Covid-19 and Medicare for All

[John Camp]

For most people, medical insurance is just that -- insurance against an unlikely event, the need for expensive medical care. But what happens when medical insurance has to start paying out for expected events, like the corona virus. Most people get through the virus without needing hospitalizations, but a pretty solid percentage do need a hospital, or at least medical care. Even though medical insurance is supposedly mandatory in the US, it's clear that hundreds of thousands of people don't have it and a significant portion of those will need hospital career which they can't afford. Do you think his pandemic will push Americans closer to a universal Medicare?

[Rob C]

For most people, medical insurance is just that -- insurance against an unlikely event, the need for expensive medical care. But what happens when medical insurance has to start paying out for expected events, like the corona virus. Most people get through the virus without needing hospitalizations, but a pretty solid percentage do need a hospital, or at least medical care. Even though medical insurance is supposedly mandatory in the US, it's clear that hundreds of thousands of people don't have it and a significant portion of those will need hospital career which they can't afford. Do you think his pandemic will push Americans closer to a universal Medicare?

With luck, some good will come out of the bad. But minds are often set in stone and common sense fails to prevail.

[Peter McLennan]

you think his pandemic will push Americans closer to a universal Medicare?

Yes.

[JoeKitchen]

Here it is, never let a good crisis go to waste right! 

Let’s use this as a way to completely rewrite the relationship with government but no thanks John. 

One of the reasons I want get out of this lockdown so big government tyrants can’t do this.  Not saying you’re a tyrant although you are fight tooth and nail to keep this lock down going.

[Alan Klein]

Have people been turned down by hospitals for medical care for Covid 19?  I haven't heard that. 

[LesPalenik]

Have people been turned down by hospitals for medical care for Covid 19?  I haven't heard that.

Not for C19, but for myriad of other ailments, because they are closed for everything except C19.

[Rob C]

Here it is, never let a good crisis go to waste right! 

Let’s use this as a way to completely rewrite the relationship with government but no thanks John. 

One of the reasons I want get out of this lockdown so big government tyrants can’t do this.  Not saying you’re a tyrant although you are fight tooth and nail to keep this lock down going.

"But minds are often set in stone and common sense fails to prevail."

Guess I knew you were coming...

;-)

[JoeKitchen]

"But minds are often set in stone and common sense fails to prevail."

Guess I knew you were coming...

;-)

Government run anything does not work nearly as good as privately run.   The reason is simple, politics.  Politicians make decision on who should run something or what should be done based on getting re-elected, not on the overall good of the institution. 

Also, last I checked, Italy has government run healthcare and they were not saved from it.  We, though, with the largest amount of ICU beds per capita, faired rather well. 

[Rob C]

1. Government run anything does not work nearly as good as privately run.   The reason is simple, politics.  Politicians make decision on who should run something or what should be done based on getting re-elected, not on the overall good of the institution. 

2, Also, last I checked, Italy has government run healthcare and they were not saved from it.  We, though, with the largest amount of ICU beds per capita, faired rather well.

1. Armies? Prison systems? The list of profit-before-value enterprises is endless.

2. No system saved any country from Corinna.

[Robert Roaldi]

Government run anything does not work nearly as good as privately run.

In my 40 years of working, I spent 35 in the private sector and just under 5 in the public sector. When I hear people say that private companies are run better, I just laugh out loud. I am sure some are run well though, don't get me wrong. And yes, there are lots of things governments should not be involved in.

But making the direct comparison, in general, is a crock since governments usually get involved in people's lives where you have market failures, so you're almost always comparing apples to oranges anyway. It's relatively easy to count widgets out the door, how do you measure how well a health care system is running, by the number cured, by the number who don't get sick, something else?  In the case of medical delivery, the best of US heath care is probably as good as it can be, but every comparison I've ever heard or read about shows that American health care is the most expensive among developed countries.

The comparison with what happened in Italy is nonsense and you know it. The medical system was overwhelmed but not because of its own internal ("socialist") failures.

One thing about supporters of private health care delivery has always puzzled me. Insurance companies are almost universally hated by everyone I've ever known, hardly a good word to say about them. But when it comes to private health care, all of a sudden the insurance companies are magically terrific in the way they compete to drive down costs, even while by any measure, costs are skyrocketing. What's wrong with this picture?

[JoeKitchen]

In my 40 years of working, I spent 35 in the private sector and just under 5 in the public sector. When I hear people say that private companies are run better, I just laugh out loud. I am sure some are run well though, don't get me wrong. And yes, there are lots of things governments should not be involved in.

But making the direct comparison, in general, is a crock since governments usually get involved in people's lives where you have market failures, so you're almost always comparing apples to oranges anyway. It's relatively easy to count widgets out the door, how do you measure how well a health care system is running, by the number cured, by the number who don't get sick, something else?  In the case of medical delivery, the best of US heath care is probably as good as it can be, but every comparison I've ever heard or read about shows that American health care is the most expensive among developed countries.

The comparison with what happened in Italy is nonsense and you know it. The medical system was overwhelmed but not because of its own internal ("socialist") failures.

One thing about supporters of private health care delivery has always puzzled me. Insurance companies are almost universally hated by everyone I've ever known, hardly a good word to say about them. But when it comes to private health care, all of a sudden the insurance companies are magically terrific in the way they compete to drive down costs, even while by any measure, costs are skyrocketing. What's wrong with this picture?

The difference Rob is that in the private world, yes some companies are run poorly but there are always other companies to go to.  So, eventually those poorly run companies go out of business since people just jump ship.  This is the free market at work. 

However, with government run institutions, they are the only game in town.  At first, maybe they run okay, but eventually since they have no competition, they become old and antiquated since there is no need to stay on top of the game.  Like I said, they are the only game in town so why bother upgrading.  And since they are the only game in town, the consumer is stuck with them with no one else to go to.  Last, dont bet on them being fixed since that means politicians will be involved who have much different incentives then to make the institution run efficiently, such as not firing anyone. 

A great example is the USPS.  They want to modernize with better mail sorting machines to decrease cost, however this means laying people off.  They need congressional approval to do so, but no politician wants to be seen destroying jobs, so it is not getting done. 

Like I said, government is always worse then the free market.  Yes, you can certainly find poorly run companies at anytime, but those companies will be replaced by better ones.  In the free market you have plenty of choices whereas with government you are stuck with just one choice who does not have an incentive to modernize or become better. 

Last, this brings us to a quasi-free market, over regulated sectors.  Healthcare is over regulated and Obama-care made it worse.  History has shown repeatably that when you increase regulations, prices go up and options go down.  This is why private insurance is going up over and over again and the options are coming down, because the government screwed it again. 

And Joe Biden wants to make it worse by having both more regulations on the private insurance market, causing prices to go up again, and providing a subsidized government option, undercutting the competition.  This is a one way road to total government run healthcare, and everyone knows it. 

Last, insofar as low approval ratings in the USA, nothing is worse then congress.  So yes, I'd take the lesser evil of private insurance companies vs. congress running the show.  We don't need a DMV of health services. 

[elliot_n]

Like I said, government is always worse then the free market.

Anti-government, free-market ideology is all well and good, but surely a global pandemic is precisely a scenario where good governance is crucial and free-market solutions are found wanting. If we leave government out of this (from transnational to local - i.e. UN, WHO, federal and state), what kind of free-market response to a global pandemic do you envision?

[Rob C]

In my 40 years of working, I spent 35 in the private sector and just under 5 in the public sector. When I hear people say that private companies are run better, I just laugh out loud. I am sure some are run well though, don't get me wrong. And yes, there are lots of things governments should not be involved in.

But making the direct comparison, in general, is a crock since governments usually get involved in people's lives where you have market failures, so you're almost always comparing apples to oranges anyway. It's relatively easy to count widgets out the door, how do you measure how well a health care system is running, by the number cured, by the number who don't get sick, something else?  In the case of medical delivery, the best of US heath care is probably as good as it can be, but every comparison I've ever heard or read about shows that American health care is the most expensive among developed countries.

The comparison with what happened in Italy is nonsense and you know it. The medical system was overwhelmed but not because of its own internal ("socialist") failures.

One thing about supporters of private health care delivery has always puzzled me. Insurance companies are almost universally hated by everyone I've ever known, hardly a good word to say about them. But when it comes to private health care, all of a sudden the insurance companies are magically terrific in the way they compete to drive down costs, even while by any measure, costs are skyrocketing. What's wrong with this picture?

On the private health aspect: when my wife was going through her cancer treatment one oncologist told her that the insurance companies didn't like him prescribing some of the meds because of cost, but that he didn't care and prescribed them regardless. This was under our private insurance at the time. You need little more than that to illuminate the pressures under which the private sector functions.

Towards the end, she found herself within the public health service literally by accident: she fell and broke her hip and the local hospital (public) was half the distance away so she opted for that due to the pain - and just the night before the day they were going to replace her hip they discover cancer was back. The oncologist told her that he was not prepared to wait longer than ten days to have the cancer removed, and so they did the hip first and the cancer second. All within the constraints of his timetable for her. She asked about the differences between having it done there, in the public unit, and privately. He told her that being in the public domain did not in any way mean that she might not get any drugs she needed.

She walked out of that public hospital without a limp or crutches, and went on to a series of rehab. treatments at the hospital. It was because she found the public service so good that we cancelled the very expensive private health insurance policy.

In our neck of the woods at least, public is as good as private ever was. And in our case, easy, direct access to the public service was all thanks to Britain's membership of the EEC. Brexit? A piece of shit designed to win the vote of those xenophobes with no imagination or expectations of a wider existence than the little town in which they were born. It seems, at the moment, that those of us eligible for EEC benefits will not be deprived of them (within the country in which we resided at time of Brexit) when Britain rushes off its cliff at the end of the year. We will not be covered if we travel into other EEC countries, so we become health prisoners within that land of residence. Viva fucking Boris and the brand new neo-Nazi Conservative Party. Was a time the entire Community was mine, should I wish it. Gone.

[JoeKitchen]

Anti-government, free-market ideology is all well and good, but surely a global pandemic is precisely a scenario where good governance is crucial and free-market solutions are found wanting. If we leave government out of this (from transnational to local - i.e. UN, WHO, federal and state), what kind of free-market response to a global pandemic do you envision?

Well first, the government run healthcare in Italy did a piss poor job, and our private sector did an amazing one.  So the idea that government run is better is just not supported by  the evidence. 

Second, USA companies are going out of their way to produce PPE and ventilators, not to mention it is the private drug companies that are working on a vaccine.  This all happened without  some grand over seer.  You don't need things to be government run to be coordinated. 

And last, look at all of the things government puts in place that screws it up, like anti-price gauging laws.  Sure, sounds nice, but it takes away the incentive for companies to spend the money to change production lines, etc., to make the goods. 

But I understand it, some people just want to have some sort of control over everything.  I use to be that way, but then I realized the sum total of billions upon billions of transactions in the economy, many just by happenstance, cant be controlled or even fully understood, and tinkering with it just slows the gears down.  So I let go of that idea. 

[Alan Goldhammer]

For most people, medical insurance is just that -- insurance against an unlikely event, the need for expensive medical care. But what happens when medical insurance has to start paying out for expected events, like the corona virus. Most people get through the virus without needing hospitalizations, but a pretty solid percentage do need a hospital, or at least medical care. Even though medical insurance is supposedly mandatory in the US, it's clear that hundreds of thousands of people don't have it and a significant portion of those will need hospital career which they can't afford. Do you think his pandemic will push Americans closer to a universal Medicare?

It's not a question of the COVID-19 related costs but all the people who are losing their health insurance through layoffs.  A lot of these people will not be coming back to their jobs.  They can continue on the company insurance plan under the COBRA regulations but they have to pay the full amount of the insurance premium.  Most employers only require the employee to pay 25% of the premium. For someone who is now out of a job, this will be a huge expense.  I haven't seen any number on how many new applications there are for coverage under the Affordable Care Act.

IMO, the pandemic and loss of health insurance will be a big issue over the next 2 years as this new reality sinks in.  If it becomes an issue in the 2020 Presidential election, the Republicans will suffer because of their long track record to repeal Obamacare.   The entire healthcare system in the US is being disrupted.

[chez]

Anti-government, free-market ideology is all well and good, but surely a global pandemic is precisely a scenario where good governance is crucial and free-market solutions are found wanting. If we leave government out of this (from transnational to local - i.e. UN, WHO, federal and state), what kind of free-market response to a global pandemic do you envision?

One that see $$$ and if you don't have the $$$...well you are on your own.

[Rob C]

The difference Rob is that in the private world, yes some companies are run poorly but there are always other companies to go to.  So, eventually those poorly run companies go out of business since people just jump ship.  This is the free market at work. 

However, with government run institutions, they are the only game in town.  At first, maybe they run okay, but eventually since they have no competition, they become old and antiquated since there is no need to stay on top of the game.  Like I said, they are the only game in town so why bother upgrading.  And since they are the only game in town, the consumer is stuck with them with no one else to go to.  Last, dont bet on them being fixed since that means politicians will be involved who have much different incentives then to make the institution run efficiently, such as not firing anyone. 

A great example is the USPS.  They want to modernize with better mail sorting machines to decrease cost, however this means laying people off.  They need congressional approval to do so, but no politician wants to be seen destroying jobs, so it is not getting done. 

Like I said, government is always worse then the free market.  Yes, you can certainly find poorly run companies at anytime, but those companies will be replaced by better ones.  In the free market you have plenty of choices whereas with government you are stuck with just one choice who does not have an incentive to modernize or become better. 

Last, this brings us to a quasi-free market, over regulated sectors.  Healthcare is over regulated and Obama-care made it worse.  History has shown repeatably that when you increase regulations, prices go up and options go down.  This is why private insurance is going up over and over again and the options are coming down, because the government screwed it again. 

And Joe Biden wants to make it worse by having both more regulations on the private insurance market, causing prices to go up again, and providing a subsidized government option, undercutting the competition.  This is a one way road to total government run healthcare, and everyone knows it. 

Last, insofar as low approval ratings in the USA, nothing is worse then congress.  So yes, I'd take the lesser evil of private insurance companies vs. congress running the show.  We don't need a DMV of health services.

Rubbish, Joe. The public health insurance route is decidely not the only game in town; there is a plethora of private options you can buy, and buying private does not exclude your eligibility for the public service at all.

And poorly run businesses do not inevitably go out of business, especially when the competition embraces exactly the same ethic of practice. And folks do not constantly jump from one badly-run insurance company to the next: until their shit hits the personal fan they have no idea whether their company is going to screw them any more or any less than any other. By the time they find out, it's too late. Jesus, the same folks fly on any number of badly-run airlines across the world, and only a very few of these ever actually vanishes.

Private or public, there is never enough money. In one case it requires higher taxation and in the other, higher premiums. I have had battles with insurance companies over many years, the latest over the Rolex that was stolen from me in the street. The local agent first told me that I was not covered, then that I was, but only if I had been seriously injured in the robbery, which seems bullshit: it's the watch of which we speak, not about whether or not I was stabbed, shot or hit over the head with a brick; that is a separate set of claims that would be lodged. So, getting nowhere with him, I sent a registered letter to the claims department (I had an actual contact name from the local agent who filed my claim when he saw I wasn't letting go) in the head office. No reply. I sent another and still nothing. Next, I wrote to the Chief Executive Officer outlining the situation. Zero response. That's Liberty, a huge international company (I think it's US- owned) and not some fly-by-night online service.

Your unbridled urges for this mythical "freedom" that you see under constant threat is much of the reason you got burned in 2008. Some regulation with teeth would have better protected the world's ass from greed and free-running speculation and fraud. Instead, you get the butchers demanding less, and the fatted calf nodding wisely and waving placards whilst wearing silly red caps as it blunders down the road to the abattoir.

[Alan Klein]

It's not a question of the COVID-19 related costs but all the people who are losing their health insurance through layoffs.  A lot of these people will not be coming back to their jobs.  They can continue on the company insurance plan under the COBRA regulations but they have to pay the full amount of the insurance premium.  Most employers only require the employee to pay 25% of the premium. For someone who is now out of a job, this will be a huge expense.  I haven't seen any number on how many new applications there are for coverage under the Affordable Care Act.

IMO, the pandemic and loss of health insurance will be a big issue over the next 2 years as this new reality sinks in.  If it becomes an issue in the 2020 Presidential election, the Republicans will suffer because of their long track record to repeal Obamacare.   The entire healthcare system in the US is being disrupted.

Trump has become an affirmed socialist.  He spending money like a drunken sailor.  So I suspect, he will support payments to everyone so they can get medical care.  He's said a long time ago he's in favor of care for pre-existing conditions.  The Republicans in Congress will go along with him because they want to be re-elected too.  After all didn't they vote for CARES act 96-0?

The fact is the government will be printing and printing and printing at least until the election.  Unfortunately, Covid happened before an election so politicians are all acting stupid like the well can't go dry.  We're all in for a big wake up call pretty soon.  The money be dropped by helicopters are pushing the stock market up.  But there's no there, there. Warren Buffet sold his complete stake in 4 US airlines.  He's no dummy.  Sure, he said he still has confidence the American economy will come back.  But he didn't say when.

[Rob C]

Well first, the government run healthcare in Italy did a piss poor job, and our private sector did an amazing one.  So the idea that government run is better is just not supported by  the evidence. 

Second, USA companies are going out of their way to produce PPE and ventilators, not to mention it is the private drug companies that are working on a vaccine.  This all happened without  some grand over seer.  You don't need things to be government run to be coordinated. 

And last, look at all of the things government puts in place that screws it up, like anti-price gauging laws.  Sure, sounds nice, but it takes away the incentive for companies to spend the money to change production lines, etc., to make the goods. 

But I understand it, some people just want to have some sort of control over everything.  I use to be that way, but then I realized the sum total of billions upon billions of transactions in the economy, many just by happenstance, cant be controlled or even fully understood, and tinkering with it just slows the gears down.  So I let go of that idea.

Italy has problems, one of which is perennially weak government and much Mafia influence in everything. It was also the first European country to get first-hand experience of what is at stake here. Your claim about the wonderful US alternative handling is funny were it not so sad for those dead, dying and going to die. That you had so much advance warning but were nationally blinded by an already blind leader first in denial, just like his mates in London, Moscow, NK and, ironically, for a while, in Iran, too, is why your deaths are immense in number. Flipping from one politically motivated move (such as travel bans for one set of foreign nationals but not others next door to them) to another was no way to deal with a factor that does not recognize politics, religion, colour or trade deals. It simply illustrated the Trumpian love for smoke, mirrors and covering one's personal ass at all times by blaming someone or something else rather than actually doing something well for a change, regardless of politics and elections. It also reminds the rest of the world of headless chickens in flight.

Of course it's private, big pharma working on vaccines - there's a fucking fortune awaiting them! British companies also make hospital equipment where before they made car parts; maybe your fake-news moguls only tell you that it happens in the States... :-) In Europe, governmental finance is already being raised for more expenditure on just that kind of thing. It's so unfortunate that Americans generally seems to see nothing beyond their own news outlets.

Anti price-gauging rules making it hard for companies to keep up to date? Doesn't that signal to you that something bad is actually already going on: you are currently being screwed, and to remedy that, to get the deal you thought you already had, you are going to have to pay more?

I'm sorry, but to argue that "some people want to have some sort of control over everything" is irrelevant to the matter of public health. What peope who have experienced real choice want is both options to remain on the table: nobody wants to take away from the wealthy their ability to be ill in luxury; wonderful for them and good luck! What the rest of us want is to have a state-provided total medical service that isn't going to skimp in its attempts to keep you healthy in body and mind, and most of all does not depend on your ability to buy insurance. I can think of very few better purposes for anybody's tax bucks.

[Alan Klein]

Italy has problems, one of which is perennially weak government and much Mafia influence in everything. It was also the first European country to get first-hand experience of what is at stake here. Your claim about the wonderful US alternative handling is funny were it not so sad for those dead, dying and going to die. That you had so much advance warning but were nationally blinded by an already blind leader first in denial, just like his mates in London, Moscow, NK and, ironically, for a while, in Iran, too, is why your deaths are immense in number. Flipping from one politically motivated move (such as travel bans for one set of foreign nationals but not others next door to them) to another was no way to deal with a factor that does not recognize politics, religion, colour or trade deals. It simply illustrated the Trumpian love for smoke, mirrors and covering one's personal ass at all times by blaming someone or something else rather than actually doing something well for a change, regardless of politics and elections. It also reminds the rest of the world of headless chickens in flight.

Of course it's private, big pharma working on vaccines - there's a fucking fortune awaiting them! British companies also make hospital equipment where before they made car parts; maybe your fake-news moguls only tell you that it happens in the States... :-)
Anti price-gauging rules making it hard for companies to keep up to date? Doesn't that signal to you that something bad is actually already going on: you are currently being screwed, and to remedy that, to get the deal you thought you already had, you are going to have to pay more?

I'm sorry, but to argue that "some people want to have some sort of control over everything" is irrelevant to the matter of public health. What peope who have experienced real choice want is both options to remain on the table: nobody wants to take away from the wealthy their ability to be ill in luxury; wonderful for them and good luck! What the rest of us want is to have a state-provided total medical service that isn't going to skimp in its attempts to keep you healthy in body and mind, and most of all does not depend on your ability to buy insurance. I can think of very few better purposes for anybody's tax bucks.

We were promised that with Obamacare.   Lower costs, better coverage, keep the same doctors we had.  We didn't get any of the three.  In fact, costs went up, less coverage as deductible went up too, and we lost many of the doctors we had been using.  So government lied to us.  Again.

Why would anyone trust the government?  Once burned; twice foolish. 

Add to that, the government in America at least is broke.,  Our economy will take a 5 trillion dollar hit.  GDP down, what, 20%.  Who knows?  There's not enough green ink.