Why do people want to have the choice of paying more for less?

Bernie's M4A highlights from the debate

If you were considering a health care plan and you were going down the list of the different options of coverage with all their different co-pay levels and deductibles and limits along with their respective prices, and you got to the bottom and the last option was a plan that covered everything, had no deductibles, co-pays, limits or complex bureaucracy, and was far cheaper than any other option in front of you, why would you want to chose one of the other plans? Why is having that option so important to you?

Someone please explain this to me.

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Edited 1 time(s). Last edit at 09/13/2019 07:25PM by Ponderer.

Most people don't kmow that. Relentless PR propaganda works until it explodes. Like Brexit in Britain.

I have that option, which I choose NOT to take. The reason is simple. The rampant abuse of record keeping (lack of HIPA), filthy hospitals, substandard "doctors," inability to get treatment, no ability to change doctors, pushing pain pills instead of being able to see a specialists, long waits (2-12 months) to see a specialist, et al.

On NRP a person named Willow explained her reason for opposing Medicare-for-all. Her reason surprised me.

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WILLOW ELIZABETH RYDER: The “Medicare for All” issue is probably the most important to me 'cause I'm trans, and I rely on health care in order to be able to afford transition-related care. And my hugest worry with Medicare for All that doesn't have a private option is that the government, which is, you know, about 50% controlled by Republicans, is not going to cover those things.
[www.npr.org]

That is a reasonable concern. I mentioned that Sanders supporters tend to be naive. It's naive to assume that any candidate's proposals can survive the legislative process intact and unscathed.

Medicare covers some transitioning procedures, but is limited to "medically necessary" and doesn't cover "cosmetic" transition surgeries. Incidentally, in the UK, their NHS covers transitioning but is subject to waiting lists. Any surgery is after doctor referrals for gender dysphoria treatments, usually followed by an assessment by a psychiatrist or another specialist doctor before any treatment begins.

Why would you even question why people want choices? What kind of American are you? Why would you want one big corporation (Government, Inc.) to have a monopoly over the entire industry?

It's the "assumption" that politicians are less crooked than industrialists....

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OldeDude
It's the "assumption" that politicians are less crooked than industrialists....

It's also an assumption that government can be more cost efficient than corporations, given that profits are removed from the equation.

If anybody is wondering why people are not clamoring for Medicare-for-all, look at the rates of healthcare system satisfaction by different segments of the population. Considering the government run programs are "free", they aren't much more popular than insurance people pay for out of their own pocket.

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WASHINGTON, D.C. -- Americans' satisfaction with the way the healthcare system works for them varies by the type of insurance they have. Satisfaction is highest among those with veterans or military health insurance, Medicare and Medicaid, and is lower among those with employer-paid and self-paid insurance. Americans with no health insurance are least satisfied of all.

Satisfaction with US healthcare system:
Military or veterans 78%
Medicare 77%
Medicaid 75%
Union 71%
Current or former employer 69%
Self-paid 65%
Uninsured 41%
Source: [news.gallup.com]

Curt- Its unclear if I would be listed as "Military or veterans" or "Current or Former Employees." I love my insurance, which is much better than either Tricare or VA (which I chose not to use, but would be free). For active duty military, Tricare is good, but far worse than I was told I would have when I was active duty early in my career. Like my retirement, congress has changed everything about my retirement than I was told when I first went in (a breach of contract in every other retirement plan).

Curt: I don't know what kind of private insurance Willow Ryder has. I had Kaiser and had to pay for my transition 100% out of pocket, which was a lot of money. A friend of mine who is transitioning now lives in Section 8 housing and has already had extensive cosmetic surgery including breast implants. She didn't pay a dime for any of it and is planning to get sex reassignment surgery the same way.

If Congress truly wanted the VA to give higher quality medical care, they'd fund it sufficiently. But the truth is that most members of the US Congress (all Republicans and many Democrats) want to essentially destroy the VA as we know it and privatise it so that profiteers can make a killing off of giving our veterans medical care, and the way they're going about that is to strangle it to death.

If we could de-corrupt our government, people would have faith in government programs.

So essentially what you are all saying is that it comes down to fear. Abject, paranoid fear. Got it.

A candidate like Obama, a popular, barely left-leaning centrist, can campaign on "Change We Can Believe In", but that change was apparently limited in the minds of people who supported him to change that still leaves everything pretty much as flawed, wasteful, and exploitative as it was. We can't have change that actually changes anything! It was a great campaign slogan though. Although "Status Quo We Can Believe is Change" would have been a more accurate slogan. Yes, it made some desperately needed augmentations to healthcare as we knew it in this country, augmentations that even helped me get health insurance when it was out of my reach. But it was nothing but putting a tourniquet on a person's lacerated, blood-gushing arm and sending them home. The actual foundational problems with the American healthcare system were nowhere near fixed. It's just not going to be fixed with more little amendments here and there.

Unfortunately, though it is absolutely what is needed and called for in this situation, actual real needed change that fully addresses the horrific, the basic, foundational problem with our healthcare system is not something that most Americans are comfortable with enacting. "Better to bear those ills we have than to fly to others that we know not of", as the Bard put it. It truly seems like this is the guiding principle for too many Americans nowadays.

Americans used to be a brave people who could band together and do big, brave things. Them days are sure as hell dead and buried, that's for sure. We've been reduced to a bunch of cowering caged mice afraid of losing what little we've been able to stuff our cheeks with that this system allowed us to have. And when someone comes along and offers to finally let us out of our cages, we instead dig ourselves deeper into the wood chippings soaked with our own pee.

Simply put, you are all terrified by the idea of Medicare For All. As I imagine a lot of people who are living comfortably blissful, upper-middle class lives are of it. Change is terrifying to a lot of people like you. You got yours. You are satisfied with what you've got. You are comfortable. And you desperately want to ensure that what you have and are comfortable with never diminishes. This is actually understandable. It's sort of basic human survival instinct behavior. But sometimes that old beat up car that you've been driving for hundreds of thousands of miles and has broken down and needed constant expensive repairs and are increasing every month just needs to be scrapped and a new car bought. Yeah, that can be scary. I had massive panic attacks the day after both of my last two care purchases. But sometimes things that need to be done simply are scary and there's no getting around the fact that they nonetheless still need to be done. Terrifying though they may be. Get past your knee-jerk fear. Stop feeding it. Stop letting propaganda feed it. You aren't going to lose anything.

There's a fast food commercial running right now where a guy is telling another guy about the free cake offer they have. The other guy vehemently insists, "But I want to pay for mine!", overplaying the humorous absurdity of such a position. I can't help but think of you guys every time I see it. Of course in this case, the cake isn't free, you are still paying for it, but it costs a fraction of what it does now and is a far larger and delicious cake. "But I want to pay more and get less!" you are all demanding. Ha ha ha, yes. Very funny absurdity indeed. Fear makes people do some pretty absurd things I suppose.


"I have that option, which I choose NOT to take." -Olde Dude

Technically no. No you don't. Not at all. The choice you are passing on, the VA, is actually full-blown socialized medicine. The government owns everything about it, including the hospitals. This is absolutely not what Medicare For All is as Bernie is proposing it. I'm embarrassed for you that you would even make such an absurd comparison. If you don't like the way the government owned and operated VA facilities work, then you have absolutely nothing to fear from Bernie's M4A. The government is not going to own and operate the hospitals and pharmacies and doctors and nurses are not going to be government employees. Medicare For All is simply going to be taking the place of private health insurance as the entity who will be writing the checks to the hospitals, doctors, etc. Hospitals and doctors will have to get their sh*t together and stop charging fifteen bucks for an aspirin and charging patients for expensive procedures that they never needed or in many cases also never even received but their insurance was charged for. And in return they will be freed from the shackles of having to pay for entire departments full of people dedicated simply to negotiating with insurance companies and filling out mountains of forms.

The only thing there really is to fear about M4A being enacted is that the Oligarchy will f*ck it up in their attempts to destroy it and return the status quo like the GOP did with Obamacare. But we have never had a champion before like Bernie Sanders who will refuse to compromise with and placate the Oligarchy like Obama did right out of the gate. And if the people are united behind him, as I am sure they will be, the Oligarchy will fail.


"I love my insurance, which is much better than either Tricare or VA" -Olde Dude

Again you are wrong. You don't love your insurance. You love the services it provides to you have and the amount of money you are paying for them. Services that are less than what would be available to you under M4A and for a lesser amount of money than it is costing you now. Services that are less than what would be available to you under M4A and for a lesser amount of money than it is costing you now. Services that are less than what would be available to you under M4A and for a lesser amount of money than it is costing you now. Services that are less than what would be available to you under M4A and for a lesser amount of money than it is costing you now. Services that are less than what would be available to you under M4A and for a lesser amount of money than it is costing you now.

Is any of this actually getting through to you yet, Oh-Dee?

So you still aren't answering the basic question I posed when I posted this thread, Olde Dude. You're avoiding it whether you realize it or not. But I am pretty sure I have answered it for you earlier in this post.


"On NRP a person named Willow explained her reason for opposing Medicare-for-all. Her reason surprised me." -Curt

I actually have access (boy what a f*cking loaded word) to transition related services through the the ACA plan I have now. It's "covered". I looked into it last year. Through my Kaiser plan I could get the final surgery that I've never been able to afford for the last 23 years. But when you throw in all the co-pays and deductibles... I still can't f*cking afford it! Meanwhile, Donna and I have a transgender friend, probably very similar to the gal in your example, who was homeless and now lives in Section 8 housing and is getting the freaking works, even facial reconstruction surgery, through Medicare. Our present system is designed to f*ck over folks like Donna and myself who are in the donut hole of income between abject poverty and the middle class. Not just for transgender care but all healthcare in general. Given our ages and income, we would be paying a higher percentage of our household income on healthcare than anyone else in the country has to right now, were it not for the ACA and the subsidy we get. You are in a the high range of the inclusion zone and Willow and our friend are in the lower range of the inclusion zone.

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"So you still aren't answering the basic question I posed when I posted this thread, Olde Dude. You're avoiding it whether you realize it or not. But I am pretty sure I have answered it for you earlier in this post."

You are only concerned about cost. I consider that an extremely shallow view of health care. I have explained this overandoverandoverandover. You refuse to actually accept that anyone in the world might have a different view than you.

""I have that option, which I choose NOT to take." -Olde Dude

Technically no. No you don't. Not at all. The choice you are passing on, the VA, is actually full-blown socialized medicine. The government owns everything about it, including the hospitals. This is absolutely not what Medicare For All is as Bernie is proposing it. I'm embarrassed for you that you would even make such an absurd comparison."

The VA is a single tiered system (same as berns). The VA is told by the government what services they have money for on a line item (same as berns). The money for that system is funneled through the an agency of the government with the purse strings pulled by congress (same as berns). Hospitals and clinics are paid at a standard rate decided on by congress (same as berns). VA workers are paid less than their counterparts, but cost more (due to the bureaucracy) (same as berns).

You and I can "discuss" this until we are both dead. Neither will change. Get over it. You're dismissed.

"You are only concerned about cost." -OD

Here's a helpful little tip, Olde Dude. When you start out a post directed at me with a ridiculous, bald-faced lie about me right out of the gate, I usually don't even read any farther than that. What would be the point if you are determined to miss it? When you go to all the trouble of writing a response to me that you begin by lying about me, you are loudly telegraphing that the rest of it is likely nothing but one big long pile of bullshit to hide the fact that you won't or can't actually answer the question. I would ask you which part of "paying more for less" you are having trouble with, but it is obviously the "getting less" part. I have very obviously all along been championing the idea of getting more and better coverage along with paying less for it.

But look, for the sake of this thread I started and in the name of baseless optimism, I'll try to get past this one lie about me and slog through the rest of your post ...


"You refuse to actually accept that anyone in the world might have a different view than you." -OD






*face palm*





Oh, and by the way, when you do this, you instantly lose the argument.

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No one has yet explained why having the choice to get less and pay more is important to them.

No one even wants to try?

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A salutary lesson in the "economics." of American healthcare and insurance coverage.

[www.pressreader.com]

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Ponderer
"You are only concerned about cost." -OD

Here's a helpful little tip, Olde Dude. When you start out a post directed at me with a ridiculous, bald-faced lie about me right out of the gate, I usually don't even read any farther than that.

In OD's defense, is it really out of line to suggest you are concerned with cost when you include in the title of this thread the phrase "paying more for less"? Not to mention your past posts that have been about the affordability (and lack thereof) of health care.

He didn't just say I was concerned about it, Curt. He said I was only concerned with it. Uh... derrrr.

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You need to read more carefully, Curt. Of course almost EVERYONE is concerned with cost. Od's charge that Ponderer is ONLY concerned about cost is just more of the kind of classic distortion I frequently see from od and others here.



Edited 1 time(s). Last edit at 09/15/2019 08:19PM by Donna.

Broadening and improving coverage - making it better - has always been an essential portion of my argument and I have always bee concerned with it.

Simply covering everything, as I have always been concerned with along with Bernie, is a vast improvement and far better than just covering some things for certain portions of the population after accounting for annual financial status of people residing within zip codes containing blah blah blah blah blah blah ad infinitum. Derrr!

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Ponderer,
So what percent of your wanting M4A is about cost: 90%, 95% 99% if not only about cost? Nobody, including Bernie, is claiming that M4A or any single-payer system would reduce wait times to see a doctor, to see a specialist, for emergency care, etc. Or that it would deliver more extravagant services than currently available with private insurance. If Bernie, Warren or any candidate has made an case for that wasn't about cost, I'd like to hear it.

I'd say somewhere between 44.9 and 58.7 percent.

That's about as far as I'll indulge your attempt to change the subject.

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Ponderer,
I think M4A is a laudable goal. I just don't believe it's achievable. The reason single-payer was achieved in other countries, is because businesses were not given a tax break for offering health insurance to their employees as we do here in the US. Thus foreign countries didn't have an entrenched, established health insurance industry as we do here.

As you pointed out, even the very blue state of California was stymied in their efforts to achieve M4A. A third of the US Senate seats are up for grabs. The odds are strong that the GOP will control the Senate. Obamacare squeaked through the Senate with 60 votes. I don't see how it's realistic that Sanders or anybody can get 60 votes in the Senate for an M4A plan. That's why I think my plan to allow the states waivers to do whatever they want (assuming federal permission is required) is the only practical way to go.

I am skeptical that 50% or so of your reasons for wanting M4A are other than cost. I won't embarrass you by asking what those other reasons are.

I doubt if that tax break fully covers their outlay for subsidizing their employees' health care coverage.

Actually those "other reasons" you're imagining (if it's what I think you're referring to) are all in your head. She and I haven't even discussed that.

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Donna
I doubt if that tax break fully covers their outlay for subsidizing their employees' health care coverage.

Actually those "other reasons" you're imagining (if it's what I think you're referring to) are all in your head. She and I haven't even discussed that.

Frankly, I don't think you have any other reasons. Cost is your reason for wanting M4A. I don't know why you are taking such umbrage at the suggestion that it is your only reason. But go ahead, shock me with the other reason that you have for wanting M4A.

As for your other point, the tax breaks don't have to fully cover it. As I said, the fact that employer-sponsored health insurance and the health insurance industry are well established here, makes a move to government-run health care system very difficult. Here is an instructive history.

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The Real Reason the U.S. Has Employer-Sponsored Health Insurance
In 1942, with so many eligible workers diverted to military service, the nation was facing a severe labor shortage. Economists feared that businesses would keep raising salaries to compete for workers, and that inflation would spiral out of control as the country came out of the Depression. To prevent this, President Roosevelt signed Executive Order 9250, establishing the Office of Economic Stabilization.

This froze wages. Businesses were not allowed to raise pay to attract workers.

Businesses were smart, though, and instead they began to use benefits to compete. Specifically, to offer more, and more generous, health care insurance.

Then, in 1943, the Internal Revenue Service decided that employer-based health insurance should be exempt from taxation. This made it cheaper to get health insurance through a job than by other means.

After World War II, Europe was devastated. As countries began to regroup and decide how they might provide health care to their citizens, often government was the only entity capable of doing so, with businesses and economies in ruin. The United States was in a completely different situation. Its economy was booming, and industry was more than happy to provide health care.

This didn’t stop President Truman from considering and promoting a national health care system in 1945. This idea had a fair amount of public support, but business, in the form of the Chamber of Commerce, opposed it. So did the American Hospital Association and American Medical Association. Even many unions did, having spent so much political capital fighting for insurance benefits for their members. Confronted by such opposition from all sides, national health insurance failed — for not the first or last time.

In 1940, about 9 percent of Americans had some form of health insurance. By 1950, more than 50 percent did. By 1960, more than two-thirds did.

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There are other countries with private insurance systems, but none that rely so heavily on employer-sponsored insurance.
[www.nytimes.com]

I wouldn't be interested in M4A if it there was little or no out-of-pocket expenses but the docs were second-rate, the medical facilities were filthy dirty, and the waiting times were unacceptable, which is what od fears would happen under M4A and which btw is why he made that comment about Ponderer only being interested in cost.

Quote
Donna
I wouldn't be interested in M4A if it there was little or no out-of-pocket expenses but the docs were second-rate, the medical facilities were filthy dirty, and the waiting times were unacceptable, which is what od fears would happen under M4A and which btw is why he made that comment about Ponderer only being interested in cost.

It's not fair to say only second rate doctors would work within the M4A system, but many doctors would opt out. So there would be a reduced choice and availability of doctors. Maybe significant, maybe not. Not all doctors take Medicare patients now; psychiatrists in particular won't. And of those doctors who do, they will only see a certain percent of Medicare patients.

Simultaneously and retroactively, something has to be done about the high cost of educating a doctor; all of my doctor friends had huge school bills which took them years to pay back.

As for wait times, it's almost inevitable they would be worse. The VA system, and the health care in other countries provide a glimpse of what M4A is likely to bring. Personally, I think it would be worth the wait, but not everybody would agree.

"I think M4A is a laudable goal. I just don't believe it's achievable." -Curt

So what?

So let's just try to get half of what we think we can get and if we're lucky we'll get half of that and be satisfied? Just give up and give in to our Corporate Overlords before any feathers get ruffled or there is any shudder experienced in the Sacred Status Quo? Let's just surrender before even declaring war?

Dear God Americans have become a terrified flock of pants-pissing chickens if you're any example, Curt.


"Frankly, I don't think you have any other reasons. Cost is your reason for wanting M4A." -Curt\

*face palm*

Frankly, even if there were no other reasons but cost for enacting M4A, I would still be 100% in favor of it. However...

Reasons other than cost for having Medicare For All?

• It would cover EVERYBODY.
• It would eliminate the psychotic, convoluted, irrelevant middleman process the insurance industry lives for.
• It would cover all basic healthcare, including dental, hearing, eye glasses, and other things not always covered..
• It would cover EVERYBODY. No one would be excluded.
• It would save lives. Fewer people would die from preventable diseases for lack of access to healthcare.
• It would help and free up businesses and employers from having to deal with employee healthcare at all.
• It would be an absolute boon to the economy. People would have more money to spend.
• It would eliminate bankruptcies caused by medical expenses.
• It would simplify doctors' lives and hospitals' workforce.
• It would simplify everyone's lives and eliminate a major stress factor for the population.
• It would cover EVERYBODY. No one would be excluded. EVERYONE WOULD BE COVERED.
• It would be automatic to have and impossible to lose
• It would eliminate at least one stranglehold the Oligarchy has us in.

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Because government is this involved is PRECISELY why we pay more for less.

#walkaway

Ponderer,
I feel about M4A as I did Trump's 1000 mile long border wall that Mexico was supposed to pay for. It is simply an extravagant but empty promise. It plays well with Bernie's faithful, but the "uninformed" (as I believe Donna called them) are skeptical. M4A or even a half M4A will not get 60 votes in the US Senate. Look at the 2009 vote passing Obama care. That is why I suggested M4A along with any other variations of government-run healthcare be tried on the state level where it has a possibility of being passed somewhere.

After reading your list, I grant that you have other reasons for supporting M4A.

Curt you remind me of a Woody Allen line from Annie Hall:

"They did not take me in the Army. I was, um, interestingly enough, I was, I was 4-P. Yes. In the, in the event of war, I'm a hostage."

So are you actually never willing to fight for anything unless success is a guaranteed given? What the hell kind of a "fight" is that?

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I'll bet that almost no one who can't afford health care coverage believes that we shouldn't at least try for M4A. But I guess if you already have yours, then why should you care, right?

If we try, at the very least, more Americans would understand what Bernie's M4A plan actually is, how it would have helped them, and who prevented them from having it.

If Curt had been president instead of FDR, we all would be speaking German or Japanese now.

Ponderer and Donna,
You two subscribe to the Don Quixote school of politics. I follow FDR's pragmatic example. Social Security was not an FDR campaign promise. The original Social Security bill did not cover nearly as many segments of the population as it does now; it evolved. FDR did not enter America into World War II headlong in 1939. There was a strong isolationist sentiment at the time. He pragmaticly started the Lend-Lease program to keep Great Britain afloat (literally) and in a situation where they could defend themselves.

I see.

So we can't possibly ever accomplish what all other civilized countries are well capable of doing. We can only ever do what this country was able to do well over half a century ago.

Got it.

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Quote
Ponderer
I see.

So we can't possibly ever accomplish what all other civilized countries are well capable of doing. We can only ever do what this country was able to do well over half a century ago.

Got it.

I already explained the historical reasons why the UK and other European countries were able to initiate national healthcare systems after WWII and American did not. If history had been different, it might have happened here. But it didn't. History is what it was.

You need to face facts. No other country, civilized or not, covers what you say M4A promises. No country's health care system covers what you listed above, namely "all basic healthcare, including dental, hearing, eye glasses, and other things not always covered." Nowhere is it covered for "EVERYBODY" or anybody (except maybe for some active military and current prisoners). If you are going to fight for something, fight for something in which your loss is not a foregone conclusion. In other words, be pragmatic. The originator of the world's first universal healthcare system, Otto von Bismarck, said "politics is the art of the possible."

Furthermore, some of the best healthcare systems in the world where coverage is mandated by law, are operated and delivered completely by private insurers. Patients go to private hospitals and see their physicians in their private practices.

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The Bismarck Model
Today, the Bismarck Model serves as the predominant means of guaranteeing universal coverage in Europe, used in Germany, France, Switzerland, Belgium, Netherlands, and others. (Japan is also a Bismarck Model country.) The implementation varies, but all mandate insurance in one form or another. In Germany, for example, employers and employees jointly fund insurance via withholding; in Switzerland, individuals purchase their own policies.
[healthmatters4.blogspot.com]

Oh.

So the United States is not only incapable of doing what other countries are capable of doing, we can also never improve on anything that every other country is capable of doing.

Got it. Thanks again.


Thank God that our Founding Fathers were nowhere near as pragmatic as you are, Curt.

Although... we would likely have universal health care for all as a part of Great Britain right now....

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Ponderer,
Au contraire! Actually America's founders were highly pragmatic. They took advantage of timing. They declared independence from England when England was weakened and stretched thin protecting their empire elsewhere around the globe.

In 1775 the British army was a volunteer force. The English army had suffered from lack of peacetime spending and ineffective recruitment in the decade since the Seven Years' War, circumstances which had left it in a dilapidated state at the outbreak of war in North America. Britain had incurred a large national debt fighting the Seven Years' War. Because Americans were not paying taxes to the Crown, the Brits were heavily taxed to finance their military. Needless to say the taxes were very unpopular in England.