Position on Healthcare
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Poll
Question: What's your position on healthcare?
#1
Privatized is best. Repeal Obamacare.
#2
It's perfect just the way it is. Keep Obamacare. No need to change anything.
#3
Have the government insure everyone; a single payer system. There will still be a healthcare industry but no isurance industry.
#4
Socialize medicine! Decent healthcare is a human right, and the healthcare and insurance industry is too greedy.
#5
I am selecting this option because I am curious to see the results of this poll, and there is no way to do so without selecting an option.
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Partisan results


Author Topic: Position on Healthcare  (Read 4581 times)
Schiff for Senate
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« on: August 05, 2021, 02:36:20 PM »

What's your opinion on healthcare? (Personally, I'm fine with any of the options except the first.)
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afleitch
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« Reply #1 on: August 05, 2021, 04:33:26 PM »

NHS.

I pay tax. Tax funds my healthcare.
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Frodo
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« Reply #2 on: August 05, 2021, 06:12:31 PM »

I think Germany and Switzerland are the future of American health care. 
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Frozen Sky Ever Why
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« Reply #3 on: August 05, 2021, 06:35:02 PM »

Option 4, though I'll accept option 3. Unfortunately, the way things are going option 1 is more likely than either.
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« Reply #4 on: August 05, 2021, 08:41:51 PM »

Personally, I would prefer a system with some government agency responsible for negotiating drug and medicine prices with the manufacturers and using their superior bargaining position to get much better deals. Then, I would set up a company with a Fannie Mae type status to offer affordable plans (which shouldn't be too hard since the costs of medicine, which is like 90% or more of costs would be negotiated down and bought in bulk). Private insurers would have to lower costs by a lot more or just go bankrupt. Let the market work amirite Smiley

The government will save money from this, so I'd also add in some money-throwing at medical infrastructure R&D.

Since Medicare would cost less, I'd turn it into a system that pays for all costs, along with expanding it to cover new mothers and kids under 16.

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parochial boy
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« Reply #5 on: August 06, 2021, 09:02:47 AM »

I think Germany and Switzerland are the future of American health care. 

I pay approximately $300 every month on health insurance that I have never once in my life been able to claim on because the insurer only covers costs once I have already spent 2'500 francs in a year. Ok for me, healthy with a decent income; an absolute horror story for someone on a lower income who might have chronic health problems; someone in their old age; someone in one of the cantons where premiums are randomly higher and where the subsidies don't go anywhere near far enough

Almost any serious issue would mean going to a public hospital, covered by tax payer funds, who would bill me for a part of the treatment that even if I sent them it on, the insurer would still wind up essentially subsidised by the cantonal government because they know they can't trust the insurer to cover the full treatment costs for all patients.

The health insurers are, of course, not allowed to make a profit out of selling basic insurance policies, but are allowed to make a benefit - theoretically to cover any unforseen emergencies or pandemics. Curiously, Covid did not actually count as such a pandemic, and the insurers were at no point required to dig into their reserves while the state wound up coverng the full cost of testing, treatment and vaccines.

The Swiss system might be less out and out absurd than the US one, but it isn't a coincidence that it is the one European country where the fundamental nature of the way the system is run is a mainstream debate. It is the most expensive European system by far, and is only kept above water because the federal and cantonal governments spend so much of their time stepping in to to cover the deficiencies of the insurers. In all honesty, it's not an example for anyone.
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« Reply #6 on: August 06, 2021, 09:57:33 PM »

I think Germany and Switzerland are the future of American health care. 

I pay approximately $300 every month on health insurance that I have never once in my life been able to claim on because the insurer only covers costs once I have already spent 2'500 francs in a year. Ok for me, healthy with a decent income; an absolute horror story for someone on a lower income who might have chronic health problems; someone in their old age; someone in one of the cantons where premiums are randomly higher and where the subsidies don't go anywhere near far enough

Almost any serious issue would mean going to a public hospital, covered by tax payer funds, who would bill me for a part of the treatment that even if I sent them it on, the insurer would still wind up essentially subsidised by the cantonal government because they know they can't trust the insurer to cover the full treatment costs for all patients.

The health insurers are, of course, not allowed to make a profit out of selling basic insurance policies, but are allowed to make a benefit - theoretically to cover any unforseen emergencies or pandemics. Curiously, Covid did not actually count as such a pandemic, and the insurers were at no point required to dig into their reserves while the state wound up coverng the full cost of testing, treatment and vaccines.

The Swiss system might be less out and out absurd than the US one, but it isn't a coincidence that it is the one European country where the fundamental nature of the way the system is run is a mainstream debate. It is the most expensive European system by far, and is only kept above water because the federal and cantonal governments spend so much of their time stepping in to to cover the deficiencies of the insurers. In all honesty, it's not an example for anyone.

That's the point. It's the most similar to the American one.

Like it keeps the hurting poor people but the middle class (of which their opinion generally shift policy due to politicians need votes) would do fine under it.
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Continential
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« Reply #7 on: August 13, 2021, 05:27:17 PM »

Between 3/4
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S019
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« Reply #8 on: August 13, 2021, 07:04:45 PM »

Option 2
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GregTheGreat657
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« Reply #9 on: August 14, 2021, 08:58:50 AM »

I support repealing Obamacare, and replacing it with a much smaller public option for those who cannot afford insurance, with no individual mandate. I support regulating life-saving prescription drug prices and banning insurers from denying those with pre-existing conditions, but other than that I support a completely free market for health insurance.
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beesley
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« Reply #10 on: August 14, 2021, 09:25:23 AM »

Option 4 is the only option I'm willing to consider.
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CEO Mindset
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« Reply #11 on: August 18, 2021, 08:07:16 PM »

singlepayer plus making anything not an antibiotic/antiviral be 100% over the counter, no questions asked, going after the ama for keeping the number of med schools/doctors who graduate too low and reforming malpractice

antibiotics/antivirals would remain prescription only bc concerns about drug resistance
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TML
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« Reply #12 on: August 19, 2021, 10:22:30 AM »

The only things private insurance companies should be allowed to cover are procedures outside basic necessities (e.g. plastic surgery). All basic necessities should be covered by a government-backed insurance system with little or no money out-of-pocket. That's how things work in pretty much all other developed countries (and their healthcare spending per capita is much lower than that of the US).

Additionally, it should be noted that even most self-described moderates support this kind of system (for example, if you looked at exit polls from the 2020 Democratic primaries in states like FL, MS, and SC, where Biden won overwhelmingly, you will notice that most primary voters in those states still supported single-payer healthcare, so their votes for Biden weren't because of his position on healthcare, but in spite of it).
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Southern Senator North Carolina Yankee
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« Reply #13 on: August 21, 2021, 08:59:53 PM »

My ideal system would combine Medicaid with universal catastrophic coverage through something like Medicare.

One of my big points of disagreement with the thrust of not just Democratic-aligned public opinion on this subject, but American public opinion in general, is that middle income people should be paying for most of their health care out-of-pocket. The aim of health care reform should be to construct a health care system in which those expenses are not outrageously high for the typical family.

Unfortunately, I don't think that the "health care system" can be reformed in the United States. It's going to take a catastrophe or the emergence of an alternative to undermine its grip on this country.

Absent the reform of the campaign finance system, reforming health care in any serious way is impossible.
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The Smiling Face On Your TV
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« Reply #14 on: August 22, 2021, 02:08:37 PM »

Single-payer system where one can purchase additional private coverage for cosmetic/unnecessary procedures.

The primary purpose of this would be to remove the negotiation of drug costs from a private insurer who has a profit incentive to a national actor that (on paper) is directly accountable to the public. When a private insurer is negotiating with a private hospital, both parties have an incentive to charge the highest possible price to a consumer as they are focused on covering their costs. That is fine in a service industry such as construction or entertainment ; In the former the end-consumer (be it a casino, energy company, etc.) has the bargaining power and/or capital to adequately supply funds, in the latter the product is elastic, and therefore the "invisible hand" is more applicable. Nobody is dying or going bankrupt because Dead and Company plus whatever venue they're performing at charges an exorbitant premium at the gate.

 However, healthcare has such a degree of inelasticity that the B2B transaction cannot take precedent over the B2C. Ergo, a system similar to Japan's Drug Pricing Standard with specific criteria on the innovation and usefulness of a drug is worth exploring.


Of course, the question then becomes what is a necessary procedure? This requires a national health agency composed of leading medical professionals, hospital administrators, and seasoned public health officials who understand the statistics/effectiveness of a given procedure's/treatment plan's improvement of quality-of-life,  average costs, etc.


Can such a system flourish without a degree of regulatory capture?  How would a nation with an existing insurance industry handle the economic transition to a full single-payer system?  The floor is open for solutions.
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Skill and Chance
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« Reply #15 on: August 22, 2021, 02:41:48 PM »

My ideal system would combine Medicaid with universal catastrophic coverage through something like Medicare.

One of my big points of disagreement with the thrust of not just Democratic-aligned public opinion on this subject, but American public opinion in general, is that middle income people should be paying for most of their health care out-of-pocket. The aim of health care reform should be to construct a health care system in which those expenses are not outrageously high for the typical family.

Unfortunately, I don't think that the "health care system" can be reformed in the United States. It's going to take a catastrophe or the emergence of an alternative to undermine its grip on this country.

For whatever reason, the current US system is highly stable.  Obamacare passed and survived court challenges by the skin of its teeth.  Pretty much every other presidential administration since LBJ has had a reform proposal go nowhere.  It's also remarkable that COVID didn't make health care a major election issue.   
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progressive85
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« Reply #16 on: August 25, 2021, 06:42:31 PM »

I think honestly people should just get whatever health care they need or want and that it should be paid by tax revenues.  There is enough excess wealth in the country to do this, it's about the political will to ram it through the Congress and onto a sympathetic President's desk.  Then you have to watch out for the backlash from Big Money and the Elite, but to have it just paid for and then people choose whatever doctor or hospital they want just makes the most sense at this point.  Personal freedom and choice, but the bill goes right to "Big Government" and everything is covered, so there's no ifs, ands, or buts.  It just gets paid for.
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AGA
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« Reply #17 on: August 29, 2021, 11:13:03 PM »

I would be open to a single-payer system if it were fully funded with relatively efficient taxes and if there were a way to prevent people with bad health habits mooching off other people's tax dollars (some sort of "fat tax").
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Biden his time
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« Reply #18 on: September 04, 2021, 02:02:36 PM »

The life expectancy of the United States is stagnating

I'm only willing to consider Option 3 and Option 4
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Del Tachi
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« Reply #19 on: September 08, 2021, 03:03:11 AM »

Single-payer system where one can purchase additional private coverage for cosmetic/unnecessary procedures.

The primary purpose of this would be to remove the negotiation of drug costs from a private insurer who has a profit incentive to a national actor that (on paper) is directly accountable to the public. When a private insurer is negotiating with a private hospital, both parties have an incentive to charge the highest possible price to a consumer as they are focused on covering their costs. That is fine in a service industry such as construction or entertainment ; In the former the end-consumer (be it a casino, energy company, etc.) has the bargaining power and/or capital to adequately supply funds, in the latter the product is elastic, and therefore the "invisible hand" is more applicable. Nobody is dying or going bankrupt because Dead and Company plus whatever venue they're performing at charges an exorbitant premium at the gate.

 However, healthcare has such a degree of inelasticity that the B2B transaction cannot take precedent over the B2C. Ergo, a system similar to Japan's Drug Pricing Standard with specific criteria on the innovation and usefulness of a drug is worth exploring.

Insurance companies generate revenue by selling policies and/or avoiding payouts, which actually makes their incentives align with promoting health within the insurance pool, eliminating medically unessecarily procedures, and offering low premiums.  Private insurers have long been doing what you want done solely by public bureaucrats under the principle of "managed care." 

It is the "leading medical professionals, hospital administrators, and seasoned public health officials" you extol that are working to make medical care as expensive as possible with opaque pricing regimes, bureaucratic bloat, and  regulations designed to keep doctors' salaries high.  Hospital consolidation has given the medical industry monopoly power to dictate the prices insurers and consumers pay.
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« Reply #20 on: September 08, 2021, 03:37:02 PM »
« Edited: September 08, 2021, 03:42:55 PM by The Swayze Train »

Single-payer system where one can purchase additional private coverage for cosmetic/unnecessary procedures.

The primary purpose of this would be to remove the negotiation of drug costs from a private insurer who has a profit incentive to a national actor that (on paper) is directly accountable to the public. When a private insurer is negotiating with a private hospital, both parties have an incentive to charge the highest possible price to a consumer as they are focused on covering their costs. That is fine in a service industry such as construction or entertainment ; In the former the end-consumer (be it a casino, energy company, etc.) has the bargaining power and/or capital to adequately supply funds, in the latter the product is elastic, and therefore the "invisible hand" is more applicable. Nobody is dying or going bankrupt because Dead and Company plus whatever venue they're performing at charges an exorbitant premium at the gate.

 However, healthcare has such a degree of inelasticity that the B2B transaction cannot take precedent over the B2C. Ergo, a system similar to Japan's Drug Pricing Standard with specific criteria on the innovation and usefulness of a drug is worth exploring.

Insurance companies generate revenue by selling policies and/or avoiding payouts, which actually makes their incentives align with promoting health within the insurance pool, eliminating medically unessecarily procedures, and offering low premiums.  Private insurers have long been doing what you want done solely by public bureaucrats under the principle of "managed care."  

It is the "leading medical professionals, hospital administrators, and seasoned public health officials" you extol that are working to make medical care as expensive as possible with opaque pricing regimes, bureaucratic bloat, and  regulations designed to keep doctors' salaries high.  Hospital consolidation has given the medical industry monopoly power to dictate the prices insurers and consumers pay.


While insurers do have an incentive to want as healthy of a pool as possible, the method taken to accomplish this goal was by denying coverage to those with pre-existing conditions. Why cover someone who is a large risk for payout? Who defines exactly what an "unnecessary procedure" is? This end often leads to the very scenario that you put at at the foot at of the hospitals where A) someone pays an enormous deductible or B) leads to higher prices for prescription drugs to cover the insurance companies costs.

Indeed, hospitals have their own incentives as well to charge a higher price in order to turn a profit. This is why a transparent pricing system a la the one I described is necessary to rein both them and the insurance companies in. The "bureaucratic bloat" you describe is due to the excessive administrative costs from constant negotiating, ensuring that a patient is in-network, and so forth.


Regulatory capture is a problem I've listed with this approach. I'm imagining a system at least somewhat close to the one I deal with everyday as a cost accountant in building maintenance - we have to provide backup for our base union wages, fringes+benefits, supplies, travel, sales tax, and overhead/profit based on federal/state requirements. Our rate sheets are available to any customer upon request, and are subject to scrutinization. While there certainly is such information available in insurance brochures et al, the sheer inelasticity of healthcare places a negative externality of time on the consumer that is inherently not present in other industries.
Creating a larger pool with government oversight both reduces the overhead of operations via economies of scale as well as streamlining the processing of payment.
 
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Vice President Christian Man
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« Reply #21 on: September 09, 2021, 01:49:18 PM »

Option 3 with the Singapore model
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« Reply #22 on: September 10, 2021, 10:13:16 AM »

Healthcare in America is a broken system that needs to be changed significantly if we want to make it more affordable. I think the French healthcare system is a good model and one that could realistically be implemented in the United States. How it works is that there is a basic government insurance plan that everyone is required to use, but private companies can provide additional coverage and hospitals are private. This way, Americans can get a more affordable plan without destroying the jobs of people in the insurance industry and the hospital system is left alone.
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« Reply #23 on: September 12, 2021, 07:44:58 PM »

people who work in the insurance industry both health/non health insurance deserve to starve

i'd consider any plan good only if it at minimum severely contracts the role of insurers in healthcare
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« Reply #24 on: September 18, 2021, 11:51:08 AM »

NHS.

I pay tax. Tax funds my healthcare.

This pretty much. Just replace NHS with the appropiate name of our system
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