calumnus said:

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July 25
Canada 346 new cases, 3 deaths
USA 65,944 new cases, 985 deaths

How anyone spins this in favor of the US's handling of the virus or as evidence of a superior health care system is mind boggling.

Not surprising coming from Trump, very surprising coming from a Cal grad.

---

I never said anything about how the US is handling the virus, but I'm not surprised how a lib with TDS would want to deflect the argument in another direction when faced with the facts...Cal grad or otherwise.

dimitrig said:

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calumnus said:

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July 25
Canada 346 new cases, 3 deaths
USA 65,944 new cases, 985 deaths

How anyone spins this in favor of the US's handling of the virus or as evidence of a superior health care system is mind boggling.

Not surprising coming from Trump, very surprising coming from a Cal grad.

---

There was a guy who lived in the dorms when I was a freshman who was the biggest homophobic, redneck, gun-toting hillbilly I ever met at Cal. He lived in one of those three person rooms and one of his roommates was gay, which is how we found out he was a homophobe. His favorite slogan: America! Love it or leave it!

---

Right? Imagine the same slogan 4 years ago or 8 years ago applied to the "Make America Great Again" crowd? I use to ask them "So you don't think America is great?" and if they were not flummoxed they would go into a diatribe, usually racist and sexist, of what was "wrong" with America.

I always loved the line in the preamble to the Constitution, "in order to form a more perfect union"

We are already perfect but we are becoming more perfect.

With a few steps backwards at times, it has been a process of continual improvement. That is what healthy people, organizations and societies do, but you cannot be in denial and it takes effort.

Your handle is an oxymoron.

You are a an ordinary one.

I do, however, like the ring of:

CALIFORNIA, LOVE IT OR LEAVE IT!



* I would actually donate to a GoFundMe to underwrite the cost of packing up and moving for every belly aching b@stard that spews the Fox News narrative about California. Go move to one of Red states that contributes 1 or 2 % to the GNP and don't let the door hit your fat a$$ on your way out of the state with the 5th largest economy in the world.

Civil Bear said:

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calumnus said:

---

July 25
Canada 346 new cases, 3 deaths
USA 65,944 new cases, 985 deaths

How anyone spins this in favor of the US's handling of the virus or as evidence of a superior health care system is mind boggling.

Not surprising coming from Trump, very surprising coming from a Cal grad.

---

I never said anything about how the US is handling the virus, but I'm not surprised how a lib with TDS would want to deflect the argument in another direction when faced with the facts...Cal grad or otherwise.

---

Then what was the point of your comment "traffic would flow better" if you were not implying you were talking about the death rate as a percentage of the population?

Even if you meant the death rate among those who get it, that would be deaths over (deaths + recovered). The stat you (and Trump) presented, deaths divided by total cases is meaningless because it includes ALL of the 2.9 million active (unresolved) cases in the US in the denominator (basically assumes all 2.9 million people that are currently sick will live). Canada only has 5,836 active (unresolved) cases. That is because they got this under control months ago while ours is still exploding.

For the US 150,199 deaths over (150,199 deaths plus 1,309,247 recovered cases) = 10.3%

For Canada 8,901 deaths over (8,901 deaths plus 99,860 recovered cases) = 8.2%

Again, of the resolved cases, 10.3% ended in death in the US and 8.2% ended in death in Canada.

Does that make it clearer? Do you understand what I am trying to say now?

calumnus said:

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Civil Bear said:

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calumnus said:

---

July 25
Canada 346 new cases, 3 deaths
USA 65,944 new cases, 985 deaths

How anyone spins this in favor of the US's handling of the virus or as evidence of a superior health care system is mind boggling.

Not surprising coming from Trump, very surprising coming from a Cal grad.

---

I never said anything about how the US is handling the virus, but I'm not surprised how a lib with TDS would want to deflect the argument in another direction when faced with the facts...Cal grad or otherwise.

---

Then what was the point of your comment "traffic would flow better" if you were not implying you were talking about the death rate as a percentage of the population?

Even if you meant the death rate among those who get it, that would be deaths over (deaths + recovered). The stat you (and Trump) presented, deaths divided by total cases is meaningless because it includes ALL of the 2.9 million active (unresolved) cases in the US in the denominator (basically assumes all 2.9 million people that are currently sick will live). Canada only has 5,836 active (unresolved) cases. That is because they got this under control months ago while ours is still exploding.

For the US 150,199 deaths over (150,199 deaths plus 1,309,247 recovered cases) = 10.3%

For Canada 8,901 deaths over (8,901 deaths plus 99,860 recovered cases) = 8.2%

Again, of the resolved cases, 10.3% ended in death in the US and 8.2% ended in death in Canada.

Does that make it clearer? Do you understand what I am trying to say now?

---

My traffic comment was sarcasm directed at smh for his preference for socialized medicine. It 100% had to do with the death rate as a percentage of those infected (not the population), and 0% to do with how the US is handling the virus. When you said, "How anyone spins this in favor of the US's handling of the virus or as evidence of a superior health care system is mind boggling" I assumed you meant those as two different things, but you seem to want to use them interchangeably. How anyone would consider the two the same is what I find mind-boggling, but TDS apparently does have those kinds of effects.

Of course I meant the death rate among those that get it. I stated so repeatedly. Why you keep wanting to drum up Trump I have no idea [because it might make him look good?], but if that is something he did then he is correct in doing it. That is how the death rate among those infected is calculated, using the most accurate data we have. Your effort to spin this with unreliable and unverifiable data would be insulting [do you really believe there are 2.9M active cases or that the death rate of those still infected will be closer to 10%?], except that you are the same person that tried to argue with a straight face that two teams with identical 4th best records would actually be tied for 5th place instead of 4th. In the slight chance you actually believe the recovery numbers are reliable, you may want to read the following:

Why aren't coronavirus recoveries always reported?

Look, I fully understood what you were trying to say, which is why I spent time explaining the death rate of newly infected should actually improve. I get that that using the death rate to date is not perfect, but it is the best indicator of the survival rate we have, which is an indicator of the quality of medical care. The death rate will be more accurate when this crisis is over. Perhaps we would be better served to revisit it then.

A recent study disclosed that the virus targets fat cells. It enters these cells and replicates increasing the viral load. Guess what? This is the fattest country on earth. Enjoy your double cheeseburger with cheese. Especially good with fries and a shake. 2,000+ calories.

mr. bearister: I'm conducting Anger management classes. You are a prime candidate. I'm sure your wife/girl friend/ boy friend agrees. Normally, I accept checks---but, in your case, cash only.

"I am glad that you are willing to appreciate the US has better medical care. It's something most people that are longing for socialized medicine are unwilling to grasp."

Late to the party, and I don't know what province your relatives are in, but my family's experience has been very different. They receive prompt and excellent care, worry free. Nobody would even think of coming to the US for care and the niece who lives in the US often talks about how she misses her Canadian health insurance.

I always think a a good test of anecdotal complaints about Canadian health insurance is to look and see how many politicians are advocating for the repeal of their system and adoption of ours. Let me know if you find any.

caltagjohnson said:

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AunBear89, like most "lefties" you don't know *** you are talking about. Countries like Sweden and Canada are not socialist countries. Socialism means "state control of the means of production".

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So, then aspiring to be like Sweden would be OK. That is great because I am pretty sure that's what the Sanders wing wants.

stu said:

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Go!Bears said:

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So, then aspiring to be like Sweden would be OK. That is great because I am pretty sure that's what the Sanders wing wants.

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Please correct me if I'm wrong, but I don't think any of the posters on this forum want the USA to become Russia or Venezuela or North Korea. Or, at the other extreme of nearly no government at all, Somalia.

My personal opinion is we could learn a few things from countries like Denmark and New Zealand.

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After sheltering in place for 4 months aren't you ready to join the party?

bearister said:

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stu said:

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Go!Bears said:

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So, then aspiring to be like Sweden would be OK. That is great because I am pretty sure that's what the Sanders wing wants.

---

Please correct me if I'm wrong, but I don't think any of the posters on this forum want the USA to become Russia or Venezuela or North Korea. Or, at the other extreme of nearly no government at all, Somalia.

My personal opinion is we could learn a few things from countries like Denmark and New Zealand.

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After sheltering in place for 4 months aren't you ready to join the party?

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Ain't no party like a Communist Party! (But I draw the line at RED Solo cups).

Civil Bear said:

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calumnus said:

---

Civil Bear said:

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calumnus said:

---

July 25
Canada 346 new cases, 3 deaths
USA 65,944 new cases, 985 deaths

How anyone spins this in favor of the US's handling of the virus or as evidence of a superior health care system is mind boggling.

Not surprising coming from Trump, very surprising coming from a Cal grad.

---

I never said anything about how the US is handling the virus, but I'm not surprised how a lib with TDS would want to deflect the argument in another direction when faced with the facts...Cal grad or otherwise.

---

Then what was the point of your comment "traffic would flow better" if you were not implying you were talking about the death rate as a percentage of the population?

Even if you meant the death rate among those who get it, that would be deaths over (deaths + recovered). The stat you (and Trump) presented, deaths divided by total cases is meaningless because it includes ALL of the 2.9 million active (unresolved) cases in the US in the denominator (basically assumes all 2.9 million people that are currently sick will live). Canada only has 5,836 active (unresolved) cases. That is because they got this under control months ago while ours is still exploding.

For the US 150,199 deaths over (150,199 deaths plus 1,309,247 recovered cases) = 10.3%

For Canada 8,901 deaths over (8,901 deaths plus 99,860 recovered cases) = 8.2%

Again, of the resolved cases, 10.3% ended in death in the US and 8.2% ended in death in Canada.

Does that make it clearer? Do you understand what I am trying to say now?

---

My traffic comment was sarcasm directed at smh for his preference for socialized medicine. It 100% had to do with the death rate as a percentage of those infected (not the population), and 0% to do with how the US is handling the virus. When you said, "How anyone spins this in favor of the US's handling of the virus or as evidence of a superior health care system is mind boggling" I assumed you meant those as two different things, but you seem to want to use them interchangeably. How anyone would consider the two the same is what I find mind-boggling, but TDS apparently does have those kinds of effects.

Of course I meant the death rate among those that get it. I stated so repeatedly. Why you keep wanting to drum up Trump I have no idea [because it might make him look good?], but if that is something he did then he is correct in doing it. That is how the death rate among those infected is calculated, using the most accurate data we have. Your effort to spin this with unreliable and unverifiable data would be insulting [do you really believe there are 2.9M active cases or that the death rate of those still infected will be closer to 10%?], except that you are the same person that tried to argue with a straight face that two teams with identical 4th best records would actually be tied for 5th place instead of 4th. In the slight chance you actually believe the recovery numbers are reliable, you may want to read the following:

Why aren't coronavirus recoveries always reported?

Look, I fully understood what you were trying to say, which is why I spent time explaining the death rate of newly infected should actually improve. I get that that using the death rate to date is not perfect, but it is the best indicator of the survival rate we have, which is an indicator of the quality of medical care. The death rate will be more accurate when this crisis is over. Perhaps we would be better served to revisit it then.

---

I'll ignore the ad hominem insults and address your last two points. 1) India's "death rate" by your measure is only 2.2% would you say that is an indication that Indians as a whole receive better medical care than Americans?

2) What I was saying is the crisis is pretty much over in Canada, so the "death rate" there (any way you measure it including the way you are measuring it) is pretty much going to be the death rate there. However it is far from over in the US so we may be waiting awhile before we find out what the death rate is in the US under your measure.

I do agree that there are issues with the data, we are not testing enough and many people in the US, especially now in the rural South, are dying at home undiagnosed. Logic is that the virus is the virus since we have no cure (and the US has higher rates of co-morbidities) but I hope you are right and our underlying death rate really is multiples below that of many of the medically advanced countries that have already contained the virus. I personally do not need to lose any more friends or family to this and I am sure you do not either.

Quote:

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After sheltering in place for 4 months aren't you ready to join the party?

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I'm ready to go to New Zealand. Where nobody is sheltering in place. But they're not admitting Americans.

stu said:

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Quote:

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After sheltering in place for 4 months aren't you ready to join the party?

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I'm ready to go to New Zealand. Where nobody is sheltering in place. But they're not admitting Americans.

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If we shared a common border with New Zealand, they'd want to build a wall to keep us out... and make us pay for it!

Quote:

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If we shared a common border with New Zealand, they'd want to build a wall to keep us out... and make us pay for it!

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Sounds reasonable.

joe amos yaks said:

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Quote:

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If we shared a common border with New Zealand, they'd want to build a wall to keep us out... and make us pay for it!

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Sounds reasonable.

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They do have a formidable moat. Every time I visit I have to pay to fly over it.

stu said:

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Quote:

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After sheltering in place for 4 months aren't you ready to join the party?

---

I'm ready to go to New Zealand. Where nobody is sheltering in place. But they're not admitting Americans.

---

I worked on a project in New Zealand and Fiji last year and my associates there tell me that except for the total absence of tourists everyone is pretty much back to normal in both places (they don't even wear masks as is still the rule in Asia) but they are not letting anyone in except returning residents who have to self-quarantine for 14 days.

Quote:

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I worked on a project in New Zealand and Fiji last year and my associates there tell me that except for the total absence of tourists everyone is pretty much back to normal in both places (they don't even wear masks as is still the rule in Asia) but they are not letting anyone in except returning residents who have to self-quarantine for 14 days.

---

After a few sick people abused the self quarantine New Zealand is now enforcing it.

mr. Bearister: You finally showed your colors....not blue and gold but RED.

stu: How about if the USA just remains the USA??

Go!Bears said:

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"I am glad that you are willing to appreciate the US has better medical care. It's something most people that are longing for socialized medicine are unwilling to grasp."

Late to the party, and I don't know what province your relatives are in, but my family's experience has been very different. They receive prompt and excellent care, worry free. Nobody would even think of coming to the US for care and the niece who lives in the US often talks about how she misses her Canadian health insurance.

I always think a a good test of anecdotal complaints about Canadian health insurance is to look and see how many politicians are advocating for the repeal of their system and adoption of ours. Let me know if you find any.

---

Sorry for the late reply. I'm glad to hear your family is in a location where they can get prompt care. Canada is notoriously bad in that regards, but it does vary by Province:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585441/

https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2018

https://www.nber.org/aginghealth/fall07/w13429.html

Now I know it is easy to find plenty of articles with an agenda that advocates for Canada's single-payer system. I especially like this one from the AARP that doesn't really dispute the "myths" so much as offer explanations:

https://www.aarp.org/politics-society/government-elections/info-03-2012/myths-canada-health-care.html

To summarize:

• Myth #1: Canadians are flocking to the United States to get medical care - except when their lives are on the line.
• Myth #2: Doctors in Canada are flocking to the United States to practice - except for the top ones. And Doctors from third world countries come to Canada resulting in a net gain.
• Myth #3: Canada rations health care; that's why hip replacements and cataract surgeries happen faster in the United States - It's true Canada rations healthcare (See myth #5 below) which leads to longer wait times, but there was a US politician that said he heard you couldn't get a hip replacement in Canada after a certain age. Not true!
• Myth #4: Canada has long wait times because it has a single-payer system. - well yeah, but we could fix that by throwing more money at it.
• Myth #5: Canada rations health care; the United States doesn't. - Okay, you got me. Canada rations health care. But US patients pay more!

It's true there are a lot of things wrong with the US healthcare system, and it has been deteriorating rapidly over the last 10 years or so. But the US still leads the world in quality of care. Even the WHO which ranks the US in the 30's overall admitted that much. Having the best doctors, the best available equipment, the best research universities, and private medical groups that compete for customers make it possible.

As for your question about politicians advocating for the repeal of their system, I hear that quite a bit. My response is I don't know many politicians advocating to give up power and control in general. Once they get it, they ain't letting go.

Civil Bear said:

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Go!Bears said:

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"I am glad that you are willing to appreciate the US has better medical care. It's something most people that are longing for socialized medicine are unwilling to grasp."

Late to the party, and I don't know what province your relatives are in, but my family's experience has been very different. They receive prompt and excellent care, worry free. Nobody would even think of coming to the US for care and the niece who lives in the US often talks about how she misses her Canadian health insurance.

I always think a a good test of anecdotal complaints about Canadian health insurance is to look and see how many politicians are advocating for the repeal of their system and adoption of ours. Let me know if you find any.

---

Sorry for the late reply. I'm glad to hear your family is in a location where they can get prompt care. Canada is notoriously bad in that regards, but it does vary by Province:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585441/

https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2018

https://www.nber.org/aginghealth/fall07/w13429.html

Now I know it is easy to find plenty of articles with an agenda that advocates for Canada's single-payer system. I especially like this one from the AARP that doesn't really dispute the "myths" so much as offer explanations:

https://www.aarp.org/politics-society/government-elections/info-03-2012/myths-canada-health-care.html

To summarize:

• Myth #1: Canadians are flocking to the United States to get medical care - except when their lives are on the line.
• Myth #2: Doctors in Canada are flocking to the United States to practice - except for the top ones. And Doctors from third world countries come to Canada resulting in a net gain.
• Myth #3: Canada rations health care; that's why hip replacements and cataract surgeries happen faster in the United States - It's true Canada rations healthcare (See myth #5 below) which leads to longer wait times, but there was a US politician that said he heard you couldn't get a hip replacement in Canada after a certain age. Not true!
• Myth #4: Canada has long wait times because it has a single-payer system. - well yeah, but we could fix that by throwing more money at it.
• Myth #5: Canada rations health care; the United States doesn't. - Okay, you got me. Canada rations health care. But US patients pay more!

It's true there are a lot of things wrong with the US healthcare system, and it has been deteriorating rapidly over the last 10 years or so. But the US still leads the world quality of care. Even the WHO which ranks the US in the 30's overall admitted that. Having the best doctors, the best available equipment, the best research universities, and private medical groups that compete for customers make it possible.

As for your question about politicians advocating for the repeal of their system, I hear that quite a bit. My response is I don't know many advocating to give up power in general. Once they got it, they ain't letting go.

---

The main problem with the American system is the cost and that it is insurance-based and even that mostly only through employers. The premise of insurance is that you form a risk pool that can pay out a limited and predictable number of claims. The premise of fire insurance is that 1) your House is not on fire 2) you will take all necessary precautions to make sure your house does not catch fire and 3) only a few houses catch fire at any given time.

The biggest issue with medical insurance is pre-existing conditions. You cannot call up an insurance agent and say "My house is on fire, how much for fire insurance?" This was especially problematic when your insurance was only through an employer. If someone in your family developed a medical condition you could not leave your job for a better one and if you ever lost your job you likely would be denied insurance. A related issue is that young very people tended not to get insurance.

The problem of old age (insurance companies don't want to insure old people who are only going to get older and eventually die, often with a long hospital stay first) was long ago solved with a public single-payer system (Medicare).

The other big issue with medical insurance is that the contracts are incredibly complex. My wife lead a medical economics team for a major insurance company and the medical provider contracts have over 10,000 cost codes. Even for consumers trying to compare one insurance provider with another it is difficult to assess all the variables.

Insurance companies typically negotiate rates that are discounts off of standard or retail rates, so doctors and hospitals are invented to increase the standard rates so they can offer bigger discounts. The uninsured then get charged ridiculously high rates, often leading to uninsured being refused or prematurely discharged from hospitals.

The ACA, originally the Republican plan based on Romney's program as governor of Massachusetts, attempted to solve these problems and bring down the cost of insurance by creating a competitive market for medical insurance. One requirement was that insurance companies would have to offer insurance even if there are pre-existing conditions. They agreed to this because carrying medical insurance was made mandatory, ie the risk pool was expanded to include everybody, especially more young healthy people.

In order to create an "efficient" competitive market for insurance, insurance had to be commoditized so that rather than comparing apples and oranges, you had a price for apples and a price for oranges, both clearly labeled (Gold plan, Silver Plan, etc).

In some states there was also an expansion of Medicare and Medicaid to cover people with pre-existing conditions and people who could not afford the private plans.

It is not clear how well the thing would have worked even if everyone wanted it to work. However, like seemingly everything else it was politicized, demonized and sabotaged. Some parts remain but it has effectively been gutted in most parts of the US. With the recent job losses there are probably 40 million Americans without medical coverage.

I think the best/politically feasible solution for America at this point is the "public option" whereby Americans would have the option to buy private insurance or buy into Medicare. The market for private insurance would revert back to what it was before the ACA with the addition that, in addition to whatever other plans the companies want to offer, they would be required to offer standardized Platinum, Gold, Silver etc plans so that consumers could easily shop for those plans. Those rates would be posted on a website for easy comparison.

UrsaMajor said:

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The US also rations health care--by wealth. If you can afford concierge care you get ally need and then some. If you have no insurance because you can't afford it or are own Medi-Cal, Good luck.

---

Yes, that was the explanation used to try and bust Myth #5. However, if you can't afford insurance there is Medicaid, clinics, the EMTALA, the VA, and as you said Medicare. Not nearly as good as having insurance, but essentially the US version of single-payer health coverage.

calumnus said:

---

Civil Bear said:

---

Go!Bears said:

---

"I am glad that you are willing to appreciate the US has better medical care. It's something most people that are longing for socialized medicine are unwilling to grasp."

Late to the party, and I don't know what province your relatives are in, but my family's experience has been very different. They receive prompt and excellent care, worry free. Nobody would even think of coming to the US for care and the niece who lives in the US often talks about how she misses her Canadian health insurance.

I always think a a good test of anecdotal complaints about Canadian health insurance is to look and see how many politicians are advocating for the repeal of their system and adoption of ours. Let me know if you find any.

---

Sorry for the late reply. I'm glad to hear your family is in a location where they can get prompt care. Canada is notoriously bad in that regards, but it does vary by Province:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585441/

https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2018

https://www.nber.org/aginghealth/fall07/w13429.html

Now I know it is easy to find plenty of articles with an agenda that advocates for Canada's single-payer system. I especially like this one from the AARP that doesn't really dispute the "myths" so much as offer explanations:

https://www.aarp.org/politics-society/government-elections/info-03-2012/myths-canada-health-care.html

To summarize:

• Myth #1: Canadians are flocking to the United States to get medical care - except when their lives are on the line.
• Myth #2: Doctors in Canada are flocking to the United States to practice - except for the top ones. And Doctors from third world countries come to Canada resulting in a net gain.
• Myth #3: Canada rations health care; that's why hip replacements and cataract surgeries happen faster in the United States - It's true Canada rations healthcare (See myth #5 below) which leads to longer wait times, but there was a US politician that said he heard you couldn't get a hip replacement in Canada after a certain age. Not true!
• Myth #4: Canada has long wait times because it has a single-payer system. - well yeah, but we could fix that by throwing more money at it.
• Myth #5: Canada rations health care; the United States doesn't. - Okay, you got me. Canada rations health care. But US patients pay more!

It's true there are a lot of things wrong with the US healthcare system, and it has been deteriorating rapidly over the last 10 years or so. But the US still leads the world quality of care. Even the WHO which ranks the US in the 30's overall admitted that. Having the best doctors, the best available equipment, the best research universities, and private medical groups that compete for customers make it possible.

As for your question about politicians advocating for the repeal of their system, I hear that quite a bit. My response is I don't know many advocating to give up power in general. Once they got it, they ain't letting go.

---

The main problem with the American system is the cost and that it is insurance based and mostly only through employers. The premise of insurance is that you form a risk pool that can pay out for a limited and predictable number of claims. The premise of fire insurance is that 1) your House is not on fire 2) you will take all necessary precautions to make sure your house does not catch fire and 3) only a few houses catch fire at any given time.

The biggest issue with medical insurance is pre-existing conditions. You cannot call up an insurance agent and say "My house is on fire, how much for fire insurance." This was especially problematic when your insurance was only through an employer. If someone in your family developed a medical condition you could not leave your job for a better one and if you ever lost your job you likely be denied insurance. A related issue is that young very people tended not to get insurance.
The problem of old age (insurance companies don't want to insure old people who are only going to get older and eventually die, often with a long hospital stay first) was long ago solved with a public single-payer system (Medicare).

The other big issue with medical insurance is that the contracts are incredibly complexmy wife leads a medical economics team for a major insurance company and the medical provider contracts have over 10,000 cost codes. Even for consumers trying to compare one insurance provider with another it is difficult to assess all the variables.

Insurance companies typically negotiate rates that are discounts off of standard or retail rates, so doctors and hospitals are invented to increase the standard rates so they can offer bigger discounts. The uninsured then get charged ridiculously high rates, often leading to uninsured being refused or prematurely discharged from hospitals.

The ACA, originally the Republican plan based on Romney's program as governor of Massachusetts, attempted to solve these problems and bring down the cost of insurance by creating a competitive market for medical insurance. One requirement was that insurance companies would have to offer insurance even if there are pre-existing conditions. They agreed to this because carrying medical insurance was made mandatory, ie the risk pool was expanded to include everybody, especially more young healthy people.

In order to create an "efficient" competitive market for insurance, insurance had to be commoditized so that rather than comparing apples and oranges, you had a price for apples and a price for oranges, both clearly labeled (Gold plan, Silver Plan, etc).

In some states there was also an expansion of Medicare and Medicaid to cover people with pre-existing conditions and people who could not afford the private plans.

It is not clear how well the thing would have worked even if everyone wanted it to work. However, like seemingly everything else it was politicized, demonized and sabotaged. Some parts remain but it has effectively been gutted in most parts of the US. With the recent job losses there are probably 40 million Americans without medical coverage.

I think the best/politically feasible solution for America at this point is the "public option" whereby Americans would have the option to buy private insurance or buy into Medicare. The market for private insurance would revert back to what it was before the ACA with the addition that, in addition to whatever other plans the companies want to offer, they would be required to offer standardized Platinum, Gold, Silver etc plans so that consumers could easily shop for those plans. Those rates would be posted on a website for easy comparison.

---

In my experience, the uninsured do not "get charged ridiculously high rates." In fact, when I have been willing to pay cash I have sometimes paid less than I would have via insurance for many services and even some drugs.

Also, I won't get into details, but I have had uninsured family members who were admitted to the hospital after trips to the ER and they paid nothing for their care. Nothing. It made me wonder why I bother paying insurance premiums at all.

Of course, circumstances matter. One might not get that super expensive maintenance drug without insurance. I have also seen family members left to die in the hospital because they did not have insurance which would have provided a higher standard of care.

However, the point I want to make is that the cost of services and drugs without insurance is sometimes less than the cost with insurance. It is not accurate to state that "The uninsured then get charged ridiculously high rates, often leading to uninsured being refused or prematurely discharged from hospitals."

Sometimes that is true. Sometimes it isn't. I also think that when people have insurance they get a lot of unnecessary testing done not in an effort to improve quality of care but to reduce malpractice liability. The two are related, but not always in the way one might think.

calumnus said:

---

Civil Bear said:

---

Go!Bears said:

---

"I am glad that you are willing to appreciate the US has better medical care. It's something most people that are longing for socialized medicine are unwilling to grasp."

Late to the party, and I don't know what province your relatives are in, but my family's experience has been very different. They receive prompt and excellent care, worry free. Nobody would even think of coming to the US for care and the niece who lives in the US often talks about how she misses her Canadian health insurance.

I always think a a good test of anecdotal complaints about Canadian health insurance is to look and see how many politicians are advocating for the repeal of their system and adoption of ours. Let me know if you find any.

---

Sorry for the late reply. I'm glad to hear your family is in a location where they can get prompt care. Canada is notoriously bad in that regards, but it does vary by Province:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585441/

https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2018

https://www.nber.org/aginghealth/fall07/w13429.html

Now I know it is easy to find plenty of articles with an agenda that advocates for Canada's single-payer system. I especially like this one from the AARP that doesn't really dispute the "myths" so much as offer explanations:

https://www.aarp.org/politics-society/government-elections/info-03-2012/myths-canada-health-care.html

To summarize:

• Myth #1: Canadians are flocking to the United States to get medical care - except when their lives are on the line.
• Myth #2: Doctors in Canada are flocking to the United States to practice - except for the top ones. And Doctors from third world countries come to Canada resulting in a net gain.
• Myth #3: Canada rations health care; that's why hip replacements and cataract surgeries happen faster in the United States - It's true Canada rations healthcare (See myth #5 below) which leads to longer wait times, but there was a US politician that said he heard you couldn't get a hip replacement in Canada after a certain age. Not true!
• Myth #4: Canada has long wait times because it has a single-payer system. - well yeah, but we could fix that by throwing more money at it.
• Myth #5: Canada rations health care; the United States doesn't. - Okay, you got me. Canada rations health care. But US patients pay more!

It's true there are a lot of things wrong with the US healthcare system, and it has been deteriorating rapidly over the last 10 years or so. But the US still leads the world quality of care. Even the WHO which ranks the US in the 30's overall admitted that. Having the best doctors, the best available equipment, the best research universities, and private medical groups that compete for customers make it possible.

As for your question about politicians advocating for the repeal of their system, I hear that quite a bit. My response is I don't know many advocating to give up power in general. Once they got it, they ain't letting go.

---

The main problem with the American system is the cost and that it is insurance-based and even that mostly only through employers. The premise of insurance is that you form a risk pool that can pay out a limited and predictable number of claims. The premise of fire insurance is that 1) your House is not on fire 2) you will take all necessary precautions to make sure your house does not catch fire and 3) only a few houses catch fire at any given time.

The biggest issue with medical insurance is pre-existing conditions. You cannot call up an insurance agent and say "My house is on fire, how much for fire insurance?" This was especially problematic when your insurance was only through an employer. If someone in your family developed a medical condition you could not leave your job for a better one and if you ever lost your job you likely would be denied insurance. A related issue is that young very people tended not to get insurance.

The problem of old age (insurance companies don't want to insure old people who are only going to get older and eventually die, often with a long hospital stay first) was long ago solved with a public single-payer system (Medicare).

The other big issue with medical insurance is that the contracts are incredibly complex. My wife lead a medical economics team for a major insurance company and the medical provider contracts have over 10,000 cost codes. Even for consumers trying to compare one insurance provider with another it is difficult to assess all the variables.

Insurance companies typically negotiate rates that are discounts off of standard or retail rates, so doctors and hospitals are invented to increase the standard rates so they can offer bigger discounts. The uninsured then get charged ridiculously high rates, often leading to uninsured being refused or prematurely discharged from hospitals.

The ACA, originally the Republican plan based on Romney's program as governor of Massachusetts, attempted to solve these problems and bring down the cost of insurance by creating a competitive market for medical insurance. One requirement was that insurance companies would have to offer insurance even if there are pre-existing conditions. They agreed to this because carrying medical insurance was made mandatory, ie the risk pool was expanded to include everybody, especially more young healthy people.

In order to create an "efficient" competitive market for insurance, insurance had to be commoditized so that rather than comparing apples and oranges, you had a price for apples and a price for oranges, both clearly labeled (Gold plan, Silver Plan, etc).

In some states there was also an expansion of Medicare and Medicaid to cover people with pre-existing conditions and people who could not afford the private plans.

It is not clear how well the thing would have worked even if everyone wanted it to work. However, like seemingly everything else it was politicized, demonized and sabotaged. Some parts remain but it has effectively been gutted in most parts of the US. With the recent job losses there are probably 40 million Americans without medical coverage.

I think the best/politically feasible solution for America at this point is the "public option" whereby Americans would have the option to buy private insurance or buy into Medicare. The market for private insurance would revert back to what it was before the ACA with the addition that, in addition to whatever other plans the companies want to offer, they would be required to offer standardized Platinum, Gold, Silver etc plans so that consumers could easily shop for those plans. Those rates would be posted on a website for easy comparison.

---

Some very good points and ideas in there. One question: would anyone be willing to buy into Medicare? Perhaps if it were much cheaper, but it isn't exactly cost-efficient (although more so than private insurance nowdays). Would those wanting to pay into private insurance still be forced to buy into Medicare as well?

Civil Bear said:

---

calumnus said:

---

Civil Bear said:

---

Go!Bears said:

---

"I am glad that you are willing to appreciate the US has better medical care. It's something most people that are longing for socialized medicine are unwilling to grasp."

Late to the party, and I don't know what province your relatives are in, but my family's experience has been very different. They receive prompt and excellent care, worry free. Nobody would even think of coming to the US for care and the niece who lives in the US often talks about how she misses her Canadian health insurance.

I always think a a good test of anecdotal complaints about Canadian health insurance is to look and see how many politicians are advocating for the repeal of their system and adoption of ours. Let me know if you find any.

---

Sorry for the late reply. I'm glad to hear your family is in a location where they can get prompt care. Canada is notoriously bad in that regards, but it does vary by Province:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585441/

https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2018

https://www.nber.org/aginghealth/fall07/w13429.html

Now I know it is easy to find plenty of articles with an agenda that advocates for Canada's single-payer system. I especially like this one from the AARP that doesn't really dispute the "myths" so much as offer explanations:

https://www.aarp.org/politics-society/government-elections/info-03-2012/myths-canada-health-care.html

To summarize:

• Myth #1: Canadians are flocking to the United States to get medical care - except when their lives are on the line.
• Myth #2: Doctors in Canada are flocking to the United States to practice - except for the top ones. And Doctors from third world countries come to Canada resulting in a net gain.
• Myth #3: Canada rations health care; that's why hip replacements and cataract surgeries happen faster in the United States - It's true Canada rations healthcare (See myth #5 below) which leads to longer wait times, but there was a US politician that said he heard you couldn't get a hip replacement in Canada after a certain age. Not true!
• Myth #4: Canada has long wait times because it has a single-payer system. - well yeah, but we could fix that by throwing more money at it.
• Myth #5: Canada rations health care; the United States doesn't. - Okay, you got me. Canada rations health care. But US patients pay more!

It's true there are a lot of things wrong with the US healthcare system, and it has been deteriorating rapidly over the last 10 years or so. But the US still leads the world quality of care. Even the WHO which ranks the US in the 30's overall admitted that. Having the best doctors, the best available equipment, the best research universities, and private medical groups that compete for customers make it possible.

As for your question about politicians advocating for the repeal of their system, I hear that quite a bit. My response is I don't know many advocating to give up power in general. Once they got it, they ain't letting go.

---

The main problem with the American system is the cost and that it is insurance-based and even that mostly only through employers. The premise of insurance is that you form a risk pool that can pay out a limited and predictable number of claims. The premise of fire insurance is that 1) your House is not on fire 2) you will take all necessary precautions to make sure your house does not catch fire and 3) only a few houses catch fire at any given time.

The biggest issue with medical insurance is pre-existing conditions. You cannot call up an insurance agent and say "My house is on fire, how much for fire insurance?" This was especially problematic when your insurance was only through an employer. If someone in your family developed a medical condition you could not leave your job for a better one and if you ever lost your job you likely would be denied insurance. A related issue is that young very people tended not to get insurance.

The problem of old age (insurance companies don't want to insure old people who are only going to get older and eventually die, often with a long hospital stay first) was long ago solved with a public single-payer system (Medicare).

The other big issue with medical insurance is that the contracts are incredibly complex. My wife lead a medical economics team for a major insurance company and the medical provider contracts have over 10,000 cost codes. Even for consumers trying to compare one insurance provider with another it is difficult to assess all the variables.

Insurance companies typically negotiate rates that are discounts off of standard or retail rates, so doctors and hospitals are invented to increase the standard rates so they can offer bigger discounts. The uninsured then get charged ridiculously high rates, often leading to uninsured being refused or prematurely discharged from hospitals.

The ACA, originally the Republican plan based on Romney's program as governor of Massachusetts, attempted to solve these problems and bring down the cost of insurance by creating a competitive market for medical insurance. One requirement was that insurance companies would have to offer insurance even if there are pre-existing conditions. They agreed to this because carrying medical insurance was made mandatory, ie the risk pool was expanded to include everybody, especially more young healthy people.

In order to create an "efficient" competitive market for insurance, insurance had to be commoditized so that rather than comparing apples and oranges, you had a price for apples and a price for oranges, both clearly labeled (Gold plan, Silver Plan, etc).

In some states there was also an expansion of Medicare and Medicaid to cover people with pre-existing conditions and people who could not afford the private plans.

It is not clear how well the thing would have worked even if everyone wanted it to work. However, like seemingly everything else it was politicized, demonized and sabotaged. Some parts remain but it has effectively been gutted in most parts of the US. With the recent job losses there are probably 40 million Americans without medical coverage.

I think the best/politically feasible solution for America at this point is the "public option" whereby Americans would have the option to buy private insurance or buy into Medicare. The market for private insurance would revert back to what it was before the ACA with the addition that, in addition to whatever other plans the companies want to offer, they would be required to offer standardized Platinum, Gold, Silver etc plans so that consumers could easily shop for those plans. Those rates would be posted on a website for easy comparison.

---

Some very good points and ideas in there. One question: would anyone be willing to buy into Medicare? Perhaps if it were much cheaper, but it isn't exactly cost-efficient (although more so than private insurance IIRC). Would those wanting to pay into private insurance still be forced to buy into Medicare as well?

---

Good summary by Calumnus and question by Civil Bear. After attempting a consulting practice to help employers deal with this stuff, it became obvious that the biggest issue in the discussion is anecdotal reaction and lack of context. I will add to those that rely on the anecdotal - just follow the money (Lebowski). Look at the profit margins of those that are MORE than benefiting. Compare that to the lobbying dollars that went into ACA and even changes to Medicare, Medicaid and state programs going back a ways.

The best idea is to deconstruct. The term Healthcare - in particular reference to a system in the USA or elsewhere is too nebulous. First - it needs to be broken down into bands by type of healthcare (i.e. public health, diagnostics, critical care, hospice, healthy development (under age 18), etc.). Then each of those bands can be addressed in different ways. Some private/personal, some insured or not, some singlepayer or government directed. For those that are governmental - it would probably be best to start at a state level and allow states to join in regional pools, if practical. Each region could use different design models and over time the more efficient models can prevail.

Finally, much needs to done on consumer education. Every patient should ask the cost and every medical practitioner should explain the cost BEFORE signing anything or beginning consult or treatment, Obviously, this does not need to apply to emergency care - but much of the cost drivers apply.

BeachedBear said:

---

Civil Bear said:

---

calumnus said:

---

Civil Bear said:

---

Go!Bears said:

---

"I am glad that you are willing to appreciate the US has better medical care. It's something most people that are longing for socialized medicine are unwilling to grasp."

Late to the party, and I don't know what province your relatives are in, but my family's experience has been very different. They receive prompt and excellent care, worry free. Nobody would even think of coming to the US for care and the niece who lives in the US often talks about how she misses her Canadian health insurance.

I always think a a good test of anecdotal complaints about Canadian health insurance is to look and see how many politicians are advocating for the repeal of their system and adoption of ours. Let me know if you find any.

---

Sorry for the late reply. I'm glad to hear your family is in a location where they can get prompt care. Canada is notoriously bad in that regards, but it does vary by Province:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585441/

https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2018

https://www.nber.org/aginghealth/fall07/w13429.html

Now I know it is easy to find plenty of articles with an agenda that advocates for Canada's single-payer system. I especially like this one from the AARP that doesn't really dispute the "myths" so much as offer explanations:

https://www.aarp.org/politics-society/government-elections/info-03-2012/myths-canada-health-care.html

To summarize:

• Myth #1: Canadians are flocking to the United States to get medical care - except when their lives are on the line.
• Myth #2: Doctors in Canada are flocking to the United States to practice - except for the top ones. And Doctors from third world countries come to Canada resulting in a net gain.
• Myth #3: Canada rations health care; that's why hip replacements and cataract surgeries happen faster in the United States - It's true Canada rations healthcare (See myth #5 below) which leads to longer wait times, but there was a US politician that said he heard you couldn't get a hip replacement in Canada after a certain age. Not true!
• Myth #4: Canada has long wait times because it has a single-payer system. - well yeah, but we could fix that by throwing more money at it.
• Myth #5: Canada rations health care; the United States doesn't. - Okay, you got me. Canada rations health care. But US patients pay more!

It's true there are a lot of things wrong with the US healthcare system, and it has been deteriorating rapidly over the last 10 years or so. But the US still leads the world quality of care. Even the WHO which ranks the US in the 30's overall admitted that. Having the best doctors, the best available equipment, the best research universities, and private medical groups that compete for customers make it possible.

As for your question about politicians advocating for the repeal of their system, I hear that quite a bit. My response is I don't know many advocating to give up power in general. Once they got it, they ain't letting go.

---

The main problem with the American system is the cost and that it is insurance-based and even that mostly only through employers. The premise of insurance is that you form a risk pool that can pay out a limited and predictable number of claims. The premise of fire insurance is that 1) your House is not on fire 2) you will take all necessary precautions to make sure your house does not catch fire and 3) only a few houses catch fire at any given time.

The biggest issue with medical insurance is pre-existing conditions. You cannot call up an insurance agent and say "My house is on fire, how much for fire insurance?" This was especially problematic when your insurance was only through an employer. If someone in your family developed a medical condition you could not leave your job for a better one and if you ever lost your job you likely would be denied insurance. A related issue is that young very people tended not to get insurance.

The problem of old age (insurance companies don't want to insure old people who are only going to get older and eventually die, often with a long hospital stay first) was long ago solved with a public single-payer system (Medicare).

The other big issue with medical insurance is that the contracts are incredibly complex. My wife lead a medical economics team for a major insurance company and the medical provider contracts have over 10,000 cost codes. Even for consumers trying to compare one insurance provider with another it is difficult to assess all the variables.

Insurance companies typically negotiate rates that are discounts off of standard or retail rates, so doctors and hospitals are invented to increase the standard rates so they can offer bigger discounts. The uninsured then get charged ridiculously high rates, often leading to uninsured being refused or prematurely discharged from hospitals.

The ACA, originally the Republican plan based on Romney's program as governor of Massachusetts, attempted to solve these problems and bring down the cost of insurance by creating a competitive market for medical insurance. One requirement was that insurance companies would have to offer insurance even if there are pre-existing conditions. They agreed to this because carrying medical insurance was made mandatory, ie the risk pool was expanded to include everybody, especially more young healthy people.

In order to create an "efficient" competitive market for insurance, insurance had to be commoditized so that rather than comparing apples and oranges, you had a price for apples and a price for oranges, both clearly labeled (Gold plan, Silver Plan, etc).

In some states there was also an expansion of Medicare and Medicaid to cover people with pre-existing conditions and people who could not afford the private plans.

It is not clear how well the thing would have worked even if everyone wanted it to work. However, like seemingly everything else it was politicized, demonized and sabotaged. Some parts remain but it has effectively been gutted in most parts of the US. With the recent job losses there are probably 40 million Americans without medical coverage.

I think the best/politically feasible solution for America at this point is the "public option" whereby Americans would have the option to buy private insurance or buy into Medicare. The market for private insurance would revert back to what it was before the ACA with the addition that, in addition to whatever other plans the companies want to offer, they would be required to offer standardized Platinum, Gold, Silver etc plans so that consumers could easily shop for those plans. Those rates would be posted on a website for easy comparison.

---

Some very good points and ideas in there. One question: would anyone be willing to buy into Medicare? Perhaps if it were much cheaper, but it isn't exactly cost-efficient (although more so than private insurance IIRC). Would those wanting to pay into private insurance still be forced to buy into Medicare as well?

---

Good summary by Calumnus and question by Civil Bear. After attempting a consulting practice to help employers deal with this stuff, it became obvious that the biggest issue in the discussion is anecdotal reaction and lack of context. I will add to those that rely on the anecdotal - just follow the money (Lebowski). Look at the profit margins of those that are MORE than benefiting. Compare that to the lobbying dollars that went into ACA and even changes to Medicare, Medicaid and state programs going back a ways.

The best idea is to deconstruct. The term Healthcare - in particular reference to a system in the USA or elsewhere is too nebulous. First - it needs to be broken down into bands by type of healthcare (i.e. public health, diagnostics, critical care, hospice, healthy development (under age 18), etc.). Then each of those bands can be addressed in different ways. Some private/personal, some insured or not, some singlepayer or government directed. For those that are governmental - it would probably be best to start at a state level and allow states to join in regional pools, if practical. Each region could use different design models and over time the more efficient models can prevail.

Finally, much needs to done on consumer education. Every patient should ask the cost and every medical practitioner should explain the cost BEFORE signing anything or beginning consult or treatment, Obviously, this does not need to apply to emergency care - but much of the cost drivers apply.

---

Agree with the last paragraph especially. Transparency of costs would go a long way in reducing them, and on the surface, it seems doable. But as you mentioned, there are powerful players lobbying against it. Heck, we can't even mandate that SF restaurants show the added health care costs on our meal checks.

Civil Bear said:

---

calumnus said:

---

Civil Bear said:

---

Go!Bears said:

---

"I am glad that you are willing to appreciate the US has better medical care. It's something most people that are longing for socialized medicine are unwilling to grasp."

Late to the party, and I don't know what province your relatives are in, but my family's experience has been very different. They receive prompt and excellent care, worry free. Nobody would even think of coming to the US for care and the niece who lives in the US often talks about how she misses her Canadian health insurance.

I always think a a good test of anecdotal complaints about Canadian health insurance is to look and see how many politicians are advocating for the repeal of their system and adoption of ours. Let me know if you find any.

---

Sorry for the late reply. I'm glad to hear your family is in a location where they can get prompt care. Canada is notoriously bad in that regards, but it does vary by Province:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585441/

https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2018

https://www.nber.org/aginghealth/fall07/w13429.html

Now I know it is easy to find plenty of articles with an agenda that advocates for Canada's single-payer system. I especially like this one from the AARP that doesn't really dispute the "myths" so much as offer explanations:

https://www.aarp.org/politics-society/government-elections/info-03-2012/myths-canada-health-care.html

To summarize:

• Myth #1: Canadians are flocking to the United States to get medical care - except when their lives are on the line.
• Myth #2: Doctors in Canada are flocking to the United States to practice - except for the top ones. And Doctors from third world countries come to Canada resulting in a net gain.
• Myth #3: Canada rations health care; that's why hip replacements and cataract surgeries happen faster in the United States - It's true Canada rations healthcare (See myth #5 below) which leads to longer wait times, but there was a US politician that said he heard you couldn't get a hip replacement in Canada after a certain age. Not true!
• Myth #4: Canada has long wait times because it has a single-payer system. - well yeah, but we could fix that by throwing more money at it.
• Myth #5: Canada rations health care; the United States doesn't. - Okay, you got me. Canada rations health care. But US patients pay more!

It's true there are a lot of things wrong with the US healthcare system, and it has been deteriorating rapidly over the last 10 years or so. But the US still leads the world quality of care. Even the WHO which ranks the US in the 30's overall admitted that. Having the best doctors, the best available equipment, the best research universities, and private medical groups that compete for customers make it possible.

As for your question about politicians advocating for the repeal of their system, I hear that quite a bit. My response is I don't know many advocating to give up power in general. Once they got it, they ain't letting go.

---

The main problem with the American system is the cost and that it is insurance-based and even that mostly only through employers. The premise of insurance is that you form a risk pool that can pay out a limited and predictable number of claims. The premise of fire insurance is that 1) your House is not on fire 2) you will take all necessary precautions to make sure your house does not catch fire and 3) only a few houses catch fire at any given time.

The biggest issue with medical insurance is pre-existing conditions. You cannot call up an insurance agent and say "My house is on fire, how much for fire insurance?" This was especially problematic when your insurance was only through an employer. If someone in your family developed a medical condition you could not leave your job for a better one and if you ever lost your job you likely would be denied insurance. A related issue is that young very people tended not to get insurance.

The problem of old age (insurance companies don't want to insure old people who are only going to get older and eventually die, often with a long hospital stay first) was long ago solved with a public single-payer system (Medicare).

The other big issue with medical insurance is that the contracts are incredibly complex. My wife lead a medical economics team for a major insurance company and the medical provider contracts have over 10,000 cost codes. Even for consumers trying to compare one insurance provider with another it is difficult to assess all the variables.

Insurance companies typically negotiate rates that are discounts off of standard or retail rates, so doctors and hospitals are invented to increase the standard rates so they can offer bigger discounts. The uninsured then get charged ridiculously high rates, often leading to uninsured being refused or prematurely discharged from hospitals.

The ACA, originally the Republican plan based on Romney's program as governor of Massachusetts, attempted to solve these problems and bring down the cost of insurance by creating a competitive market for medical insurance. One requirement was that insurance companies would have to offer insurance even if there are pre-existing conditions. They agreed to this because carrying medical insurance was made mandatory, ie the risk pool was expanded to include everybody, especially more young healthy people.

In order to create an "efficient" competitive market for insurance, insurance had to be commoditized so that rather than comparing apples and oranges, you had a price for apples and a price for oranges, both clearly labeled (Gold plan, Silver Plan, etc).

In some states there was also an expansion of Medicare and Medicaid to cover people with pre-existing conditions and people who could not afford the private plans.

It is not clear how well the thing would have worked even if everyone wanted it to work. However, like seemingly everything else it was politicized, demonized and sabotaged. Some parts remain but it has effectively been gutted in most parts of the US. With the recent job losses there are probably 40 million Americans without medical coverage.

I think the best/politically feasible solution for America at this point is the "public option" whereby Americans would have the option to buy private insurance or buy into Medicare. The market for private insurance would revert back to what it was before the ACA with the addition that, in addition to whatever other plans the companies want to offer, they would be required to offer standardized Platinum, Gold, Silver etc plans so that consumers could easily shop for those plans. Those rates would be posted on a website for easy comparison.

---

Some very good points and ideas in there. One question: would anyone be willing to buy into Medicare? Perhaps if it were much cheaper, but it isn't exactly cost-efficient (although more so than private insurance nowdays). Would those wanting to pay into private insurance still be forced to buy into Medicare as well?

---

The idea is it would be an option for those not covered by Medicare. You could buy private insurance or pay to be in Medicare. Medicare is "expensive" mostly because it covers the elderly who are far and away the largest users of medical services and are the most expensive to cover (the reason private insurers won't cover them and the public needed to).

Many younger people with pre-existing conditions (diabetes for example) would find the option of buying Medicare coverage to be their only choice. Many young healthy people would find private insurance to be the more affordable option. For everyone in between it would depend on how the public option was priced which would depend on actuarials and if there were any subsidies made available.

Civil Bear said:

---

UrsaMajor said:

---

The US also rations health care--by wealth. If you can afford concierge care you get ally need and then some. If you have no insurance because you can't afford it or are own Medi-Cal, Good luck.

---

Yes, that was the explanation used to try and bust Myth #5. However, if you can't afford insurance there is Medicaid, clinics, the EMTALA, the VA, and as you said Medicare. Not nearly as good as having insurance, but essentially the US version of single-payer health coverage.

---

And one-third of "Go Fund Me" is for medical costs. Medical costs are the single largest source of personal bankruptcies in America. Hospitals have to admit you for emergencies and free clinics can treat minor ailments but if you have a chronic issue and need a procedure, a stent for example, or just need insulin, you are generally out of luck if you do not have insurance and cannot prove ability to pay.

If you receive disability payments under Social Security your income will be above the income limit for Medicaid in the 24 states that rejected the Medicaid expansion under the ACA ($12,760 for one person in 2020). If you work even a minimum wage job, your income will be well above that limit. Even for the 26 states that accepted the Medicaid expansion under the ACA the income limit is $16,968). That is above the Federal minimum wage ($7.50 per hour) but well below the minimum wage in most of those same states (for example California is $13.00 per hour).

Also, the states have been given considerable leeway in how they administer their Medicaid funds. Many states have added or plan to add work requirements for Medicaid which will be a catch-22 for many as work income can make one ineligible.

To Bearister: Yes, CA is the 5th largest economy. CA also has other accomplishments

50% of all homeless in the US
50% of all welfare recipients in the US
highest taxes in the US
highest COL in the US
highest home prices in the US
Dumbest politicians
Most poop on the sidewalks
690,000+ people moved out last year. Of scourse 500,000+ moved in. Still net migration out.

I moved out 2 years ago after living in 7 bay Area cities for 42 years. Best move I ever made. The Dumbocrats are leading CA right over the cliff.

Ironically....if Trumpster doesn't want people to kneel during the anthem then he should goto games. Nobody would want to bend the knee for him.