all type deal with private insurance working like it does with Medicare now if we must keep any form of private insurance.

In order to move to Medicare for all, someone would need to pay in to the system for everyone added. Let's say that someone in 60. That person couldn't simply join the system and be treated equally to those on medicare that have paid into the system of 30 years. That cost would be about about $1.8B (as I last recall).

The issue you mention can be solved by 1) portability of coverage and 2) a public option available to all

 

[FireDragon76]

What's needed is a focus on the problem, it is more important than any other apart from immigration and global warming, but it could be solved very quickly.

One obstacle is the amount of wrong information out there. For example two people in one day told me that cancelling one new aircraft carrier would pay for the entire medical system for one year. The new aircraft carrier was 12.3 billion dollars, medical care for the country in 2019 was 3,800 billion.

Some of the health insurance companies made a lot more in profit alone than the aircraft carrier cost even after adding the planes.

Funding aircraft carriers and not healthcare is a feature, not a bug.