There's talk and hope in many quarters that the United States will end up with Medicare for all. How would this affect nursing?
I currently pay a lot for my portion of high deductible insurance through work. It's basically mainly useless to me since I'm healthy, don't take meds etc. Even going to the doctor would cost me.
Honestly, the middle class has become the new underserved in America. Frugal, responsible people think twice about going to the doctor because of huge copays that have made basic healthcare a budget buster.
How would Medicare for all affect the middle class, nursing in particular? Employers would no longer have to pay for insurance. Would they pass savings on to us in the form of higher wages? How would we fare economically with higher taxes? Would the poor government compensation to facilities drive down wages?
"..repeal what remains of Obamacare after the Supreme Court struck down its "State Mandate" as unconstitutional in 2012...‘The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States Respectively, or to the people’ — as an interpretive rule to construe ambiguities against the proffering party, i.e., against Congress (Newsmax, 2019)."
Basically it's like this.
My side (people that does not want universal health care) does not agree in universal health care plans.
Your side (people that do want universal health care) agree with universal health care plans.
Everything else, is just noise. Why or how, or what reasons..large government, small government, etc.
Let them duke it out in the Supreme court and the elections. It's just sad that people are flocking out of places like Massachusetts.
And I grew up there. ? Like I said, everything else is noise. I tend to focus on tax rates.
I did not agree with Obamacare then or now. I thought it helped the insurance companies (which it did) and it is anything but affordable. I think what a lot of people are proposing now is much different from Obamacare.
I was never for universal payer until recently. Id even be in favor of a hybrid system that had both universal and private payer.
It is unfortunate that people are leaving places like Massachusetts but they like California tax everything and anything.
I did not agree with Obamacare then or now. I thought it helped the insurance companies (which it did) and it is anything but affordable. I think what a lot of people are proposing now is much different from Obamacare.
I was never for universal payer until recently. Id even be in favor of a hybrid system that had both universal and private payer.
It is unfortunate that people are leaving places like Massachusetts but they like California tax everything and anything.
Everything else is noise.
Difference in opinions exist. It all starts getting complicated when someone starts to say, "I can make this word into a better place!"
Always ends up in higher taxes. I again emphasize..I can't believe this nation's income tax rate is higher than Japan or even China.
Look at the residents of New Jersey for an example.
Education was their mantra (no doubt, top notch when it comes to public schools). People are leaving that state in droves. Even the children who benefited from the education system there, are just moving out once they are able to.
Why? Real estate tax rates. Ridiculous in my personal opinion. Holding people hostage by grabbing onto their scrotum, I mean, their house.
It's weird how you came to that one single conclusion, when there's a vast possibility that could come out.
It's like saying: since I am not for a "universal health care plan," I must be for the one-for profit company that covers all health care needs.
Aren't you missing (for an example) on:
a) charitable health care
b) people paying OOP
c) people not using any of those services
d) people who has the freedom to choose, exercising their free will and choice, to enroll in a insurance plan.
Your plan is: my way or the highway type of a thing. Last I heard, we live in a nation that promotes individual liberty.
Pesky little thing, isn't it? Our Constitution.
The problem currently is that people are 'free to choose' to not buy health insurance, yet hospitals are required to provide acute care to anyone who needs it, and the number of uninsured is rising and is going to continue to rise until hospitals no longer get paid, to use your example earlier of "Money out > Money in", how do you figure that is sustainable? If you're legally guaranteed a service to be provided for someone, why don't you feel that person should have to pay into that service?
Hospitals are free to choose not to take medicare, although they generally don't choose to not get paid, some I'm not sure what you're getting at there.
Regarding who pays into it, medicare is funded through payroll taxes, not income taxes, and 80% of households pay payroll taxes and most of the remaining 20% has paid into payroll taxes at some point.
One of the advantages of medicare is that medicare controls healthcare cost inflation far better than the private insurance sector, so I'm not sure where you're getting that healthcare inflation would increase. Healthcare costs are going to go up either way due a variety of reasons, but I don't get why you would be for even higher healthcare cost inflation than necessary.
Private insurers don't actually go away under a medicare-for-all system, it's still private insurers that manage many of the plans, but at Medicare's significantly reduced overhead costs (about 3% vs about 14% for private insurers). I'm not sure why you're so insistent on paying more for the same product.
I'm basically for, let the market decide on the price. That always worked for the better interest of the consumers.
It got complicated as we are all aware. Somewhere along the line, we did get the government involved.
That has actually consistently not worked out in the better interest of the consumers when it comes to healthcare.
"Let the market decide the price" works great when we're talking about things that people can just choose to do without if the price is excessive, when that's not an option, like when you're probably going to die without the service in question, then unrestrained free market forces are a horrible idea and why where that's been allowed to occur those costs have risen at a rate far greater than inflation.
That's we regulate the prices of things like electricity, it's considered too much of a necessity to allow for a fair consumer driven method of setting costs, otherwise costs skyrocket, do you feel that acute hospital care is less of a necessity than electricity?
That has actually consistently not worked out in the better interest of the consumers when it comes to healthcare.
"Let the market decide the price" works great when we're talking about things that people can just choose to do without if the price is excessive, when that's not an option, like when you're probably going to die without the service in question, then unrestrained free market forces are a horrible idea and why where that's been allowed to occur those costs have risen at a rate far greater than inflation.
That's we regulate the prices of things like electricity, it's considered too much of a necessity to allow for a fair consumer driven method of setting costs, otherwise costs skyrocket, do you feel that acute hospital care is less of a necessity than electricity?
The two cannot be compared for acute care is something that a person's life would depend on. However, if you place variables such as, the electricity powering up the ventilator..etc.
It did get complicated no doubt. My point is this again:
Do whatever you like. But don't raise the income tax rates. All my spider senses are going off, that what you are trying to do..is going to raise the income tax rates.
This is why I'm opposed to the idea of a universal health care plan. According to some people with this forum, it will rid of private health insurances, going directly against the 10th amendment.
I hate using this example..but how is Venezuela coping with all their "universal health care?"
Holy cow, I am getting whiplash trying to follow KonichiwaRN’s reasoning. It has gone from keep taxes low, to rich people leave, to individual freedom, to free enterprise, to LASIK surgery, to property tax, to 10th amendment, to Venezuela. What am I missing? New World Order? Big Pharma? Deep State?
Holy cow, I am getting whiplash trying to follow KonichiwaRN’s reasoning. It has gone from keep taxes low, to rich people leave, to individual freedom, to free enterprise, to LASIK surgery, to property tax, to 10th amendment, to Venezuela. What am I missing? New World Order? Big Pharma? Deep State?
Nah. It all comes down to one teeny weenie thing,
called..if you get the government involved, it will raise costs and guess who pays for it?
The two cannot be compared for acute care is something that a person's life would depend on. However, if you place variables such as, the electricity powering up the ventilator..etc.
It did get complicated no doubt. My point is this again:
Do whatever you like. But don't raise the income tax rates. All my spider senses are going off, that what you are trying to do..is going to raise the income tax rates.
This is why I'm opposed to the idea of a universal health care plan. According to some people with this forum, it will rid of private health insurances, going directly against the 10th amendment.
I hate using this example..but how is Venezuela coping with all their "universal health care?"
Doctors just stopped writing scripts. ?
You're correct, you can't compare care that someone's life depends on with a take-it-or-leave-it consumer product or service, which is why I was asking why you kept comparing the two.
Expanding the current system wouldn't cause income taxes to go up, it would cause payroll taxes to go up, but decrease employer-provided healthcare premiums by a larger amount than the increase in payroll taxes.
I currently pay about $20,000 a year, which is average, for an employer-provided healthcare plan. If my employer and I could use medicare instead, that would drop to about $17,500, so I'm not sure why you're so insistent that we can't afford to pay less money. And in addition to the decrease in cost to me just due to decreased insurance administrative costs, it would likely go down even further for those currently paying into the system because those just as capable of paying but who are instead currently cheating the system would have to pay their fair share.
You're correct, you can't compare care that someone's life depends on with a take-it-or-leave-it consumer product or service, which is why I was asking why you kept comparing the two.
Expanding the current system wouldn't cause income taxes to go up, it would cause payroll taxes to go up, but decrease employer-provided healthcare premiums by a larger amount than the increase in payroll taxes.
I currently pay about $20,000 a year, which is average, for an employer-provided healthcare plan. If my employer and I could use medicare instead, that would drop to about $17,500, so I'm not sure why you're so insistent that we can't afford to pay less money. And in addition to the decrease in cost to me just due to decreased insurance administrative costs, it would likely go down even further for those currently paying into the system because those just as capable of paying but who are instead currently cheating the system would have to pay their fair share.
I think that is the scenario since somewhat of a market competition still exists. You (and me) would have no say should Medicare come in to replace "everything," and the surcharges are skyrocketing. The taxpayers (people like you or I) would be receiving the bill, while everyone (including around 44% of Americans who do not pay any income taxes) will have access and use it.
And 10 out of 10 times, whenever our government gets involved..the costs do go up. That is a absolute reality of anything.
That is why I use Lasik surgeries as a simple example. I see the one variable that keeps that procedure relatively cheaper, is because the government won't pay for it; compared to other similar procedures that our government does.
Just a difference in opinions. As I have stated before, let the elections and the supreme court duke it out. ?
Medicare already exists, and it exists in the same healthcare system as private insurers, so the potential costs aren't up to conjecture or opinion, we already know that medicare provides coverage far more efficiently than private insurers, and that medicare is far better at controlling the increase in healthcare costs, this is directly observable so I'm not sure what you're basing your claims on.
I'm not sure how you think things currently work, but people already get care they haven't paid into, under medicare-for-all those capable of paying into the system but haven't been will be required to, you seem to agree with that but then disagree with it at the same time.
And again, medicare is paid for not through income taxes but payroll taxes, which 80% of households pay into.
Why should people get to utilize a system they aren't paying into despite no excuse of financial hardship? Why should I have to pay $20k a year to pay the costs of those who make just as much, or more, than me but who choose not to pay into the system?
Specializes in Critical care, tele, Medical-Surgical.
This article is several years old. Still it shows the numbers comparing Medicare costs versus private insurance. Please keep in mind that Medicare beneficiaries are over 65 or permanently disabled and thus likely to need more healthcare than younger healthy people.
Quote
Private Insurance vs. Medicare: Truth in Numbers
Sometimes it takes just a couple of numbers to clarify a huge, complex issue--In this case, what to do about Medicare. Medicare costs are up 400% since 1969--scary, right? But private health insurance premiums in the same period are up 700%--nearly twice as scary...
OUxPhys, BSN, RN
1,203 Posts
I did not agree with Obamacare then or now. I thought it helped the insurance companies (which it did) and it is anything but affordable. I think what a lot of people are proposing now is much different from Obamacare.
I was never for universal payer until recently. Id even be in favor of a hybrid system that had both universal and private payer.
It is unfortunate that people are leaving places like Massachusetts but they like California tax everything and anything.