I am not an advocate for single payer health care but it surely looks like we are heading that way either by offering a Medicare/Medicaid for all or by providing subsidies for any who don't have insurance. So let's advance the discussion, how do we pay for it? I scanned a number of articles and depending on your leanings you can find explanations the suggest
. huge savings in administrative costs - Catch might fit here
. no savings because the administrative costs sited
- overlook duplicative costs provided by other agencies like Soc Sec, IRS etc.
- extraordinary govt waste that is almost always associated with large govt agencies
- the comparisons misstate costs because older people [Medicare consume much more actual health care so as a % the admin costs drop. [Think $500 admin per patient and an older person consumes $5,000 per year and a young person consumes $1,000. These are examples only. The admin costs for older folks are $500/$5000 = 10% while the admin costs for younger people $500 / $1,000 = %50. Further, when looked at on cost per patient Medicare is actually higher.
If you are strongly inclined in either camp the rest of the discussion is moot.
So we often get compared to rest of the Western world. I looked at France Germany and UK and they all pay a "health tax". For those who suggest all we need to do to solve this is eliminate the greedy insurance companies it appears in each of those countries there is additional insurance that can be purchased or is provided by their employers. This might suggest the existing programs might be more like the Fish/Lemonears proposal of very basic insurance and anything above that you get by purchasing insurance.
France for example sounds like the basic plan is govt pays 70% and customer pays 30% and if folks want to buy insurance to cover the 30% they can. Anyone who has had any major health care expense knows that paying 30% would be very expensive. My wife and I each had major [but common] surgeries this year and each bill ended up being over $50,000. Not too many folks budget $30,000 in a year for health care.[that excludes the $ooo's in pre and post surgery check ups..
It looks to me like the "health care tax" ranges between 11% and 20%. [again and then perhaps additional insurance] .
Health care is made up of
1. Dr's & Hospitals charges - There has been a lot of discussion suggesting we shouldn't lower these.
2. expensive technological advancements - I doubt anyone wants to stop these
3. treatment protocols particularly end of life- hello death panels?
4. life choices - fat people, smokers, drug and alcohol problems, lack of exercise etc. [discrimination?]
5 administrative overhead & profits - debateable and discussed above
So presuming we can't get any other savings from our national budget. [we certainly haven't yet]
how do we pay? Do single payer advocates think either a 15% health care tax on gross incomes or a 15% health insurance sales tax would fly with the public? I think it is easy to suggest everyone get health insurance but the thought that we somehow don't have to pay for it is typical of Washington and completely misleading
PS for those who think once corporations no longer pay for health insurance they could fund the shortage it appears that US corporate tax rates are higher than European tax rates by a similar amount to what they pay for health care so eliminating it would only bring them to par with European companies.
I would also add we shouldn't be trying to model European economic growth with comparable corporate tax rates.
. huge savings in administrative costs - Catch might fit here
. no savings because the administrative costs sited
- overlook duplicative costs provided by other agencies like Soc Sec, IRS etc.
- extraordinary govt waste that is almost always associated with large govt agencies
- the comparisons misstate costs because older people [Medicare consume much more actual health care so as a % the admin costs drop. [Think $500 admin per patient and an older person consumes $5,000 per year and a young person consumes $1,000. These are examples only. The admin costs for older folks are $500/$5000 = 10% while the admin costs for younger people $500 / $1,000 = %50. Further, when looked at on cost per patient Medicare is actually higher.
If you are strongly inclined in either camp the rest of the discussion is moot.
So we often get compared to rest of the Western world. I looked at France Germany and UK and they all pay a "health tax". For those who suggest all we need to do to solve this is eliminate the greedy insurance companies it appears in each of those countries there is additional insurance that can be purchased or is provided by their employers. This might suggest the existing programs might be more like the Fish/Lemonears proposal of very basic insurance and anything above that you get by purchasing insurance.
France for example sounds like the basic plan is govt pays 70% and customer pays 30% and if folks want to buy insurance to cover the 30% they can. Anyone who has had any major health care expense knows that paying 30% would be very expensive. My wife and I each had major [but common] surgeries this year and each bill ended up being over $50,000. Not too many folks budget $30,000 in a year for health care.[that excludes the $ooo's in pre and post surgery check ups..
It looks to me like the "health care tax" ranges between 11% and 20%. [again and then perhaps additional insurance] .
Health care is made up of
1. Dr's & Hospitals charges - There has been a lot of discussion suggesting we shouldn't lower these.
2. expensive technological advancements - I doubt anyone wants to stop these
3. treatment protocols particularly end of life- hello death panels?
4. life choices - fat people, smokers, drug and alcohol problems, lack of exercise etc. [discrimination?]
5 administrative overhead & profits - debateable and discussed above
So presuming we can't get any other savings from our national budget. [we certainly haven't yet]
how do we pay? Do single payer advocates think either a 15% health care tax on gross incomes or a 15% health insurance sales tax would fly with the public? I think it is easy to suggest everyone get health insurance but the thought that we somehow don't have to pay for it is typical of Washington and completely misleading
PS for those who think once corporations no longer pay for health insurance they could fund the shortage it appears that US corporate tax rates are higher than European tax rates by a similar amount to what they pay for health care so eliminating it would only bring them to par with European companies.
I would also add we shouldn't be trying to model European economic growth with comparable corporate tax rates.
