‘Medicare for All’ would cover everyone, save billions in first year: new study

[dblack]

I'm just wondering if it's clear to everyone, doctors and patients alike, that the goal here is to change doctors from professional service providers into employees of the state.

Only to someone who doesn't understand how the current iteration of Medicare actually works.

Wake up and smell the coffee. The oft cited advantage of single-payer is that government would be able to leverage its position as "the only game in town" to negotiate lower prices with health care providers. Are you denying that?

That's not "making doctors employees of the state." Stop waffling.

Stop dodging. The primary 'selling point' of single payer is that the government will be able to dictate prices - because they are the only source of health care financing by design. Are you denying that? Or waffling?

Explain what you mean by "making doctors employees of the state."

The whole point of single payer is to turn the tables. Traditionally, doctors have operated as services providers. This leaves them free to set their prices as they see fit. Some customers will be willing to pay their prices, some won't. Single payer seeks to reduce the number of 'customers' to one. A 'service provider' who works for only one customer is an employee.

The key is that it changes the power dynamic. When combined with the fact that there are no other 'employers', and that this is dictated by law, this gives government the power to set prices, to simply state how much it will pay for given drugs or services. Doctors can either choose to accept it, or quit - or go on strike, etc...

 

[Arianrhod]

Only to someone who doesn't understand how the current iteration of Medicare actually works.

Wake up and smell the coffee. The oft cited advantage of single-payer is that government would be able to leverage its position as "the only game in town" to negotiate lower prices with health care providers. Are you denying that?

That's not "making doctors employees of the state." Stop waffling.

Stop dodging. The primary 'selling point' of single payer is that the government will be able to dictate prices - because they are the only source of health care financing by design. Are you denying that? Or waffling?

Explain what you mean by "making doctors employees of the state."

The whole point of single payer is to turn the tables. Traditionally, doctors have operated as services providers. This leaves them free to set their prices as they see fit. Some customers will be willing to pay their prices, some won't. Single payer seeks to reduce the number of 'customers' to one. A 'service provider' who works for only one customer is an employee.

The key is that it changes the power dynamic. When combined with the fact that there are no other 'employers', and that this is dictated by law, this gives government the power to set prices, to simply state how much it will pay for given drugs or services. Doctors can either choose to accept it, or quit - or go on strike, etc...

There now, was that so hard? Nevertheless, for one thing, you've got the terminology wrong. Doctors would not be "employees," but "independent contractors."

Can you name any of the healthcare systems in the rest of the industrialized world where this is the case - i.e., doctors have no freedom in setting prices for private insurance (e.g., the UK) over and above the standard healthcare? I'm not familiar with any.

Also, who's more important, the doctor or the patient? You made an impassioned - if not entirely accurate - plea for the medical community, but I don't see anything about patients.

The consensus is, everybody hates the insurer, but one usually hears "doctors are greedy, doctors get paid too much, blah-blah-blah." You seem to be pleading the opposite. Interesting.

 

[dblack]

Wake up and smell the coffee. The oft cited advantage of single-payer is that government would be able to leverage its position as "the only game in town" to negotiate lower prices with health care providers. Are you denying that?

That's not "making doctors employees of the state." Stop waffling.

Stop dodging. The primary 'selling point' of single payer is that the government will be able to dictate prices - because they are the only source of health care financing by design. Are you denying that? Or waffling?

Explain what you mean by "making doctors employees of the state."

The whole point of single payer is to turn the tables. Traditionally, doctors have operated as services providers. This leaves them free to set their prices as they see fit. Some customers will be willing to pay their prices, some won't. Single payer seeks to reduce the number of 'customers' to one. A 'service provider' who works for only one customer is an employee.

The key is that it changes the power dynamic. When combined with the fact that there are no other 'employers', and that this is dictated by law, this gives government the power to set prices, to simply state how much it will pay for given drugs or services. Doctors can either choose to accept it, or quit - or go on strike, etc...

There now, was that so hard? Nevertheless, for one thing, you've got the terminology wrong. Doctors would not be "employees," but "independent contractors."

Can you name any of the healthcare systems in the rest of the industrialized world where this is the case - i.e., doctors have no freedom in setting prices for private insurance (e.g., the UK) over and above the standard healthcare? I'm not familiar with any.

Also, who's more important, the doctor or the patient? You made an impassioned - if not entirely accurate - plea for the medical community, but I don't see anything about patients.

The consensus is, everybody hates the insurer, but one usually hears "doctors are greedy, doctors get paid too much, blah-blah-blah." You seem to be pleading the opposite. Interesting.

???

 

[Arianrhod]

That's not "making doctors employees of the state." Stop waffling.

Stop dodging. The primary 'selling point' of single payer is that the government will be able to dictate prices - because they are the only source of health care financing by design. Are you denying that? Or waffling?

Explain what you mean by "making doctors employees of the state."

The whole point of single payer is to turn the tables. Traditionally, doctors have operated as services providers. This leaves them free to set their prices as they see fit. Some customers will be willing to pay their prices, some won't. Single payer seeks to reduce the number of 'customers' to one. A 'service provider' who works for only one customer is an employee.

The key is that it changes the power dynamic. When combined with the fact that there are no other 'employers', and that this is dictated by law, this gives government the power to set prices, to simply state how much it will pay for given drugs or services. Doctors can either choose to accept it, or quit - or go on strike, etc...

There now, was that so hard? Nevertheless, for one thing, you've got the terminology wrong. Doctors would not be "employees," but "independent contractors."

Can you name any of the healthcare systems in the rest of the industrialized world where this is the case - i.e., doctors have no freedom in setting prices for private insurance (e.g., the UK) over and above the standard healthcare? I'm not familiar with any.

Also, who's more important, the doctor or the patient? You made an impassioned - if not entirely accurate - plea for the medical community, but I don't see anything about patients.

The consensus is, everybody hates the insurer, but one usually hears "doctors are greedy, doctors get paid too much, blah-blah-blah." You seem to be pleading the opposite. Interesting.

???

 

[dblack]

Stop dodging. The primary 'selling point' of single payer is that the government will be able to dictate prices - because they are the only source of health care financing by design. Are you denying that? Or waffling?

Explain what you mean by "making doctors employees of the state."

The whole point of single payer is to turn the tables. Traditionally, doctors have operated as services providers. This leaves them free to set their prices as they see fit. Some customers will be willing to pay their prices, some won't. Single payer seeks to reduce the number of 'customers' to one. A 'service provider' who works for only one customer is an employee.

The key is that it changes the power dynamic. When combined with the fact that there are no other 'employers', and that this is dictated by law, this gives government the power to set prices, to simply state how much it will pay for given drugs or services. Doctors can either choose to accept it, or quit - or go on strike, etc...

There now, was that so hard? Nevertheless, for one thing, you've got the terminology wrong. Doctors would not be "employees," but "independent contractors."

Can you name any of the healthcare systems in the rest of the industrialized world where this is the case - i.e., doctors have no freedom in setting prices for private insurance (e.g., the UK) over and above the standard healthcare? I'm not familiar with any.

Also, who's more important, the doctor or the patient? You made an impassioned - if not entirely accurate - plea for the medical community, but I don't see anything about patients.

The consensus is, everybody hates the insurer, but one usually hears "doctors are greedy, doctors get paid too much, blah-blah-blah." You seem to be pleading the opposite. Interesting.

???

Are you drunk? In the middle of the day??

 

[Arianrhod]

Explain what you mean by "making doctors employees of the state."

The whole point of single payer is to turn the tables. Traditionally, doctors have operated as services providers. This leaves them free to set their prices as they see fit. Some customers will be willing to pay their prices, some won't. Single payer seeks to reduce the number of 'customers' to one. A 'service provider' who works for only one customer is an employee.

The key is that it changes the power dynamic. When combined with the fact that there are no other 'employers', and that this is dictated by law, this gives government the power to set prices, to simply state how much it will pay for given drugs or services. Doctors can either choose to accept it, or quit - or go on strike, etc...

There now, was that so hard? Nevertheless, for one thing, you've got the terminology wrong. Doctors would not be "employees," but "independent contractors."

Can you name any of the healthcare systems in the rest of the industrialized world where this is the case - i.e., doctors have no freedom in setting prices for private insurance (e.g., the UK) over and above the standard healthcare? I'm not familiar with any.

Also, who's more important, the doctor or the patient? You made an impassioned - if not entirely accurate - plea for the medical community, but I don't see anything about patients.

The consensus is, everybody hates the insurer, but one usually hears "doctors are greedy, doctors get paid too much, blah-blah-blah." You seem to be pleading the opposite. Interesting.

???

Are you drunk? In the middle of the day??

You're the one who failed to understand my post.

 

[Flopper]

Ya gotta love doctors who evaded all courses in basic economics. They firmly believe that, though they lose money on every Medicare patient, they make it up on the volume.

If they ever catch on look for a government ban on medical students enrolling in any course in economics, ever.

The notion that doctors lose money on their treatment of Medicare patients arises frequently mostly from highly paid specialty physicians. Is their any validity to this. Let's look just office visits.

It’s possible to perform some simple calculations to check the veracity of this claim. Assume that a doctor sees 16 patients a day for half an hour each, for 8 hours of patient time per day. With two hours of overtime work that makes for a 10 hour day, or 50 hours per week. That’s busy, but not an uncommon workweek for many professionals in the US. If the physician works 48 weeks per year, 5 days a week, that’s a potential 3840 patient visits a year. Assuming a 10% vacancy rate in appointments, whether due to cancellations, additional vacation, or otherwise, this leaves 3456 appointments per year.

Medicare reimburses office visits at around $85 per visit, though precise reimbursements vary by region. At $85 per visit, a primary care physician seeing nothing but Medicare patients could expect to receive $293,760 in annual reimbursements. Subtracting out the physician’s annual overhead provides an estimate of the physician’s salary. According to this physicians’ overhead spreadsheet, 50% is a good target for a primary care physician’s overhead. Overhead cannot fall below 100-150k for most physicians, as many expenses are fixed. This would leave our example physician with net income of roughly $147,000 annually. For specialist performance surgeries and other in hospital procedures, income can be much higher.

Do Doctors Really Lose Money on Medicare?

 

[Flopper]

‘Medicare for All’ would cover everyone, save billions in first year: new study

Economist says Canadian-style, single-payer health plan would reap huge savings from reduced paperwork and from negotiated drug prices, enough to pay for quality coverage for all – at less cost to families and businesses



Upgrading the nation’s Medicare program and expanding it to cover people of all ages would yield more than a half-trillion dollars in efficiency savings in its first year of operation, enough to pay for high-quality, comprehensive health benefits for all residents of the United States at a lower cost to most individuals, families and businesses.


That’s the chief finding of a new fiscal study by Gerald Friedman, a professor of economics at the University of Massachusetts, Amherst. There would even be money left over to help pay down the national debt, he said.


Friedman says his analysis shows that a nonprofit single-payer system based on the principles of the Expanded and Improved Medicare for All Act, H.R. 676, introduced by Rep. John Conyers Jr., D-Mich., and co-sponsored by 45 other lawmakers, would save an estimated $592 billion in 2014. That would be more than enough to cover all 44 million people the government estimates will be uninsured in that year and to upgrade benefits for everyone else.


“No other plan can achieve this magnitude of savings on health care,” Friedman said.


His findings were released this morning [Wednesday, July 31, 11 a.m. EDT] at a congressional briefing in the Cannon House Office Building hosted by Public Citizen and Physicians for a National Health Program, followed by a 1 p.m. news conference with Rep. Conyers and others in observance of Medicare’s 48th anniversary at the House Triangle near the Capitol steps. A copy of Friedman’s full report, with tables and charts, is available here.


Friedman said the savings would come from slashing the administrative waste associated with today’s private health insurance industry ($476 billion) and using the new, public system’s bargaining muscle to negotiate pharmaceutical drug prices down to European levels ($116 billion).


“These savings would be more than enough to fund $343 billion in improvements to our health system, including the achievement of truly universal coverage, improved benefits, and the elimination of premiums, co-payments and deductibles, which are major barriers to people seeking care,” he said.




*snip*

And put the quality of care into the shitter

Tell me do you want the people responsible for the VA in charge of your health care

I sure as fuck don't

The VA is both a medical provider and an insurer. That's a lot different not than Medicare and private medical providers.

So is Kaiser.

Nope, not the same thing. With Medicare all healthcare is delivered by private healthcare providers of the patients choosing.

 

[HenryBHough]

Friend of mine in England needed to go to the hospital last night.

Wasted trip.

The doctors were on strike.

 

[Skull Pilot]

‘Medicare for All’ would cover everyone, save billions in first year: new study

Economist says Canadian-style, single-payer health plan would reap huge savings from reduced paperwork and from negotiated drug prices, enough to pay for quality coverage for all – at less cost to families and businesses



Upgrading the nation’s Medicare program and expanding it to cover people of all ages would yield more than a half-trillion dollars in efficiency savings in its first year of operation, enough to pay for high-quality, comprehensive health benefits for all residents of the United States at a lower cost to most individuals, families and businesses.


That’s the chief finding of a new fiscal study by Gerald Friedman, a professor of economics at the University of Massachusetts, Amherst. There would even be money left over to help pay down the national debt, he said.


Friedman says his analysis shows that a nonprofit single-payer system based on the principles of the Expanded and Improved Medicare for All Act, H.R. 676, introduced by Rep. John Conyers Jr., D-Mich., and co-sponsored by 45 other lawmakers, would save an estimated $592 billion in 2014. That would be more than enough to cover all 44 million people the government estimates will be uninsured in that year and to upgrade benefits for everyone else.


“No other plan can achieve this magnitude of savings on health care,” Friedman said.


His findings were released this morning [Wednesday, July 31, 11 a.m. EDT] at a congressional briefing in the Cannon House Office Building hosted by Public Citizen and Physicians for a National Health Program, followed by a 1 p.m. news conference with Rep. Conyers and others in observance of Medicare’s 48th anniversary at the House Triangle near the Capitol steps. A copy of Friedman’s full report, with tables and charts, is available here.


Friedman said the savings would come from slashing the administrative waste associated with today’s private health insurance industry ($476 billion) and using the new, public system’s bargaining muscle to negotiate pharmaceutical drug prices down to European levels ($116 billion).


“These savings would be more than enough to fund $343 billion in improvements to our health system, including the achievement of truly universal coverage, improved benefits, and the elimination of premiums, co-payments and deductibles, which are major barriers to people seeking care,” he said.




*snip*

And put the quality of care into the shitter

Tell me do you want the people responsible for the VA in charge of your health care

I sure as fuck don't

The VA is both a medical provider and an insurer. That's a lot different not than Medicare and private medical providers.

So is Kaiser.

Nope, not the same thing. With Medicare all healthcare is delivered by private healthcare providers of the patients choosing.

Until no doctors will accept it and then the government will be forced to either drop it or take it over a la the VA

 

[Arianrhod]

Until no doctors will accept it...

Why do you imagine they'd do that?

 

[Greenbeard]

‘Medicare for All’ would cover everyone, save billions in first year: new study

Economist says Canadian-style, single-payer health plan would reap huge savings from reduced paperwork and from negotiated drug prices, enough to pay for quality coverage for all – at less cost to families and businesses

Kind of a zombie thread, but Friedman is the one crunching numbers for Bernie Sanders these days (at least unofficially) so it's relevant. These kinds of instant savings projections just aren't realistic. For lots of reasons, not least of which is that slicing hundreds of billions out of health care overnight would be a bad thing.

There is a lot of administrative spending in health care--on the provider side and on the insurer side--no doubt. Let's just assume Friedman's numbers as to the amount of administrative spending that gets eliminated by dissolving the multipayer system are right:

Friedman said the savings would come from slashing the administrative waste associated with today’s private health insurance industry ($476 billion) and using the new, public system’s bargaining muscle to negotiate pharmaceutical drug prices down to European levels ($116 billion).

That "administrative waste" largely consists of FTEs: people who work for insurers, people who work in hospital finance or revenue cycle departments; in physician offices, etc. A general rule of thumb for a hospital is that 2/3 of its costs are labor; I would imagine that proportion is higher when looking only at the administrative side of the house and not clinical operations. Ballpark, we could be talking in the neighborhood of 4 million FTEs.

You can't lay 4 million people off (sorry, "slash administrative waste") overnight. That's almost halfway to the Great Recession.

I know everyone hates incrementalism and slow progress, but there's a reason you can't do this too quickly, there's a reason people talk about bending the cost curve (i.e., slowing future cost growth) and not trying to reset prices or "slash" hundreds of billions out of the health sector immediately. And that reason is simple: that sector employs a lot of people, anchors the local economy in many places, and does very important work.

 

[Sun Devil 92]

That "administrative waste" largely consists of FTEs: people who work for insurers, people who work in hospital finance or revenue cycle departments; in physician offices, etc. A general rule of thumb for a hospital is that 2/3 of its costs are labor; I would imagine that proportion is higher when looking only at the administrative side of the house and not clinical operations. Ballpark, we could be talking in the neighborhood of 4 million FTEs.

You can't lay 4 million people off (sorry, "slash administrative waste") overnight. That's almost halfway to the Great Recession.

I know everyone hates incrementalism and slow progress, but there's a reason you can't do this too quickly, there's a reason people talk about bending the cost curve (i.e., slowing future cost growth) and not trying to reset prices or "slash" hundreds of billions out of the health sector immediately. And that reason is simple: that sector employs a lot of people, anchors the local economy in many places, and does very important work.

4 Million FTE's.

Our country employes roughly 150 million people.

You are saying we have 4 million "extras" in health care ?

That is roughly 2.7% of the total work force.

I find that hard to believe.

 

[Greenbeard]

4 Million FTE's.

Our country employes roughly 150 million people.

You are saying we have 4 million "extras" in health care ?

That is roughly 2.7% of the total work force.

I find that hard to believe.

That's using Friedman's administrative savings numbers ($476B), which are almost certainly heavily inflated. Actual savings and job losses would probably be closer to half that.

 

[Dot Com]

Incremental steps? Fine, just git 'r done

 

[Sun Devil 92]

Incremental steps? Fine, just git 'r done

Get what done ?

 

[Flopper]

‘Medicare for All’ would cover everyone, save billions in first year: new study

Economist says Canadian-style, single-payer health plan would reap huge savings from reduced paperwork and from negotiated drug prices, enough to pay for quality coverage for all – at less cost to families and businesses



Upgrading the nation’s Medicare program and expanding it to cover people of all ages would yield more than a half-trillion dollars in efficiency savings in its first year of operation, enough to pay for high-quality, comprehensive health benefits for all residents of the United States at a lower cost to most individuals, families and businesses.


That’s the chief finding of a new fiscal study by Gerald Friedman, a professor of economics at the University of Massachusetts, Amherst. There would even be money left over to help pay down the national debt, he said.


Friedman says his analysis shows that a nonprofit single-payer system based on the principles of the Expanded and Improved Medicare for All Act, H.R. 676, introduced by Rep. John Conyers Jr., D-Mich., and co-sponsored by 45 other lawmakers, would save an estimated $592 billion in 2014. That would be more than enough to cover all 44 million people the government estimates will be uninsured in that year and to upgrade benefits for everyone else.


“No other plan can achieve this magnitude of savings on health care,” Friedman said.


His findings were released this morning [Wednesday, July 31, 11 a.m. EDT] at a congressional briefing in the Cannon House Office Building hosted by Public Citizen and Physicians for a National Health Program, followed by a 1 p.m. news conference with Rep. Conyers and others in observance of Medicare’s 48th anniversary at the House Triangle near the Capitol steps. A copy of Friedman’s full report, with tables and charts, is available here.


Friedman said the savings would come from slashing the administrative waste associated with today’s private health insurance industry ($476 billion) and using the new, public system’s bargaining muscle to negotiate pharmaceutical drug prices down to European levels ($116 billion).


“These savings would be more than enough to fund $343 billion in improvements to our health system, including the achievement of truly universal coverage, improved benefits, and the elimination of premiums, co-payments and deductibles, which are major barriers to people seeking care,” he said.




*snip*

And put the quality of care into the shitter

Tell me do you want the people responsible for the VA in charge of your health care

I sure as fuck don't

The VA is both a medical provider and an insurer. That's a lot different not than Medicare and private medical providers.

So is Kaiser.

Nope, not the same thing. With Medicare all healthcare is delivered by private healthcare providers of the patients choosing.

Until no doctors will accept it and then the government will be forced to either drop it or take it over a la the VA

There is no national shortage of doctors accepting Medicare as of 2015. 95.3% of all doctors accept Medicare patients, 83.7% are accepting new patients, and nearly 100% of all general hospitals accept Medicare.
Since 2000, the number of doctors accepting Medicare has increased by 1.2%. There are no large private insurance networks that provide as large a choice of doctors as Medicare does.

Most doctors that do not accept Medicare are those that that provide limited or no coverage for the procedures they perform such as cosmetic surgeons, and Psychiatrists.

Medicare Patients’ Access to Physicians: A Synthesis of the Evidence
http://www.cdc.gov/nchs/data/databriefs/db195.pdf

 

[HUGGY]

So why did everyone who was instrumental in passing Obamacare exempt themselves from it?

Some people have been voting against their own best interests for their whole lives. They are willfully ignorant fools.

 

[Skull Pilot]

And put the quality of care into the shitter

Tell me do you want the people responsible for the VA in charge of your health care

I sure as fuck don't

The VA is both a medical provider and an insurer. That's a lot different not than Medicare and private medical providers.

So is Kaiser.

Nope, not the same thing. With Medicare all healthcare is delivered by private healthcare providers of the patients choosing.

Until no doctors will accept it and then the government will be forced to either drop it or take it over a la the VA

There is no national shortage of doctors accepting Medicare as of 2015. 95.3% of all doctors accept Medicare patients, 83.7% are accepting new patients, and nearly 100% of all general hospitals accept Medicare.
Since 2000, the number of doctors accepting Medicare has increased by 1.2%. There are no large private insurance networks that provide as large a choice of doctors as Medicare does.

Most doctors that do not accept Medicare are those that that provide limited or no coverage for the procedures they perform such as cosmetic surgeons, and Psychiatrists.

Medicare Patients’ Access to Physicians: A Synthesis of the Evidence
http://www.cdc.gov/nchs/data/databriefs/db195.pdf

But when the pay outs get lower and thy will more will not accept it
Or it will lead to less people becoming Doctors because the income won't be there anymore

 

[WheelieAddict]

Government provided health care would make it easier for businesses, especially small businesses. A large pool of healthy employees to hire and no expenses to provide care for employees. As long as tax on employers is reasonable and capped this would be a win win. There would be a loss in the bloated insurance industry though.