{"id":1401,"date":"2018-12-19T08:54:48","date_gmt":"2018-12-19T13:54:48","guid":{"rendered":"https:\/\/dahlman.online\/?p=1401"},"modified":"2018-12-19T08:54:51","modified_gmt":"2018-12-19T13:54:51","slug":"health-insurance","status":"publish","type":"post","link":"https:\/\/dahlman.online\/index.php\/2018\/12\/19\/health-insurance\/","title":{"rendered":"Health Insurance"},"content":{"rendered":"\n<p>Health Insurance\u00a0<\/p>\n\n\n<p>I listened to a podcast by Chris Hayes, the MSNBC commentator, called \u201c<em>Why is this Happening?<\/em>.\u201d\u00a0\u00a0Chris was interviewing Abdul El-Sayed, the former Director of Health for Detroit, and a candidate for Governor in Michigan.\u00a0\u00a0(if you have a 40 minute drive, it\u2019s absolutely worth the time &#8211;<em><a href=\"https:\/\/www.nbcnews.com\/think\/opinion\/making-case-medicare-all-abdul-el-sayed-podcast-transcript-ncna922911\">Why is this Happening<\/a>?)<\/em><\/p>\n\n\n<p>There is a lot to talk about, but the interview helped me clarify some of the health care issues.\u00a0The first was the difference between \u201csingle payer\u201d insurance, and \u201cnationalized medicine.\u201d\u00a0\u00a0Single payer means that private providers (doctors, hospitals, pharmacies) are paid be a single \u201cinsurance\u201d entity.\u00a0\u00a0It changes the health care cost equation in two ways.\u00a0<\/p>\n\n\n<p>First, it takes the \u201cinsurance entity,\u201d \u201cMedicare for all\u201d for the sake of discussion, and makes it a powerful bargaining tool.\u00a0\u00a0Currently, large insurance companies bargain with providers for reduced costs.\u00a0\u00a0The larger the insurance company, the better the \u201cdeal\u201d.\u00a0\u00a0We see this reflected in hospital bills, where we see a \u201cretail\u201d cost, a \u201ccharged\u201d cost, as much as forty percent less, and the difference that the patient might have to pay.\u00a0\u00a0Those without insurance pay the \u201cretail cost:\u201d no wonder they go broke in a medical crisis.<\/p>\n\n\n<p>A single payer \u201cMedicare for all\u201d plan would make the insurance provider a massively powerful bargainer.\u00a0\u00a0This is already recognized, as the GW Bush administration specifically prevented the current Medicare plan from negotiating for lower drug prices (<a href=\"https:\/\/www.kff.org\/medicare\/issue-brief\/searching-for-savings-in-medicare-drug-price-negotiations\/\">Kaiser Family Foundation<\/a>.)\u00a0\u00a0An expansion to \u201cMedicare for all\u201d should include the power to negotiate, while allowing for pharmaceutical companies to continue research.\u00a0The \u201ccost of the first pill\u201d needs to be recognized, but the cost of stable and unchanged drugs, like insulin, should be controlled (Humalog insulin prices have tripled in the past decade \u2013\u00a0<a href=\"https:\/\/www.cbsnews.com\/news\/insulin-prices-rise-yet-again-causing-diabetics-to-cry-foul\/\">CBS<\/a>.)<\/p>\n\n\n<p>A single payer program could reduce medical costs.\u00a0\u00a0The United States has some of the best medical care in the world, but it also has the MOST expensive medical costs in the world.\u00a0\u00a0In 2016, the average medical cost per person in the United States was $10348.\u00a0\u00a0The next highest was Switzerland at $7919, while Germany, Austria, the Netherlands and Sweden were all in the $5000\u2019s (<a href=\"https:\/\/www.healthsystemtracker.org\/chart-collection\/how-do-healthcare-prices-and-use-in-the-u-s-compare-to-other-countries\/#item-start\">Kaiser Family Foundation<\/a>.)\u00a0\u00a0<\/p>\n\n\n<p>A single payer system is NOT Nationalized Medicine (like the United Kingdom) or, dare I say it, \u201csocialized Medicine.\u201d\u00a0\u00a0The pharmacies, hospitals, and doctors remain private entities.\u00a0\u00a0A single payer system takes out the cost of insurance company profits (in 2017, the top six insurance companies made $6 Billion, up 29% from the year before,\u00a0<a href=\"https:\/\/www.cnbc.com\/2017\/08\/05\/top-health-insurers-profit-surge-29-percent-to-6-billion-dollars.html\">CNBC<\/a>.)\u00a0\u00a0And while the health insurance companies, Anthem, United Health Care and the like, would be out of business, their employees would not be.\u00a0\u00a0They would still be needed to provide the services for the new \u201cMedicare for All\u201d program, just as CMS runs the current Medicare.<\/p>\n\n\n<p>By the way, \u201cMedicare for all\u201d should NOT threaten existing Medicare.\u00a0\u00a0Republican Senator Roy Blount (MO) used the current fear-mongering catchphrase on\u00a0<em>Meet the Press\u00a0<\/em>this week, \u201cMedicare for all will be Medicare for none.\u201d\u00a0\u00a0This makes the invalid assumption that the current Medicare resources would have to deal with the incredibly expanded patient base of \u201cMedicare for all.\u201d\u00a0\u00a0But, of course, that wouldn\u2019t be true, the resources would have to be expanded in conjunction with the patients.\u00a0\u00a0The Republican criticism is just a way to scare those \u201cold folks\u201d (I have two and a half years to go) who use and love Medicare now.<\/p>\n\n\n<p>So a single payer system, well organized and staffed (like current Medicare) would reduce medical costs and remove a substantial cost in insurance company profits.\u00a0\u00a0But it wouldn\u2019t be free.\u00a0\u00a0Medicare isn\u2019t free now either.<\/p>\n\n\n<p>Everyone with insurance pays something for it.\u00a0\u00a0In our current employer-based insurance environment, a portion of insurance cost is part of your \u201cpay.\u201d \u00a0That part is paid directly by the employer, while the remaining costs are paid by the employee.\u00a0\u00a0Under \u201csingle payer\u201d the employer no longer has an insurance responsibility.\u00a0Employers could (whether they would or not) pay their \u201cshare\u201d amount directly to the employee in wages, who would then \u201cpay\u201d for single payer through taxes.\u00a0\u00a0Estimates show that while \u201cTAXES WOULD GO UP\u201d (of course) payers would no longer pay the now continually rising cost of medical insurance, for a net decrease in cost to the individual. <\/p>\n\n\n<p>Personally we have a great healthcare plan, the advantage of being retired government employees.\u00a0\u00a0We pay almost $5000 a year (for the two of us); it&#8217;s a great deal considering what the retail cost of insuring two retirees is.\u00a0\u00a0But we are in a unique position; there are many Americans who pay much more for less quality insurance, and many who cannot afford insurance (and can\u2019t qualify for Medicaid.)\u00a0\u00a0<\/p>\n\n\n<p>The cost of medical care is careening out of control.\u00a0\u00a0Our system may work for many of the 90% of Americans that have insurance, but the cost is increasingly steep.\u00a0\u00a0And for the 28 million Americans that don\u2019t have insurance, it doesn\u2019t work at all (<a href=\"https:\/\/www.census.gov\/library\/publications\/2017\/demo\/p60-260.html\">US Census<\/a>.)\u00a0\u00a0We need to look at alternatives without the scare tactics of loaded terms like \u201csocialism\u201d and \u201closing Medicare benefits.\u201d\u00a0\u00a0We are paying more than the rest of the world for care, and that \u201cmore\u201d is simply going to profit of\u00a0<a href=\"https:\/\/www.modernhealthcare.com\/article\/20180104\/NEWS\/180109966\">hospital systems<\/a>, insurance companies, and\u00a0<a href=\"https:\/\/www.gao.gov\/products\/GAO-18-40\">pharmaceutical firms<\/a>.\u00a0\u00a0While We are a capitalist country and they have the right to a profit, it should not be at the expense of the health of Americans.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Health Insurance\u00a0 I listened to a podcast by Chris Hayes, the MSNBC commentator, called \u201cWhy is this Happening?.\u201d\u00a0\u00a0Chris was interviewing Abdul El-Sayed, the former Director of Health for Detroit, and a candidate for Governor in Michigan.\u00a0\u00a0(if you have a 40 minute drive, it\u2019s absolutely worth the time &#8211;Why is this Happening?) There is a lot &hellip; <a href=\"https:\/\/dahlman.online\/index.php\/2018\/12\/19\/health-insurance\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Health Insurance&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","om_disable_all_campaigns":false,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[],"class_list":["post-1401","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Health Insurance : Our America - Essays on Politics and American Life<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dahlman.online\/index.php\/2018\/12\/19\/health-insurance\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Health Insurance : Our America - Essays on Politics and American Life\" \/>\n<meta property=\"og:description\" content=\"Health Insurance\u00a0 I listened to a podcast by Chris Hayes, the MSNBC commentator, called \u201cWhy is this Happening?.\u201d\u00a0\u00a0Chris was interviewing Abdul El-Sayed, the former Director of Health for Detroit, and a candidate for Governor in Michigan.\u00a0\u00a0(if you have a 40 minute drive, it\u2019s absolutely worth the time &#8211;Why is this Happening?) 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