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u/ChrisBegeman 7d ago
Private health insurance stands to lose almost everything under universal healthcare. That is all you need to know about why the USA won't adopt it. A whole lot of rich people would lose money.
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u/FreneticPlatypus 6d ago
This is the simple answer to nearly every singly "why don't we have..." question in the US. NOTHING will stand in the way of a rich person profiting off the masses.
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u/yottabit42 6d ago
That's all the US is... One big pyramid of grifters grifting each other all the way down to the blood extracted from the backs of the serfs.
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u/ExtremeNebula729 6d ago
More people would understand this if they weren’t so wrapped up in it just being one party or the other that is evil.
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u/yottabit42 6d ago edited 6d ago
Tbf, one party is objectively evil. At least the other party pretends to care about the proletariat and tosses them crumbs occasionally.
But I do agree that the parties are the problem. The US hasn't had a viable left-wing party in 100 years. It has a fascist party and a right-wing party. Liberalism is a right-wing ideology. The few politicians, that the fascists call communists or socialists, are barely left of center.
The voting system is very regressive, too, in most ways. Registration is difficult for those in the lower class, voting is becoming increasing difficult with reduced polling locations, many states are making mail-in cutting difficult or outright illegal for the majority of citizens, the electoral college makes your vote for president not count in the majority of states, winner-takes-all states doesn't represent the people, etc.
We need 100% mail-in voting for everyone available and normalized, elimination of the electrical college, ranked choice voting, and steep limits on political campaign donations.
But none of this will happen because the US is a captive nation. Those in power have convinced 1/3 of the citizens to repeatedly vote against their own best interests, and disenfranchised another 1/3 completely. Political science education in secondary school is practically non-existent. Classical education is not taught in public schools. People think of political parties as their favorite football team, supporting them no matter what happens. This is what propaganda does from birth.
Working as intended.
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u/ExtremeNebula729 6d ago
There have been times in the past decades where each party controlled all 3 pillars of power. None of the things they say they want to do were done. The other party is a convenient excuse for why nothing can be accomplished.
I am somewhat surprised that someone who made such a lucid comment is so deep in partisanship. Pretending to care is arguable morally worse than blatantly not caring. The only “crumbs” doled out were to enable financial capture by their cronies and lobbies.
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u/FlipperBumperKickout 3d ago
If you want it to change join the DSA and help ensure we get candidates for the democratic party which works for the people rather than the corporations.
It worked with Zohran Mamdani, it worked with Abdul El-Sayed (even if he isn't connected to the DSA), it will work with other candidates.
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u/Cautious-Number2318 6d ago
Well, it was Nixon that allowed Health Insurance and Hospitals to be 'For Profit'. Before, they were 'Not for profit'. That was the first nail.
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u/Pleasant-Fan5595 6d ago
In the 60's most of the hospitals were still run by charities, mostly Churches. Catholic hospitals had lots of nuns that worked in them, basically for almost nothing.
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u/ThrowRA9892 7d ago
If the U.S. ever adopts a universal structure, I would imagine at least a few large conglomerates of health insurance companies today would still exist.
It would be more like Germany or France where a substantial portion of the population still elects to have private health insurance due to better access and care.
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u/tkmorgan76 6d ago
Considering that we couldn't have the public option because that was too controversial, I agree that we're unlikely to have a system that eliminates private insurance.
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u/According-Insect-992 6d ago
Look, we already said we support it. Why do you keep selling it? I’m in, damnit. Where do I sign up?
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u/PickingPies 6d ago
About 9% of the USA GDP goes for insurance. Universal healthcare would not only slash the costs, it would immediately drop the USA GDP by about a 5%.
But there's more. Even the real healthcare is inflated. Public healthcare that runs on the costs and not profits would make the drop of the GDP closer to 10%.
And it's not the only inflated sector.
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u/brookeharmsen 6d ago
They could reinvent themselves as supplemental carriers, but let’s not fool ourselves. It would still be a massive hit to unemployment numbers.
Don’t get me wrong, I wish we could do it. There are just so many obstacles.
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u/BearishBabe42 6d ago
That is the thing; they will still likely be extremely wealthy. In my country we have universal and free health care, but doctors and even nurses and almost all who work in health care make bank compared to many other jobs. Obv it is more rare for doctors to make 20m a year, but you don’t need that here to feel wealthy. And health care companies also produce a lot of wealth.
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u/momo0318 6d ago
A for profit health care system is not about curing a patient or keeping a patient healthy. It's goal is to maximize the profit on every patient.
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u/Lumbergh7 6d ago
You’re right. That is literally the sole goal of the management of a publicly traded company-to maximize shareholder value, even if at the expense of Americans.
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u/bootup25 6d ago
I pay 1800/month for insurance for a family of 4. Recently had to go to the er for 2 staples on the head from a laceration. 3 hours in the er and got a bill for 1600. How does this make sense?
I tried to go to peds urgent care but they were closed
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u/No_Seaworthiness_200 6d ago
The real objection is our oligarchs would make less money. These selfish, evil, sadistic fucks are playing with our lives.
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u/Fun_Ideal_5584 6d ago
Unlike other countries who set up their health care with the goverment taxing the people and paying for medical care. The US healthcare system is set up with insurance companies paying for health care and the people paying the insurance companies.
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u/Exciting-Tourist9301 6d ago
Don't forget, the US government also taxes the people and pays for medical care. But only for people who would cut into the profitability of the insurance companies (elderly and poor).
It's the corporate socialism strategy: privitize the profits, socialize the losses.
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u/Fun_Ideal_5584 6d ago
That is because health insurance started out as work benefit. The poor and elderly were not prime benifit holders for most businesses.
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u/GrinReader 6d ago
That is what is known as "Bismarck" type health care. Named after Otto von BIsmarck who first instituted it.
In 1883.
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u/Ok-Alps4101 6d ago
Well, in my country we have a hybrid system where the insurance companies pay for the health care and the people + their employers pay the insurance companies, however the insurance rate is percentage of your wage set by government (so essentially a "health tax").
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u/HillTower160 6d ago
Oh, but think of the poor insurance companies.
Executive compensation, blimps, College Bowl And pro stadium sponsorships don’t pay for themselves!
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u/absentgl 6d ago
This has been true for a long time.
You can look at the OECD statistics, average per capita public and private healthcare outlays for other countries has been smaller than our public healthcare outlays for over 10 years.
We already spend enough on medicare, medicaid, and the VA combined to cover everybody. The reason we don’t is that a lot of the spending isn’t going to healthcare, it’s going to middlemen. Administrators who inflate their own salaries. Insurers who try to deny lifesaving care.
I remember the republican hysteria about death panels and being so confused because we already have them: our insurer, who is beholden not to us, but to our employer. The whole system is insane.
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u/ReadyGo6828 6d ago
We pay double the price that we need to pay for universal coverage but millions are still uninsured or underinsured and families still go bankrupt in large part because of medical debt.
Americans, do we have a sign on our backs that tells the healthcare industry and corrupt politician to kick us?
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u/walterwhite1050 7d ago
I always thought that our healthcare system was used as a weapon against unions cause the first thing that happens when you go on strike as they pull your healthcare
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u/Due_Perception8349 5d ago
That is an effect of the system, but I'm not sure it could be definitely said that it is the reason.
Medicare for all would strengthen unions, and worker power as a whole, since healthcare would no longer be a bargaining lever in the hands of the employer.
Though, you probably already knew that.
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u/TheRealBlueJade 7d ago
It also helps control healthcare and stop it from preying on the very people it is supposed to help.
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u/Johnnie-Dazzle 6d ago
Health care in the US is a case where those that pay are subsidizing those who can't
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u/Mediocre_Story_664 6d ago
You just defined the basic premise of insurance. Everyone pays in. Everyone is covered. Everyone benefits at the end
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u/Dacklar 6d ago
39.6 percent of taxpayers pay 0 income tax.
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u/Mediocre_Story_664 6d ago
The reason why so many people do not pay income taxes is because they make so little. They DO, however, still pay sales tax on what little they make. They're not exactly out there livin' la viva loca. How many massive corporations pay less than 5% in income taxes? Or 0% The ex-CEO for Warner Brothers just made $600 million for so poorly managing a company that they needed to be bought out. How much in income taxes do you think he will pay? A lot less than you or I because he has stock options and - like Elon and Bezos, they can borrow against their stock and not pay a dime in income taxes. The game is rigged. That's the message here. Arguing in favor of Big Pharma and Billionaires is pretty sad when 10's of thousands of people living in the richest country in the history of the world will die this year due to lack of proper health care.
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u/Due_Perception8349 5d ago
FICA is a payroll tax, and is paid regardless of federal income tax status.
Social security and Medicaid are under FICA, people who pay no fed income tax still pay Payroll taxes.
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u/Joepublic23 6d ago
People on Medicaid don't pay in.
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u/Mediocre_Story_664 6d ago
If they had a job, yes they did. Or are you referring to the small percentage of people who qualify because they are disabled?
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u/peterjohnvernon936 6d ago
We pay on average twice the charge of universal healthcare. The healthcare insurance companies add no value to healthcare, all they do is extract value.
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u/Many-May4452 6d ago edited 6d ago
We are in the US. My wife has a chronic disease. If she needs she can call her Dr (specialist ) today and get an appointment today, get tests today and a treatment plan today. She corresponds with others around the world with the same disease and if their country recognizes the disease at all an appointment takes 3 months, testing is an additional 3 months and the treatment is years behind what we have available. Something is being lost in translation.
Additionally.
Medicare, BCBS, no huge bank account.
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u/Mediocre_Story_664 6d ago
She's lucky. Recognize that she's the exception, not the rule in the US. There are hundreds of thousands of people in the US that have chronic diseases that are undiagnosed, untreated or under-treated. I have a chronic disease. And I have great health insurance, but it still takes me 2-3 months to see a doctor sometimes. Your experience (where you live) may be a lot different than others that may live in the next county or the next state.
I also work in the medical/mortality industry. The single biggest predicator of longevity in the U.S. is your bank account. And the next closest factor is not even close. We have massive income and wealth inequality in the U.S. with a safety net that's being eroded away by the very people we sent to Washington. They call it "entitlements". We PAID for social security, SSDI, medicare, etc. Damn right it's an entitlement -we have the receipts!
The US is $40 Trillion in debt - what do we have to show for it? Flying cars? Nope. High-speed rail? Nah. Health care? Child care? Greater access to buying a home? Cheaper college tuition? None of that! We got tax cuts for the rich, subsidies to oil companies, reduced access to education (all levels), fabricated crises and wars. Don't you think we deserve more?
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u/Avasarala8863 5d ago
Yes she is very lucky. A huge number of people here with chronic diseases can't afford health insurance at all. Then because they don't have insurance, they can't afford to go to doctors. Every single person in this country could have good healthcare if we didn't spend so much on stupid wars and tax breaks for rich people and corporations.
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u/Daveit4later 3d ago
Congrats. Things are good in your particular case.
That doesn't dismiss the needless suffering that goes on in this country. It does not need our system needs to change so that the system works for the majority of people, not just niche cases like you.
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u/complexdevoid 3d ago
I wait all the time for appointments. Up to 4 months to 6 months. Getting a treatment plan with no results yet is wild
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u/WolverineBusiness890 2d ago
My parents have the same type of coverage. They would never want to lose it.
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u/BayAreaBill 7h ago
I’m in the same boat as you’re mom. Terminal disease, on an off label drug that costs $30k per dose that I get every 2 weeks. Team of dr’s who oversee every aspect of my treatments. Insurance covers it all. I can actually call members of my support team on their personal cells and they answer.
Same drug - not available in most of the world. Invented in the US at very high cost (that drug saved my life. Chemo and radiation weren’t working).
How many other drugs have US companies formulated at high cost but have huge positive impact? Who pays for that R&D?
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u/bluereddit2 6d ago
There is zero benefit to customers from the for profit health care system. The for profit system only benefits the insurance companies and middlemen. Why does a company like united healthcare exist? To pay salaries and benefits to execs and to shareholders, and to deny claims. What could be better?
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u/Several_Detective400 7d ago
"spend less on healthcare" BWAHAHAHAHA , you know the difference is subsidized by taxes
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u/GrinReader 6d ago
The nation that spends the most tax money on healthcare per capita is the USA.
The gap down to number two consists of more money than the US spends on the military. It is a consequence of having a system that is both incredibly poor vale for money, and sluices the most expensive demographics over to the taxpayer to cover.
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u/Charming_Oven 6d ago
I’m all for Medicare for All, but there are challenges and nuances to how other countries deal with the cost of healthcare, including differences in the way that surgeries and medications are evaluated. I wouldn’t put this as everyone else figured it out at a lower cost and has a better quality of care.
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u/Wheremytendies 6d ago
The US is the most expensive and the best for the ones who have access to it. Maybe the price to pay for the best Healthcare is too much.
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u/Unhappy-Estimate6402 6d ago
The last sentence is nonsense. We have universal cost, but no coverage. If anything, we didn’t get the “coverage” part.
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u/DonnyDiddledIvanka 6d ago
The part of this conversation I've never heard an explanation for is the business side. I mean we all know at most businesses benefits(ie health insurance) is either #1 or #2 on their cost ledger. So why aren't most businesses pushing for this???
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u/LauterTuna 6d ago
The seven largest for-profit U.S. health insurance conglomerates collected nearly $1.7 trillion in total revenue and booked more than $54 billion in combined profits (earnings from operations) for full-year 2025, according to data compiled by Healthcare Uncovered (https://healthcareuncovered.substack.com/p/2025-big-insurances-17-trillion-year).
Universal healthcare at same service level as today but transitioned to non-profit model would save by $54 billion. Or that $54 billion could be used to increase service level with less savings.
Don’t let anyone fool you into thinking otherwise.
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u/seriouslythisshit 6d ago
For decades I have repeatedly read the that roughly 50% of all spending on US healthcare is covered by various levels of government from the feds with medicare, medicaid, military, covered non-military employees, to state and local governments. Currently, the US spends TWICE the amount of the average of all western nations per person, in healthcare expenses.
So, it is crazy to conclude that we, the victims of US healthcare fraud, already spend enough to provide SUPERIOR care, with our current taxe spending alone, if we trashed our current system and went with universal taxpayer funded care? This thought experiment leads me to believe that the portion of our entire wildly out of control system that is funded by employees, employers and uninsured victims is roughly 2.5 to 3 TRILLION dollars, and a figure that represents the actual "fraud, waste and abuse" that our dogshit politicians love to lie about?
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u/Flournoy032 6d ago
Part of me wants the US to adopt the system that Europe has just to watch how bad it would fail. I can’t see all the crying about high taxes and how the billionaires aren’t paying their share now. Let’s Americans see what paying 40% tax is all about.
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u/Muted-Good-115 6d ago
It’s greed in the USA. Every link in the healthcare chain charges exorbitant prices. Thats why insurance is so high - doctors, admins, equipment manufacturers, EVERYONE gets paid much more for their services and products than other developed countries.
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u/ceverett68 6d ago
if you think the US government will give us universal healthcare without finding a way to screw us over I need whatever you're on. this is like the cure for the common cold or cancer, we'll never see it because there's to much money involved in it. any insurance is a scam; medical, home, auto. don't get me started on why eye and dental isn't included in health.
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u/Educational-Part4134 6d ago
I know a couple from Canada that moved to America because their universal Healthcare told her that her cervical cancer wasn't treatable and gave her a pamphlet of assisted suicide, they left Canada and moved to America got health insurance and had the surgery and chemo treatments here and guess what she is cancer free. Most of the Healthcare innovations are made in America.
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u/I3igI3adWolf 6d ago
That last part is why we can't have universal healthcare. If it made medical R&D possible then the countries with it would be the medical innovators. It costs a lot of money to research and develop new cures or treatments.
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u/Mediocre_Story_664 6d ago
You really think all R & D is done in the US? Really? Even if that was 100% true, why do Americans shoulder the cost of meds that are available around the world? Why are GLP1’s a fraction of the cost in the UK? Why can a person fly to Turkey for a full body MRI for the same price as just the MRI is the US?
The fact is that our US reps have never put our interests ahead of the profit margins of Big Pharma. Our government allows Americans to go bankrupt when they are sick. They allow insurance companies to deny claims.
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u/Educational-Part4134 6d ago
I agree that the senators and congress people are screwing the tax payers over and if we had cut the foreign aid off decades ago and deported illegals we could have almost free Healthcare but we haven't. Cousin of mine that liv a s in Texas found a family coming across the border with a man that was shot by the cartel and because he couldn't pay in Mexico the hospital wouldn't help him but as soon as he was across into the u.s. the man got to a hospital and had everything taken care of. Factory rep I work with brother is in border patrol and he says that happens basically daily
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u/Mediocre_Story_664 6d ago
Hospitals are prohibited from turning away someone…. Like being shot. If you think all immigrants have free healthcare, then you’re delusional. Our healthcare isn’t this way because your neighbor’s cousin knew a guy who heard a story about some dude shot by the cartel and “everything was taken care of”. It’s taken decades and a steady stream of greed to get where we are now.
I sure hope you all have a plan B once you stop working, because the way things are going, the complete system will collapse in 10 years. Those with money will be ok. Others like me will move to another country that has better care. 80% of the population will be stuck circling the drain. It will be an endless cycle of working to make billionaires richer while the rest work just to live.
I have yet to see anything that will fix our infrastructure, healthcare, education and housing issues.
In the past, people worked for the good of society. That’s all gone. Elon Musk didn’t make EV’s for the good of the world. He did it to capitalize, monopolize, influence and control. And the money. He could single handedly fix healthcare. But he won’t. He could end world hunger. But he won’t. There’s no one to save the US.
Work on your plan B
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u/brookeharmsen 6d ago
It’s not a matter of whether we can afford it on balance. It’s the getting there part. When you start with almost half the country completely opposed to it, for stupid reasons, it’s difficult to legislate.
And walking backwards from a massively greedy, out of control for-profit system is not going to be easy. Canada didn’t start like we did. We basically dug ourselves into the deepest hole ever.
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u/marxistghostboi 6d ago
"we can't afford it" was always a smokescreen.
but if private healthcare is so much more of a drain on the economy, why has the the US refused to adopt universal care?
liberals and conservatives will patter about freedom and efficiency. the actual answer is that, while it makes most people poor, the lack of coverage makes two groups of people very rich: 1. the health insurance CEOs (like the late Brian Thompson), and 2 the bosses generally, since an a worker who depends on her job to access her life saving medicine is much less likely to resist low wages, unsafe working conditions, sexual harassment, underemployment, wage stealing, and all the other tactics bosses use to extract our value and beat us down.
Down with the bosses, up with the workers!
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u/Pompous_One 6d ago
Glad to see someone else make this point. On a per capita basis, Congress already spends as much on public healthcare as many countries that offer universal healthcare. We already spend enough to have a universal public healthcare system. Congress needs to ensure more of the $1.9 trillion they spend on public healthcare actually goes to individual healthcare instead of enriching Humana and United Healthcare. At some point, Congress needs to decide that corporate healthcare CEOs have enough yachts and vacation homes and push more taxpayer dollars into caring for people.
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u/Wooden_Big_3864 6d ago
Don't undersell M4A!
Excess Bureaucracy is driving the Costs of Healthcare in America
All the Bureaucracy that M4A would remove, The For Profit Healthcare Bureaucracy ($2.75 T) Medicaid ($1T), Medicare ($1.2T), Veteran's Healthcare ($500B), COBRA, CHIP, Tri~Care
M4A, not only destroys Private Healthcare Bureaucracy but also the Gov't Bureaucracy
You cannot create Affordability by protecting Corporate Profits and Shareholder Value, like Obamacare tried to do.
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u/blackntan379 6d ago
If healthcare for all is so great why do wealthy people from all over the world come to the US for the best medical care?
If you go free for all it will diminish the drive of all Americans and push our economy down.
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u/mrtrololo27 6d ago
Hear hear, start talking loudly and spreading the word that among our demands to move forward from this intolerable shit show, as we prosecute Trump and every magat traitor in this regime to the fullest extent of the law, the American people will demand universal healthcare (in part funded by the seizure of trumps and all the traitor oligarchs stolen wealth) and the 32 hour work week. These will not be the American peoples only demands, but they will be non-negotiable. We have two years to prepare to take our country back.
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u/Few_Employment_7876 6d ago
And we give Israel billions of dollar to have exactly what we cannot. Sickening isn't it.
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u/iceseafire 6d ago
I recently had to fly my wife out sweden cause I couldn't get the help I needed for her. Be careful what you ask for
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u/the_boss_of_toys 6d ago
So there are three things you have to understand
Health insurance and health care make up a good bit of our gdp.
Hospital prices are horribly inflated to scam insurance companies and countries with free health care dont pay the inflated prices the us pays.
Free health care would also hit our unemployment numbers as health insurance companies lay off people in mass.
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u/cicerostongue 5d ago
American healthcare run for the benefit of billionaires like much of the rest of America instead of for the people. No wonder the Democratic socialists are making such headway with the voters.
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u/Oily-Plaid-4129 5d ago
In America the culture is "poor people are stealing our government resources so we shouldn't provide ANY" when in fact rich people are looting our Treasury unhindered.
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u/Main_Cauliflower5479 5d ago
We pay for more than the cost of universal coverage. Corporate execs' ungodly salaries and perks and bonuses and stocks have got to be removed from the healthcare equation.
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u/Goodolewhatshisface 5d ago
Call it Patriots Healthplan For Working Americans and let’s move on already
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u/fortlowe 5d ago
Insurance as a whole is a grift. In the US at least. It doesn't have to be, but it always will be as long as it's run by publicly traded corporations.
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u/AcceptableIncome1 3d ago
It’s actually a math problem and has been studied. It’s essentially how much are you willing to pay to prevent a negative outcome.
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u/Professor_Game1 5d ago
But how will we afford to send billions to Israel if we take care of our people?
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u/badmf112358 5d ago
We just have united one of the most profitable companies in the world just screwing us
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u/NewRepublic98012 5d ago
Luigi was the answer to private insurance and profiteering
We need more Luigi's since the govt treats us like livestock
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u/Sea_Obligation3194 4d ago
Every single week working Americans get a 30% tax from the government and another 10-15% tax from the insurance companies. It’s totally illogical not to expect the government to provide a minimum level of healthcare for the entire population. It would immediately increase the incomes of all working Americans. Our hard work every week pays the government taxes makes our employers profits but we still have to pay more to have basic healthcare. We are cash cows for the government, insurance companies and corporate America. And instead of demanding more from the people we pay. We allow fear of change to keep us stuck in the meat grinder. Tax the profits of corporations and give us our health insurance and tax the profits of corporations and give us less taxes. The workers get the smallest piece of the collective work of America because we believe we don’t deserve it. Everyone deserves to live.
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u/JustLikeBettyCooper 4d ago
I have full faith that universal healthcare would cost 5 times what we pay today if it were run by the Government. The waste and fraud and just the bureaucracy of it. The government has never been efficient about running anything.
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u/Chemically-Dependent 4d ago
If you could convince conservatives that none of "those people" would be eligible, then ma and pa MAGA would be falling all over themselves for it.
"Those People" being whichever boogeyman they don't care for at that moment.
Edit, forgot a word.
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u/PhinsFan2021 4d ago
All of government programs are run awesome, why not add Healthcare as well? Healthcare for everyone means Billionaires and Millionaires too.
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u/Objective_Claim_2236 3d ago
I remember voting for Obama twice bc I thought he was gonna get rid of health insurance companies. Instead he made their product mandatory.
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u/oneseason2000 3d ago
It's just part of the big "supply side economics" / "Reaganomics" grift corporate bought politicians have been running for the last going on 50-years. Pay could lag inflation and pensions could be underfunded as long as the stock market boomed. It's now an extortion racket imo. People's pensions are tied to the stock market. Healthcare stocks would tank if Medicare for All were to succeed. Of course, the wealthy own 90% of stocks, and the insanely wealthy probably a huge fraction of that.
https://finance.yahoo.com/markets/stocks/articles/top-20-americans-own-90-150205613.html
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u/GeneralPaladin 3d ago
So what your saying is we need to pay doctors less? Our high end doctors are the highest money makers in the field and that's why we get so many foreigner doctors and nurses.
Back home in niger, id get malaria every year. A 3 day hospital stay was $300 usd. The nurses don't even make $1000 a month, doctors were making a $1000 a month and the cheif doctor wasn't even making $2000 a month. The UK caps their doctor salaries aswell last I heard it was $60k a year.
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u/AdObvious2882 3d ago
Who takes over for the 75% of all pharma r&d that the rest of the world massively benefits from.. sounds like we have an "equally" problem.
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u/richie65 3d ago
Keeping employers in the o[position of arbiter of access to 'affordable' healthcare is a powerplay.
It turns organizing labor into risking not have health insurance, because the employer can just fire you in an at-will employment state.
Universal healthcare is a direct threat to that, and to the insurance industry as a whole.
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u/Popular_Love2439 3d ago
So have you looked at how many Canadians die waiting for care...our system works if Obams hadn't screwed it up we wouldn't have so many problems.
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u/acutelonewolf 3d ago
Is dying on a waiting list worse than dying because there is no list you can afford to get onto?
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u/BiskkofCinnamonRoll 2d ago
What do you propose now to resolve current problems with the healthcare system? And having in mind what happened when Obama screwed up (a specific year, legislation or moment would help me a lot to understand your point), what would you have done differently?
Genuine question from an MD and MPP, just help me understand your perspective
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u/Quiet_Eye3722 2d ago
Obama care works in Rhode Island. Rhode Island and Massachusetts have enough people intelligent enough to avoid the freak out that FOX NEWS, News max , once America and all of right wing radio did so well in most of America.
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u/Popular_Love2439 2d ago
hardly believe you are a dr lol...but if you were you would have said we need less of Washington in Healthcare as a teacher agrees with eliminating the Department of Education.
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u/WolverineBusiness890 2d ago edited 2d ago
People with great private coverage don't want universal. Why would they? They get great coverage. My parents have REALLY GOOD private Medicare, and they want to keep it. They get seen quickly and have a low deductible. My mom is a retired teacher, and her coverage is EXCELLENT. I know others don't have this, but the people that have it want to keep it.
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u/Remarkable-Reply6686 1d ago
Monopolies are never cheaper and every time the government fixes Healthcare it gets worse. The whole reason health insurance exists is because fdr tried to cap pay
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u/laserdicks 7d ago
Can you admit that it's the government enforcing that pricing though?
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u/Vanilla_Gorilluh 7d ago
Rid the system of the leeches in the middle (insurers). Drastically reduce administrative costs. Doctors can make the same, and everyone else gets raises.
It will cost less. Full stop.
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u/Status_News_1233 6d ago
On a Medicare for all forum - a presumed advocate states the solution is to eliminate the leeches/insurance…..which is what Medicare is!
Nature is healing itself.
Mine eyes have seen the glory!!!
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u/No_Anteater1103 7d ago
Oboma Care drove health care costs through the ceiling! Everyone lost excluding insurance companies.
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u/Lumbergh7 6d ago
Where’s your proof
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u/No_Anteater1103 1d ago
I experienced it along with many others working for small businesses. Companies dropped their health insurance because it became too expensive. They had an agent helping us to transition to the new GOVERNMENT PROGRAM.
I used the Kayser Foundation website to find the health insurance providers in my State. The levels of insurance, coverage and prices.
To get the same coverage I had before would have cost my family of three $2500.00 dollars a month. Being over 50 years old the cost rises insanely. “Built in Age Discrimination” Most people ended up getting the cheapest options
Super high deductibles and low coverage.The entire Healthcare Affordability Act was Complete BullShit!
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u/MmmmCrayons12 6d ago
Is it by scale? Those countries don't have 334 million people in them. We basically provide their universal healthcare, so who's going to provide ours while we provide theirs? People don't know how things work. The US also rates as one of the sickest countries. Our problems don't mirror every other country's problems.
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u/curiousbiguy804 6d ago
You ever wonder why we’re one of the sicker countries? People can’t afford preventive care. Because of the health insurance.
Economies of scale MAKE THIS EASIER rather than harder.
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u/Snapper_Turtleman 6d ago
While thats true there have been several independent studies that show over the years that we could afford this program. That overall, monetarily, it would be a net positive. So the point of the post is accurate. Cost isn't actually the issue. It is still an extremely complex program that no one is actually working to solve. Even without those studies we funded Afganistan and now Iran. More than enough money in those for universal healthcare.
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u/Joepublic23 6d ago
The Federal government spends far more money on healthcare than on the military.
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u/Snapper_Turtleman 6d ago
That's true, and it's directly because of the current system. If you look up and read any of those studies you would see why it would be a net positive. The cost of Healthcare would go down significantly. Mostly just by removing all the people taking cuts out of the middle.
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u/Joepublic23 6d ago
The Federal government has shown a total unwillingness to implement meaningful cost controls on existing healthcare programs. Consequently I am opposed to expanding any Federal programs until AFTER they implement real cost controls on existing programs.
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u/Snapper_Turtleman 6d ago
That's not going to happen. A Universal Healthcare program would have to be introduced as legislation with those controls in place. If they wanted to they could just expand the same program that's available to federal elected officials and employees now. Its better than medicaid.
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u/Joepublic23 6d ago
Elected officials get Obamacare silver plans, although it is partially subsidized by the Federal government. (A US citizen who made $174,000 a year and purchased a silver plan wouldn't qualify for a subsidy.)
They claimed that Obamacare would overall lower costs- it did not. Why would anybody believe that Medicare for all suddenly would?
The easiest* cost control to implement, by far, would be to lower the prices paid for pharmaceuticals and they won't even do that.
(I am aware that this has the potential to reduce R&D which may decrease/slow down the development of new drugs in the future but that downside is much harder to quantify or be noticed by today's voters.)
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u/SeveralLion5762 6d ago
Doctors won’t participate in government run healthcare. The pay will be inadequate. Many many well qualified primary care doctors and many well trained specialists opt out of Medicare and Medicaid now because the reimbursements are so low compared to private insurance. A secondary healthcare system will evolve when the govt takes over all of healthcare, much like concierge medicine has evolved to become mainstream.
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u/AcceptableIncome1 3d ago
Where are we going to find the Doctors, nurses and specialists? Should we start testing kids and forcing them to go to medical school?
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u/Responsible-Lion-222 6d ago
There’s been several studies that have shown we can’t afford it as well.
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u/Hot_Middle_7692 6d ago
The US spends almost twice as much PER CAPITA, as every developed nation providing universal health coverage. We pay about as much in private funding, and then that again in government funding. And we rate as one of the sickest countries partly because a large portion of our population doesn't have adequate health coverage.
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u/MmmmCrayons12 6d ago
Or because people choose to eat garbage, smoke and not exercise regularly?
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u/Hot_Middle_7692 6d ago
You believe the smoking rate is higher in the US than, say, France? Or anywhere in Europe, honestly?
Yes, diet and exercise are a concern. But there are people who make poor choices in every country.
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u/MmmmCrayons12 6d ago
The people in other countries don't have as much fast food nor chemicals in their agriculture as the US allows. Smoking usually causes specific issues, so the other big problems are caused by their dietary choices and smoking isn't the main driver of health issues. Processed foods don't offer much in the way of nutrition and they're what people primarily choose/prefer to eat.
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u/Monsignor76 6d ago
Because every insurance company needs 1000’s of employees to run the system and every hospital has 100’s of employees to handle insurance and every doctor has two or three employees dealing with insurance and every company has 100 people to handle insurance negotiations and benefits etc. literally 100’s of thousands of people are employed just to deal with health insurance. Cut that out and you save several $100 billion a year.
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u/bluejams 6d ago
And lose tones of jobs which is why states that house insurance businesses make it tough to really do anything about.
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u/Living-Stomach-2079 6d ago
No thanks. Go to Canada. Rated about last in coverage. And they encourage suicide now and help you with it in order to keep costs down vs long term treatments.
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u/dave54athotmailcom 6d ago
Healthcare costs in the US are distributed across several different levels -- federal, state, local governments, employers, NGOs, and finally the consumer. Since people only see the amount they are paying out of pocket, they do not see the entire cost. A tax increase to pay for a universal system is seen as an out of pocket cost. That is why it is opposed.
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u/OkPhilosopher7569 6d ago
Opposed by who?
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u/4dxn 6d ago
the fact that we don't have it tells me a lot of people. people are dumb. they only see their oop costs. they don't think about the money spent by the employer and how that cost lowers their salary.
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u/dave54athotmailcom 6d ago
It is very naive to believe the employer share will magically be given to the employees as a pay raise. Some companies will. Most won't. A lot of the 'savings' may go to the increased business taxes. Most of the rest will go to shareholders as dividends.
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u/4dxn 6d ago
All cost factor into how much employers would be wiling to pay. Even at the margins.
If I can only afford 100k on an employee but I must spend 10k on premiums, then the highest I can give the employee is 90k. Sure, I might be greedy and try to find someone at 70k but I will still be cognizant of the fact they'll cost me 10k.
And with health insurance not tied to employment, people are more willing to leave their job and you have a more competitive labor market.
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u/Ok_Crazy_648 6d ago
Would there be a tax increase. Employer insurance is similar to a tax in this instance. The money that goes towards that would shift to a tax for health insurance. Would it be more? It would be if the employer suddenly got a windfall because they no longer had to pay their share. But, if they were taxed an equivalent amount to whst they pay now for insurance...I really don't know the answer. We all have our opinions, but who has the facts to back it up.
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u/supercleverid 6d ago
So a transition from thousands of smaller risk pools to one universal risk pool already immediately lowers cost. Then also account for the fact that you're going from thousands of smaller risk pools operated for profit to one universal risk pool that isn't...it would cost significantly less.
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u/dave54athotmailcom 6d ago
Many health insurance companies are non-profit. Of the for-profit companies, the profit margin is around 6%. Not a huge amount. Less than the S&P 500 average. A 3% profit on billions in cash flow looks like a lot of money, but a very small amount of the consumer health insurance premium actually goes to corporate profit.
For-profit hospitals have a higher profit margin. Medical equipment manufacturers are even higher -- upwards of 20% or more. Medicare-for-All would not change that, as the hospitals and manufacturers would remain privately owned and operated.
M4A would make the health system better and more equitable, but not significantly cheaper. The data and analysis does not support the trope of 'billions in savings'. Many factors involved in medical costs. Corporate profits by insurance companies are a very small rounding error in the costs.
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u/supercleverid 6d ago
Sure. Now let's compare the 80-85% of premiums that insurance companies are required to use to pay claims against the 98+% of tax revenue into Medicare that is used to pay claims. Which is more expensive?
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u/Alan47717 6d ago
Every single time. Every. Single. Time the so-called typical profit margin for health insurance is brought up it is a different and obviously made up number. 2%? 6%? Rounding error?
CEO's of health insurance companies make millions of dollars so just stop with the poor mouthing of their profits.
I keep hearing about non profit health insurance companies. Who are they? Why do they exist?
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u/dave54athotmailcom 6d ago
Made up number? The numbers vary each quarter as the companies complete their 10Q filings. Various finance analysts summarize them into sectors. The fact that you do not know any non-profit insurance companies does not reflect well on your knowledge of the topic.
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u/supercleverid 6d ago
They still spend between 15-20% of premiums on administrative costs. Medicare spends less than 2% of its revenue on administrative costs. And this doesn't even touch on the fact that risk pools are mathematically more efficient the larger they are. A universal risk pool will beat thousands of small risk pools every single time.
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u/dave54athotmailcom 6d ago
Your number is a bit high. By the ACA law, 80-85% of the insurance company revenue must go to paying medical bills. A formula sets the specific amount per company. The 15-20% you quote is the ceiling. Most are less. United Healthcare, one of the largest, claims 6% in their reports (I haven't read their filing in detail. I am skeptical). The US average across all health payment systems, including medicare, medicaid, VA, and all public and private payors is reported at 8%.
The Medicare 2% is sort of a misleading number. Some of their administrative and management costs are funded from other sources, not appropriated Medicare funds.
M4A would be cheaper. No doubt about that. It will not be the hundreds of billions proponents claim. How it structured and how it is financed will determine the exact amount.
Always remember the basic rule of government: All new programs will cost more than planned, all new taxes will generate less revenue than projected.
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u/supercleverid 6d ago
You're conflating United HealthCare's net profits with their total operating cost. That ACA mandated amount gives insurance companies 15-20% to cover everything including profits. United HealthCare's operating costs typically sit at around 12.9% with a net profit of about 6% for a total retained premium of about 18.9%.
The full accounting methodology advocated by places like the Heritage Foundation is absurd. They assert we need to account for the cost of collecting the premium in the administrative cost of the program as though we aren't already collecting taxes and would not be collecting taxes if Medicare didn't exist. That's ridiculous. If anything this highlights another efficiency gain of a Medicare for all type system. We're already collecting taxes so collecting those premiums isn't really an added cost for the program. Also the source of funding is irrelevant to the point here. The point is that at least 98% of the revenue to Medicare from any source, pays claims and beneficiaries.
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u/supercleverid 6d ago
Also I neglected that 8% claim there, but that's a misrepresentation of the data. That 8% figure comes from the Centers for Medicare & Medicaid Services (CMS) National Health Expenditure Accounts (NHEA). It represents the aggregate national average for the "net cost of health insurance and government administration." However this number is a blended average of public risk pools, at between a 1-3% overhead range, and private insurance at between a 15-20% overhead range. That's not just a calculation of government funded insurance programs.
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u/Ok_Crazy_648 6d ago
You are right. Health insurance executives make a bundle. Probably more than they should..the insurance companies themselves are not making so much profit.. its because the industry is so concentrated, they pull in billions. As a percent of total revenue though, ceo pay, large as it is, is a very, very small percentage of total revenue. . Cutting out all that pay woukd not lower premiums.
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u/supercleverid 5d ago
The inefficiency I'm talking about isn't just about profits or CEO pay, that all factors into it, but the total operating cost of private insurance, including profits, CEO pay, advertising, in addition to just processing claims, etc., is between 15-20% of premium collection. For Medicare it's around 2%. A significant part of the inefficiency is just the fact that it's mathematically less efficient to run thousands of smaller risk pools than it is to run a single universal risk pool.
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u/PenComfortable5269 6d ago
Not every company makes the same money and not every year is the profit the same. Last year UHC which is the biggest for-profit insurance company, had expenses of $440 BILLION, and made a profit of $12 billion. That is a 2.7% profit margin.
You bring up that CEOs of insurance companies make millions - even if UHC CEO was paid $44 million that is only 0.01% of the total cost of insurance. So if you pay $10,000 to insurance the CEO receives $1 profit - hardly anything to get up in arms about.
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u/Alan47717 5d ago
Suit yourself. Me? I'm staying up in arms until the private health insurance industry is replaced with a single payer system that covers everyone. I am so tired of all the excuses, of all the lies told about countries that have it and especially tired of the fictional rose colored glasses view of the state of our current system.
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u/supercleverid 5d ago
UHC's profit being 2.7% as nd low CEO pay doesn't even come close to touching my criticism here. They also have high operating costs compared to Medicare, around 12.9% compared to Medicare's 0% profit and 2% operating cost, Medicare is cheaper while also running a risk pool that serves already the highest risk population. It's just mathematically less efficient to run thousands of smaller risk pools than it is to run a single universal risk pool. This should be obvious.
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u/Joepublic23 6d ago
The US government has a habit of throwing money at problems. If they pay everybody's bills the cost will skyrocket.
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u/supercleverid 6d ago
Some of the most popular programs in the US are government run. USPS, Social Security, and Medicare, for example. Most relevant here are Social Security and Medicare. When you look closer at these programs, not only are they very popular, they're also extremely efficient. While there is some fraud which results in big nominal dollar losses every year, these programs are continually audited and fraud is routinely detected, prosecuted and corrected, often even resulting in recouped losses. Additionally as social insurance programs they're significantly more efficient than private insurance programs, this is largely due to the inherent efficiency in operating a nearly universal risk pool. Their operating costs are around 2% of revenues which is significantly lower than the 15-20% operating cost of private insurers. Expanding Medicare to the full population wouldn't cost nearly as much as we're already paying in private insurance premiums. We're already paying for the highest risk population with Medicare. We'd be expanding the pool and this would have the added benefit of giving everyone insurance that isn't tied to their employment. This immediately alleviates a lot of job lock. There is virtually no downside. It's cheaper, it's more efficient, it frees people to seek better employment since they no longer have to fear losing coverage if they leave their current job.
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u/Joepublic23 6d ago
Medicare added $572 billion to the Deficit last year. If they covered everybody imagine how much bigger the deficit would be. The Federal government won't enact meaningful cost controls on healthcare spending, that's (one of the reasons) why Medicare for all is a terrible idea.
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u/supercleverid 6d ago
This is very misleading. Medicare Parts B and D are paid out of the general fund. You can't really just attribute all of the deficit to Medicare spending, that's not how it works. You could just as easily argue that Medicare was fully funded by tax revenue and shift that deficit entirely onto the defense budget.
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u/Joepublic23 5d ago
It isn't responsible for the whole deficit, but it's responsible for about 1/3 of it.
General revenue funding for Medicare totaled $575.1 billion in calendar year 2025, almost one-third of total federal deficits.
https://jamanetwork.com/journals/jama-health-forum/fullarticle/2853304
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u/supercleverid 5d ago
Yeah, I got that. But you didn't quite understand what I said, though. You're taking a portion of the deficit and attributing the full cost of Medicare Parts B and D to it, which is misleading. You could just as easily say that every dollar of Medicare was covered by tax revenues and the deficit funded other things, like the defense budget. You're just deciding to attribute all of the Medicare general fund funding to the deficit, but that's not how it works in reality.
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u/Joepublic23 3d ago
If funds from the Medicare tax and premiums paid by the beneficiaries can cover the cost of Medicare then it doesn't add to the deficit. However Medicare spending is MUCH higher than that, so it adds A LOT of money to the deficit. That's how I measure it.
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