Non partisan doctors group welcomes national debate

[candrew]

Doctors group welcomes national debate on ‘Medicare for All’ | Physicians for a National Health Program

Excerpts:

Myth: A single-payer system would impose an unacceptable financial burden on U.S. households. Reality: Single payer is the only health reform that pays for itself. By replacing hundreds of insurers and thousands of different private health plans, each with their own marketing, enrollment, billing, utilization review, actuary and other departments, with a single, streamlined, tax-financed nonprofit program, more than $400 billion in health spending would be freed up to guarantee coverage to all of the 30 million people who are currently uninsured and to upgrade the coverage of everyone else, including the tens of millions who are underinsured.

Myth: The U.S. has a privately financed health care system. Reality: About 64 percent of U.S. health spending is currently financed by taxpayers. (Estimates that are lower than this exclude two large sources of taxpayer-funded care: health insurance for government employees and tax subsidies to employers and individuals for purchasing private health plans.) On a per capita basis, the amount of government-funded health care in the U.S. exceeds the health spending of nations with universal health systems, e.g. Canada. We are paying for a national health program, but not getting it.

Myth: A single-payer system would overturn the gains won under the Affordable Care Act and provide inferior coverage to what people have today. Reality: A single-payer system would go far beyond the modest improvements that the ACA made around the edges of our current private-insurance-based system and ensure truly universal care, affordability and health security.

Myth: The American people don’t support single payer. Reality: Surveys have repeatedly shown that an improved Medicare for All is the remedy preferred by about two-thirds of the population.

Myth: The goal of establishing a single-payer system in the U.S. is unrealistic, or “politically infeasible.” Reality: It’s true that single-payer health reform faces formidable opposition, especially from the private insurance industry, Big Pharma, and other for-profit interests in health care, along with their allies in government.

What is truly “unrealistic” is believing that we can provide universal and affordable health care, and control costs, in a system dominated by private insurers and Big Pharma.

 

[MichaelB]

This topic is more appropriate as a separate thread. Hot topic enabled. Avoiding partisan rhetoric will give the discussion a longer lifespan.

 

[explanade]

Interesting but I suspect they represent a small percentage of all doctors.

I found the About page about this organization. They've been around since 1987 so they've probably not been able to sway other doctor organizations like the AMA.

Doctors are among the most respected professions in the country so their opinions on health care policy probably carries some weight.

However, they along with hospitals take up a good chunk of our very high health care spending.

There are some who believe that to rein in the growth in health care costs, doctors and other providers would have to take in a lot less money. Not necessarily cutting their salaries but changing the way they're compensated, from fees for procedures to fees for outcome, as an example.

Or other ideas like funding their medical education and training, so that they're free of heavy debt to pursue less lucrative but very much in demand fields like primary care.

Maybe something to consider for future doctors, not ones who've been operating under the current system for years.

 

[MRG]

Doctors group welcomes national debate on ‘Medicare for All’ | Physicians for a National Health Program

Excerpts:


What is truly “unrealistic” is believing that we can provide universal and affordable health care, and control costs, in a system dominated by private insurers and Big Pharma.

I agree!

I w*rked around health and life insurance companies for some years. To say they have deep pockets is a small understatement. I recall one Rube Goldberg R&D effort, ten of the biggest dropped 8 figures on software that couldn't be developed. I thought they'd be a little upset, not at all. I really felt dirty just consulting with the development teams as I knew it would never work(thirty years later still not viable).

 

[Big_Hitter]

Doctors are among the most respected professions in the country so their opinions on health care policy probably carries some weight.

yes but I'm not sure they have their opinions are backed with sufficient financial acumen

 

[CaliKid]

Great topic. I sincerely wish this were possible but it's sort of like abolishing our current, very complex, tax system. There are too many people whose jobs would be eliminated immediately. As the first point mentions: "... By replacing hundreds of insurers and thousands of different private health plans, each with their own marketing, enrollment, billing, utilization review, actuary and other departments, with a single, streamlined, tax-financed nonprofit program, more than $400 billion in health spending would be freed up...."

This is so true. I just think there are too many people who would lose jobs that it would never happen. We like to complain, in this country, but we also like jobs. To make change we need to do it slowly and incrementally. Sort of like how the minimum wage gets raised a little each year not all at once.

 

[GrayHare]

I'm sure doctors would be glad to see the insurance paperwork reduced. There are many doctors I cannot see because they refuse insurance. I'd gladly pay a small premium to consult with them but Medicare, for one, disallows that.

 

[explanade]

Great topic. I sincerely wish this were possible but it's sort of like abolishing our current, very complex, tax system. There are too many people whose jobs would be eliminated immediately. As the first point mentions: "... By replacing hundreds of insurers and thousands of different private health plans, each with their own marketing, enrollment, billing, utilization review, actuary and other departments, with a single, streamlined, tax-financed nonprofit program, more than $400 billion in health spending would be freed up...."

This is so true. I just think there are too many people who would lose jobs that it would never happen. We like to complain, in this country, but we also like jobs. To make change we need to do it slowly and incrementally. Sort of like how the minimum wage gets raised a little each year not all at once.

Of course people who'd lose jobs under the current system are going to fight any change that threatens their livelihood.

But if the country as a whole sees benefits from saving costs on health care, which is probably the biggest cost item and one that threatens the fiscal integrity of the nation, it should create a lot of other opportunities for people who would be displaced.

It's a lot easier to say that, as someone whose job doesn't depend on the current system. But they have to know the current gravy train can't last forever.

 

[donheff]

So, have we already done a poll to see how many of us would prefer a Medicare for all type single payer system to what we have?

 

[Alan]

So, have we already done a poll to see how many of us would prefer a Medicare for all type single payer system to what we have?

http://www.early-retirement.org/for...-a-single-payer-health-care-system-68771.html

64% in favor of a single payer on this poll from 2013.

 

[donheff]

http://www.early-retirement.org/for...-a-single-payer-health-care-system-68771.html

64% in favor of a single payer on this poll from 2013.

Consistent with the statistic stated above for the general population. I don't expect to see it in my life time but I sure would like to.

 

[MRG]

Consistent with the statistic stated above for the general population. I don't expect to see it in my life time but I sure would like to.

State of Colorado votes on single payer this fall. Maybe another first?

Sent from my SAMSUNG-SM-G920A using Early Retirement Forum mobile app

 

[travelover]

As Warren Buffet says, trees don't grow to the sky. Eventually, as health care costs continue to outstrip inflation, there will come a day when it consumes all of the pie and even our elected officials will be forced to face the reality that more reform is needed. It is only a question of when.

 

[ExFlyBoy5]

This topic is more appropriate as a separate thread. Hot topic enabled. Avoiding partisan rhetoric will give the discussion a longer lifespan.

Hot topic? What?! Come on...you know the title said "NON PARTISAN" in it, right?


Sorry, I couldn't resist.

Edit...OK, a couple of things. This article is from January. And from Wikipedia:

Physicians for a National Health Program (PNHP) is an advocacy organization of some 20,000 American physicians, medical students, and health professionals co-founded in 1987 by David Himmelstein and Steffie Woolhandler that supports a single-payer (Canadian-style) system of universal national health insurance.

Maybe I am nitpicking, but this sure seems to be a topic that well...anyway.

 

[GTFan]

Myth: The goal of establishing a single-payer system in the U.S. is unrealistic, or “politically infeasible.” Reality: It’s true that single-payer health reform faces formidable opposition, especially from the private insurance industry, Big Pharma, and other for-profit interests in health care, along with their allies in government.

This is the main issue, and everything else advocated is irrelevant with the status quo as it is. I.e. it doesn't really matter whether it makes sense, financially or socially. Too much money at stake to buy off folks, same as the reason why true tax reform will not get enacted.

On both sides of the aisle, btw. Money is corrosive that way.

 

[brett]

We live in Canada. We have had a single payer system for years. It is not perfect. No health care system will ever be perfect.

What is interesting is that every poll taken shows that 80 plus percent of the population supports the current system. Our right wing politicians don't even think of introducing user fees or even discussing for it is a sure fire way for them to end up in political oblivion.

The medical associations in Canada are now recommending, and have been for the past few years, the next step. The inclusion of prescription drugs into the plan.

The discussion is making it's way to the political forum Naturally, the drug companies are against this, as are the insurance companies.

Seems to me that if the drug companies and the insurance companies are against it, it must be to the benefit of the rest of us.

 

[ziggy29]

One of the wild cards, I think, is that drug costs may be out of control in the US at least **in part** because of cost controls in most other nations. It creates a form of cost-shifting where the US health care system has to eat untold billions of dollars a year in extra drug costs compared to the rest of the world. It's not unlike Medicare creating cost shifting on private insurance plans, and even more on the uninsured, because of lower Medicare reimbursement rates.

Could the US create similar cost caps as many other nations, and still have these blockbuster drugs be economically feasible to develop? Hard to say.

 

[explanade]

One of the wild cards, I think, is that drug costs may be out of control in the US at least **in part** because of cost controls in most other nations. It creates a form of cost-shifting where the US health care system has to eat untold billions of dollars a year in extra drug costs compared to the rest of the world. It's not unlike Medicare creating cost shifting on private insurance plans, and even more on the uninsured, because of lower Medicare reimbursement rates.

Could the US create similar cost caps as many other nations, and still have these blockbuster drugs be economically feasible to develop? Hard to say.

I would tend to think so.

First of all, a lot of these companies are outside the US yet they have a lobby with a lot of clout.

There are stories about recent drug price increases to the point where there are more and more therapies which cost tens of thousands or even over $100k.

And these are not all fancy biotech miracle cures. Some are drugs which are decades old but the owner has such market power and the US allows them to raise prices with impunity.

The drug cos. will say a lot of patients won't pay full price, which suggests they're pricing well above costs, including cutting edge R&D.

But a lot of pharma companies are in fact spending more on marketing than R&D. Not just those ED commercials but the hot sales reps. who use their come hither charms on doctors to push the product onto patients.

Are any of these practices going to change any time soon?

 

[travelover]

................Are any of these practices going to change any time soon?

Eventually and inevitably.

As Warren Buffet says, trees don't grow to the sky. Eventually, as health care costs continue to outstrip inflation, there will come a day when it consumes all of the pie and even our elected officials will be forced to face the reality that more reform is needed. It is only a question of when.

 

[ShokWaveRider]

We live in Canada. We have had a single payer system for years. It is not perfect. No health care system will ever be perfect.

What is interesting is that every poll taken shows that 80 plus percent of the population supports the current system. Our right wing politicians don't even think of introducing user fees or even discussing for it is a sure fire way for them to end up in political oblivion.

The medical associations in Canada are now recommending, and have been for the past few years, the next step. The inclusion of prescription drugs into the plan.

The discussion is making it's way to the political forum Naturally, the drug companies are against this, as are the insurance companies.

Seems to me that if the drug companies and the insurance companies are against it, it must be to the benefit of the rest of us.

My wife and I are considering (Just considering) moving back to Canada for this reason. A solid healthcare system for all. We have been in the USA for 30 years now, America has been VERY good to us, we enjoy the lifestyle, high standard of living and mild temperatures.

However, if ACA is repealed, it would make Healthcare cost prohibitive for most folk, especially those who need it most, this goes against our core principles. We certainly would not want to pay the price of an open market healthcare system. We believe Healthcare should be one of those non profit services. Not too many of us can control their need for healthcare services. Not for the most part anyway.

 

[brett]

Just about every industrialized western country has a universal health care system of one sort or another. Most single payer. They spend less of their GDP on health care, the costs are not rising as quickly and certainly not at multiples of the country's inflation rate. Nor do they threaten to pass the level of 18 percent of GDP which is deemed by many economists to be unsustainable in the long run and a drain on a country's financial well being. Their health outcomes are as good, and often better.


Nor has the so called threat of 'socialized medicine' turned their countries away from capitalism or caused other terrible results that the fear mongers and special interest groups have preached for so long. If anything, it will make their economies more competitive in the long run.

It really comes down to whether one believes that the provision of healthcare, like fire, police, clean water etc, is a basic need or if it should be rationed based upon ability to pay.


We have considered purchasing retirement property in the US. We decided some time ago that the healthcare situation, the gun control issue, and to a lesser extent the tax provisions precluded us from moving forward with a purchase. Just our opinion.

 

[MichaelB]

One of the wild cards, I think, is that drug costs may be out of control in the US at least **in part** because of cost controls in most other nations. It creates a form of cost-shifting where the US health care system has to eat untold billions of dollars a year in extra drug costs compared to the rest of the world. It's not unlike Medicare creating cost shifting on private insurance plans, and even more on the uninsured, because of lower Medicare reimbursement rates.

Could the US create similar cost caps as many other nations, and still have these blockbuster drugs be economically feasible to develop? Hard to say.

Thinking about that question, I took a look at Pfizer's 2015 financial statement (here). Just one company, only three years of data and just browsing over the data. Still, a couple of things jump out:

Gross profit margins are 80%, while R&D cost is only 15%. Over the past 3 years they invested roughly the same amount of cash in research as they did buying back stock. The high drug prices aren't funding product development, they are funding the high sales expense and shareholder return. The bombardment of tv commercials to generate demand would seem to support that view.

 

[travelover]

Thinking about that question, I took a look at Pfizer's 2015 financial statement (here). Just one company, only three years of data and just browsing over the data. Still, a couple of things jump out:

Gross profit margins are 80%, while R&D cost is only 15%. Over the past 3 years they invested roughly the same amount of cash in research as they did buying back stock. The high drug prices aren't funding product development, they are funding the high sales expense and shareholder return. The bombardment of tv commercials to generate demand would seem to support that view.

I guess the lesson is to buy drug company stocks in order to be able to afford their drugs.

 

[ShokWaveRider]

Thinking about that question, I took a look at Pfizer's 2015 financial statement (here). Just one company, only three years of data and just browsing over the data. Still, a couple of things jump out:

Gross profit margins are 80%, while R&D cost is only 15%. Over the past 3 years they invested roughly the same amount of cash in research as they did buying back stock. The high drug prices aren't funding product development, they are funding the high sales expense and shareholder return. The bombardment of tv commercials to generate demand would seem to support that view.

I seem to remember that some countries do not allow ads for Drugs.

 

[Alan]

I seem to remember that some countries do not allow ads for Drugs.

Good point, it looks like only 2 or 3 countries allow Direct To Consumer marketing of drugs.

https://en.wikipedia.org/wiki/Direct-to-consumer_advertising#Nations_permitting_DTC

All Western nations, with the exception of New Zealand and the United States, have historically (since the 1940s for Australasia, North America, and Europe) banned direct advertising of pharmaceuticals to consumers