Is this a good place to begin dismantling America's failing health care system?

As a pragmatist, I eschew ideological gewgaws, and embrace what is demonstrated to work best.

That is why I advocate the practical approach of all advanced nations that, in one form or another, provide coverage for everyone, usually at considerably less expense than the US incurs to cove a fraction of the People while routinely dumping the bloated costs of the uninsured on the taxpayer.

The least disruptive method of achieving that goal would be to progressively lower the Medicare eligibility age, incorporating into the risk poll the age demographics that incur fewer medical expenses than do the 65+ that the privateers rather not insure anyway, for obvious reasons.

How to begin? The special interests for whom the exorbitant and inadequate system has been a fatted cash cow will allocate their vast resources and control of politicians to perpetuate their gorging on the banquet the US taxpayer serves them, and their ideological dupes will do their bidding in that endeavour. All those executives with their astronomical compensation will not relinquish their perceived entitlements without a fight.

Start with a genuflection before the altar of free market capitalism: Eliminate a massive federal subsidy!

Employer-administered plans are sustained only via a giant subsidy. Private companies deduct the cost of their plans, and their privileged employees do not pay taxes on the benefits they receive - a huge giveaway.. The U.S. Treasury has estimated this subsidy will cost $2.7 trillion over the next decade.

Relieve the bureaucratic burden inflicted by the government on employers whilst relieving Americans from the fiscal onus. Let those Americans currently subsidized in this way engage directly in free market capitalism with insurers who decide whether they and their family members are insurable at whatever cost the market will bear.

Would such an advance of free market principles hasten the progress to the repeatedly-affirmed superior approach by which all are covered at lower cost?

You betcha!

 

You've been given the problems associated with nationalized health care over and over and over and over again -- yet you never seem to listen.

1. With *every* single working person in the US paying for Medicare it is going broke. Loading more people into it will just advance the bankruptcy data even further.
2. What makes you think employer plans don't cause tax implications for the employees. I have an entry on my W2 every year showing that as a benefit that I pay taxes on!
3. What are you going to do with all the shareholders of the health insurance companies? Just confiscate their property with no compensation? If you would ever bother to read the Constitution you would find that the federal government can't do that.
4. What will you do with all the former employees of the health insurance companies? Just lay them off? Or make them government employees? If you make them government employees I can insure you that they will wind up costing the taxpayers more than they do today as private employees!
5. Nationalized health insurance operates on a government budget prepared at least a year ahead of time. That's why they ration care using the QALY metric or one similar. The US spends more on health care because health care in the US is *not* rationed based on government budgets. The American people are never going to accept rationing - EVER.
6. You will *never* relieve the American people of the fiscal onus of paying for health care. We spend about $3.5T per year on health care. That means the government is going to have to raise that revenue from somewhere. It would require raising FICA taxes to 30% or more! You will absolutely destroy the working poor with that kind of FICA tax. And there aren't enough rich people earning enough earned income to collect it via income taxes. If you raise the business tax high enough to pay for it you will absolutely kill small business in the US. And if you try to collect it from the large multi-nationals you will just force more inversions and off-shoring.

Nationalized health care is a pipe-dream. There *is* a reason it will never pass in Congress!

 

Your ideological opposition to adopting the approach of the most successful nations on earth in covering everyone at far lower cost affords a feeble defense of the most expensive approach ever devised that leaves tens of millions with inflated medical expenses to be dumped on the taxpayer.

Those covered by subsidized employer-administered plans are exempt from that subsidy being taxed as a portion of their compensation. The enormous subsidy now necessary to persuade employers to endure the bureaucratic burden is unsustainable - $2.7 trillion over the next decade that benefits only a segment of Americans in need of heath coverage.

IRS: "If an employer pays the cost of an accident or health insurance plan for his/her employees, including an employee’s spouse and dependents,
the employer’s payments are not wages and are not subject to Social Security, Medicare, and FUTA taxes, or federal income tax withholding."​

Obviously, an efficient single-player system would require a much-reduced workforce and payroll, with the elimination of all those exorbitant executive salaries, repeatedly-duplicated clerical functions, agency commissions, etc. To eliminate that bloat would displace people - as so many have had their jobs eliminated by technological advantages and other economic efficiencies. Private, for-profit enterprises would still be free to sell their products - just as private, for-profit schools can compete with the public system.
An incremental lowering of the Medicare eligibility age over whatever period is deemed appropriate would reduce the crisis of inevitable displacement with normal attrition being a factor as well.

The draconian measures of abandoning so many Americans in order to gift the extremely wealthy with an enormous tax cut that the GOP has been trying to ram through Congress in the face of widespread popular opposition only underscores the need for the proven paradigm.

Despite all the excuses and handwringing of those hellbent on perpetuating the plight of overpriced, partial coverage, we know what is shown to work far better for everyone.

The level of public satisfaction with the health care systems of advanced nations is far higher than in the US.

 

With many disagreements I was interested in your post until I got to that trite old mythical meme.

A dollar left untaxed is NOT a cost to the government.

 

A targeted tax exemption benefits one segment of the populace, and revenue lost is revenue lost. The exemptions granted to prop up employer-administered plans and the privileged who benefit from them are made up for by other taxpayers who are not thusly privileged. Of course, the government could also grant a $2.7 trillion exemption to any groups - e.g., short, bald, left-handed dudes who are tone deaf - and allege that such a massive write-off doesn't impact the deficit if not fleeced elsewhere, but it still does.

The ethics of the arbitrary favouritism aside,, consider the comparative empirical data:

Organisation for Economic Co-operation and Development

HEALTH SPENDING PER PERSON

Canada: $4,609

France: $4,407

Germany: $5,267

U.K.: $4.003

U.S. $9,451

Despite spending about twice as much for their healthcare, life expectancy in the United States is less than Canada’s, France’s, Germany’s, and the United Kingdom’s.
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

Despite spending about twice as much for their healthcare, the infant mortality rate in the United States is higher than Canada’s, France’s, Germany’s, and the United Kingdom’s.
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html
​

NUMBER OF PRIMARY CARE DOCTORS PER 1,000

Germany: 4.1

France: 2.1

U.K.: 2.8

U.S.: 2.6

Canada: 2.5

HOSPITAL BEDS PER THOUSAND

Germany: 8.2

France: 6.2

U.S.: 2.9

U.K.: 2.7

Canada: 2

PERCENTAGE OF PEOPLE WITHOUT MEDICAL INSURANCE*

Canada: 0%

U.K.: 0%

France: 0.1%

Germany: 0.2%

U.S.: 9.1%

* Of course the U.S. taxpayer still foots the bill for the bloated medical expenses incurred by the tens of millions of Americans uninsured. They may be foolish to pay astronomical health costs while advanced nations have achieved a superior approach, but they're not immoral.

​

 

This is what we've been saying. Obamacare killed our healthcare system.

 

Nationalized RomneyCare extended coverage to 20 million Americans, but the US system has been inferior for decades, and the Congressional GOP, after whining for seven years, is impotent in contriving anything remotely as good or acceptable to the public.

That is why most Americans want them to improve rather than abandon it, so it'll be a while yet before what advanced nations have achieved will be approximated in the US.

 

Too many people lost their doctors, cancer specialists, etc., and died. It is more inferior than ever, but there are fewer people to complain. Congrats.

 

Effectively if this is correct you do have a nationalised health care system only without any benefits

 

You have data to back this assertion? More importantly do you have data that proves America as a nation, was worse off?

 

Bottom line - yours costs nearly twice as much per person for a worse outcome

Why not advocate for a two tier system like Australia? Everyone pays into basic health care (Medicare) but we have a private option we can pay for if we do not want to join the great unwashed in ED

 

Something we've known for years, yet, Republicans continue their failed experiment into the abyss.

Their experiment where 2+2=5, (or tax cuts for the wealthy) always seems to meet a bunch of hurdles.

They could go with 2+2=4, (or medicare for all), but that math probably gets them a free ticket back home?

At the end of the day, it all comes down to a choice between accurate math and their job. And for 8 years, we all knew where Republicans stood when it came to those two choices now didn't we?

 

It sounds intellectual, but one can only conclude that you believe all money belongs to the government and we get to keep and use what they give us.
10% of total receipts for the untaxed medical premiums seem terribly high, but who am I to question Treasury. Why not eliminate the entire personal medical deduction and reduce the government's cost? Why not other taxes, contributions and casualty losses? Hell, as you hinted, why not eliminate a business' deduction for business expense? Imagine what that cost the federal government! And what is this costly stuff about allowing carry forward of business losses?
Beyond the exceptions that prove the rule how many people are clamoring to get to Canada, France, Germany, or UK for medical treatment compared to them traveling here?

 

Some folks will contrive all sorts of excuses to perpetuate a system that costs about twice as much as advanced nations and, uniquely, leaves tens of millions uninsured whose bloated medical expenses are then dumped on the taxpayer.

Yes, some individuals who can afford it choose to travel to the US to take advantage of specific areas of medical expertise - just as television celebrity Charlie Rose, after considering his options, decided to have his mitral valve surgery performed at the Georges Pompidou European Hospital in Paris.

"Medical tourism" has become popular with many Americans seeking quality care at far lower cost . Even with the added travel expense, they decide it makes sense to go elsewhere.

Given the empirical data, the multiple examples of inclusive, far less expensive quality health care afford a paradigm only the vested special interests that feed off the exorbitant farce and dogmatic ideologues rage against enlightened pragmatism.

Obviously, they are powerful and passionate obstacles to progress.

 

I gave you nothing of ideology. I gave you facts to be debated.

What did you offer in return? Ideology. Class warfare.

You didn't address a single issue. Not a solitary thing about how the shareholders of the insurance companies will be compensated. Not a solitary thing about how to make Medicare financially solvent. Not a solitary thing about how all those laid off people will be compensated for future loss of earnings because of direct government action. The lawsuits will be legion *and* expensive for the taxpayer to resolve.

And you are simply unconcerned about it all as long as the Marxist utopia is advanced! That's why the Soviet Union no longer exists!

 

Once you reach age 65 the life expectancy for the US and Europe is the same. It is those under 65 who die early that are the tproblem. There are more reasons why than you have fingers and toes. Drug use, car accidents, and poor lifestyle choices are three man ones. There are many more. Health care is not among them!

 

We should back to where we were before Obamacare, but allow health insurance to be purchased across state laws, encourage co-ops, increase the contribution amount to HSA's and allow consumers to purchase insurance with HSA funds. The government has no business in health care, the VA is an example of how well that works!

 

1. We offer health care that the basic health care option in Australia does not. It is a rationed system while America's is not.
2. It would *still* leave us with a two tier system that the Marxist Democrats will never accept. Equal outcomes for all has been and always will be their mantra! Always remember "from each according to ability and to each according to need".

 

I'm not sure what you are saying, but in answer to my question, "Beyond the exceptions that prove the rule how many people are clamoring to get to Canada, France, Germany, or UK for medical treatment compared to them traveling here?" I saw no negative rebuttal.

 

What are you talking about???

 

By best estimates 6 million, give or take, got insurance who previously didn't have insurance but wanted/needed insurance. The other 15 to 20 million added to insurance rolls did not want or need it but had to purchase it under penalty of law.
Now, 6 million should not be ignored, but they ought to be viewed in actual perspective, not as part of a big sounding passionate impressive number

 

It was the most successful and advanced health system in the world until Obamacare.

We had the highest survival rates for cancer, diabetes, etc. and 80%+ were happy with their medical insurance.

Then government got more involved ....

 

I do not know how many people are clamoring to come here or to go elsewhere for treatment.

As noted, the quality of care varies depending on the malady, and one can assume that Charlie Rose is not unique as an American who decided that France afforded the best care for his condition.

 

uh, we were ranked 37th for healthcare prior to the ACA. We haven't improved since its implementation. We need to adopt the proven superior system of single payer.

 

I believe this applies to all countries with national health plans,if you want to avoid queues etc you can take out extra insurance.