What are the pros and cons for transforming into a single payer system?
I think the universe is a bit of a leap, it's hard enough to organise it just for the USA
Take a close look at Medicare - think of it as a "test drive".
If you don't want to read it all, I'll summarize.
Medicare is an 80/20 health plan. For 2009, there is a $0 premium for Part A with a deductible of $1,068 for days 1 - 60 in the hospital, $267 per day for days 61 - 90, and $534 per lifetime reserve day. Most people have a $96.40 Part B premium with a deductible of $135. You can go to any doctor or hospital that accepts Medicare, but you pay 20% with no top limit to your out of pocket expenses. The services that cost you 20% include doctor visits, chiropractic, podiatry, outpatient substance abuse, outpatient surgery, ambulance, emergency, urgent care, outpatient rehabilitation, durable medical equipment, prosthetic devices, diabetes self monitoring, diagnostic, x-ray, lab, bone mass, colorectal screening, immunizations, mammograms, pap smears, prostate cancer screening, and end stage renal dialysis. As an example, diagnostic tests of $2,000 would cost the "insured person" $400 out of pocket after meeting the $135 deductible.
Next is Part B drugs at 20% (hospital) including chemotherapy. Most drugs fall under Part D coverage. Most stand alone PDP plans cost about $30 per month. The 2009 deductible is $295 and will rise to $310 in 2010. For the first $2,700 in covered drugs the insured person pays a share of the total cost of the drugs (maybe 20% o $540 out of pocket) plus the deductible. At this point the plan reaches the "coverage gap" or "donut hole". In the coverage gap, the insured pays 100% of the cost of their prescriptions until the total amount paid reaches $4,350 in 2009 and will increase in 2010. There is a catch also. Because the insured only paid $540 (in our example) of the $2,700, they will pay the difference between $540 and $4,350 (not $2,700). Once the insured emerges from the coverage gap at $4,350, prescriptions will cost 5%.
There are also penalties of 1% per month for not signing up for Part D and 10% per year for not signing up for Part B.
Is this better than YOUR group plan?
Anybody(including people that arent supposed to be here) in the US has access to healthcare. A person need only to go to any ER and they will get treatment. Granted the cost of those visits are padded excessively and are tranferred to the rest of us, but I dont see much difference in this and making everyone pay through a government program, the people who dont have resources will have their care paid for by people with resources, same as it is know, except that we will also have to fund the middleman.
IMO the costs of healthcare have continually increased right along with more people getting insurance, and this is done by design, if the insurance companies can increase the cost of medical care it will give them leverage as to why we would need them. If healthcare became affordable the insurance companies wouldnt have a leg to stand on. I would like to add though that the leg they are standing on now is government created and backed, and without that we wouldnt be able to label the insurance companies as bad, nor would we be having this discussion, IMHO. Government makes it living by creating a problem then creating a new program to solve that problem which creates another problem which they use to make a new program which cause a new problem which they use to make a new program and on and on.
I currently have (modest) healthcare through my employer. I would prefer to consume significantly less healthcare, but I don't really have that option -- my employer pays about 90% of the cost, so if I discontinue my income would only be increased by (10% of the value - tax on the 10%).
Universal healthcare would further rob me of my choice. Hard as it is to believe, it would be even worse than our current system (which is terrible).
I'm not sure what you mean by "modest" - it sounds like a discount program or an indemnity plan. Make sure you understand what you have and how it works.
Depending upon your state, (keep what you have) consider adding to your coverage privately. A good place to start is with your current plan, see if there are any riders you could add (low cost)- like term life, accident or vision. Another good rider is the maximum lifetime limit increase (usually varies anywhere from $1 to $7 million). If there isn't any flexibility, talk to your personal life, home, or car agent to see if they sell health. Ask them take a look at your existing coverage/limits and make recommendations. You can't duplicate coverage, but you can supplement.
A good rule of thumb is to plan for the unexpected and don't over-insure.
A typical ER visit for a broken bone (for example) may cost between $500 and $1,500. If your plan has a network - your insurer should have a negotiated (lower) rate - up to 50%. Normally $1,000 coverage (per event) will suffice. A network discount may also apply to doctor visits and prescriptions. Again, ask your local agent to analyze local costs.
On the other end, you need to consider the effect of a catastrophic event. If you own a home (for example), you need to protect your assets. Make sure you have adequate coverage for a large event $50,000 to $100,000. This should cover most surgeries and short term conditions. Again, your local agent should have some local stats.
If you have a family history of long term illnesses - address them.
There's definitely significant differences in state-to-state, even when it's ostensibly the same company like BCBS. In my previous company, we had BCBS, and that was a high deductible 80/20 (the insurance paid 80% of the usual and customary, and the U&C varied according to where one lived in the state). We had a lot of out of pocket expenses. The company eventually dropped BCBS when the premium increased to something like $1000/mo for family coverage.
My colleagues daughter broke her arm last winter. The ER cost was about $2500.
One should also consider - what if one becomes unemployed - and has a catastrophic illness, which will likely prevent one from obtaining further employment. This is relevant and just happened to a family acquaintance.
The husband recently lost his job with a large corporation (one of top of Fortune 100). I'm not sure what benefits he has or if he was able to go under the wife's benefits. He has been looking for a job and had some potential opportunities. He's not even 60.
However, this weekend he suffered a stroke in his brain stem and became paralyzed on one side with difficulty breathing. AFAIK, he's in intensive care and is slowly being weened from the respirator. His prognosis is uncertain - but with partial paralysis, he won't be able to find employment anytime soon - if ever. The wife may have to take time-off, and her job doesn't pay so great to begin with. If he survives, she may have to sell the house to provide some income and cover his expenses. Presumably he could go on disability (SSI?). And she could lose her job and whatever insurance she has.
So think about your situation and whether or not a stroke or other severely disabling illness could wipe you out.
It's situations like these (that I hear about all the time -- such as a friend of mine in Boston who had to sell her own house because her mother-in-law suffered a catastrophic illness and didn't have health care coverage) that frightens me so much on behalf of all of my friends and people I've worked with who live in the States. There's no reason for this situation to persist and why some people fight it tooth and nail is beyond me. Why people cannot understand that, no, the situation that exists right now in the States is nowhere near "good" or even "good enough" astounds me.
Yes, we need universal healthcare or if people can't accespt that then we need someone to introduce a trojan horse to break the death grip that employers hold over healthcare.
RIght now, healthcare isn't a choice i get to make. I get to chose from plans that my company forces down my throat and they only let me chose once a year and even then they only let me chose between bad and worse (as they keep on getting more expensive and less coverage)
The problem is not that it would be for everyone to have health care. The problem is we can not pay for everyone to have health care. If this was proposed during economic prosperity then it would probably go right through, but has anyone considered what happens when the federal government bankrupts itself. What happens when the dollar is worthless on the international market. You may think this is extreme thinking, but that is what eventually happens when you spend more money than you make.
If you think that I am supporting the republicans then you are wrong. If they were in charge we would be wasting money on something else.
TBH we should fire the lot of them, bring in new people with principles. Then start talking about social reform when we have a balanced budget.
I don't believe that such a condition should be imposed on 'talking about social reform'.
Perhaps some reform is what is needed to create a balanced budget.
I can not argue against that logic. I guess I should say that a system should be created with an overall balanced budget in mind. To say social reform should wait is too broad of a statement.
I'm sure that everyone wants everyone to have health care, but raising taxes and sacrificing ingenuity and efficiency is not the answer.
I don't think anyone in the US is AGAINST health care reform. The problem is that it's become a political issue.
What we need to do is apply the scientific method to the problem. Unfortunately, that is not politically expedient.
Well, my health insurance just went up AGAIN for a second time in a year even though I haven't used it once since I've had it. Yes, we need healthcare reform. With the status-quo, no one will be able to afford healthcare in 10 years.
Please see this thread https://www.physicsforums.com/showthread.php?t=326231
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