6 thoughts on “Medicare for All

  1. Medicare for All: 

    On today’s 48th anniversary of the law that created Medicare, Sen. Bernie Sanders joined a coalition advocating a Medicare-for-all health care system to provide better care at less cost.

    Sanders spoke at a news conference with Rep. John Conyers Jr. (D-Mich.), Rep. Jim McDermott (D-Wash.) and other supporters of a single-payer health care system. 

    “It is long past time that we recognize health care is a right, not a privilege,” Sanders said. “I am proud that Vermont is leading the nation in working to establish a single-payer system to provide better care at less cost.”

    Watch Sen. Sanders’ speech here: Medicare for All

    • +philip ramsey Your argument against single payer is true for any one in any system who does not pay for medical costs out of pocket. Insurance companies have a fiduciary responsibility to their stock holders to maximize profits. They do this in three main ways:
      1. managing care
      2. raising premiums
      3. denying claims

    • +Kevin Smith that is true. However, no one is compelled to sign up with any private health insurance plan, where as with this government sponsored plan, everyone is compelled to join. People may choose to change insurance providers or even not to be insured at any time. When the government is the sole provider, the patient is locked in for life with no option to even opt out.

      Here in Canada, residents are not able to opt out of the government run health care system. Even if they could, it is a criminal offence for doctors and hospitals to bill the patient directly. The result is a very expensive and inefficient system where it is normal for patients wait for over 18 months for specific surgeries. There are also documented cases where patients die in Emergency ward while waiting for over 3 months for a bed.

      When the government becomes the sole provider of health care, it becomes a conflict of interest for the very people deciding whether or not a procedure is best for patients are the same people that may enact laws that affect the services the patient receives. What protection is there for the patient when the government decides to farm out the “insurance coverage” to a large health insurance provider to cut costs? You Americans will be worse off as you would have lost your ability to choose for yourself what your need but will have a worse issue – access to effective health care. You will be forced to be content to substandard health care just like we do in Canada.

      There is a more efficient way to deal with health care costs – treat all medical expenses as taxes paid on the patient’s tax return. There will be no need for a committee to decide whether a patient should receive a procedure or be restricted in the choices available. As Ronald Reagan said in one of his many speeches, “when the patient pays the doctor or hospital directly, the patient will always choose what is best for him/her”. They also will be in a position to control what they want. When the government is the sole provider, the patient has to conform to the policies established by the government committee regardless of whether it is in the best interest of the patient.

    • +philip ramsey I am not proposing that the US change anything in how we deliver healthcare, just how we pay for it.

      I have no way to counter your anecdotal claims other than to point out that the several Canadian friends I have are all pleased with your healthcare system. That being said, I think a US system modelled after the Australian system would work better in the US. This system allows people to buy coverage over and above the universal coverage.

      As a percentage of GDP the US spends twice as much as Canada on health care. The US does not provide universal coverage and by every study of which I am aware, Canada healthcare is rated better than US healthcare.

      In your tax deduction healthcare plan what happens when your healthcare costs exceed your tax liability? Do you get a refund? This plan does nothing to help the working poor in the US who are currently uninsured and nothing to stem the mounting wave of healthcare related bankruptcies in the US.

      I do not share your and President Reagan’s faith in consumer driven healthcare outcomes but ignoring those points how would you replace government tax receipts that would be lost under this plan?

    • +philip ramsey Also, under your plan who gets to decide what medical procedures are counted as taxes paid? The consumer?

    • Do I say all medical expenses? I meant to say all medical expenses – doctor’s visits, all hospital stays, all surgeries, all alternative medicine treatments, chiropractic treatments and physiotherapy. If the government is generous, they could also include medication as taxes paid, otherwise either allow the deduction of medication as a medical expense from “gross” income for determining  “net income” or allow a portion of the cost of medication (up to 80%) to be treated as taxes paid.

      This would be a refundable tax credit otherwise it will only benefit the rich. So if a person has $10,000 in medical expenses but is only required to pay say $250 then the person would get a $9,750 refund. The US constitution also has a clause that prevents hospitals from turning away patients because of the inability to pay their bill. This little used clause in the constitution should be enforced. The American poor needs to be informed of their constitutional rights, including the right to medical care.

      In situations where a family is not able to pay their medical bills, the banks will be willing to provide medical loans as the patient is guaranteed to be refunded their medical expenses. The interest will also be claimed as a refundable tax credit (taxes already paid).

      As for your friends’ experiences, they are healthy people with minor health issues. However, if they had major issues requiring hospitalization, then it becomes the luck of the draw that depends on the medical issue, the severity, and what city you live in. There are documented cases of certain types of cancer, the waiting list for treatment is 18 months in certain cities. Other illnesses are even worse.

      Then we have issues in Ontario specifically where we have brand new hospitals with three or more closed wings and Emergency is full with people waiting for beds. The wings are closed because the hospital do not have the staff operate the closed wings resulting in people that are being admitted to be held in Emergency for over three months. This also happens at older hospitals including Toronto Western Hospital, Toronto General Hospital and London General Hospital.

      My experience with the medical system here in Toronto is that it is substandard to Jamaica.  I have always got better medical treatment in Jamaica even though no hospital and very few doctors have the advanced equipment that are available in Toronto.

      After 40 years of socialized medicine in Canada, the standard of medical education in Canada has fallen. Doctors are now spending four years in medical school and one year as an intern before receiving full certification. Before socialized medicine was introduced in 1969/1970 it took 8 years of med school and 2 years as intern before they received full certification. Now a-days, in Canada, most doctors only know what the computer tells them. Whenever the doctor’s computer stops working the doctor stops working also as he will not be able to provide a diagnosis nor know what to prescribe for treatment. The reason is the study time and certification process was cut in half is encourage more people to get into the medical profession as too many people were deciding not to become doctors as their income is capped by the government at $120,000 for general practice doctors and at $250,000 for specialists doctors. On top of that, the doctors that graduated med school were moving to the US where they earn a lot more. So reducing the standards get more poor quality doctors practicing medicine in Canada while making it more difficult for them to get a medical job in the US.

      From what I understand about the Australian system is that it is where Ontario was in the late 1970’s to early 1980’s. Even back then Canada had (and still has) a three tier system – government run medicare for the masses, professional sports medicine for professional athletes and go to a private hospital in the US for the rich and powerful. So if you want to create an expensive, inefficient and substandard system for not just the poor but for everyone that is not a professional athlete nor rich and powerful, by all means go for ObamaCare. In less than fifty years, the general public health will be worse off. All medical care will be run by unelected committee that has no medical training but are qualified accountants and administrators.

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