# America's conversion to a single payer system easy peasy.



## Knight (May 25, 2017)

Everyone on Medicare & Medicaid, Veterans, active duty military personal within the borders of America & employees covered by employers will change from what they have now to the government run single payer system. Funding will come from taxes collected from those working and employers payments to insurance companies used for health care. In addition all deductions for Medicare and budget monies used for Medicaid will be redirected. to the new government agency set up to administer the single payer system. 

During the conversion unpaid patient health care needs will be documented, supplied to the patient for submission to the new agency for payment. 

Insurance companies will still be able to provide for those that want extra coverage to insure preferential treatment. 

All personal information will be stored in a secure government data base so treatment and diagnosis can be accessed anywhere in America. 

To avoid confusion about who is or isn't covered, phase in will begin immediately after the new government agency is staffed and all citizens are identified as having the legal right to coverage.  

That should work. Or not!


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## Don M. (May 25, 2017)

One way or another, the U.S. is going to HAVE TO transition to some sort of UHC.  Our present "for Profit" system is slowly beginning to implode, and the costs are becoming prohibitive for more and more, every year.  Just yesterday, the local news said that BCBS is pulling out of the Obamacare plans for the Kansas City area, in 2018.  That will leave at least 20,000 in that area with no coverage.  This is going to continue to happen, in areas where there is only one insurance company participating in the ACA/Obamacare.


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## Aunt Bea (May 25, 2017)

Good or bad I believe it will come to that.  

I think employers will gross up employee wages with a one time adjustment for the amount that they currently spend to subsidize employee health care and remove themselves from the whole issue.  When that day comes it will be Medicare for all.  

The million dollar question is what will the premiums/taxes and the coverage look like.


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## WhatInThe (May 25, 2017)

The problem with single payer and other systems is the focus is on who and how a bill will paid. Instead more focus needs to be placed on the actual costs of physical care. Throw insurance out of the equation for a minute. Why is one night in the hospital cost $3000 to $5000 or why did one band aid cost $5 or bag of basically salt water cost $35.

The way actual CARE is delivered needs to addressed as well. I for one am an advocate of urgent care type clinics which should help eliminate emergency room visits and/or the $200-$300 office visit. Also even though I think they waste money on the 'free' home visit every year I would shift those resources from people already seeing doctors several times a year to someone who doesn't see a doctor once a year.

And people need to use common sense as well, not the emergency room for every medical need when their doctor isn't available. If you injure your ankle playing a sport or working why not go directly to an orthopedic or sports medicine clinic or urgent care office right away. It's frequently not that difficult to figure what kind of specialists one might need. The industry has to accept this practice as well. 

Step by step brick by brick the US health care system will have to be changed. Not by one piece of legislative action.


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## Knight (May 25, 2017)

Aunt Bea said:


> Good or bad I believe it will come to that.
> 
> I think employers will gross up employee wages with a one time adjustment for the amount that they currently spend to subsidize employee health care and remove themselves from the whole issue.  When that day comes it will be Medicare for all.
> 
> The million dollar question is what will the premiums/taxes and the coverage look like.


With a single payer system just like other places in our world premiums would be for those that wanted to buy additional coverage from an insurance company.

The question of taxes gets a little tricky. Would better paid be taxed more? Would taking the taxed money supporting Medicare Medicaid and veterans be enough to cover the cost of the multitude of reasons people seek medical care? Would money businesses spend for employee health care benefits in combination with the diverted tax money close the cost.


 Toss in controlled hospital and doctor fees then pharma costs. Would less translate to less innovation and availability to doctors ? 

Then there is the tax deduction for high cost health care. That goes away. 

Insurance company employment would take a hit, job loss in a major section of the economy decreases the tax revenue. No mystery what the end result of less taxable revenue  is.


There is no easy peasy. The variety of issues to be resolved is as confusing as what Adam does on mother's day.


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## WhatInThe (May 26, 2017)

*California single payer would double state budget*

California recently proposed a single payer health care/insurance plan in which the state budget would have be to at least doubled.

http://losangeles.cbslocal.com/2017...-cost-nearly-double-californias-state-budget/


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## Lolly (May 27, 2017)

There is a difference between "single payer" and government run healthcare (socialized medicine) ..   Medicare is "single payer"... that means the government collects the premiums and pays out to private Healthcare providers.    The VA is true socialized or government healthcare.   The Government owns the facilities and hospitals... the employees including the doctors work for the government.    To me Medicare for all would be the better option.


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## Butterfly (May 27, 2017)

Lolly said:


> There is a difference between "single payer" and government run healthcare (socialized medicine) ..   Medicare is "single payer"... that means the government collects the premiums and pays out to private Healthcare providers.    The VA is true socialized or government healthcare.   The Government owns the facilities and hospitals... the employees including the doctors work for the government.    To me Medicare for all would be the better option.



I strongly agree, Lolly.


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## nvtribefan (May 27, 2017)

WhatInThe said:


> And people need to use common sense as well, not the emergency room for every medical need when their doctor isn't available. If you injure your ankle playing a sport or working why not go directly to an orthopedic or sports medicine clinic or urgent care office right away. It's frequently not that difficult to figure what kind of specialists one might need. The industry has to accept this practice as well.



This.  We have orthopedic "express" clinics here.  I've gone to them when I ruptured a biceps tendon, and for steroid injections in my trigger fingers.  No waiting weeks for an appointment, and the same copay as a regular specialist visit!


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## Trade (Jun 3, 2017)

*$400-Billion Single-Payer Health Care Plan Advances in California Senate*

A small but encouraging step forward IMO. 


http://ktla.com/2017/06/02/400-billion-single-payer-health-care-plan-advances-in-california-senate/


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## Knight (Jun 3, 2017)

Trade said:


> A small but encouraging step forward IMO.
> 
> 
> http://ktla.com/2017/06/02/400-billion-single-payer-health-care-plan-advances-in-california-senate/


   Something to think about in these few words from the article.
Quote
"Thursday when the state Senate approved a bare-bones bill that lacks a method for paying the $400-billion cost of the plan."

What exactly is a bare bones bill?

Estimated $400 billion cost?
 *Note I added the word estimated because anyone that understands how government works government and costs,  knows that leaving out estimate is a clue that the final cost will exceed $400 billion.  

Nothing is free, taxes will be used. It's a question of will taxes on consumer goods be the method used  or a combination of  taxes?. 

One constant in the systems in other countries is the escalation of cost to provide health care. Not knowing what bare bones really is, if I were a resident of California I'd be skeptical.


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## WhatInThe (Jun 3, 2017)

Trade said:


> A small but encouraging step forward IMO.
> 
> 
> http://ktla.com/2017/06/02/400-billion-single-payer-health-care-plan-advances-in-california-senate/



Along with a 15% payroll tax and contingent with not losing federal subsidies for health insurance. This in a state where a recent gas tax increase of about $500 year more in vehicle fees and taxes caused backlash including a recall election of that bill's sponsor. Should add that when San Francisco raised the minimum wage approximately 50 restaurants closed. Also saw where a rail project is burdened with billions of cost overruns or new additional cost projections. I don't think the tax payers or businesses will tolerate an additional tax.


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## Aunt Bea (Jun 3, 2017)

I think the California bill is symbolic at this point but I do believe that we will soon reach a tipping point and that Medicare for all will become a reality.

As far as how we pay for it, I don't see a big difference in paying insurance premiums or payroll taxes, it's just a case of moving the pea around under the walnut shells.







I am concerned over what the cost will be and how we can control health care costs going forward.

We'll see!


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## Knight (Jun 3, 2017)

Aunt Bea said:


> I think the California bill is symbolic at this point but I do believe that we will soon reach a tipping point and that Medicare for all will become a reality.
> 
> As far as how we pay for it, I don't see a big difference in paying insurance premiums or payroll taxes, it's just a case of moving the pea around under the walnut shells.
> 
> ...




Medicare for all should work but there is no doubt what it will take to make that happen won't be cheap at 1st. or easy to implement. 

We already know obesity in America is creating a massive amount of health care issues. What will happen to seniors already
enrolled in Medicare with age related problems  when millions more will have access to the doctor base?


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## Aunt Bea (Jun 4, 2017)

Knight said:


> Medicare for all should work but there is no doubt what it will take to make that happen won't be cheap at 1st. or easy to implement.
> 
> We already know obesity in America is creating a massive amount of health care issues. What will happen to seniors already
> enrolled in Medicare with age related problems  when millions more will have access to the doctor base?



Healthcare is not cheap or easy to understand now.  I would just as soon cut out the insurance company and pay my $757.97/month premium directly to the government.  If all Americans are enrolled in Medicare _for all _it would mean that young healthy folks would be contributing to the annual cost along with those that are sick or disabled.  I think that major employers would welcome the chance to go out of the health insurance benefit business by grossing up employee wages, in a one time adjustment, and letting employees pay for health insurance directly to the government.  I don't know what the cost of Medicare for all would be but I don't believe it would be any more expensive than the current system. 

I'm not too concerned about obesity, I'm concerned with the generally fit and healthy folks that develop some form of dementia and live for years and years in supervised care.

I assume that the seniors/retirees on Medicare will continue as they have and that those aging out and retiring in the future will pay some sort of income based premium to the government, similar to what they do today.

If Medicare for all becomes the law of the land I assume that all doctors will accept Medicare or only treat the uber rich in very cushy private clinics.

We'll see, whatever will be, will be!


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## Trade (Jun 4, 2017)

Aunt Bea said:


> I think the California bill is symbolic at this point but I do believe that we will soon reach a tipping point and that Medicare for all will become a reality.
> 
> As far as how we pay for it, I don't see a big difference in paying insurance premiums or payroll taxes, it's just a case of moving the pea around under the walnut shells.
> 
> ...



Exactly. What people who use the argument that single payer don't seem to understand is that we are already paying through the nose for healthcare to the tune of 17% of our GDP currently. Of course most of these naysayers aren't seeing that because someone else, like their employer, is picking up 80 or 90%, or in the case of retired military 95%+ of the tab for their health insurance. And what they are afraid of is that if the country goes to single payer they will have to pay higher taxes and get nothing more in return than what they already have. Which means those additional taxes may be going to pay for the health insurance of someone else.


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## Trade (Jun 4, 2017)

Aunt Bea said:


> I would just as soon cut out the insurance company and pay my $757.97/month premium directly to the government.



Amen to that!


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## Marie5656 (Jun 4, 2017)

*I am anxious to see how California does with the single payer.  I think it would be great if all states adopted it.*


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## Butterfly (Jun 4, 2017)

If I had to pay $757 to the govt for healthcare, I wouldn't have much left for anything else.


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## GreenSky (Jun 4, 2017)

There is no chance of Medicare for all.  We'll wind up with Medicaid for all.  Meaning lousy service.  Doctors getting 70% of what they get now.  

It will cause an even greater difference between the haves and the have-nots.  Those with money will pay cash or buy expensive insurance.  The rest of us will get terrible care.  VA for all!

Rick


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## Aunt Bea (Jun 4, 2017)

Butterfly said:


> If I had to pay $757 to the govt for healthcare, I wouldn't have much left for anything else.



It has been my biggest monthly expense since I stopped working.  

I'm thankful that the government contributes $131.00/month, the total premium is actually $888.97/month.

When I read about the payments that other people make for family coverage I feel very fortunate.


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## Lolly (Jun 5, 2017)

GreenSky said:


> There is no chance of Medicare for all.  We'll wind up with Medicaid for all.  Meaning lousy service.  Doctors getting 70% of what they get now.
> 
> It will cause an even greater difference between the haves and the have-nots.  Those with money will pay cash or buy expensive insurance.  The rest of us will get terrible care.  VA for all!
> 
> Rick



The VA is socialized medicine... completely owned and implemented by the government.    Medicare is single payer.   I thank GOD for my Medicare every single day.  My 100% coverage with zero copay costs me about $300 a month... which is  my Part B premium and supplement.


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## GreenSky (Jun 5, 2017)

You make my point.  Much of the service at the VA is terrible.

The cost of your Medicare and supplement is closer to $1,100 monthly with the taxpayers kicking in most of it.  I'm not saying it's wrong but let's get the actually cost correct.  Without your supplement (and since you clearly have Plan F you are paying way too much), the cost of Medicare itself is about $900 monthly for 80% coverage.  

There is no Medicare trust fund as the money has been "borrowed" out by the feds.  I still think the only affordable option is Medicaid which pays about 70% of the Medicare payments to doctors.  This will cause docs to opt out of any insurance and go to cash only.  Or we could still have insurance but only the wealthy would afford it.

I don't have an answer but there are 2 parts to every issue.  Those who receive a benefit and those who pay for it.

Rick


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## Don M. (Jun 5, 2017)

Our present Health Care system costs the nation over 17% of its GDP.  Most other nations supply quality health care to their people for about half that much.  Our present system is headed for a brick wall unless our government begins to look at what is working in other nations, and begins to adopt similar measures here.  There are dozens of reasons why our system is getting out of control, and the solutions will not be easy, nor occur overnight, but we have to begin to start Somewhere, and Soon.  

The last time the WHO...World Health Organization....ranked the nations, in 2000, the U.S. came in at number 1, in term of costs, but ranked number 37, in terms of results.  In the years since, that gap has probably widened.  

https://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000


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## WhatInThe (Jun 5, 2017)

Don M. said:


> Our present Health Care system costs the nation over 17% of its GDP.  Most other nations supply quality health care to their people for about half that much.  Our present system is headed for a brick wall unless our government begins to look at what is working in other nations, and begins to adopt similar measures here.  There are dozens of reasons why our system is getting out of control, and the solutions will not be easy, nor occur overnight, but we have to begin to start Somewhere, and Soon.
> 
> The last time the WHO...World Health Organization....ranked the nations, in 2000, the U.S. came in at number 1, in term of costs, but ranked number 37, in terms of results.  In the years since, that gap has probably widened.
> 
> https://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000



Exactly. Costs are the issue. Not who is going to pay for it. COSTS-why? Many reasons but the biggest is somebody else is paying for it syndrome via third party money/insurance companies. This sets the stage in the secondary market in supply and education as well. If providers, suppliers and educators realized their patients, customers and students were paying on their own rather than through insurance, loans, grants, subsidies etc the cost would drop. Third party money is now entrenched in the culture of medical care in America. That mindset will have to be dug out and changed step by step brick by brick. There is no one solution until third party money is eliminated let alone reduced.


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## GreenSky (Jun 5, 2017)

Having taxpayers fund healthcare is using 3rd party money.  People thinking that "it cost me nothing" is one of the reasons healthcare is so expensive.

Lasik is dirt cheap because people pay themselves.  Colleges cost a fortune because so much government (taxpayer) money is available.

I don't have a solution but I know we're going to the way of Canada or the UK with single payer.  Once the profit motive is gone I think we can say goodbye to innovation.

Rick


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## WhatInThe (Jun 5, 2017)

Some of the other ways being considered to "help" fund the plan include a 2.3% sales tax and 2.3% business tax on gross sales. That's just to "help" pay for it which means the 15% payroll tax could still be in play along with any federal taxes. 

https://finance.yahoo.com/news/latest-sales-business-tax-may-202715039.html


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## GreenSky (Jun 5, 2017)

So what is suggested is 4.6% paid by consumers.  Plus an additional 15% payroll tax.  

Socialism hasn't worked anywhere.  Why would it work here?

Rick


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## Lolly (Jun 5, 2017)

Medicare works VERY well.... and with much less overhead than private insurance companies..  But it isn't socialism...  It's single payer...   The VA is socialism... completely owned by the government.  Federal government owns the hospitals and clinics...  Doctors and nurses and all personnel are government employees..


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## GreenSky (Jun 5, 2017)

Medicare works great.  Except it's broke.  Much of the overhead is buried in the general fund so we have no idea about overhead.  We do know there is much greater fraud compared to private insurance.

People receiving the benefit think it works VERY well.  But it costs a fortune and it still is running in the red.  You have to look at both sides; cost and benefit.

There is hardly any government program that works.  Medicare is no exception.

Rick


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## Lolly (Jun 5, 2017)

GreenSky said:


> Medicare works great.  Except it's broke.  Much of the overhead is buried in the general fund so we have no idea about overhead.  We do know there is much greater fraud compared to private insurance.
> 
> People receiving the benefit think it works VERY well.  But it costs a fortune and it still is running in the red.  You have to look at both sides; cost and benefit.
> 
> ...



http://www.cbpp.org/research/health/medicare-is-not-bankrupt


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## GreenSky (Jun 5, 2017)

https://www.wsj.com/articles/social...ency-over-20-years-trustees-report-1466605893

Do we need to continue?  Medicare is going broke.  Period. 

There is no trust fund  except for the IOU from the Feds for taking money out.  It's being double counted.

I don't want Medicare to go bust, but like all government programs it is underfunded.

Anyone else can have the last word.   I know I'm right.

Rick


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## WhatInThe (Jun 12, 2017)

This is a little older but probably still holds true for the most part. Canada's health care might not be the example to follow. For costs/tax reasons alone. Seems to be a quality and time factor/downer as well.

https://www.psychologytoday.com/blo...-t-romanticize-the-canadian-healthcare-system


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