Simple solution to the Medicare for All debate:

Herdfan

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Original poster
Apr 11, 2011
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Let the citizens decide. And not by a vote at the ballot box.

Let's allow anyone who wants MFA to be able to opt-in on their tax return. They will get Medicare based HC coverage and pay the corresponding tax surcharge.

The rest MUST provide proof of private coverage or they will be automatically converted to MFA, and taxes accordingly. Private coverage can include varying deductibles and OOP's and all plans will be national.

Private companies can chose which type of plan they want to provide their workers, as they do now. Coverage minimums will be what Medicare currently covers and private insurers mush meet that threshold.

Since the country is divided very close to 50/50 Liberal/Conservative there should be plenty of people opting in to MFA. Enough to show if it is even manageable with that number of people.

Doctors and hospitals must accept both and the rates charged must be identical.

All government workers, including ALL members of Congress and their staffs must be on MFA.

Bernie commented that yes taxes will rise, but will be offset by not having to ever to pay a penny out of pocket. This will give us a chance to see if this works without completely dismantling the existing system.

Fire away.
 

Herdfan

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Apr 11, 2011
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What about people who aren't working and therefore aren't paying in?
And how would that be any different than just moving everyone over to MFA? There are still going to be those who aren't working. They get better coverage with Medicaid anyway.
 
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Zenithal

macrumors G3
Sep 10, 2009
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Your suggestion is somewhat like what the Dutch do. It's honestly a good system including your suggestion.
 

lowendlinux

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Sep 24, 2014
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Or how about we not drag this all to the absurd..I know jumping down the slippery slope is fun but back in reality land there are many systems of UHC and MFA is just one...

On Tuesday I enrolled in VA health care due to my disability and combat status my priority 2 status makes my private health care pretty much redundant. The VA system is silly expensive, medicare is expensive, medicaid is expensive and when we combine all three we have more than just a couple bucks on the side. So lets just do UHC and get rid of all those programs, I'm not special my needed services aren't all that different than those of my age bracket, except I'll probably die before most of my peers. So let's give basic medical care to everyone and if you want something beyond that you can buy whatever supplemental policy you want.

This entire debate is simply stupid 'cause OMG UK..Canada...waits..death panels...cheddar soup
 

thekev

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Aug 5, 2010
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Australia has a system similar to that. They levy a certain amount of taxes. Past a certain age or income level you can either purchase private insurance or pay a slightly higher tax contribution. It seems to work for them. It's not perfect, but their own projected shortages of medical professionals do not seem worse than those in the US. The US scaled back medical residencies in the 1990s, and we have an aging population.

I suspect our bureaucratic systems are just ****ed up in a lot of ways, and these things are merely symptomatic of underlying problems.
 

FrankieTDouglas

macrumors 65816
Mar 10, 2005
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Australia has a system similar to that. They levy a certain amount of taxes. Past a certain age or income level you can either purchase private insurance or pay a slightly higher tax contribution.
So past a certain age, once someone is retired and probably on a fixed income, they're kicked off their insurance plan in the time of life when they'd most likely be seeking to use it?
 

lowendlinux

macrumors 603
Sep 24, 2014
5,155
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So past a certain age, once someone is retired and probably on a fixed income, they're kicked off their insurance plan in the time of life when they'd most likely be seeking to use it?
Yuppers everyone old is kicked off to face death panels :rolleyes:

Perhaps we should put all boomers on that track...you get a death panel, you get a death panel...everyone gets a death panel...

pedantry is why American politics is dumb v dumber
 

A.Goldberg

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Jan 31, 2015
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Lets be clear, when it comes to healthcare reform there are no “simple” solutions. Suggesting any major reform can easily be made is unfortunately not really the case.

There’s also a unrealistic expectations here, like healthcare providers will receive equal reimbursement from MFA and private insurance. Medicare has never paid anywhere close to the reimbursement rates of private insurance. Or are we going to instead have private insurers pay the pennies on the dollar Medicaid pays making healthcare delivery unsustainable.

All government employees on MFA - that’s funny. That’ll be the day when government actually applies their policies to themselves.

I’m afraid you’d end up with a situation where people with high healthcare costs or low incomes would be utilizing MFA. Inevitably the taxes of the MFA group alone would be insufficient to fund the program.

Or you’d just be making MFA as costly as private insurance in which case the overall healthcare costs would be greater than what we have already.

I’m guessing this is just meant to be essentially a loaded hypothetical.

I’m not sure Bernie will win over America by promising higher taxes with such unknown outcomes. Frankly I think we should be afraid of his rhetoric around destroying the healthcare system. I’m not sure he understands (or cares) how much damage a reckless plan could have on healthcare and the economy.
 

thekev

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Aug 5, 2010
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So past a certain age, once someone is retired and probably on a fixed income, they're kicked off their insurance plan in the time of life when they'd most likely be seeking to use it?
No. That policy applies to working age adults past the age of 30 or something around there and tends to be means tested. Their system isn't actually a bad one. It encourages the use of private insurance for those that can afford it. The unfortunate thing for them is the increasing shift away from not for profit insurance companies in that country, similar to what we had in the US in the 1970s, although theirs were genuinely non-profits.
 

Herdfan

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Original poster
Apr 11, 2011
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Problem is Medicare would get stuck with all the expensive cases while privates will only offer affordable plans for those that won‘t need them.
There will be no individual private plans. Only private plans will be employer/union plans which must cover everyone in the company equally.
 

GermanSuplex

macrumors 6502a
Aug 26, 2009
963
9,978
I'd be curious to see what this would cost vs. what we let the richest people in America keep of their own money because they will supposedly reinvest in the job market (which is usually nothing, or less than before so they can amass more wealth while the getting is good).

They always claim these social programs are going to bankrupt us. Its usually the people who are actually doing the bankrupting telling us that.
 
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VictorTango777

macrumors 6502
Oct 28, 2017
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Controlling the cost of medications needs to be part of the discussion.

As for other places like Canada, UK, Australia and Europe, perhaps their health systems are successful because their governments do a better job of protecting the environment, controlling air pollution and water pollution so fewer people are poisoned. And maybe their citizens are more likely to believe in science and do basic things like get vaccinated.
 

Herdfan

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Apr 11, 2011
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Perhaps someone in the UK or EU in general can answer this.

Here in the US, you can pretty much sue a Dr. for anything that went wrong. Baby dies during delivery, Dr. gets sued even if he/she did everything right and the insurance company will most likely settle to avoid a trial. Without a doubt this increases cost for everyone.

What happens in the countries with UHC? Are lawsuits as rampant? Will insurance companies settle to avoid court or will they fight?
 
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Eraserhead

macrumors G4
Nov 3, 2005
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Perhaps someone in the UK or EU in general can answer this.

Here in the US, you can pretty much sue a Dr. for anything that went wrong. Baby dies during delivery, Dr. gets sued even if he/she did everything right and the insurance company will most likely settle to avoid a trial. Without a doubt this increases cost for everyone.

What happens in the countries with UHC? Are lawsuits as rampant? Will insurance companies settle to avoid court or will they fight?
You can sue the NHS in court. They lose sometimes and settle sometimes.
 
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VictorTango777

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Oct 28, 2017
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During Trump's visit to UK, was he really trying to get private US companies into UK's National Health System, and for what purpose?
Drag down healthcare in other countries so the US doesn't look so bad?
 
Last edited:

Huntn

macrumors demi-god
May 5, 2008
17,089
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The Misty Mountains
Let the citizens decide. And not by a vote at the ballot box.

Let's allow anyone who wants MFA to be able to opt-in on their tax return. They will get Medicare based HC coverage and pay the corresponding tax surcharge.

The rest MUST provide proof of private coverage or they will be automatically converted to MFA, and taxes accordingly. Private coverage can include varying deductibles and OOP's and all plans will be national.

Private companies can chose which type of plan they want to provide their workers, as they do now. Coverage minimums will be what Medicare currently covers and private insurers mush meet that threshold.

Since the country is divided very close to 50/50 Liberal/Conservative there should be plenty of people opting in to MFA. Enough to show if it is even manageable with that number of people.

Doctors and hospitals must accept both and the rates charged must be identical.

All government workers, including ALL members of Congress and their staffs must be on MFA.

Bernie commented that yes taxes will rise, but will be offset by not having to ever to pay a penny out of pocket. This will give us a chance to see if this works without completely dismantling the existing system.

Fire away.
Not a bad sounding idea. My Dad retired 25 years ago as a GS something, with govt insurance and it’s incredibly good. I suspect it’s been lessened since then.
[doublepost=1561851005][/doublepost]
What about people who aren't working and therefore aren't paying in?
They go to the Emergency Room and wait? That has always been one of my pet peeves, and the reason I liked The ACA , the mandate. Of course the Rs are doing their best to destroy the ACA with nothing replacing it, a big F*CK You to those who need a solution. :(
 
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Herdfan

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Apr 11, 2011
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You can sue the NHS in court. They lose sometimes and settle sometimes.
Does that include the Dr.? Or are you referring to suing the NHS for something they didn't cover?

I am talking about people in the USA that will sue Dr.'s anytime the results don't end in their favor. Some states have tried to limit frivolous suits, but some still get through costing money and the Dr.'s Reputation.
 

Apple OC

macrumors 68040
Oct 14, 2010
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Hogtown
Perhaps someone in the UK or EU in general can answer this.

Here in the US, you can pretty much sue a Dr. for anything that went wrong. Baby dies during delivery, Dr. gets sued even if he/she did everything right and the insurance company will most likely settle to avoid a trial. Without a doubt this increases cost for everyone.

What happens in the countries with UHC? Are lawsuits as rampant? Will insurance companies settle to avoid court or will they fight?
They kill you on your next follow up appointment ;)
 

Sydde

macrumors 68020
Aug 17, 2009
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Way back in 2009, there was talk kind of along these lines. It was called the "public option", whereby people would have had publicly-funded alternative insurance that they could sign up with. However, the large insurance companies got together and stuck a major player, Senator Max Baucus, in their pocket, thus killing the public option. Because, that would have been unfair competition for them. And here we are.
 

appleisking

macrumors 6502a
May 24, 2013
658
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Why don't we just fund a public option that anyone can pay into and whose cost is dependent on income? Everyone else who's happy with their plan can stay and nothing has to change? Meantime we focus on the real issues causing increased healthcare spending (like lawsuits, lack of transparency on prices, and not enough doctors in primary care due to the expense of medical school necessitating more lucrative specializations).
 
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Herdfan

macrumors 6502
Original poster
Apr 11, 2011
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Why don't we just fund a public option that anyone can pay into and whose cost is dependent on income?
I would be all for that, but there is a huge risk for the MFA crowd.

What if it absolutely sucked and nobody was happy with it? At that point chances of UC would be dead for years.