For The Cost Of Obamacare Bills Congress Could Build And Run Free Clinics

[Tijuana]

So what if the answer to question two was, "To save this person, we need to devote every single extra penny every American has to save them.
Would you do it?

There's always a point at which something becomes too costly, even in healthcare. Finite resources are a real constraint. So it's something we have to address.

I like how the Netherlands did it when building dams to protect their country. They set the value of a human life at 2.2 million Euros and allocated spending where they estimated that you could save 1 life by spending 2.2 million Euros. This number was reached by seeing how much the overall program would cost and adjusting it until it was affordable. This is the only way to manage the cost effectively. You can't pretend cost concerns don't exist.

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854 billion over 10 years. That's 85 billion a year.

That also includes construction of the facilities.

[Glnger]

Well the US isn't really big on facts right now.

This just reminds me of the thread yesterday asking why can't we have free wifi everywhere. The guy was like, "I bet it only costs $60 a person per year! Why haven't we done this if it's so easy!" The answer is, duh, it doesn't only cost $60 a person.

Same thing with healthcare. If you can claim to cover people for $1000 a year and your entire argument rests on that premise, hey, either you're starting from a false premise or else you've discovered some revolutionary way to make health care cost 1/8 of what it does now. Which is more likely?

And I agree with the idea of nationalized healthcare because it introduces much better cost control and gives the consumers far more negotiating power. I just am bothered by this style of argument that assumes there's some sort of magic bullet them proceeds from there.

try progressive movements, if you find yourself arguing among friends the way in which to enable policies rather than to discuss if to introduce them at all, you've probably found a worthy progressive group that's probably worth your efforts.

[Tijuana]

No because that's been argued for fucking decades. Ironically enough what you call Obamacare was originally the Heritage foundations healthcare plan. Again I'm not surprised CONSERVATIVE PLANS WASTE MORE MONEY...

Do you find it curious that in the effort to get 30 million more insured, they only got 9 to sign up, they have deductibles so high the plan is pointless, and somehow, even with the astronomically high cost, insurers are leaving the system in droves because they can't make any money. Only government could seek to fix a problem, and then make it so much worse, that nobody can afford it, it provides nothing, and nobody even makes any money. Point me to the winner in this situation?

I said all along that the simplest solution was to just take this money and expand Medicaid to more people.

[Deleted]

Those are not the figures, actually. The article cites what we estimated we would spend on Obamacare, and it's $854, not 85 billion. Under this plan, we would still be spending far more per person than the UK. Meanwhile, according to other posters, this would be akin to letting them die, since their care would be less than that of the wealthy.

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If the insurance companies are making 3.8% profit (example provided earlier by another poster), how can you meaningfully lower the cost of healthcare more than 3.8%, while only addressing the insurance, and not the actual care?

My point is that insurance companies OBVIOUSLY are not the people that are collecting the majority of what we spend on health care. Therefore, a bill that only addresses insurance, has little to no chance of lowering the overall costs, in any meaningful way. If you have math that can prove otherwise, I would like to see it. I think if you could prove that math, it would change all that we know about math, and would likely result in some sort of Nobel prize. =)

It's just bizarre to me how so many people think the high costs of insurance are the issue, and think taking any aim at the people who actually collect the money for the care, is blasphemy.

In the USA it's known the health insurances are making closer to 500% profit though. In my country for example health insurance companies do not make profit as they are funded or sublet by the government itself, and in case of a deficit, the government will raise taxes the next year to compensate and fill the gap (though generally you don't notice it, as for example, last year they raise the price from €67 annually to €88 annually).

True the insurance companies don't take everything, but at the same time they are a big part why the system in the USA is so majorly broken.

For example in my country we pay high taxes, it's around 5-7k per year per working citizen to cover free national healthcare (that's nearly two full months of paychecks). However we do know, a portion of it goes back to the hospital which partially pays the wages of the medical employees and another portion gets used to refund medicines and surgery costs. Therefor hospitals have more room for growth and investment and don't have to directly work it into surgery prices to cover those potential investments.

From what I've read regarding healthcare in the USA a lot of the money that ends up getting paid to your insurances does not flow back into the healthcare, it remains with the insurance companies, who become richer every year and still end up charging more every year, whilst those price hikes actually outnumber the average salary growth of that said year.

Another flaw in the American system, over here, prices cannot rise higher than the % salaries have risen by and if it does, the government takes action very swiftly (in every sector that is).

Though mainly, the two problems in the USA are both the insurance companies and the lackluster governmental involvement in such key systems.

[Tijuana]

Your original argument was that we can cover 85 million people for the cost of Obamacare. Then you stated that this would be spending a lot more than the UK spends on its people on a per person basis. I pointed out that it's actually a lot less.

Sure, there's some upfront investment in facilities, but you still haven't explained how that means you can magically cover people for massively less than the UK spends.

I'm not making the claim, the article is. He links his sources if you go to the actual page. You can follow along with his napkin math and read his sources if you need further clarification. If you can refute his math, great. I just found it interesting. If it's only interesting because his math is shit, please show us where he made the errors. I just did a spot check to UK costs, in order to see if he is in the ball park.

But, generally speaking, many of you miss the point of the article completely. Just sayin...

Here is the math I found from here: http://www.nhs.uk/NHSEngland/thenhs/.../overview.aspx

64 million users at a cost of 116 billion pounds per year two year period equates to a per person cost, after currency adjustment, of $1,132.5 per year. I may have done some incorrect math there, but again, I was only looking to hit the ball park, to see if this writer is nuts or not.

[Glnger]

Your original argument was that we can cover 85 million people for the cost of Obamacare. Then you stated that this would be spending a lot more than the UK spends on its people on a per person basis. I pointed out that it's actually a lot less.

Sure, there's some upfront investment in facilities, but you still haven't explained how that means you can magically cover people for massively less than the UK spends.

It doesn't have to make sense, it's the dog chasing the car analogy on a grand scale and it took someone with the inability to articulate a failure scenario, like Trump to truly show the American people how much they would rather have guaranteed nation-wide coverage...again afforded by the virtue of them being born in the most powerful, most prosperous nation that ever has existed in modern history.

[Deleted]

That also includes construction of the facilities.

In 2016 the American hospitals (5564 hospitals) spent around 963 billion USD on expenses.

That brings the average operating cost per hospital to 173 million USD per year.

You won't do much with 85 billion USD per year.

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What the USA needs to do and I'll say it again, take control over health insurances and be the first party to take the payments, that way they can distribute the innings better and make sure a portion flows back to the hospitals so they can reduce the costs of patients by a decent portion.

[Tijuana]

In the USA it's known the health insurances are making closer to 500% profit though. In my country for example health insurance companies do not make profit as they are funded or sublet by the government itself, and in case of a deficit, the government will raise taxes the next year to compensate and fill the gap (though generally you don't notice it, as for example, last year they raise the price from €67 annually to €88 annually).

True the insurance companies don't take everything, but at the same time they are a big part why the system in the USA is so majorly broken.

For example in my country we pay high taxes, it's around 5-7k per year per working citizen to cover free national healthcare (that's nearly two full months of paychecks). However we do know, a portion of it goes back to the hospital which partially pays the wages of the medical employees and another portion gets used to refund medicines and surgery costs. Therefor hospitals have more room for growth and investment and don't have to directly work it into surgery prices to cover those potential investments.

From what I've read regarding healthcare in the USA a lot of the money that ends up getting paid to your insurances does not flow back into the healthcare, it remains with the insurance companies, who become richer every year and still end up charging more every year, whilst those price hikes actually outnumber the average salary growth of that said year.

Another flaw in the American system, over here, prices cannot rise higher than the % salaries have risen by and if it does, the government takes action very swiftly (in every sector that is).

Though mainly, the two problems in the USA are both the insurance companies and the lackluster governmental involvement in such key systems.

ROFL. Ok guy, you just can't be taken seriously, if that is your claim. That would be the greatest stock investment of all time. I didn't even read the rest, after that gem.

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No, because your facts are incorrect. It doesn't provide nothing, it provides catastrophic insurance, so people don't just die if they get gravely ill. That's the most important thing here.

And someone is making money if something has an "astronomically high cost". The money doesn't just disappear. Fine, I'll concede that it might not be the insurers. But then it's the providers, or the people who get employed in annoying clerical work that's unnecessary.

Obamacare has real flaws but you're cartooning them by making it sound more outrageous than it really is. Make real arguments please. Again, this a flawed argument style... "Do you find it curious that..." then using a bunch of fake facts. No, you're not using facts, you're calling your opinions and poorly supported conclusions facts. Trump does the same thing all the time.

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I think I just did... you yourself said that you checked to see how much money it would cost relative to the UK, and that it cost more and that gave you some sense that it wasn't crazy.

I pointed out a flaw in your math (counting the 10 year cost of Obamacare as the yearly cost) that indicates that this plan actually proposes spending approximately 25% of what the UK spends on healthcare on a per person basis. So to me it seems totally impractical and that his math is just off. He's not "in the ball park", he's in space, arguing that he can cover people for 1/4 of what the UK spends and 1/8 of what the US spends.

We had catastrophic plans before Obamacare, and he called them rip off plans. They were MUCH cheaper than this is. Astronomically so...

If my facts are incorrect, please cite a source that refutes them, or refute them with logic.

I replied to your UK math. Check it and see if I'm wrong. It would not surprise me if it is.

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In 2016 the American hospitals (5564 hospitals) spent around 963 billion USD on expenses.

That brings the average operating cost per hospital to 173 million USD per year.

You won't do much with 85 billion USD per year.

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What the USA needs to do and I'll say it again, take control over health insurances and be the first party to take the payments, that way they can distribute the innings better and make sure a portion flows back to the hospitals so they can reduce the costs of patients by a decent portion.

The article lists all his sources. You should refute the facts in that manner, as I am not the author. Check his sources; maybe they suck. /shrug

[Glorious Leader]

Do you find it curious that in the effort to get 30 million more insured, they only got 9 to sign up, they have deductibles so high the plan is pointless, and somehow, even with the astronomically high cost, insurers are leaving the system in droves because they can't make any money. Only government could seek to fix a problem, and then make it so much worse, that nobody can afford it, it provides nothing, and nobody even makes any money. Point me to the winner in this situation?

I said all along that the simplest solution was to just take this money and expand Medicaid to more people.

No I don't find any of that curious. Every single flaw in the plan goes back to the insistence on keeping markets in healthcare instead of single payer or medicaid expansion. Of course this was a conservative plan so your criticism should be laid with them. "Obamacare" is a result of decades of Republican obstruction towards fixing the healthcare system. "Obamacare" is the best that could be done given the level of obstruction on the part of the republican party and the influence of the health care insurance lobby.

Yea I want single payer too. It's too bad right wing retards stood in the way of getting it.

[Polarthief]

You think an all red congress, house, and presidency is going to allow socialism into America? Rip.

[Tijuana]

No I don't find any of that curious. Every single flaw in the plan goes back to the insistence on keeping markets in healthcare instead of single payer or medicaid expansion. Of course this was a conservative plan so your criticism should be laid with them.

I could not disagree more on your general notion that market forces cause costs to go up compared to government forces.

However, to your point, the big problem with the US system, is that it's neither free market, not government controlled, but somewhere in the bastard middle between crony capitalist, and government incompetence. We are quite literally getting the worst of both worlds.

That is why I prefer single provider overall. The benefits of capitalism, primarily competition, are non-existent in healthcare. Nobody says this, while riding in an ambulance: "Take me to the place across town that is cheaper!" Nobody asks the price of any of the services. There is no logical way to compare the costs of competitors, due to no standard of billing. There is little logical way to judge quality of care, from the consumer perspective. It's fake capitalism, so why bother with it?

What I find curious, is that so many posters say they prefer the concept of single provider, but bash this article, a single provider article. I think it must be that it's a sore subject because it has Dear Leader Obama's name on it. Otherwise, what would explain the preference to Obamacare for the poor, but to single provider overall?

[Tijuana]

It's 116 billion pounds per 1 year for 64 million users. That means it's 1790 pounds per person. And that's only the public contribution, ignoring private spending.

I used:

https://www.ons.gov.uk/peoplepopulat...euk/2015-03-26

which states:

"Total spending per person on healthcare was £2,350 in 2013."

2,350 is $3000. That's 2013 data.

If you go to Wikipedia:

https://en.wikipedia.org/wiki/List_o...ure_per_capita

They have a more recent estimate that says the UK spends about $4000 per person in 2017.

The 116 billion figure is listed as the 2015/2016 cost, as I read it. Do I have that wrong? I read that to mean that was the cost for those two years. Perhaps they meant that was the cost, and it was the same both years? I obviously don't know jack about UK budgetary practices...

I wish I had found this Wikipedia page, it would have saved me the bad math! But, holy shit look at the US expenditures! I seriously doubt anyone can say our healthcare, while great, is over double as good. We are just flat going bankrupt from our fucked up system.

Read my post one above yours to see what I am getting at though.

[Tijuana]

You think an all red congress, house, and presidency is going to allow socialism into America? Rip.

You think we have no socialism now?

I think single payer is stupid, because they will just rip off the government. But, I think if Liberals had passed the single provider bill they really wanted to pass, that didn't need any more than the zero Republican votes Obamacare got, we would be better off.

[Tijuana]

Speaking for myself, I'm bashing it because the article is nonsense, starting from the ridiculous premise that 85,000,000 people only need 100 hospitals. How'd he come up with that? Oh right, he used a napkin.

In the age of Trump it's really important to have consistent and logical arguments with a strong foundation, because if you don't he's just going to point and you and say, "See! You lie too!" and use it as cover for his own ridiculousness. This article doesn't have that, so we're starting with made up nonsense and trying to have a discussion. Garbage in, garbage out.

If you think that, then I'm sorry but, you grossly misunderstood the article. The point was to see what you could get instead of Obamacare, at the same cost as the original estimate. This is in NO WAY intended to be an all encompassing plan. It's akin to saying for the cost of one Ferrari, look how many Volkswagens you can get! It's not supposed to be an apples to apples deal.

[Glnger]

Speaking for myself, I'm bashing it because the article is nonsense, starting from the ridiculous premise that 85,000,000 people only need 100 hospitals. How'd he come up with that? Oh right, he used a napkin.

In the age of Trump it's really important to have consistent and logical arguments with a strong foundation, because if you don't he's just going to point and you and say, "See! You lie too!" and use it as cover for his own ridiculousness. This article doesn't have that, so we're starting with made up nonsense and trying to have a discussion. Garbage in, garbage out.

doesn't matter, he's still campaigning. and people are still eating his shit like he's campaigning and not in charge of a republican house, senate, and judiciary. How in the hell does " I want to do R but if only for D" arguments still find merit at this point... its truly astounding.

[Independent voter]

Here's what we do, everyone at birth gets a Health Savings Account, HSA. Every year the government puts $1,000 in your HSA. Families can share their HSA money. Employers also can put money in your HSA, 1 or more thousand per year. On top of that you have very cheap catastrophic insurance to take care of cancers and other extremely expensive illnesses.

All this is tax free.

Also we'll buff up Nurse Practitioners who are nurses who can prescribe medicines. Why pay doctors all that money when a nurse practitioner can do 90% of what doctors do.

[Glnger]

Here's what we do, everyone at birth gets a Health Savings Account, HSA. Every year the government puts $1,000 in your HSA. Families can share their HSA money. Employers also can put money in your HSA, 1 or more thousand per year. On top of that you have very cheap catastrophic insurance to take care of cancers and other extremely expensive illnesses.

All this is tax free.

Also we'll buff up Nurse Practitioners who are nurses who can prescribe medicines. Why pay doctors all that money when a nurse practitioner can do 90% of what doctors do.

so you'd only need to buy into and pay into a "HSA" for..... about 50 years at that rate to pay for any thing beyond a week in the hospital with no major surgery... you're plan is about as sound as Jame's Giant Peach bro.... What happens if someone has a major medical emergency in that period? idk you have no fucking plan, you're plans are made by intellectual children with zero experience in governance, this entire thread is a giant embarrassment to you, and what ever effort your trying to push and just a masturbatory exercise to further your viewpoint which is gaining no traction in reality.

I'm not trying to call out you personally, but more so the OP... and do a /thread. all in one.

[Logwyn]

You think an all red congress, house, and presidency is going to allow socialism into America? Rip.

Do you honestly believe this?

[Tijuana]

Direct quote from the article:

"So for a cost of $850 billion—a huge number, to be sure, but equal to the original Obamacare estimate—the government can hypothetically provide actual health care for 85 million people for the next decade, without accounting for a single cent of potential revenue to offset it."

My point - it can't provide actual health care because his plan is to only have 100 hospitals for those 85 million people and depend on a miracle (outpatient clinics taking over the bulk of the work hospitals do) to solve the rest of the problem. If outpatient clinics can really do that, then everyone would be building and using outpatient clinics and that would solve our health spending problem. It has nothing to do with Obamacare. It's just nonsense. It also ignores long term care facilities for the infirm, and a host of other expenses that drive up our health costs. There's a lot more to the health system than hospitals and outpatient facilities.

You're now trying to make the argument less specific to make it seem more reasonable. Let it go.

Is it a miracle to think that people would use clinics that are free, instead of hospitals that they can't afford? If we actually made people pay up, I think this is pretty easily attainable. As it stands now, you can walk in to any hospital in the US, make up a name, and get emergency care. Of course nobody chooses an all day wait at the clinic over that!

Having a different opinion from yours is not a crime. I'm not moving goal posts, you erected goal posts that were never there. The point of the article is to math out what an alternative would be, from public data sources. The guy likely wrote this in less than a day. It is you, not me, that is trying to equate this to a bill that took a year to write, and encompassed 2,000+ pages.

It's just a napkin math article. It's not an actual plan. I don't understand why that is a difficult concept.

[Glnger]

It's just a napkin math article. It's not an actual plan. I don't understand why that is a difficult concept.

again, the criticism is that you're posting this one article based admittedly on "napkin math" when there's hundreds if not thousands of actual peer reviewed articles done by scholars. You're entire goal is to look for disinformation by actively avoiding scholarly work, then cherry pick this article as confirmation bias. you're as see through as a ziploc bag dude.

Why don't you "man up" and challenge your party to be more receptive to the populist outcry, instead of just trying to trick people into voting for your party, perhaps by offering actual solutions.