I don't like that he said that dumb thing because the gov never had the ability to dictate the plan details or control the markets / who competed. It was a lie!
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I don't like that he said that dumb thing because the gov never had the ability to dictate the plan details or control the markets / who competed. It was a lie!
PhDeac
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Which is what we're going through now. We took 2 steps forward under Obama while Republicans took steps back at the state level. Now Democrats are trying to take a step forward before running on it in 2018.
Private insurance subsidizes medicare today in a big wy. Not sure the system would survive a Medicare rates. Medicare is also a program aimed at srs and the disabled and not sure Id roll out this program for the masses.
We can debate single payer but the idea of Medicare for all is a great bumper sticker but impractical solution.
There are some off exchange options in some areas.
Its hard to keep your plan if you like your plan when no new business entered the pool since March 2010.
Bad news for sure and by bad I mean $$$.
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PhDeac
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How would a program aimed at the least healthy segment of the population be more expensive when scaled up to include healthier people?
Back to my earlier point, lots of companies can take a loss on Medicare bc they make a ton on private insurance. If it was all Medicare they wouldn't make any money. Realistically they would have to increase premiums to make more money so that the variety of healthcare businesses that directly or indirectly rely on reimbursement levels could get a larger cut than Medicare as it currently stands would pay out
dartsndeacs
THE quintessential dwarf
We can't make healthcare cheaper without taking money out of someone's pocket. Not sure I like this argument.
I didn't say it would. My point is docs would get paid a whole lot less and the "efficiencies" from a single payer wont cover this cut IMHO. Medicare is also a FFS system which is inherently inflationary and drives trend, esp is you move more people to it. Granted MACRA will help this but its an un-launched and unproven program.
I'll stand by my last comment that a Sr. program isn't what you want to base single payer on.
You save $ on health care by cutting per unit cost (like Medicare) or limiting care (like managed care). I think we need to do both and have advocated that the ACA should mandate reimbursement at some amount above Medicare but well below commercial rates.
I alway tell people Medicare wouldn't qualify as an ACA plan. Pretty ironic.
Exactly.
Isnt the question whose pocket?
dartsndeacs
THE quintessential dwarf
Fixed costs vs variable costs. We have clients who we can charge a multiple of X of our hourly rate to. Government contracts we can charge Y, which is less.
If all we had were government contracts, we'd be losing money, because we wouldn't pay for the fixed costs and overhead. Rent and people like myself who don't bill to clients. We'd have to take on smaller space and let some people go.
But since we already have 60 people employed, we could take on a brand new government contract, and it's profitable for us. Because we've already paid all the fixed costs and now its just straight "(Y) - (What we pay a newly hired employee) = Profit."
We would prefer to just take on all X, but once we get past the break-even point, we're happy to also take the Y.
dartsndeacs
THE quintessential dwarf
Like most businesses, firing excess people and companies and teaching them a different line of work seems the best solution, like the coal miners before them and the horse and carriage drivers before them. So I don't like the "shock to the system" caution. Seems the system needs a shock.
PhDeac
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Agreed.
Which docs are going away? What medical services aren't we covering?
I am not sure that is even possible, TBH. My monthly premium for a high deductible plan for a family of five is over $1,200.00 per month. Assuming we use the full deductible, we're at $20,400.00 for the year out of pocket. That's insane, considering nobody is actually even sick.
Totally understand. You have access to have a group plan? There are also faith based plans out there that are somewhat popular and cheap.
I operate a business with soon to be 12 employees. Perhaps the Bar Association has something.