General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsIf we want Medicare to work we are going to have to raise Medicare taxes and premiums.
I don't see how we can expect a system to work where we pay $100,000 - $150,000 and get back $300,000 - $400,000.
Maybe if that were the payback for a minority of the recipients, but it that's the average, it doesn't look sustainable to me.
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Response to dkf (Original post)
littlemissmartypants This message was self-deleted by its author.
TreasonousBastard
(43,049 posts)how can we make the elderly comfortable without breaking the bank?
Response to TreasonousBastard (Reply #2)
littlemissmartypants This message was self-deleted by its author.
TreasonousBastard
(43,049 posts)that we have to look at ways to reduce costs.
As far as "artificial means" goes, that sort of thing has to be further defined. I recently was asked about a feeding tube for my mother, who was refusing to eat. When I said to wait until it was absolutely necessary, they were relieved and admitted they hated the idea themselves, but had to ask. As you probably know, a large percentage of patients rip the tube out, meaning more surgery or other expense to deal with that. So far, they've found ways to get her to eat enough to keep going. She's paying almost $40,000 a year for this facility, including pharmacy charges, and at least once a year gets rushed to the hospital for a 30 grand day or two of ER and intensive care.
It's not the care that's the problem, it's the cost. The facility she's in is excellent, and the hospitals are first-rate. And, the truth is that 3-4 grand a month is toward the low end of what a decent NYC hotel would charge for the room and three meals a day delivered to the room.
But, she's not staying in a hotel for a couple hundred a day-- this is her home for the rest of her life,and it's a very expensive way to live. I'm not sure just where we can cut costs, but starting at the hospital may be the first place to look. Fee for service is outmoded and the Europeans are way ahead of us there. I'm not looking to single payer as a salvation because it will be politically impossible to impose and doesn't answer the fee for service questions.
Anyway, people closer to the nuts and bolts of providing care have to have even more imagination at coming up with savings before millions of us boomers are in nursing homes spending 50 grand or more a year to sit in our wheelchairs. And not Ryan's "plan" which would be more efficient than those death panels at eliminating patients as the problem.
HiPointDem
(20,729 posts)TreasonousBastard
(43,049 posts)people I know who went through that already.
I don't owe you a link, but if you know for sure that they are all in error, you might tell me how you know this.
HiPointDem
(20,729 posts)general knowledge, i want a reference and a definition of "large percentage". not just "my mother did" or "all the nurses say so".
TreasonousBastard
(43,049 posts)Two other people here have confirmed it's happened.
More than that that, you're on your own.
HiPointDem
(20,729 posts)a large percentage of patients (which, where, what kind of) pull out their feeding tubes (what kind of feeding tubes, what placement)
demwing
(16,916 posts)whats your point? What is it you want to accomplish?
dkf
(37,305 posts)They had to strap him in to keep him from doing so. When he got to the point of not eating (he couldn't swallow) they didn't offer tube feeding as an option and directed us to hospice care. I tried to argue with them, because he was still acknowledging our presence and was so happy to see us but they said the risk of infection and other things were a problem. They said he would need to be rehospitalized every time he pulled it out.
People with dementia don't know why they have these tubes sticking out of them and when they are irritated by them they try to pull them out. They don't even realize they are sick. At least that is my experience.
HiPointDem
(20,729 posts)attached to anything except during feeding, it's not painful or uncomfortable and doesn't impede movement.
Response to HiPointDem (Reply #9)
littlemissmartypants This message was self-deleted by its author.
HiPointDem
(20,729 posts)Response to HiPointDem (Reply #39)
littlemissmartypants This message was self-deleted by its author.
HiPointDem
(20,729 posts)feeding tubes.
and as you confirmed his statement that a large percentage of patients "rip their feeding tubes out" and as you say you're 'in the trenches', & as you say you've seen feeding tubes placed, that it's called "quick money" (apparently by the docs doing the placement), i'm asking you to tell me what kind of feeding tubes you've seen large percentages of people rip out.
because, as a professional, you must know there are several kinds of feeding tubes, some more comfortable than others.
Response to HiPointDem (Reply #61)
littlemissmartypants This message was self-deleted by its author.
HiPointDem
(20,729 posts)feeding tubes.
if you knew what you were talking about you wouldn't be writing naso gastic and per-cutaneous endoscopic gastrostomy, but ng, peg. pej, g-tube.
Response to HiPointDem (Reply #73)
Post removed
HiPointDem
(20,729 posts)which tubes and what kind of patients, because i know for a fact that if you're talking about patients generally, a large percent do not rip them out. maybe you work in a hospital with assholes that talk of 'quick money' when they do a peg placement and they rip them out in disgust.
what i hear is people talking up denying services to old people.
nasogastric
percutaneous
SkyDaddy7
(6,045 posts)My Grandmother pulled her feeding tube out twice. I cannot speak on whether this is a problem with other patients but it was with my Grandmother.
Response to SkyDaddy7 (Reply #37)
littlemissmartypants This message was self-deleted by its author.
HiPointDem
(20,729 posts)Response to HiPointDem (Reply #56)
littlemissmartypants This message was self-deleted by its author.
HiPointDem
(20,729 posts)
Freddie
(9,330 posts)Sadly, refusing to eat or forgetting how to eat or swallow is the end stage of the disease. I've read horror stories of Alzheimer's patients with feeding tubes who live years as basically bodies with no brain left (please no offense intended). I understand that even the Catholic Church does not recommend feeding tubes for end-stage Alzheimer's patients.
TreasonousBastard
(43,049 posts)Response to TreasonousBastard (Reply #7)
littlemissmartypants This message was self-deleted by its author.
TreasonousBastard
(43,049 posts)Response to TreasonousBastard (Reply #74)
littlemissmartypants This message was self-deleted by its author.
TreasonousBastard
(43,049 posts)
forthemiddle
(1,392 posts)If you have first hand knowledge of ANY of this happening in a place that you work (upcoding, coding based on diagnosis that will be paid, and not what is dictated, etc), and you do not report it, you are just as guilty as fraud as they are, and just as liable (financially, and jail time).
begin_within
(21,551 posts)My Mom is 94 as of today, and she can't swallow any more. She would have died of starvation had she not agreed to have the feeding tube put in. She had dropped from 145 pounds to 117 pounds in 16 months. So she had the feeding tube installed. It has literally given her 2 more years of life so far. She is now back up to 145 pounds. She gets all her nutrition through that tube (a liquid formula called Jevity). It is actually easier now, just to give her the formula 3 times per day, than it was to try to prepare and feed her food and drink. There is a danger of the patient pulling out the feeding tube, and if that happens it has to be restored immediately in a hospital. There are wide belts that can be put around the patient's abdomen, which cover up the feeding tube when not in use, so that they can't get to it. We have not had to use the belt. My Mom sometimes fiddles with the end of the tube and asks what it is, but she has never pulled it out. I was initially dismayed at the idea of the feeding tube for her, but in her case it has saved her life and it is easier then her trying to swallow and a more certain way of her getting her nutrition. And it is paid for, including the formula, by a combination of Medicare and Tricare, since it is medically necessary.
grantcart
(53,061 posts)My mother had procedures done in her nineties that gave her 6 more years.
During the last 6 years she would be awake for only a few minutes a day and was barely in communication. When she was able to communicate all she could say was "how much longer will this torture continue?".
For decades she had told everyone the only thing she wanted was to make sure that she didn't linger in a nursing home in a semi conscious state. And that's what happened all paid for by Medicare.
Her last year of life went on for 8 years. It was senseless.
I don't have any answers but know that our ability to maintain a body's biological life has far exceeded our ability to sustain a quality of life. In my mother's case it became a horrific scientific experiment.
DURHAM D
(32,638 posts)Was it paid for by Medicare or Medicaid?
grantcart
(53,061 posts)I thought that it was Medicare but now that you mention it the last few years must have included Medicaid too.
DURHAM D
(32,638 posts)I think it is important to know the difference. Thanks
As President Clinton said in his speech from the DNC - two thirds of the money spent in the Medicaid program is for senior care.
pnwmom
(109,068 posts)It is only in RETROSPECT that we know when the end of life actually was.
For example, they're no longer recommending routine colon cancer screenings for people over the age of 80. However I knew a woman who had surgery for colon cancer at age 86. A few months later, she was found to have a breast lump, but she refused further surgery. She did agree to take an anti-estrogen pill, however.
She had another 9 active years of life, attending her grandchildren's graduations and weddings. It was only in her last couple months, at age 95, when she really slowed down and went into hospice care for her terminal breast cancer.
Should she have been denied cancer treatment at age 86? Some people might think so, but no one who knew her during those nine years would have agreed.
TreasonousBastard
(43,049 posts)how long someone might live, we have to reduce the costs for the years they do live.
But, as I said in another post above, I have no idea how to do that.
And, of course, there are those horribly gray areas where we have to make decisions almost blindly. One surgeon says to cut, another says there's a 2% chance of recovery... At what percentage do we decide it's worth it to do a major surgery on an octogenarian? At what age or over all health condition do we start questioning procedures and asking for the percentages?
I'm dealing with it now, and all i have are more questions.
HiPointDem
(20,729 posts)when people start talking like you are, it makes me uncomfortable.
TreasonousBastard
(43,049 posts)at which you have to prove you are not a load on society. Make it 62 and you eliminate Social Security payments, too. Nobody who is not still productive gets past whatever age we set and we save a bundle.
This has been suggested in a number of science fiction works and by at least one rather evil government.
It is not my suggestion.
GreenPartyVoter
(72,425 posts)Alzheimer's and dementia like my grandfather and his mother. My Dad escaped it while having a heart attack while in his early 60s. I will probably go that way myself, given my health choices. 
HiPointDem
(20,729 posts)in a medical facility, you have the option of refusing treatment a/o signing a medical directive indicating that you don't want life-prolonging treatment.
that's the option.
i'm not eager to have medical facilities transformed into euthanasia facilities.
GreenPartyVoter
(72,425 posts)still somewhat painful. I want to go quietly, I want my family to still be able to collect my life insurance, and I don't want to become a burden on them even for the days or weeks it takes me to dehydrate to death. If I had bone cancer, for example, I would be in excruciating pain the entire time I was waiting to die.
Just because some people would choose euthanasia doesn't mean we will suddenly have euthanasia facilities. That would be like calling women's health centers abortion mills. It would just be a small part of medical care, and not everyone would avail themselves of it. Some people would forgo on religious grounds, some would skip it and roll the dice and see how long they will make it. There would have to be some standards set in place for nonterminal patients suffering from mental illness. There would also have to be some worked out to prevent families from chucking their parents when they get tired of taking care of them and don't want to pay exorbitant costs for professional care. But even so, that doesn't mean we should give up on the idea that people should have the right to choose a _painless_ dignified death.
HiPointDem
(20,729 posts)a time of budget cutting and for-profit health care.
because, guaranteed, people *would* be killed against their will.
GreenPartyVoter
(72,425 posts)HiPointDem
(20,729 posts)about is making it legal to force medical personnel to kill people.
if someone is in end-stage anything they can refuse treatment and if they want drugs to make it easier they can go to hospice.
if people want to commit suicide they can do it on their own time.
GreenPartyVoter
(72,425 posts)we should let them decide?
Again, yes, you have DNR options and suicide. But DNR doesn't mean you won't suffer until that life-ending event occurs. Perhaps someone doesn't want to wait until that point but would prefer to go at the time of diagnosis, for example. And suicide is not an option for people who have life insurance policies they want to benefit their families, and if you screw it up you might wind up living like a vegetable, hence my suggestion that medical personnel oversee the situation. It has worked very well for my pets, why not myself and the rest of my family?
What about a compromise? Your idea of dehydration, but the medical personnel keep me comfortable as possible and completely lights out so I can't give in to the thirst and screw it up? Would that be viable? (And not just at end stage, but at the point of diagnosis in the case of a terrible disease for example.)
HiPointDem
(20,729 posts)into the killerati. that's a line i personally would not like to see crossed.
Response to HiPointDem (Reply #62)
littlemissmartypants This message was self-deleted by its author.
GreenPartyVoter
(72,425 posts)either of my parents because of the timing of their heart attacks. At least I know Mom went in Dad's arms, and Dad went surrounded by very kind hospital staff.
TreasonousBastard
(43,049 posts)my stepfather for maybe 6 months or so, and my grandmother years in a nursing home with dementia, and now my mother with dementia.
Heart attack, man, it's the way to go if you can't just be walking down the street and a piano falls on you. It's not death that scares me any more, it's suffering and living as a vegetable.
GreenPartyVoter
(72,425 posts)my folks went from heart attacks.
I saw my grandfather and his mother suffer from Alzheimer's and dementia, and I watched my MIL wither in extreme pain from pancreatic cancer. Just horrible.
cyclezealot
(4,802 posts)Here a night in the hospital cost on average 8 euros.. Just for the room and board .. An MRI costs around $200.. getting an MRI is no problem since they are reasonable.. A doctors visit is set at 22 euros.. Of which the patient only pays 2 euros should you subscribe to the national health care plan.. .. ( Those mentioned above are out of pocket costs , should you not subscribe to the national health care plan.. ) There is no charge for an aspirin during a hospital stay.. Subscribing to the national plan is dependent upon a subscribers income.. Our's cost us only $250 every third month.. What less than 1/10 of what US insurance would cost.. ? And the French plan has no deductibles other than the 2 euro charge for doctors visits and pays often 70% of total hospital costs on Some procedures.. But , consider French costs are about 1/5 of US costs, that will not break your bank account. Should a procedure be life threatening , the system will pay 100%.. AND.. We find far fewer 'surly ' doctors here than we do in the US.. A visit to the doctor at times is like a social event , because many of them are trained to look at the "Whole Patient." What US doctor has the time to look at the 'whole patient.' And a doctor will not be paid unless he spends at least 22 minutes with each and every patient during a doctors visit...
Which cost closer reflects the true cost of health care. the US system or the French system.. ?
TreasonousBastard
(43,049 posts)as having the best healthcare on the planet, I would assume your system works a bit better than ours.
We have some unique problems and situations I suspect you don't. First, medical school leaves our new doctors at least a quarter million in debt, usually more. There is no adequate method of reducing the debt, or the school cost, for most of them so they tend to head first for dermatology and then the other higher paying specialties. Primary care physicians are pretty much the bottom of the pay scale, so we're looking at shortages there, since hardly anyone is signing up. Lots of Indian doctors find primary care an entry into US healthcare since no one else wants it.
The "whole patient" concept is excellent, and much like doctors used to work until things became so complicated we needed specialists. More people are being healed since the specialists are so good, but a lot is being lost when nobody is "in control" of the patient's healing. And more money, much more money, is spent.
MRIs are an interesting case-- here doctors groups and hospitals have set up MRI, and/or Radiology, Centers that are profit centers and demand lots of patients at high prices. Dialysis and other procedures are also done this way, often a local monopoly with no effective cost controls, other times excessively competing, but rarely with any cost competition. The end result is that they are done too often and too expensively.
Another curious thing is the concept of doctors having privileges at specific hospitals but not others. In my mother's case, her favorite doctor, who also happens to be the house doctor at her facility, is not admitted in the best hospital in the area. When she was rushed to the best hospital in the area because of heart palpitations, the team there redid all the tests and created a new history when the other hospital and her regular doctor had all that on file. Cost quite a bit for all that unnecessary testing.
There's more, but some other time.
WinkyDink
(51,311 posts)Freddie
(9,330 posts)Right now when people hit $110000 in wages the 4.2% (normally 6.2%) SS tax stops being deducted from their pay, and the highly paid get yet another privelege.
Remove the cap, keep the person's SS contribution capped, and apply the excess to Medicare. This would be result in a progressive Medicare tax to offset the regressive FICA tax.
However whenever this is mentioned it seems politicians eye glaze over and they zone out.
Freddie
(9,330 posts)No it would not, it would simply be making things fair! If I have to pay that 6.2% on every penny I earn, so should everyone.
but in this country the rich and corporations rule. The hell with the rest of us.
daleanime
(17,796 posts)
dkf
(37,305 posts)
valerief
(53,235 posts)lives.
Are these taxable???
Got the answer here.
http://ssa-custhelp.ssa.gov/app/answers/detail/a_id/493/~/paying-income-tax-on-social-security-benefits
peace13
(11,076 posts)But of course an answer to the problem is not what most are looking for!
JNelson6563
(28,151 posts)I am one of those low wage earners and that particular tax is one of the biggest chunks out of my check as it is.
I say that medical care is ridiculously over priced from what doctors make all the way down to what they charge for a damn tylenol at the hospital.
And don't get me started on prescription drugs.
No, the premiums should not be the first place we look when we think about fixing medicare.
Julie
dkf
(37,305 posts)How do we make the inflows equal the outflows?
JNelson6563
(28,151 posts)Ever look at a hospital bill? $14 for 2 tylenol. $25 to use a heating pad.
Yeah, we need higher premiums to pay for that shit.
Oy.
Julie
Freddie
(9,330 posts)To make up for all the uninsured who use the ER as a family doctor (hello, Mitt!) your insurance co. (or you) is billed ridiculous amounts in hopes of making up for at least some of the care they give away for "free".
bluestate10
(10,942 posts)shows how clueless Romney is. The entire concept of health care reform rides on early diagnosis so that use of expensive care like emergency rooms is limited to true emergencies. I grew up poor. I know that my primary care was the emergency room, or a doctor after we were sick. Routine physicals was not part of my early life. Most poor people only know emergency rooms and use them for even routine issues like bad colds or the flu.
bluestate10
(10,942 posts)The average person pays into SS and Medicare for around 43 years, some more. Compounding over such periods, even with low rates of compounding produces a number that is equal or higher than what dfk, and Paul Ryan, claim is being paid out.
HiPointDem
(20,729 posts)dkf
(37,305 posts)But as long as neither party advocates this route it's not even a glimmer of a hope. This is one reason politicians drive me batty, especially Obama. I don't really expect Republicans to come to their senses.
bluestate10
(10,942 posts)But in this country, it will never be a first, giant step. Instead we must take the route that Canada took, abet with a much larger population. Canada's plan was an incremental plan that ended up where that nation is now.
HiPointDem
(20,729 posts)saskatchewan introduced a universal provincial hospital plan in 1947 & a universal provincial healthcare program in 1962, and canada introduced a national healthcare program in 1966.
there were no intermediary steps that involved insurance companies or any national intermediary steps at all.
the 'intermediary steps' took place after 1966, and they all lead in the direction of defunding & privatizing their universal program.
aandegoons
(473 posts)More people working and earning a living wage is the answer that and raising the cap on payroll taxes. Raising premiums is the absolutely worse way to fix it.
What you are suggesting is a republicans wet dream.
dkf
(37,305 posts)Moreover when it was first established the premiums were 50% where now is 25%.
So the system was designed to payout based on higher premium contributions in a much less expensive health care world.
aandegoons
(473 posts)Removing the payroll cap allows a redistribution of those taxes therefore allowing Medicare to be 100% funded well past 2026.
Freddie
(9,330 posts)dkf
(37,305 posts)They have specific trust funds. Income taxes fund Medicare part b and d.
Remove that cap and apply the over-the-cap $$ to Medicare.
dkf
(37,305 posts)The Medicare growth rate is the problem. If you specifically use Social Security funds you will manage to crash that too.
MiniMe
(21,737 posts)But ending the cap, and putting the $$ over the cap to medicare. That should not tax the social security trust fund any more than it already is
JNelson6563
(28,151 posts)I too thought this smacked of Republican views.
Gawd forbid we make medical care affordable!1! No! Raise the premiums!1! Doctors' yachts and country club memberships don't pay for themselves! Big pharma can't roll naked in piles of money and buy Congress without gouging the people!
WTF? Is this really DemocraticUnderground?
Julie
dkf
(37,305 posts)I'm all for cutting expenses but how?
JNelson6563
(28,151 posts)Hard to believe this would be so beyond your imagination....
Perhaps, like Medicaid, there could be a pricing structure imposed. This is how much will be paid for this, this and this.
Don't like it? Tough shit. Go set up shop elsewhere.
Simple. At least for some of us...
Julie
dkf
(37,305 posts)Hillary?
JNelson6563
(28,151 posts)Bye now.
customerserviceguy
(25,183 posts)Even without going into a discussion of the practice of defensive medicine (which drives costs up all by itself), can we agree that the current tort system provides a great uncertainty of results, often taking many years, with the results of bad care being hidden by gag orders in settlements that merely protect the guilty, all while enriching trial lawyers?
When we look at the efficient medical systems of other countries, we do not see our tort system (or anything like it) in use. I feel that's a large part of the difference between their successes and our failure.
Capt. Obvious
(9,002 posts)
Ship of Fools
(1,453 posts)exit gracefully when I damn well choose. Maybe it would help
if the nation could get this conversation up and running.
eridani
(51,907 posts)If our per capita health care expenses were the same as in the rest of the developed world, there would be no Medicare problem.
dkf
(37,305 posts)"Britain and Canada control costs in a very specific fashion: The government sets a budget for how much will be spent on healthcare that year, and the system figures out how to spend that much and no more. One of the ways the British and Canadians save money is to punt elective surgeries to a lower priority level. A 2001 survey by the policy journal "Health Affairs" found that 38% of Britons and 27% of Canadians reported waiting four months or more for elective surgery. Among Americans, that number was only 5%. Score one of us!"
http://articles.latimes.com/2009/apr/07/opinion/oe-klein7
eridani
(51,907 posts)--and would solve all of our health care financing problems.
littlemissmartypants
(23,233 posts)obxhead
(8,434 posts)Or maybe we close military bases overseas "protecting" us from enemies that no longer exist.
Or maybe we just stop killing brown people so we can alter prices and allow access to resources.
Any, or better yet, all of those things would give us enough money to triple Medicare/caid coverage and pay off the national debt.
raouldukelives
(5,178 posts)How could investors save enough money for retirement? Manufacturing and then releasing those instruments of death on poor people is one of the backbones of a well structured retirement plan. That and deforestation, fracking, deep sea drilling, GMO's, and the ever lovely health care insurance industry, allowing you to profit from the denial of care to those who are unlucky enough to live near the fallout from Wall Streets dreams.
"Sorry the chemicals we dumped in your drinking water made you sick. Maybe if you had invested wisely in Dow, Lockheed and Monsanto you'd be able to afford the treatment."
bl968
(360 posts)It works like this....
1. We have to remove the profit motive out of healthcare.
2. Cover everyone
3. When you are healthy you pay for others, when you get sick they pay for you.
dkf
(37,305 posts)Response to dkf (Reply #43)
littlemissmartypants This message was self-deleted by its author.
Response to littlemissmartypants (Reply #45)
RandiFan1290 This message was self-deleted by its author.
WinkyDink
(51,311 posts)
RandiFan1290
(6,280 posts)She came here to tell us how important the Bush tax cuts are.
dkf
(37,305 posts)The public option should have been offered, especially if people are forced to buy insurance.
I am interested in keeping our country solvent. Health costs are a huge obstacle to that goal.
WinkyDink
(51,311 posts)littlemissmartypants
(23,233 posts)reformist2
(9,841 posts)I hate to say it, but when it comes to desperate dying people, the health care and pharmaceutical industry can become downright predatory with their pricing. It's immoral.
Response to dkf (Original post)
littlemissmartypants This message was self-deleted by its author.
reformist2
(9,841 posts)
ibegurpard
(16,685 posts)of course it's not going to work when there are no younger healthy people enrolled and we have a huge demographic now in the senior citizen category.
raccoon
(31,182 posts)WinkyDink
(51,311 posts)raccoon
(31,182 posts)Response to dkf (Original post)
littlemissmartypants This message was self-deleted by its author.
MiniMe
(21,737 posts)My mother got a bill from her primary care doc last week, It was for $250, I asked what that was for. She said her doc wouldn't take Medicare assignment, but if you paid the $250 she would take it. She has a good secondary insurance plan, but she has to pay the extra $250. She told me a lot of docs are doing that now. I was surprised.
thucythucy
(8,257 posts)allowing people to buy in on a sliding fee scale until retirement? There are tens of millions of people for whom this would be a cheaper option than private insurance, or who don't have insurance through work, or who continue to work at sucky jobs only because they need the insurance.
Lowering the eligibility age with a sliding premium scale would bring in millions of people who are relatively healthy, meaning low cost to the system, who would pump in cash in premiums, off-setting the current losses.
After all, that's how insurance is supposed to work. People who don't need the service now subsidize those who do, with the assumption that it balances out. The way the system works now, the private insurance companies mostly get the young and middle-aged, relatively healthy, relatively well-to-do, leaving the rest--elderly, people with disabilities, people in poverty who often have health issues related to their poverty--to be taken care of by government programs. Then folks complain about the "high cost" of those programs.
This was actually a part of the AHA for about twenty-four hours, until Joe Leiberman (R-Insurance Industry) said he'd block any such plan.
But that doesn't mean we have to stop trying.
Freddie
(9,330 posts)If this were possible--millions!--and free up jobs for younger people.
But no, that would be Socialism!
awake
(3,226 posts)This is a good start but what about letting everyone under 55 buy in if they want to, since we will all soon have to buy Health Ins.
The profit from the younger healthier "clients" premiums could help to off set the cost of others. The system could stay close to how it is to day for the elderly but allowing younger people to "buy in" this would be creating a single payer system for anyone who wants to join. Why pay for health Ins. only to have Medicare pay for you when you are most likely to need it the most, letting your health ins. provider whom you payed for most of your life off the hook?
Those who do not want to buy in early do not have to they can get it from another provider like they do now. This way we would not be adding any new mandate just offering the medicare ins. to anyone who wants to buy in to it.
thucythucy
(8,257 posts)This wouldn't be single payer over night, but the public option that so many of us wanted to see in the original AHA. I think the reason the insurance companies fought it tooth and nail is because they know, once Americans have a taste of how much better--and cheaper--such a syste would work, they'd lose their customer base and go exinct within a decade.
My hope is that someday we'll get there. In the meantime, we're stuck with this sucky system.
But I agree one hundred percent with what you're saying.
Response to dkf (Original post)
littlemissmartypants This message was self-deleted by its author.
Cal Carpenter
(4,959 posts)It is appalling that you say that subject line as if it is a fact.
If our 'system' was slightly more in line with other civilized nations and their health care systems, we would be able to afford health care for all.
Throwing more money from taxes and premiums in will do nothing to help our citizens receive the *service* of proper health care. It will just continue to fluff up all the unnecessary layers of profit in our health care, pharmaceutical, and health insurance industries.
Throwing good money after bad is not the answer. But you already know that.
porphyrian
(18,530 posts)Lots of funding for various programs is found elsewhere.
kentuck
(111,263 posts)Or just those above a certain income level?
What would be wrong with cutting Defense budget by $200 billion per year? That would give us back $2 trillion dollars over a ten-year period. And we would still have a larger defense budget than during the Cold War.
What would be wrong with raising taxes on those folks that only pay 14% on millions and millions of dollars of income (earned or unearned)?
What would be wrong with raising the tax rate back to Clinton levels and closing the tax loopholes? Nobody pays the top rate anyway. How much revenue are we losing with our present tax laws?
And what would be wrong in raising the present capital gains rate back to 30%? And raising the limit on FICA taxes to $250K or doing away with it completely?
That is not socialism. That is basic fairness.
on edit:
This is about priorities. It is not about too much spending.
BlueToTheBone
(3,747 posts)and you will find that it would be sustainable for a long time to come.
bluestate10
(10,942 posts)even if the account only pays an average interest rate of 4% over that time, compounding will bring you close to the higher figures that you listed. People that pay in have earned the money they get out. SS can be modified by removing the cap on SS and Medicare payments, even if the pay rate is left where President Obama set it last year. With the current system, high earners get a holiday that extends from virtually all of the year, to a couple months of the year.
AllyCat
(16,383 posts)It is sustainable. It has worked fine for decades for the segment of the population with the MOST health concerns. Add in a bunch of healthy people to the pool and it would be less expensive. The cost of care would go down because people would get care sooner in the disease process resulting in prevention and easier cures instead of expensive cures and death.
valerief
(53,235 posts)
Yavin4
(35,528 posts)And we could pay for it with a combo of higher marginal rates on the wealthy and a VAT on non-essential goods and services. We'd exlcude food, housing, medical care, clothing, and energy from the VAT.
Major Nikon
(36,856 posts)Socialize the medical finance industry and extend Medicare to all. Set premiums on a progressive scale based on income. Once you eliminate the 20% or so that private health care insurers are skimming off the top, there's money available to cover everyone for less.
begin_within
(21,551 posts)Younger people typically have lower medical costs than elderly people.
More young people paying Medicare premiums = more money coming in.
Lower medical bills for young people = less money going out per person.
This would make Medicare stronger and more solvent.
MadDash
(87 posts)My dad and my uncle paid in all their lives and didn't collect a cent before they passed.
jwirr
(39,215 posts)schools, jobs etc. the demand was bigger during these ages. What we need to do is find a way that we can get through the challenge until the population goes back down. We did it with schools etc and we can do it with these programs without totally eliminating them. Raising the taxes or a cap if there is one sounds like a possibility to me. They paid in more but the cost of medicines have really gone up. It is a real problem.