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1 minute ago, jonoh81 said:

 

It's really one of the glaring differences between conservatives and liberals.  For conservatives, more often than not, it's about the ideology rather than practical results.  They cling to things like "trickle down" even though it doesn't work and we've seen it fail multiple times, the latest being the corporate tax cut.  Liberals can sometimes go a little far in the rhetoric, but their policies are much more often based in results. 

 

Point in case was all the hate of the Affordable Care Act.

 

After voting to repeal it time and time again (symbolically), when they controlled all parts of the legislative process they had no solution whatsoever ever to “fix” or “replace” it. Only had 8 years to come up with a plan.

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1 minute ago, tklg said:

 

download.jpg.2f33e197c5d2255a07ff8191550809ca.jpg

 

You completely avoided my question.

I only saw 2 hypothetical questions.  No real questions were asked.  And the best point you made is the medical insurance companies provide no added value to health care.

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2 minutes ago, Enginerd said:

 

Point in case was all the hate of the Affordable Care Act.

 

After voting to repeal it time and time again (symbolically), when they controlled all parts of the legislative process they had no solution whatsoever ever to “fix” or “replace” it. Only had 8 years to come up with a plan.

Their plan is too scare people into voting for them.  That is it.

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9 minutes ago, YABO713 said:

 

I have a cousin from County Mayo, Ireland staying with me in late March to get a knee replacement. 

This is anecdotal though. Let's compare health outcomes and cost per capita for all other nations.

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6 minutes ago, YABO713 said:

 

I have a cousin from County Mayo, Ireland staying with me in late March to get a knee replacement. 

 

I do not know the details of Ireland’s health system or your cousin. Anecdotes are powerful, but I think it should only be a part of the discussion.

 

I won’t be able to say it any better, so I’ll quote directly from the big Harvard study on the U.S. Heath system:

 

Overall, quality of care in the U.S. isn’t markedly different from that of other countries, and in fact excels in many areas. For example, the U.S. appears to have the best outcomes for those who have heart attacks or strokes, but is below average for avoidable hospitalizations for patients with diabetes and asthma.

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1 minute ago, freefourur said:

 

I only saw 2 hypothetical questions.  No real questions were asked.  And the best point you made is the medical insurance companies provide no added value to health care.

 

 

Good straw man argument...I never made any comment on the value of medical insurance companies.  I will make the comment now that the value to me personally is not being attached to a gov't plan. I lived 4 years on Medi-cal in California and was extremely limited in my choice of providers.  I see much more value in paying astronomical prices in a current f'd up system then letting the gov't control who and when I'm able to see.

 

And the real question I'm asking is how is "How is mandating that all citizens use a gov't plan a good thing?"

 

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1 minute ago, tklg said:

 I see much more value in paying astronomical prices in a current f'd up system then letting the gov't control who and when I'm able to see.

 

This only works if you have (enough) money.  A lot of people don't have that luxury.

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Very Stable Genius

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2 minutes ago, freefourur said:

This is anecdotal though. Let's compare health outcomes and cost per capita for all other nations.

 

Just now, Enginerd said:

 

I do not know the details of Ireland’s health system or your cousin. Anecdotes are powerful, but I think it should only be a part of the discussion.

 

I won’t be able to say it any better, so I’ll quote directly from the big Harvard study on the U.S. Heath system:

 

Overall, quality of care in the U.S. isn’t markedly different from that of other countries, and in fact excels in many areas. For example, the U.S. appears to have the best outcomes for those who have heart attacks or strokes, but is below average for avoidable hospitalizations for patients with diabetes and asthma.

 

 

Both points are fair, and this is certainly anecdotal - maybe some background will add value.

 

My cousin is 47 and, to be frank, is the largest real estate developer in Connacht province. He built a construction company that went from replacing driveways to building commercial developments, hotels, and golf courses as the Irish Lion economy roared. The labor took a toll on his body, and in October, they determined he needed a knee replacement. In Ireland, he would have been eligible to get a new knee, as a "non-critical" surgery, in late August. Because he has the means and also because he's in terrible pain, as his knee is bone on bone as cartilage has been damaged beyond repair, he decided to come to Cleveland instead of waiting the additional five months. 

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2 minutes ago, tklg said:

 

 

Good straw man argument...I never made any comment on the value of medical insurance companies.  I will make the comment now that the value to me personally is not being attached to a gov't plan. I lived 4 years on Medi-cal in California and was extremely limited in my choice of providers.  I see much more value in paying astronomical prices in a current f'd up system then letting the gov't control who and when I'm able to see.

 

And the real question I'm asking is how is "How is mandating that all citizens use a gov't plan a good thing?"

 

How is this different than letting a bureaucrat from Anthem make this decision?

 

So your point about health insurance not being health care remains poignant even if you are too blinded by ideology to see it.

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2 minutes ago, DarkandStormy said:

 

This only works if you have (enough) money.  A lot of people don't have that luxury.

 

That's fine, they can use the gov't plan, just allow me and others the choice.

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2 minutes ago, DarkandStormy said:

 

This only works if you have (enough) money.  A lot of people don't have that luxury.

and in places with single payer coverage, those with money can buy supplemental plans if they want "Cadillac" insurance.

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Just now, freefourur said:

How is this different than letting a bureaucrat from Anthem make this decision?

 

So your point about health insurance not being health care remains poignant even if you are too blinded by ideology to see it.

 

I see you're avoiding the question again, so will no longer respond.

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2 minutes ago, YABO713 said:

 

 

 

Both points are fair, and this is certainly anecdotal - maybe some background will add value.

 

My cousin is 47 and, to be frank, is the largest real estate developer in Connacht province. He built a construction company that went from replacing driveways to building commercial developments, hotels, and golf courses as the Irish Lion economy roared. The labor took a toll on his body, and in October, they determined he needed a knee replacement. In Ireland, he would have been eligible to get a new knee, as a "non-critical" surgery, in late August. Because he has the means and also because he's in terrible pain, as his knee is bone on bone as cartilage has been damaged beyond repair, he decided to come to Cleveland instead of waiting the additional five months. 

but if he were not financial successful, where would he be better off?

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1 minute ago, freefourur said:

but if he were not financial successful, where would he be better off?

 

I think that's a philosophical question that will drive debate in this 2020 primary.

 

For one, he could be a CMSD janitor, and be less well off, and would likely pay a higher deductible here, but would have it taken care of more quickly - now granted, debt due to medical care is unacceptable - I agree with you there. 

 

On the other hand, he could be an auto mechanic in Ireland and pay no deductible but wait for 10 months to get a needed surgery. And extreme waitlists are unacceptable. 

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10 minutes ago, YABO713 said:

 

I think that's a philosophical question that will drive debate in this 2020 primary.

 

For one, he could be a CMSD janitor, and be less well off, and would likely pay a higher deductible here, but would have it taken care of more quickly - now granted, debt due to medical care is unacceptable - I agree with you there. 

 

On the other hand, he could be an auto mechanic in Ireland and pay no deductible but wait for 10 months to get a needed surgery. And extreme waitlists are unacceptable. 

 

It will be interesting definitely. Politicians have to be able to propose, and convince voters, of their plan often in small sound bites.

 

And these types of debates truly depend

on the details.

Edited by Enginerd
Wow I cannot spell
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12 minutes ago, YABO713 said:

 

I think that's a philosophical question that will drive debate in this 2020 primary.

 

For one, he could be a CMSD janitor, and be less well off, and would likely pay a higher deductible here, but would have it taken care of more quickly - now granted, debt due to medical care is unacceptable - I agree with you there. 

 

On the other hand, he could be an auto mechanic in Ireland and pay no deductible but wait for 10 months to get a needed surgery. And extreme waitlists are unacceptable. 

I'm glad to be engaging in this in a reasonable manner.  You have to consider the full debate consists of a CMSD janitor who can no longer worke because of his cancer treatment and therefore has no coverage at all or the many working people with no coverage who get no preventive care because they cannot afford it. I feel that waiting to see specialists is a fair drawback to know that one will be covered even in the very worst of circumstances.  waiting lists are inconvenient; having no coverage when you need it is dire.

Edited by freefourur

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2 minutes ago, freefourur said:

I'm glad to be engaging in this in a reasonable manner.  You have to consider the full debate consists of a CMSD janitor who can no longer worke because of his cancer treatment and therefore has no coverage at all or the many working people with no coverage who get no preventive care because they cannot afford it. I feel that waiting to see specialists is a fair drawback to know that one will be covered even in the very worst of circumstances.  waiting lists are inconvenient; having no coverage when you need it is dire.

 

But there are still private options to help people in that situation. Though they aren't always available or accessible. One of the plus sides of Obamacare was that hospitals had to begin spending more on pro-bono medical work to maintain their 501c3 status. 

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I never understand people who love their insurance.

 

What I always hear is that you get to "choose your doctor". But that's only if your employer (who for some reason controls who you get insurance through) stays with the same company, if their "network" doesn't change, and if you keep your job.

 

If you're in an accident, the hospital you are taken to might be "out of network" and cost you 3X what you would otherwise pay. It makes absolutely no sense and does nothing but bankrupt individuals.

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3 minutes ago, YABO713 said:

 

But there are still private options to help people in that situation. Though they aren't always available or accessible. One of the plus sides of Obamacare was that hospitals had to begin spending more on pro-bono medical work to maintain their 501c3 status. 

to be left to the whims of charity is not a good situation to be in.

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Ha...all I'm trying to say is that Harris be crazy for stating she believes private health insurance should be eliminated and forcing everyone onto a gov't health program.

 

I've still yet to hear how gov't controlling individual access to healthcare is a positive thing.  

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3 minutes ago, tklg said:

Ha...all I'm trying to say is that Harris be crazy for stating she believes private health insurance should be eliminated and forcing everyone onto a gov't health program.

 

I've still yet to hear how gov't controlling individual access to healthcare is a positive thing.  

You have yet to establish how it will be any different than being forced into the plan that your employer provides now. You have to establish that there is value added by the insurance market.  You have not done so yet.

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2 hours ago, ryanlammi said:

I never understand people who love their insurance.

 

What I always hear is that you get to "choose your doctor". But that's only if your employer (who for some reason controls who you get insurance through) stays with the same company, if their "network" doesn't change, and if you keep your job.

 

If you're in an accident, the hospital you are taken to might be "out of network" and cost you 3X what you would otherwise pay. It makes absolutely no sense and does nothing but bankrupt individuals.

I had to explain this to a friend from South Africa here on a work Visa. He just could not believe that we would have such a stupid system in place. 

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2 hours ago, freefourur said:

You have yet to establish how it will be any different than being forced into the plan that your employer provides now. You have to establish that there is value added by the insurance market.  You have not done so yet.

 

I'm not currently forced into an employer provided plan - I'm free to choose between my employer provided plans or whatever is available on the gov't marketplace. 

 

Harris is proposing to eliminate the private industry which forces everyone to a gov't plan, which I feel is a crazy position to maintain. 

 

The value added by private industry is definitely a topic for an economics thread, but in this context it's simply allowing the freedom of choice between public and private plans. 

 

I do not wish to continue any further debate with you as you've avoided most of my questions and have diverted attention to other topics, so we can let this be and move on.

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15 minutes ago, tklg said:

 

I'm not currently forced into an employer provided plan - I'm free to choose between my employer provided plans or whatever is available on the gov't marketplace. 

 

Harris is proposing to eliminate the private industry which forces everyone to a gov't plan, which I feel is a crazy position to maintain. 

 

The value added by private industry is definitely a topic for an economics thread, but in this context it's simply allowing the freedom of choice between public and private plans. 

 

I do not wish to continue any further debate with you as you've avoided most of my questions and have diverted attention to other topics, so we can let this be and move on.

You are describing a health care system that exists for people who have money to go out on a whim a buy a plan because they don't like their employer's plan.  Since that doesn't exist, I'm going to ask you to only ask about reality.  Clearly you are not living in it.

 

You also previously established that insurance is not health care. even without health insurance companies you'd be able to go to any doctor you wanted and pay out of pocket.  No freedom has been lost.  

 

Again, if your visits are covered, then why do you care who pays them?

Edited by freefourur

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42 minutes ago, freefourur said:

You are describing a health care system that exists for people who have money to go out on a whim a buy a plan because they don't like their employer's plan.  Since that doesn't exist, I'm going to ask you to only ask about reality.  Clearly you are not living in it.

 

You also previously established that insurance is not health care. even without health insurance companies you'd be able to go to any doctor you wanted and pay out of pocket.  No freedom has been lost.  

 

Again, if your visits are covered, then why do you care who pays them?

 

Troll level is getting high with this one.  There are plenty of affordable plans outside of employers and depends on personal needs.  Healthcare only started becoming expensive as more people started using your philosophy of "since my visits are covered, who cares who pays them?"  

 

Harris seems to agree with you there as well.

 

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Healthcare is absolutely not affordable unless your employer is taking on a huge chunk of the cost.  And it still doesn't address the issue of out-of-network visits, which are basically a bankruptcy sentence. I honestly don't understand how this isn't a bigger issue to more Americans.  I had an emergency while on vacation in FL and a 3 hr hospital visit cost $5,000.  For most Americans, that's more than they have in savings.

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49 minutes ago, tklg said:

 

Troll level is getting high with this one.  There are plenty of affordable plans outside of employers and depends on personal needs.  Healthcare only started becoming expensive as more people started using your philosophy of "since my visits are covered, who cares who pays them?"  

 

Harris seems to agree with you there as well.

 

You are still not talking  about reality at all. As soon as you understand healthcare we can engage in a policy discussion. There is so mu h wrong with your post I dont know where to begin.

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2 hours ago, 10albersa said:

Healthcare is absolutely not affordable unless your employer is taking on a huge chunk of the cost.  And it still doesn't address the issue of out-of-network visits, which are basically a bankruptcy sentence. I honestly don't understand how this isn't a bigger issue to more Americans.  I had an emergency while on vacation in FL and a 3 hr hospital visit cost $5,000.  For most Americans, that's more than they have in savings.

 

One of my brothers went to an out-of-network ER this past summer because he was near-death after a Spin class that he got a free pass for served alcohol in the lobby.  He ended up spending 4-5 days in an out-of-network hospital and got a $35,000 bill.  He negotiated to merely pay $5,000.  So the system "worked".  He also consulted a lawyer regarding suing the gym for negligence, but I don't think it went anywhere because of the waiver he signed.     

 

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1 hour ago, jmecklenborg said:

 

One of my brothers went to an out-of-network ER this past summer because he was near-death after a Spin class that he got a free pass for served alcohol in the lobby.  He ended up spending 4-5 days in an out-of-network hospital and got a $35,000 bill.  He negotiated to merely pay $5,000.  So the system "worked".  He also consulted a lawyer regarding suing the gym for negligence, but I don't think it went anywhere because of the waiver he signed.     

 

444-4444

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^LOL, Mat Hoffman, Travis Pastrana and all those other big extreme sports guys know the game. They turn down ambulance rides all the time for buddy transport. Even if they're passed out their people control the hospital and transport situation.

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On ‎2‎/‎5‎/‎2019 at 12:13 PM, DarkandStormy said:

 

https://www.vox.com/policy-and-politics/2019/2/11/18220721/utah-medicaid-expansion-prop-3-sb96

 

Quote

Utah voters decided to expand Medicaid under the Affordable Care Act in November. But the Republican legislature is scaling back the voter-approved plan.

 

The Republican legislature has passed legislation that would, in effect, replace the voter-approved Medicaid expansion with a more limited version that would actually cover fewer people while spending more money in the first few years. The bill passed both chambers with a two-thirds majority. It now heads to Republican Gov. Gary Herbert, who is expected to sign it.

 

So this bill overrides the ballot initiative (i.e. "will of the people"), spends more taxpayer dollars (at least initially) than the ballot measure, and covers fewer people.

 

There is no moral, policy, or political reasoning for this.  The GOP is still a public health crisis.

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Very Stable Genius

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That's great that we agree that universal coverage is a worthwhile goal. 

 

By definition "insurance" of any kind has lower costs when the pool of insured is as big as possible -- and our current system of defining each "pool" by employer is not a very good way to ensure a large pool.  That's why I like the Swiss system that is highly regulated but allows competition, or the Canadian system of a national health insurance program (I do not favor a national health provider system, as in the UK).  U.S. conservatives often hate the very existence of regulations, however, so I don't see the Swiss plan happening here.  (I think we could also agree that more should be done to simplify and have clearly-written regulations, even though you might prefer fewer regulations and I'd prefer more.  I appreciate what regulations can do to mitigate capitalism's downsides.)  

 

I can live with a government insurance plan being available to compete with private plans.  I would expect that the government plan could be relatively expensive and cover only very basic service and it would still be a huge win.  Without the profit requirement it could be a lot less expensive, particularly if the cost structure is scaled to income and/or age. 

 

I disagree with your theory that competition always drives innovation or lower prices, as shown by historical insurance rates.  Insurance companies themselves don't operate in an ideal environment.  Because insurance companies have to negotiate rates with hospitals, for example, rural hospitals see a lot less competition -- it's not worth their time or effort to negotiate with a hospital in an area where few people live. The potential for huge losses if a small number of people have big health emergencies outweighs the benefit of making the effort to sell them insurance.  The "free market" has little incentive to solve that problem.

 

I also see a problem in healthcare where you often are not in a position to shop around when you need the service.  Where to get that mole removed?  Yes, I think we can agree that those prices should be posted somewhere or should be within a standardized range so that you can comparison shop.  Where to get those recurring debilitating headaches looked at?  Maybe you can shop around, but the "debilitating" nature of the symptoms make that more difficult.  Injured in a car accident that wasn't your fault -- yeah, you need to go to the closest care you can get to and not fall into bankruptcy.

 

So what can government do to level the playing field, increase insurance "pools," and foster competition to keep prices low?  You can make the pool nationwide, you can create an online insurance "marketplace" for anyone in the country to use to buy national-based plans, you can regulate the reporting on that website so that consumers can make apples to apples comparisons -- I'm talking about some labeling standards so people know what they're buying.  The Affordable Care Act pushed us in the right direction, and could definitely be improved if Republicans in Congress stopped undermining it and worked on actually improving it.

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Obamacare is a good example of how treating everyone as equal can be a disaster in that it prevents insurance companies from charging high-risk customers more than low-risk customers.  The only way this is financially sustainable is by forcing the young and healthy to buy insurance.  However, the constitution does not allow the feds to enforce and the penalties for NOT BUYING are too low to provide incentive to buy.  

 

Quote

If you could afford health insurance in 2018 but did not purchase coverage, you will likely have to pay a penalty amounting to either 2.5 percent of your yearly household income or $695 per person ($347.50 per child under 18), whichever is greater.

https://www.medmutual.com/For-Individuals-and-Families/Health-Insurance-Education/Health-Insurance-Basics/Penalty-Estimator.aspx

 

So now, we're stuck in a system where the incentive to purchase health insurance can be ignored which leads to higher annual premiums since young and healthy are not paying into the system.  In other words, the sick are pulling all the funds from the pool that the healthy are supposed to be covering.

 

The problem is the current system is designed so poorly that health insurance is being used in place of a healthcare plan and people have become incentivized to use healthINSURANCE plans as healthCARE plans.  Instead of filing a claim for just catastrophic injuries or illnesses and paying out of pocket for maintenance and routine checkups, we have a system that requires filing claims for everything.

 

Government legislation, allowing employers to provide health insurance tax free is likely what started this whole mess.If I hire somebody and pay them cash, they have to pay income taxes.  If I give them health insurance instead of cash, it's tax free.  So now people are using health insurance plans like healthcare plans and costs have spiraled out of control.  

 

Now we have a mindset of, "who cares who pays for it", like @freefourur mentioned, which allows providers to jack up the prices since there isn't any real competition to keep low.  If the insurance companies are free to negotiate the prices, why not just start at the top and work down?  For every seller there must be a buyer, so if insurance companies are buying at inflated prices, we have an inflated market (bubble).

 

TL;DR - So the point is, the gov't legislation allowing health insurance to be used as tax free healthcare plan is what has effectively eliminated the free market.  Obamacare is a disaster due to an increased incentive of paying penalty taxes over annual premiums,  which has increased premiums across the board due to lack of funds.  Asking what can the gov't do to level the playing field is not a line of successful questioning given what the gov't has done to get us here.

 

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1 minute ago, tklg said:

 

 

Now we have a mindset of, "who cares who pays for it", like @freefourur mentioned, which allows providers to jack up the prices since there isn't any real competition to keep low.  If the insurance companies are free to negotiate the prices, why not just start at the top and work down?  For every seller there must be a buyer, so if insurance companies are buying at inflated prices, we have an inflated market (bubble).

 

Weirdly, all of the examples around the world confirm that you are wrong.  We pay more for health care and get worse results.  It's easy to just spout of slogans.  But the proof is in the pudding.  

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2 minutes ago, freefourur said:

Weirdly, all of the examples around the world confirm that you are wrong.  We pay more for health care and get worse results.  It's easy to just spout of slogans.  But the proof is in the pudding.  

 

Is it fair to compare the current state of US healthcare to other successful socialized programs?  Obamacare being bad economics is not spouting off slogans.

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3 minutes ago, tklg said:

 

Is it fair to compare the current state of US healthcare to other successful socialized programs?  Obamacare being bad economics is not spouting off slogans.

US healthcare has always been outperformed by single-payer systems.  You can call it socialized all you want by you seem to be implying that I am correct on this point. 

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4 minutes ago, freefourur said:

US healthcare has always been outperformed by single-payer systems.  You can call it socialized all you want by you seem to be implying that I am correct on this point. 

 

You lost me...I'm referring to this quote referencing examples around the world:

Quote

Weirdly, all of the examples around the world confirm that you are wrong.  We pay more for health care and get worse results

 

Is it fair to say that the US healthcare system can easily transition to a successful socialized system, given the restraints of the constitution and current state of the system?

 

We pay more for healthcare given bad economic policy and legislation...see previous post citations.

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3 minutes ago, tklg said:

 

You lost me...I'm referring to this quote referencing examples around the world:

 

Is it fair to say that the US healthcare system can easily transition to a successful socialized system, given the restraints of the constitution and current state of the system?

 

We pay more for healthcare given bad economic policy and legislation...see previous post citations.

There are no restraints to a "socialized" system/.  We can transition to it tomorrow with legislation.  As a matter of fact Medicare for all could be done through reconciliation with 50 votes in the Senate.  

 

We pay more because we are too afraid to get rid of worthless insurance who add no value to the system. This is due to lobbyist that line campaign coffers of politicians.  We know what policies work because they already exist and the rest of the world is outperforming us. 

Edited by freefourur
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