
Medicare for All Could Eliminate the $600B Private Insurance Industry - qsymmachus
http://fortune.com/2019/03/25/medicare-for-all-eliminate-private-insurance/
======
ineedasername
The article talks about the current private insurance companies moving to a
role of supplemental insurance. As an important note on this, that's how it
works in both Canada and the UK, but in very different ways:

In Canada, private insurance is not allowed to cover anything that is covered
by the public insurance. So, no jumping the queue by paying out of pocket or
through private insurance. Hopping over to the USA and paying out of pocket is
an option for the well off though.

In the UK, there is no such limit, and there is no cap on doctor earnings from
private practice, but there are minimums on how much work must be performed
for NHS, the public health system. Again, the well off have a way to jump the
queue and receive faster/higher quality care.

How these types of factors would play into a US private insurance and private
doctor practice of course is unclear, and would be key sticking points in any
Medicare for All plan. One thing for sure is that the insurance companies are
unlikely to go willingly. Kicking and screaming is more like it, at least if
they aren't just nationalized with massive golden parachutes for all of the
top brass.

~~~
malandrew
> but there are minimums on how much work must be performed for NHS

So basically doctors are not free in the UK?

~~~
Something1234
I think the NHS actually pays for their training.

------
xs83
As someone who has lived in the UK with an amazing free healthcare system and
now Australia who has a more complex model - but basically still universal
free healthcare for the most part - I can safely say I took the NHS for
granted in the UK. Australia is pretty good - most stuff will get fixed free,
and they are at least transparent about where your tax goes (We have a
Medicare Levy that is paid as a specific % of income, and a Medicare Levy
Surcharge if you earn above a certain amount and don't take out private
medical care).

Private Healthcare is offered as a perk to employees, not as an expected part
of the package.

However - the article header sums this up - "Could Eliminate the 600B Private
Insurance Industry" \- Money talks and if you think for a second the super
rich people running these companies give a shit over your welfare vs their
money you are sorely mistaken.

This would always fall at the first hurdle - and if by some magic measure
something passed (Obamacare for example) - the next person would just repeal
it.

~~~
masonic

      an amazing free healthcare system
    

Well, sure -- you can't beat _free_.

------
tracker1
And how many billion will that cost... Let's consider we have over 300 million
people in the USA, and even $1K/person on average (it will be more) is $300
Billion (with a B)... added to the Federal Budget... it will be at least 2-3X
that not even accounting for abuse.

~~~
xs83
With the efficiency savings from a nationalised entity 2-3x is a stretch, yes
people will probably pay more tax, that tax will be significantly lower than
what they probably pay for private medical care. It removes the onus on
Employers to provide medical care as a "requirement", it provides people who
cant afford medical care a choice of treatment rather than just 'dying'.

~~~
basementcat
For older people with more medical issues, the tax will be lower than paying
for private medical care. For younger people it will be a tougher sell. Also,
don't underestimate the political power of those who are accustomed to the
"freedom" of not having insurance and just going to the emergency room when
they get hurt.

Nationalized health care will also have to grapple with freedom of religion.
Does Medicare pay extra money for specialized operations so that Jehovah's
Witnesses don't have to get blood transfusions? Does Medicare not cover
certain medical treatments or procedures to ensure certain religious
constituencies don't have their hard earned tax dollars paying for "sinful"
activities?

~~~
xs83
It occurs to me just how much the US has poisoned its citizens against a
national medicare type system.

You know - no one in the UK even thinks - "Well I am paying more in taxes to
treat old people", we all realise that at some point we will all be there and
not having to worry about it or maintaining it or being excluded from
something certainly makes everything a whole lot less stressful!

Likewise I don't even think about how much I am paying for Midwifery, Anti
Natal, Pediatric services etc - I understand that different people have
different needs and that everyone should get a fair shot at getting what they
need.

------
verdverm
Being a Trekie, I'm a fan of healthcare as a human right, free of costs to the
patient. My main concern is that the current (recent) congresses have shown
that they cannot create effective legislation. When was the last time the
government made something better or more efficient?

~~~
erikpukinskis
It's brilliant really, the Republican strategy: sabotage government from
within until people stop believing it could have ever been effective. Win
elections playing on people's fears, which are increased as society backslides
into dysfunction. Meanwhile run a beautiful pristine operation serving the
needs of corporations, protecting your donor base.

It's a total perversion of democracy and even human decency, but I sure
respect it as a strategic play.

~~~
objektif
This is pretty much the essence of crony capitalism. Unfortunately I have to
say Democrats are catching up to republicans on that department led by Pelosi
and friends.

