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#health care reform – @diegueno on Tumblr

Is It in My Head?

@diegueno / diegueno.tumblr.com

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You mentioned on a caption regarding Obama probably introducing Medicare for All if he is reelected and the Court strikes down the ACA. Why isn't Medicare for All a single payer system? I thought it was? Or are you synonymously using "Medicare for All" for the "public option"

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Medicare isn't a Single Payer System because Medicare would be one insurer of many who would pay for supplies, medicine and services. There would still be Aetna, Anthem, Blue Shields and Crosses (and companies licensing that name) and many others with negotiated rates and prices that they'd pay on a list. The administrata would remain in place.

Single-payer is a term used to describe a type of financing system. It refers to one entity acting as administrator, or “payer.” In the case of health care, a single-payer system would be setup such that one entity—a government run organization—would collect all health care fees, and pay out all health care costs. In the current US system, there are literally tens of thousands of different health care organizations—HMOs, billing agencies, etc. By having so many different payers of health care fees, there is an enormous amount of administrative waste generated in the system. (Just imagine how complex billing must be in a doctor’s office, when each insurance company requires a different form to be completed, has a different billing system, different billing contacts and phone numbers—it’s very confusing.) In a single-payer system, all hospitals, doctors, and other health care providers would bill one entity for their services. This alone reduces administrative waste greatly, and saves money, which can be used to provide care and insurance to those who currently don’t have it.
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So the intent is to improve quality and the cost effectiveness of health care by encouraging integration of the health care providers, as through accountable care organizations, yet we will be seeing higher costs and higher profits as a result. That inevitably means that premiums for the private health plans will be higher – a problem that the Affordable Care Act was supposed to address.
What is the link that causes this unintended perversity? It is the insistence of our policymakers that the private insurers be included as the financial intermediaries. Plenty of studies have now shown that the private insurers do not have negotiating clout in markets with provider consolidation. So why should we continue to include them, especially when they waste so much in imposing a huge administration burden, while taking away patients’ choices of health care providers?
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Adding all of this up, we can only conclude that employer-sponsored health insurance, and the overly expensive, wasteful private insurance industry upon which it is based, is in its death throes. As the Vice chairman of Ford Motor Co. said in 2004: “Right now the country is on an unsustainable track and it won’t get any better until we begin—business, labor and government in partnership—to make a pact for reform. A lot of people think a single-payer system is better.”
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But as I discussed in a lengthy article four years ago, this theory has been fully discredited over the years as a cost-containment tool in U.S. health care..... Instead of cutting health care spending, cost-sharing leads many patients to delay or forego necessary health care, resulting in later diagnosis of illness and higher costs down the road, together with decreased quality and outcomes of care.
Overall health care costs are not reduced. Cost-sharing just shifts more costs to patients and families at a time when these costs are already unbearable for many. Meanwhile, the real drivers of health care costs continue unimpeded— perverse incentives within the medical marketplace that encourage physicians, other providers, hospitals and other facilities to deliver more services, whether appropriate or necessary or not; lack of price controls; blatant profiteering by Big PhRMA, investor-owned hospitals and medical supply companies; introduction of new technologies with lax requirements to document their effectiveness; and excess bureaucracy of our 1,300 private insurers.
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And what are these new jobs in Massachusetts? According to this report, “Most of the difference in health care employment growth occurred in administrative occupations.” More administration!
Although there is much interest in finding new employment opportunities for residents of the United States, there is also a compelling interest in controlling runaway health care costs. With a single payer system, one of the most important efficiency targets is to reduce this profound administrative waste. Instead, our legislators brought us changes that dramatically increase this waste!
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Measuring the Affordability of Employer Health Coverage

By Larry Levitt and Gary Claxton Kaiser Family Foundation, August 24, 2011
What would this mean for families? We estimated the effect based on coverage in 2008 using demographic and insurance data from the Medical Expenditure Panel Survey and employee premium contribution information from the Kaiser/HRET Employer Health Benefits Survey. The analysis – which assumes no behavior changes by employers in response to the health reform law – suggests that there are about 3.9 million non-working dependents in families (technically, “health insurance units”) in which the worker has access to affordable employer-sponsored coverage but the family does not. Under the draft regulation, these family members would be excluded from getting federal tax credits to help them buy coverage in health insurance exchanges. On average they’d have to pay 14% of their income to opt into the employer coverage, substantially more than what they would pay in an exchange.
This is not a Catch 22, but rather a Catch 4,000,000 since it is estimated that close to four million dependents will fall into this trap in which the worker has access to “affordable” employer-sponsored coverage but the family members do not. This will impact most heavily middle-income families since those with low incomes may be eligible for Medicaid, and those with very high incomes will likely be able to afford family coverage.
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reblogged
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cheatsheet

All because we don't have single payer health care....

Earlier this week a man robbed a bank for $1 just to get access to health care through the federal prison system. The stunt worked: James Verone is now receiving medical services for a growth on his chest, two ruptured disks, and a problem with his left foot. But he'll likely get less than a year's time, in which case he's said he'll rob again.

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diegueno

This doesn't happen in Canada or Great Britain.

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At the end of May, Vermont Governor Peter Shumlin signed a bill that can put Vermont on the path to single-payer health care. As it stands, Vermont’s plan is to cover every resident of the state for actual health care they can use. But the Green Mountain State’s ambitious plan can only succeed if the Federal Government grants several critical waivers of existing health care laws.

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Ah, 2009. (photo: eiuhealthcare775nw)

At the request of Sen. Ben Nelson (D-NE), the Government Accountability Office put out a report examining several alternatives to the individual mandate that could be used alone or in combination to increase the number of insured if there were no mandate. Nine of the possibilities looked at by the GAO....

...none of the possibilities included Single Payer

Nelson!!!!

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Despite predictions by some prominent Democrats that the popularity of health care reform would soar after passage, one year after it was signed by President Obama, support for the law has actually dropped slightly. According to the latest Kaiser Family Foundation poll, 42 percent of Americans hold a favorable view of the law while 46 percent view it unfavorably. This is a slightly drop from April of last year when 46 percent viewed the law favorably and only 40 percent viewed it unfavorably.

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There are many legitimate diverging opinions about the quality of the new health care reform law, what shouldn’t be in dispute is the well-documented fact that it was a corporate sellout, or at least contained several large very specific sellouts to large corporate interests. Yet David Leonhardt, who must have been hiding under a rock during the entire debate, put it “on the list of blind spots for the noneconomist left”

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The Chamber of Commerce would surely oppose one entity paying for healthcare which makes their argument for supporting healthcare repeal a sham. The thought that keeping hundreds of insurance companies in business all with their own high salaried CEO, President, VP, accounting department, advertising budgets, and other overhead simply to pay a bill that any government employee could pay is comical. The idea that over 30 cents on every dollar is issued for expenses to pay a healthcare bill is more than irresponsible, it is theft. The Chamber of Commerce shows that it is the union of the business executive intent on keeping the executives employed however unnecessary. The Chamber of Commerce is there to ensure profit maximization on any industry willing to pay their dues to effect the misinforming of the American population to support policies against their own interest and to pay off politicians in legally politician approved discrete forms. At the same time they are a powerful union for business they are in complete opposition of the American workers’ ability to unionize. The inefficiencies they accuse union workers of having is in effect the inefficiency of the CEO and other corporate executives. Middle class worker productivity gains from low wages, automation, and outsourcing has become the bonuses of the executive.
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Bill Dailey is Unfit to Become White House Chief of Staff

Bill Dailey opposes the American people in 2 ways:

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