Is health care the top reason for bankruptcies, as a Florida GOP leader said?
This may well be the most mendacious, ass backwards, leap of
illogic any politician has ideated recently (this excludes almost every single
Trump lie, of course). First off, Jose Oliva, Miami Lakes scumbaggery expert,
ignores the fact that essentially all insurance in the US which isn't Medicare
or Medicaid is private insurance. He comes across as a sort of "Marco Rubio Lite." Oliva has made reducing Education and Health Care spending his two principal legislative goals in the upcoming Florida Legislative session. Does anyone really think this is out of genuine concern for any interests other than Pharma and Insurance?
Fact: We have the
highest per capita costs of all OECD (developed, generally European) nations
and close to the lowest consumer satisfaction. Simply put, we pay far more and
get far less than nations with Single payer systems. This is perhaps the most
thinly veiled shill for the insurance industry ever. The only truth here is
that many Americans find themselves in dire financial straits when major health
issues arise. There are many reasons but leading the way is the prohibitively
high cost, for many, if not most, working class households, of truly
comprehensive coverage. Add to that, the abusive drug pricing not only allowed,
but forced upon consumers by a pharmaceutical industry whose annual NET
profits, routinely top 25%. That's about 3 to 4 times the average for other US
economic sectors. Cap the whole mess with the fact that Medicare/Medicaid
cannot negotiate drug prices lower because of the provisions in the Medicare
Part D legislation, Bush 43's Valentine to Big Pharma.
Want to cut
healthcare spending on a national level?
Allow Medicare/Medicaid to negotiate drug prices. If the Government paid
what most insurers pay for Drugs across the entire spectrum (significantly
lower prices) Medicare costs would decrease by about 10%. This alone would go a
long way towards making the economic side of things much better.
Let me be clear
and simple here: None of the bitching and moaning from Congress or State level
legislators about high Medicare costs takes the highly inflated Medicare/ Medicaid
drug prices involved into account.
If you have healthcare insurance and need,
just as an example, an Epi-pen 2 pack, your insurer and you, (what you spend depends
on the copay) pay somewhere in the area of $175, minus further reduction for any
coupons you might have which further defray the cost, for the product. This is
still, for this product (I’ve done the research), about 1166% profit on every
Epi-pen 2 pack! Understand this. For a $25,000 automobile, the actual percentage
that is profit is about 5%, or about $1250. If auto manufacturers enjoyed the
same ability to punish consumers as drug manufacturers do, that car would cost
you about $277,000!
If you are a Medicare or Medicaid patient,
the manufacturer lists the 2 pack at about $600, and that's what they get,
either from Medicare, your co-pay, or both. Medicare’s cost, on the other hand, yields a 4000%
profit on the same product. God forbid that, as a Medicare patient you find yourself
in the “Doughnut Hole” and get stuck with the entire cost. Now you know why the
Big Pharma companies list lobbying as their third or fourth largest budget line
item, with advertising the first.
Finally, and I
repeat this because you’re going to hear a lot of misleading babble re: single-payer
health care over the next year and a half, so far, all negative comparisons re:
the cost of single- payer (in some cases labelled “Medicare for all”) healthcare
concepts have similar data driven gross inaccuracies:
·
They compare private insurance costs to Medicare
without factoring in Medicare’s inflated drug costs. In 2018, drug costs were
about 25% of all Medicare spending. Even with a very conservative estimate that
Medicare is paying just twice as much for the same drugs, on average, as private
insurance, eliminating that inequity would decrease the cost of Medicare by
more than 10%. In round numbers for 2018, that savings, alone, would come to
well over $70 billion!
·
The high costs cited by opponents of single-payer
equate the cost of Medicare for all to the costs of Medicare for those who are
currently on it. This is grossly inaccurate for several reasons:
a.
The
average Medicare patient is over 65, ergo has generally higher medical bills
that a 35-year-old. Having all citizens on Medicare would result in a lower
average cost per-capita due to simple demographics.
b.
Medicare patients over 65 contribute relatively
little to the cost of their healthcare under Medicare. At $137 monthly, which
is Part b coverage, that is (minus deductibles and copays) the contribution for
a healthy senior over 65. Adding part D drug coverage adds a bit more, but as
discussed, the drug prices are hugely inflated. Equating Medicare for all to
this figure ignores the fact that most working persons under 65 (And, for many
if not most, their employers) spend far more for all services) for healthcare
insurance, at present. In fact: Premiums for individual coverage in 2016 (higher
now!) averaged $440 per month while premiums for family plans averaged $1,168
per month. This is in addition to paycheck deductions for Medicare, which, for
a wage earner making $50,000 annually, comes to another $60 monthly.
·
S Single payer is inherently more cost effective
from an administrative standpoint. Canada administers a truly far flung system
with about the same administrative staffing as Blue Cross uses to handle just Massachusetts.
· Summarizing: The average working age American
currently pays somewhere in the area of $500 monthly for themselves, and the
average American family of four now spends an almost unbelievable amount for
all healthcare related expenses. The total (2018) annual costs for a typical
family of four, insured by the most common health plan offered by employers,
will average $28,166, according to the annual Milliman Medical Index. This
number alone exceeds the current federal “poverty level” for a family of four!
... But every month, a family of four's health care costs are going up another $100!
This current expenditure of private funds is usually also conveniently
ignored when comparing Single payer, usually Medicare for all, to private insurance.
If the current input from retirees over 65 is the only monetary input, as it is
now (plus the minimal paycheck deductions for those working and under 65) yes, Medicare
for all would be prohibitively expensive. But…. even at current prices, considering
all Americans from 1 to 65, the average health care spending per month is now $587
monthly (kids included). So, 65% of the population (Medicare accounts for 15%,
Medicaid for 20%) represent an additional spending which greatly exceeds that
of current Medicare recipients but goes to private interests. This is also
conveniently ignored when comparing what is now obviously apples to oranges.
So, what to do?
Initially, dispel the concept that the government can’t do things efficiently.
Medicare is efficient, by comparison to any and all private insurers. Most doctors
I know agree that single payer is better. Billing specialists are even more
avid fans of single payer.
Then, negate
Medicare part D’s ban on the government negotiating drug prices. Have most, or
all, (it could probably actually be less!) of what is currently spent by
employers on employee health insurance go to Medicare.
Retain
reasonable (but lower) copays on way would be lower drug prices.
Enroll citizens
in Medicare at birth just like Social Security.
“Bump up” the
Medicare payroll deduction to, say, 5%, which is still far, far less than the
current cost of family insurance plans through employers or private plans.
Finally, allow private supplemental insurance
to be purchased, as about 11% of those in the UK do. Because basic services are
free under Single payer programs, supplemental insurance would be (is in the
UK) relatively cheap.
Also: increasing
the Medicare deduct would also somewhat increase the contribution of those now
on Medicaid to the overall national healthcare expenditure. Most Americans on
Medicare are either disabled or simply don’t have sufficient income to afford regular/preventive
medical care. Consequently, many are in far worse shape when they finally seek medical
attention, than if they had Medicare for all with the attendant free routine
visits. Without any research I would state with confidence that single payer
would have the beneficial unintended consequence of reducing the numbers of
Medicaid patients.
What is he likelihood of seeing this information from most
legislators? Slim at best, because most take huge campaign contributions from
the Pharma industry and it takes a bit of real analysis to grasp the facts and
apply critical thinking when the talking heads ae so loud and ubiquitous.
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