Current Events > Medicare for all won't work; hospitals will go out of business.

(+) Yeah! (+)

Medicare does not pay the doctors or hospitals enough to even cover their costs. They get their money from private insurers who pay approximately double or more of what Medicare pays out. Some sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4191486/
https://www.kff.org/medicare/issue-brief/how-much-more-than-medicare-do-private-insurers-pay-a-review-of-the-literature/
https://hbr.org/2017/11/5-ways-u-s-hospitals-can-respond-to-medicares-mounting-costs
https://www.aha.org/fact-sheets/2020-01-07-fact-sheet-underpayment-medicare-and-medicaid
https://www.nytimes.com/2019/04/21/health/medicare-for-all-hospitals.html

So this means for Medicare for all to work, it'll have to cost at least double what it does now (to pay out 2x or more), or we need to nationalize all hospitals and doctor offices.

It'll work, but we have to accept that it'll be VA for all.

Questionmarktarius posted...

It'll work, but we have to accept that it'll be VA for all.

Even that is better than what we have now

I mean we increase our taxes...

Username checks out

It's because the doctors are more than likely not addressing/reporting all conditions with CMS assigned risk a patient has to get properly reimbursed. All of the populations we take risk on (aka Medicare Advantage) are in the black as far as what we're reimbursed because our Providers are well educated on reporting out all appropriate conditions.

if everyone has free healthcare you don't need insurance companies anymore, so prices go down

I can't tell if this is a real topic or not from the username

Germany has free health care. And college.

https://youtu.be/7qEOJzAa4rQ

hospitals will go out of business

Do you not see anything wrong with this sentence?

It's incredible how extremely smart people with PhDs from Yale can't understand that Medicare doesn't even cover half of hospital costs... for example:

Here's literally a Yale study that concludes cost of Medicare for all is cheaper than what we spend today:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8572548/

And literally, in the study, it says:
The first set of savings could be achieved by applying the current Medicare fee schedule across all hospital and clinical services.

IdiotMachine posted...

we need to nationalize all hospitals and doctor offices.

Sounds good.

Thinking this is a good reason not to have universal healthcare is batshit

Man I can't believe most of Europe has no hospitals

Fucked up, man

Hospitals are literally already going out of business left and right because we should never have entrusted a public good to a system that demands profits at any cost?

Edit: Not for nothing, but pretty much every hospital in Connecticut is owned by either Hartford Health or Yale, and that's pretty not great!

Just_a_loser posted...

Germany has free health care. And college.

https://youtu.be/7qEOJzAa4rQ

Perhaps you should actually find out how it works. Germans making less than ~60k pay a ~15% tax that funds the program; those who make more can opt out and purchase private insurance. Those who are under the German government healthcare are not entitled to any of the "standard" stuff that we are accustomed to here in the US, like private rooms in hospitals, consultations with private doctors, alternative or complimentary treatments.

IdiotMachine posted...

Perhaps you should actually find out how it works. Germans making less than ~60k pay a ~15% tax that funds the program; those who make more can opt out and purchase private insurance. Those who are under the German government healthcare are not entitled to any of the "standard" stuff that we are accustomed to here in the US, like private rooms in hospitals, consultations with private doctors, alternative or complimentary treatments.

@Choco

Is any of this true?

Popcorn2000 posted...

Thinking this is a good reason not to have universal healthcare is batshit

If hospitals can't cover their costs because Medicare payouts are bullshit to begin with and go out of business, we're all fucked brah.

Nationalizing all hospitals and doctors OR medicare for all while doubling (or tripling) Medicare payouts are two actual viable options. However, the cost of doing this would be astronomical. Take the Yale figure and essentially double or triple it.

Turbam posted...

@Choco

Is any of this true?

Here's a source, brah (delete the line break since gamefaqs is stupid and can't handle long links):
https://www.commonwealthfund.org/international-health-policy-center/
countries/germany

I was slightly off on the income limit.

Just_a_loser posted...

Germany has free health care. And college.

https://youtu.be/7qEOJzAa4rQ

Germany has free college because they determine at the age of 12 whether you're smart enough to get to go and if you're not they put you down a technical track that ends in a trade school.

That's also one of the reasons why Germany has a University graduation rate of roughly half what the United States does.

IdiotMachine posted...

If hospitals can't cover their costs because Medicare payouts are bullshit to begin with and go out of business, we're all fucked brah.

Nationalizing all hospitals and doctors OR medicare for all while doubling (or tripling) Medicare payouts are two actual viable options. However, the cost of doing this would be astronomical. Take the Yale figure and essentially double or triple it.

youre looking at the surface level. Why are those costs so astronomical? Bad medicine!

If healthcare workers salaries go down there will be massive shortages. Nurses, doctors, even techs are leaving because work is so busy and stressful, they don't feel like it's worth it. Imagine now telling them sorry we're gonna cut your pay in half. The critical shortages of healthcare workers that you'll get will have bad consequences. Not to mention alot of talent will fade away from the profession of being a physician. Healthcare quality would u doubtedly go down. I don't think anyone wants that.

Popcorn2000 posted...

youre looking at the surface level. Why are those costs so astronomical? Bad medicine!

Good point on pharmaceutical medicine. Guess what... The rest of the world rides on the US ability to fuck US citizens. To put it simply, because US has no laws on limiting how much to charge for medicine, the US actually pays for innovation and the R&D in medicine, whereas every other country just pays for the production cost of the medicine:
https://www.brookings.edu/research/the-global-burden-of-medical-innovation/

It's complete bullshit.

Dan_Haren- posted...

If healthcare workers salaries go down there will be massive shortages. Nurses, doctors, even techs are leaving because work is so busy and stressful, they don't feel like it's worth it. Imagine now telling them sorry we're gonna cut your pay in half. The critical shortages of healthcare workers that you'll get will have bad consequences. Not to mention alot of talent will fade away from the profession of being a physician. Healthcare quality would u doubtedly go down. I don't think anyone wants that.

Healthcare. Should. Not. Be. A. Business.

Healthcare shouldn't be a "business". It fundamentally does not operate via standard market economics anyway. There's too much demand, too little supply, and too many middle men.

hockeybub89 posted...

Healthcare. Should. Not. Be. A. Business.

How do you propose doctors, nurses, and surgeons get paid?

IdiotMachine posted...

Good point on pharmaceutical medicine. Guess what... The rest of the world rides on the US ability to fuck US citizens. To put it simply, because US has no laws on limiting how much to charge for medicine, the US actually pays for innovation and the R&D in medicine, whereas every other country just pays for the production cost of the medicine:
https://www.brookings.edu/research/the-global-burden-of-medical-innovation/

It's complete bullshit.

ugh. The whole system needs a reboot

jist like the criminal justice system

IdiotMachine posted...

How do you propose doctors, nurses, and surgeons get paid?

How do CEOs of nonprofit organizations get paid millions?

Just because the hospital network is nonprofit doesn't mean the people working for it aren't paid handsomely.

DarkRoast posted...

Healthcare shouldn't be a "business". It fundamentally does not operate via standard market economics anyway. There's too much demand, too little supply, and too many middle men.

That's fine to believe that, but all this hub hub on how it's cheaper to do Medicare for all vs keeping the system as is by extrapolating Medicare right now but to everyone is bullshit, is my point. Campaign on the correct number (say double the Yale figure so $6 trillion per year) and raising the taxes accordingly.

IdiotMachine posted...

That's fine to believe that, but all this hub hub on how it's cheaper to do Medicare for all vs keeping the system as is by extrapolating Medicare right now but to everyone is bullshit, is my point. Campaign on the correct number (say double the Yale figure so $6 trillion per year) and raising the taxes accordingly.

Medicare For All is a stupid idea if it's applied as simply another option to private insurance.

But replacing insurance entirely would actually be a huge improvement.

But then again I only have a Master of Public Health in Health Administration and a Doctor of Medicine. I'm sure Bubba has a more nuanced opinion.

If the government cracks down on all these useless admin titles and positions that are plagued with RNs, NPs, and PAs, and also MD/DO, then healthcare costs will go down.

https://nypost.com/2022/02/27/struggling-nyc-hospital-pays-fat-salaries-despite-staffing-problems/

I was a resident there, and it was fucking awful.

DarkRoast posted...

Medicare For All is a stupid idea if it's applied as simply another option to private insurance.

But replacing insurance entirely would actually be a huge improvement.

Every other country with nationalized healthcare has private insurance add-ons as well.

DarkRoast posted...

But then again I only have a Master of Public Health in Health Administration and a Doctor of Medicine. I'm sure Bubba has a more nuanced opinion.

Cool? We're talking public policy, and I have linked actual studies and reputable university/news sources vs some random tabloid articles.

IdiotMachine posted...

How do you propose doctors, nurses, and surgeons get paid?

With money, ideally. Bartering is a dead art.

thronedfire2 posted...

if everyone has free healthcare you don't need insurance companies anymore, so prices go down

Not only you don't need insurance companies but hospitals no longer have to worry about patients who can't pay

hockeybub89 posted...

Healthcare. Should. Not. Be. A. Business.

Do you want quality healthcare or not?

I mean you are so far out of touch with reality if you think the government can take control, make free medicare for all, and the quality won't diminish

megamanfreakXD posted...

If the government cracks down on all these useless admin titles and positions that are plagued with RNs, NPs, and PAs, and also MD/DO, then healthcare costs will go down.

https://nypost.com/2022/02/27/struggling-nyc-hospital-pays-fat-salaries-despite-staffing-problems/

I was a resident there, and it was fucking awful.

Question on this:
Meanwhile, Jacob Shani, chief of heart surgery, received $3.5 million; Patrick Borgen, department of surgery, $2 million; Greg Ribakove, chair of cardiothoracic surgery, $1.8 million; Robert Frankel, director of interventional cardiology, $1.7 million; and Alex Shaknovich, cardiologist, $1.7 million, records show.

What if they don't pay them this? Would they just leave and go to another hospital that will still pay them that much? Are these skills that rare and in high demand to warrant those salaries?

"We should overhaul the healthcare system"

"Oh so it should run on fairy dust and people should work for free? Hospitals will close!"

"Let's do it like they do in Europe."

"Oh but I thought capitalism was bad? They aren't the communists you wish they were!!! Besides, America big!"

I'm all for a single payer system and free insurance for all, but it has to have the funding. And knowing this country anything federally run will be shortcutted and low quality. You don't want that for your own health.

I agree it will turn into the VA for everyone and as someone who worked in the VA for 6 years...trust me you don't want that.

The price of treatments are literally just made up. The "true cost" of M4A can't even be determined because the system is so fucked up as is by design.

This topic is really fucking stupid and the TC has no idea what he is talking about as per usual.

Dan_Haren- posted...

Do you want quality healthcare or not?

I mean you are so far out of touch with reality if you think the government can take control, make free medicare for all, and the quality won't diminish

Is this why America has the highest life expectancy and health quality in the world? Because everyone else is rubbing dirt in their open sores?

We need to blow up the system in some way. I have a personal vendetta against Big Pharma and it's a goddamn crime that healthcare workers are limited in what they can do for patients thanks to capitalist bullshit. If tons of people can't even afford care, who gives a shit that some people want to pay for the best?

Anybody who doesnt think universal healthcare will work is either a corporate shill who only wants more money and nothing else, or they are a legitimate idiot with less than 3 digits in their IQ and less than 2 digits in the highest year they achieved in grade school

IdiotMachine posted...

That's fine to believe that, but all this hub hub on how it's cheaper to do Medicare for all vs keeping the system as is by extrapolating Medicare right now but to everyone is bullshit, is my point. Campaign on the correct number (say double the Yale figure so $6 trillion per year) and raising the taxes accordingly.

Just doing some random math, assuming $6 trillion would be the cost to implement Medicare for all but with actual good payouts for hospitals to stay open:

US budget in 2022 was $6 trillion. Minus the $1.3 trillion we already spend on Medicare/Medicaid = $4.7 trillion. + $6 trillion = $10.7 trillion, or a budget increase of $4.7 trillion (+78%).

Increase your federal tax by 78% and see if it's still worth this. For example, if you paid the average 16% net federal income tax, now that is 28% net federal income tax.

Lonestar2000 posted...

This topic is really fucking stupid and the TC has no idea what he is talking about as per usual.

Would love you to elaborate.

Coffee, there's something I'm curious about, but my question is a bit personal so I'm going to try to keep this as details-ambiguous as possible, and I ask this with the utmost respect for you and your profession, and ALSO as someone who believes the US healthcare system is a fucked up mess: As a doctor, how much of a pay cut would you realistically accept in exchange for a shift to a more EU-centered style of medicine?

From what I can tell, outside of the US the second most highly paid doctors are German doctors, and they make roughly half of what US doctors of the exact same profession pay. In the UK, they make roughly a third of what a US physician makes (again, on average). As I understand it, US doctors are largely on the hook for paying for their own malpractice insurance, which is crazy expensive, so in terms of net difference I'm sure it's less than half, but let's be practical and say it's 40%. Would you cut your pay by 60% tomorrow if it meant a different, more globally available system?

Feel free to be as vague as possible because I understand that letting CE know (even roughly) what you make is a terrible idea, but I'm very curious what your perspective is as someone who would be directly impacted by a large shift in the industry and whether you feel like your peers would stand with you on the issue.

EDIT: and if you'd rather not answer, that's fine too, although I'd appreciate it if you'd at least say you chose not to answer rather than just ignoring the question, but really whatever you're comfortable saying.

It works every other civizilzed country, no reason why it wouldn't work in the most prosperous country in human history. It's almost like the insurance companies exist solely to raise prices 4000%. I wonder what would happen if we got rid of them all?

Lonestar2000 posted...

This topic is really fucking stupid and the TC has no idea what he is talking about as per usual.

TC was crying yesterday about how unfair it is to people who paid their student loans that we're getting debt forgiveness

We should put this dude in charge and see where it gets us

nexigrams posted...

It works every other civizilzed country, no reason why it wouldn't work in the most prosperous country in human history. It's almost like the insurance companies exist solely to raise prices 4000%. I wonder what would happen if we got rid of them all?

You're literally ignoring the base problem, which are (i) high salaries for doctors/surgeons (who get paid more than double in the US on average than in any other country), and (ii) US disproportionately paying for innovation.

If you think that's the base problem then just lol.

I'm just wasting my time arguing with a nobody with bad opinions.

Gwynevere posted...

TC was crying yesterday about how unfair it is to people who paid their student loans that we're getting debt forgiveness

We should put this dude in charge and see where it gets us

lol it is objectively unfair. If I was in charge, I would correct the base problem to begin with and make all public universities free by increasing taxes, or having 0% interest loans. Private schools, leave them as-is.