Comments by "Xyz Same" (@xyzsame4081) on "Steve Rattner: “Medicare For All Will Sink The Democrats”" video.

  1. I know single payer systems (Austria, Germany) there are NO disadvantages for the citizens ! There is always room for improvment of course - but they can do the friendly competiton among themselves. But the competition will NOT be with the U.S. or Switzerland. in Switzerland they have private for-profit insurance agencies. Everyone is covered, I assume there are subsidies for low income people or a public option. Staff is well paid even considering the generally high costs of living, and the healthcare has a good reputation. But their expenditures per capita are even higher than those of the U.S.
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  2. The more "for-profit and private" is in the system (for instance a two tier system, with basic insurance and coverage for everyone and then the extras for instance in Australia ) - the less cost-efficient it gets. That said even 2 tier systems or public option systems beat the U.S. by far. There are DISADVANTAGES for wealthy people, investors and ideologues. "Private for profit is always better" - nope ! and since that is so visible with public healthcare it undermines the worshippers of the mythical "free market" and the anti government rhetoric. even cost efficient healthcare costs a lot. Low inocme poeple will need help. Resp. wealthy people will have to pay more in taxes. There are advantages of cost-efficiencey (they are considerable) but for really wealthy people the higer costs will outweigh those possilbe savings. When everyone uses the same facilities and when doctors and medical necessities determine treatment plans - then a "divide and conquer" strategy or a fragmented confrontation with ALL the costs is not possible. The beauty of deductibles, and unclear later costs and refused treatments is that every patient then fights alone and is on their own and only when they ALREADY in a vulnerable spot because of bad health. Kicking the can down the road, not revealing the full statistical costs right away .... the risk hits some and later and with unforeseeable costs. Politicians and the industry can grant premiums that look reasonable (but aren't because they do not give full coverage). One cannot compare costs (each police is different). If there are LATER UNPLEASANT financial suprises it is the fault of the patient who was too stupid to understand the fine print or is no medical and legal expert - and forget to mention a harmless acne treatment which is the pretext later to deny cancer treatment. The insurance premiums LOOK good (because they are incomplete) - so they can hide a lot of dysfunctional adminstrative costs and profits in those premiums. The REST will hit some unsuspecting, unprepared, overwhelmed patients later. Everyone gets the same, contribution monthly according to income NO payments later. It is a very transparent affair. All costs are upfront - and the NEED for taxation of the rich is abundantly clear. If a politician does not want rich people pay more taxes to help fund - they have a political problem. The rational and honest admission would be that some people are just going to die , poor children will not get life saving treatments. that is impossible to sell to the voters. So "offering" "coverage" that seems not too costly - but then come the later payments - is a way for those weasels to avoid an intellectually honest debate. (Ted Cruz ...) Single payer systems firmly establish the idea that it makes sense that the broad shoulders have to carry more weight. In an area that voters very directly experience. Once the population gets used to it - it is really, really hard to take it away. = those higher taxes are here to stay. The rich suffer that already with Social Security. Countless attacks - but they still could not shoot it down. One could lose elections over that.
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  3. 7 - 11 % of GDP (17 % in the U.S.) are off limits for the investors. Most of that part of the economy is delivered and consumed without anyone making a profit (exception Big Pharma, private companies building medical equipment, ....) And the doctors - although being upper middle class - do not earn as much as in the U.S. The system provides enough trained doctors and most need to accept the well negoatiated contract of the non-profit insurance agency. Else they would not find enough patients. The systems are very cost efficient and "process" many patients through. That promotes a certain kind of medicine (Mc Medicine). No time for the doctor to encourage the patient to change their life style. They certainly cannot have long heart to heart talks. On the other hand: surgery and other expensive procedures can be treated well in the standard system. Unclear ongoing symptoms ? One can take it to the private doctors who specializes in TCM or homeophathy or allergies ... That will not break the bank affordable.
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  4. Those wonderful Corporate Democrats will never, ever vote for Universal healthcare (a European style system). These systems ALL lean towards non-profit. A country either can have good and cost-efficient healthcare OR the industry makes a lot of profits (and wil pay huge bribes ...aka donations). Most countries took version 1 after WW2 - not the U.S. (it got worse, more dysfunction, and over time medicine got much more effective but also expensive. In the 60s persons died of strokes and cancer which can be saved today. So we want them saved. Yes, but that costs). The Dems will have to be dragged kicking and screaming there - resp. they need to be replaced by representatives that are willing to work for the voters. Which is not easy. Under Corbyn Labour U.K changed course, it was a takeover by the progressives against the neoliberals, who fought fiercly against it. They took over the institutions within the party and now they replace some MPs that STILL do not get it (and in the U.K. money in politics is not even an issue. which is why it was even possible. With a fiece fight !). Good solutions for the U.S. voters ? the Big Donors would be pissed off. And they bribe BOTH parties.
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  5. The (sellout) politicians are pressured heavily !! by the party establishment (of both parties). So even if they are honest, the party will cut their funding, challenge them with another candidate which will get millions for campaigns. That's the stick. The carrot: they stand to profit as ex politican. The election circus where insane budgets are spent on advertising budgets offers many employment opportunities for sellout ex-politicians (where they can make more money than in politics). Consultants, strategists, think tanks, lobbyists,... Clinton collected 1 BILLION USD. Trump 500 million, Sanders more than 200 million (but in his case only from small donors). The Big Donors want a ballot with a Corporate sellout Dem OR a fierce Republican. That's the "choice" the voters are going to have. The parties differ in gun rights, abortion, gay rights - nothing that reduces PROFITS for the Big Donors. Republicans are good in tax cuts and doing away with protective laws. The Dems roll over, throw up their hands in the air, they let the Repubs do the dirty work (which benefits the donors, which are ALSO their donors). It starts looking like a Good cop / Bad cop game. The Big Donors bribe the Dems to WIN PRIMARIES against PROGRESSIVES (by all means necessary) to keep them away from influence . Which is why the Dems cannot be bothered to talk about massive voter roll purges. They do it TOO - only they use it more for primaries. (Greg Palast, Operation Crosscheck). And the Repubs repeat that right now. (why wouldn't they). If Dems lose the GE because they have a lukewarm message and stand for nothing and are notorious weaklings * - oh well .... they are getting lucrative jobs for ex-politicians. The Big Donors ALWAYS WIN. * Weak only when it is about standing up against the Republicans - they are careerists. When you have no convictions and chase the donations - why even fight ?
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  6. It is an Op-ed - an opinion piece not an article from a journalist. Of course they should take better care WHO is allowed on those still influental pages (or sites). BUT: the shill must not be right - he must sound convincing and help the agenda.
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  7. Iceland has 300,000 people, Europea has many countries with a few million, a few with 20 - 30, and a few with 60 - 85 millions and they ALL pay much less per capita for healthcare. Downside: their healthcare industry does not make profits hand over fist. Canada is in the 20 - 30 million range, it could well DEFEND itself and so could Europe (plus 530 million people). When was Canada invaded the last time ?? U.K. demanded their help in WW2 - and got it. The U.S. Military Industrial Comples would freak out if Europe ever wanted/decided to do their own thing regarding military and DEFENSE (as opposed to NATO aggressions). Russia is no threat to Canada - they have enough cold regions already and plenty of natural resources. They KNOW about the trouble to control such vast areas militarily (it helped THEM when the French under Napoleon and Germany under Hitler invaded them). But it does not matter IF much higher military budets would be necessary. Then it would be a good thing that they have it figured out how to deliver good and cost-efficient healthcare for the citizens. (I can testify to the quality of care in Germany and Austria. You could slap 70 % on the per capita expenditures of Germany and land at the U.S. level. And the care available for the masses is excellent. Nonwithstanding some famous U.S. clinics - they cannot serve 325 million people. Nor are they necessary for the major part of standard cases (accidents, broken limbs, giving birth, heart attacks, strokes, controlling diabetes, alzheimer, cancer ...) Peak performers are interesting - and exist in Europe as well - but for the USERS of the system and general life expectancy they do not count. Here it is necessary to have a broad good quality level of care for conditions that occur often. And most of these countries BEAT the U.S. regarding life expectancy and infant mortality. They smoke, drink, are not that into exercise, ... so it is not the healthy lifestyle that gives them 1 or 2 extra years. their systems must work well. If - IF - much more military spending was necessary - at least they do not waste money in the healthcare system. The U.S. raised the regular military budget from 600 - 680 billion USD. Wars and letter agencies are extra. Russia reduced the budget from 80 - 60 bn (KSA has 70 - 80 bn, well they BUY goodwill, they cannot really integrate all the expensive toys into a strategy and the Saudi army does not enjoy a good reputation). A country can have a noteable military (Russia) without the insane level of U.S. spending. Iran also has a strategy of asymmetric warfare - having major deterrents for relatively cheap. I think the "bang for your buck" expression comes from using nukes as cheap DETERRENT (or the phrase changed its meaning under Eisenhower). The strategy then was that nukes were cheaper than a standing huge army.
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  8. A pool of 300,000 people (Vermont or Iceland *) is enough BUT Iceland is part of the European non-profit "ecosystem", I assume they have a good idea about the well negotiated prices the other countries are paying for medical drugs, for medical equipment (the rest is the costs of staff and buildings and the training of dictors and nurses, costs which a country can control). Some countries have only a few million people, others have 60 - 80 million, the smaller ones profit from the negotiation pressure in a market of plus 530 million people wherer there is a lot of transparency for the buyers (which are the non-profit agencies NOT the clueless and weak patients). The drug prices CANNOT be negoatiated and imports are not allowed (Big Pharma had the laws passed). Doctors associations control (informally) how many new doctors graduate and get practical training. And they make sure that no immigrants can come (that is for IT and engineers, but doctors suffer no competition, nor do lawyers). That is why U.S. doctors earn double the income of doctors of other wealthy ! countries. Which still do very well and are upper middle class. Sure in the U.S. the very expensive medical school is not publicly financed - but they still earn much more over lifetime. Little Vermont cannot go against those dynamics. If they offer their doctors the same sharply negoatiated contracts that the European non-profit insurance agencies offer - the doctors of Vermont would refuse to work with the system. In which case the citizens - needing those service - have no choice but to accept whatever doctors outside the system charge. In Europe approx. 80 % of doctors (the small practices) have a contract with the non-profit agency. And there are hardly any hospitals w/o such a contract (fertility treatment, laser correction of short sightedness, maternity clinics yes, but the general and big stuff - that costs money is handled in the public system). Per region there will be only so many of them. The patients can chose - they usually stay in the region - s a doctor will have enough patients to make a good living. (and if not they probably should not practice anyway). So they are protected that way. Private practices (or even hospitals) can open without regional quota restriction and charge what they want. Doctors and lawyers are very restricted in their marketing. They need word of mouth. So they better be good and the doctors will need a speciality or they do not attract enough patients. Germany has per capita expenditures of 5,600, and I think Iceland is below that (but overall age plays a role, general wage level, ...) The average range in Canada and Europe (wealthy countries) is USD 5,000 - 5,500, the U.S. 9,200 ! (World Bank per capita expenditures of nations, in USD, data 2014).
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  9. oh yes regarding healthcare one can SCALE UP from a few 100,000 to 325 million. If anything the U.S. system should have the advanaage of SIZE - Tiny and large Europan countries have much lower PER CAPITA EXPENDITURES. Population 300,000 (Iceland), a few millions (Denmark, Sweden, Austria,....) - or the big players with 60 - 80 millions (Germany, France, Italy, ...) Iceland is large enough to run an efficient operation. I assume they have their own medical school, for very rare conditions, extraordinary surgery they can fly people out (I assume, that is so rare that it does not matter cost-wise) and pool with the resources of nearby countries that have a large enough population so that they can specialize. And they profit of course from the fact that the "market" is transparent for the buyers of medication and medical equipment. The buyers being the non-profit insurance agencies that these countries have. Big Pharma for sure would like to rip off litte Icleand. Ain't gonna happen: they have a good general idea what the Nordic countries or Germany or UK, .... are paying. If necessary they could pool together with the Nordic countries or import from other countries. Only the U.S. forbids !! such imports. Hospitals and doctors serve smaller groups of the population - more like 10,000 or 20,000 for hospitals. They need buildings and staff - things a country can control. And regarding the things Iceland needs to import (likely all drugs and other medical devices, machines), they do not pay too much.
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  10. + Christine M - in Europe NO ONE would put up with the expensive and dysfunctional system the U.S. citizens are forced to accept (for now). forget about the labels (socialist healthcare or whatever). Has been working since the 1950s. In Europe the label would perplex people. They just take it for granted - that applies also to Convervatives.
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  11. 800 or 1300 per month ? And not even full coverage or co-pays and deductibles ? Holy shit ! - Get single payer healthcare !
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