Competition is needed to improve health insurance options for Americans

[Peter1469]

We too don’t trust government, it’s why we pay for non-profit universal health care.

Everyone everywhere is sick of taxes, but are you wondering why your taxes are so high? Did you know the US spends over $3tr every year of your tax payer money to fund medical care and people still die because they can’t afford it?

When you say ‘we’ are accustomed to a high quality of care, do you include those that don’t get it? So you’d riot if patient demand became too high, but not if people died who couldn’t afford care?

Again the ‘we.’ Does the ‘we’ include those who never get surgery because they can’t afford it?

So what you’re saying is while you personally might have quality insurance and it covers everything, those that haven’t do what?

Cost, quality and access, for whom? The cost is dependent on wealth to buy insurance. The quality depends on being able to afford the cost and access is available to those that can bear the cost. Why does that word ‘cost’ keep cropping up? If my healthcare costs are much, much lower than yours, but I get all the coverage without the additional cost, what case are you making for privatized medicine?

Do you have a link that the US pays 3T every year for the uninsured? I don't see that reflected in our deficits and debt.

The rest we have covered and we simply don't and won't agree.

I would like to commend everyone involved in this thread. I don't think any substantive thread on tPF has ever got to 131 posts without personal attacks and troll posts!

[Refugee]

Do you have a link that the US pays 3T every year for the uninsured? I don't see that reflected in our deficits and debt.

The rest we have covered and we simply don't and won't agree.

I would like to commend everyone involved in this thread. I don't think any substantive thread on tPF has ever got to 131 posts without personal attacks and troll posts!

I did do but it was just a link and I assumed you already would have known. You might try and look up how much the US government subsidizes healthcare costs and it’s in there somewhere.

Well, earlier some of the trolls were quite active, but if you don’t bite they tend to move on after they've done the obligatory Hoo Rar bit.

[Peter1469]

Spending on Health Care for Uninsured Americans: How Much, and Who Pays?

This is old data, but in 2001 spending on the uninsured was:

Finding: The best available estimate of the value of uncompensated health care services provided to persons who lack health insurance for some or all of a year is roughly $35 billion annually, about 2.8 percent of total national spending for personal health care services.

[Refugee]

Spending on Health Care for Uninsured Americans: How Much, and Who Pays?

This is old data, but in 2001 spending on the uninsured was:

This isn’t the one I used, but it’s similar.

https://www.crfb.org/papers/american...federal-budget

[Peter1469]

This isn’t the one I used, but it’s similar.

https://www.crfb.org/papers/american...federal-budget

OK, that makes sense. Medicare and Medicaid are unsustainable in their current form. I thought you were saying that money was spend in the commercial market space, which it is not.

[John Galt]

Except bringing costs down is only part of the entire equation. The Iron Triangle of Health Care: Access, cost and quality. Generally, you can control one or two but not all three. In the UK, for instance, they control cost, i.e., lower costs, but the effect also lowers access and quality.

Market competition allows parties to experiment with all three variables effectively. Government monopoly does not.

Interesting read. First, let's remember that the Individual Mandate that Obama acknowledged was the Heritage Foundations ploy back in the late 80's. Just before Clinton attempted to put out her plan.

This paragraph is pertinent:

Ultimately, reducing waste in health care remains a challenge. As Uwe Reinhardt and others have reminded us, “20 percent to 30 percent of medical spending could be eliminated with no adverse effects on patient outcomes.” However, one person’s waste is another’s revenue. Reducing waste through discontinuous regulatory events, as well as disruptive technological advances, will eventually allow us to overcome the constraints of the Iron Triangle.

Overwhelmingly, people who get no/low cost insurance from an employer tend to abuse it. They go to the doctor for everything. Perhaps because they get bennies in lieu of higher salary, so they tend to take full advantage?

A big part of reducing the cost of health insurance, is to stop wasteful office visits. A bigger part is to create a healthier society. That was a big part of ACA's laundry list of preventive services that were mandated at no extra out of pocket cost.

Insurance companies were happy to pay for a 'free' colonoscopy, than treat colon cancer for years.

Likewise for 'free' birth control. It's cheaper to hand out pills, than to pay for maternity and 26 years of insurance coverage for a child.

Any discussion of the successes/failures of ACA must include a discussion about the immediate de funding of key provisions. Without them, insurance companies were essentially lied to, and taken for fools after agreeing to supply new services at great expense.

Of course they had to raise premiums.

[John Galt]

Here in the US the wealthy do not go to the head in emergency rooms or the majority of doctors offices. There are doctors whose practice caters to the wealthy. They don't accept insurance thereby keeping the "rift-raft" out. Cash only.



And that quality of care is well below what we get in the US (and I have admitted already that our quality is probably wasteful to some extent, but that is what dives up our costs and Americans likely would riot if they had to give it up).

I think it's more accurate to reference the private hospitals who don't take Medicare. They are allowed to turn anyone away, as EMTALA only applies to hospitals that take Fed funding.

So, they only do the profitable procedures, and turn away numerous patients who have insurance.

That's a common issue in our for profit system. Drug companies are refusing to make new antibiotics, now that the old ones have been over prescribed and useless.

They don't want to spend the time/money on a drug that someone takes for 1 week, and then doesn't need them anymore. They want to spend the money on a drug that people take for the rest of their lives.

[John Galt]

We can only deal with two, not all three. The US has chosen access and quality. With an emphasis on quality. That is why our costs are high.

That brings us back to competition. If insurance companies could compete nation-wide costs would necessarily drop.

This seems to focus on insurance costs, when the issue is the costs of care/meds. No?

[Chris]

Interesting read. First, let's remember that the Individual Mandate that Obama acknowledged was the Heritage Foundations ploy back in the late 80's. Just before Clinton attempted to put out her plan.

This paragraph is pertinent:

Overwhelmingly, people who get no/low cost insurance from an employer tend to abuse it. They go to the doctor for everything. Perhaps because they get bennies in lieu of higher salary, so they tend to take full advantage?

A big part of reducing the cost of health insurance, is to stop wasteful office visits. A bigger part is to create a healthier society. That was a big part of ACA's laundry list of preventive services that were mandated at no extra out of pocket cost.

Insurance companies were happy to pay for a 'free' colonoscopy, than treat colon cancer for years.

Likewise for 'free' birth control. It's cheaper to hand out pills, than to pay for maternity and 26 years of insurance coverage for a child.

Any discussion of the successes/failures of ACA must include a discussion about the immediate de funding of key provisions. Without them, insurance companies were essentially lied to, and taken for fools after agreeing to supply new services at great expense.

Of course they had to raise premiums.

The Heritage Foundation plan was quite different. It simply mandated consumers participate in the market for health care.

Company-supplied insurance companies generally offer options, high premiums for low copays and high limits or low premiums for high copays and lower limits. This incentivizes people to save and not run to the doctor for every sniffle.

Generally, your complaints don't really address the Iron Triangle of health care.

[Captdon]

The thread has nothing to do with general tax rates and the National contribution rate is a separate tax. It takes you days to see a primary doctor? Takes me about an hour on a good day, two or three on a bad one. Do you get surgery in a week if you can't afford the cost because you haven't got insurance? I don’t know why you bother with distractions. I think you're best ignored on this topic, because you really haven't got anything to say.

The thread is about competition. You have been all over the place but never about competition. I responded to whatever post is made. The tax rate is 13.8% for NHS. You don't even know what taxes you pay. After you get your small tax exempt dedurtion you are paying 33.8 percent in taxes. Under our system I would pay 2.25%health insurance and 15% in income taxes. When working. I paid nothing for health insurance. My employer did as another cost.

You shouldn't go off topic just to look foolish.

(Note: 33.8 is more that double 17.5. No wonder your Brits are a second rate country.)


https://www.citizensadvice.org.uk/de...ome-tax-rates/