If Hillary were serious about improving healthcare

[gyroscope]

She would be advocating price regulation of private insurance companies and price controls on healthcare providers. In Germany for example public and private health insurance is non-profit and compulsory for all citizens. This might be the next best system to single-payer.

She keeps saying the ACA should be improved but doesn't give any specifics.
Does anyone really believe she would lift a finger to make it better?


--------------------


Health insurance is compulsory for the whole population in Germany. Salaried workers and employees below the relatively high income threshold of almost 50,000 Euros per year are automatically enrolled into one of currently around 130 public non-profit "sickness funds" at common rates for all members, and is paid for with joint employer-employee contributions. Provider payment is negotiated in complex corporatist social bargaining among specified self-governed bodies (e.g. physicians' associations) at the level of federal states (Länder). The sickness funds are mandated to provide a unique and broad benefit package and cannot refuse membership or otherwise discriminate on an actuarial basis. Social welfare beneficiaries are also enrolled in statutory health insurance, and municipalities pay contributions on behalf of them.

https://en.wikipedia.org/wiki/Healthcare_in_Germany

[enid602]

1. stances

"She keeps saying the ACA should be improved but doesn't give any specifics." I think she will now have to specify how she will make the ACA true Universal Healthcare. Just as Bernie will have to answer a lot of questions about his proposal. If either side fails to do this, it could be fatal for them. I think this race will gradually become less about personalities and rhetoric, and more about policy; specifically, the differences between their healthcare stances. Should be interesting. This nomination could rest on healthcare.

[daleanime]

2. I don't think that it will be allowed to be about policy.....

because that would be fatal for Hillary.

[enid602]

4. proposals

I don't think so. She will need to show how she can invigorate ACA, and show how that might be easier and more expedient than scrapping it for Bernie's proposal.

The ACA's major shortcomings are two-fold; 29 million uninsured and the fact that healthcare in this country is just too expensive.

I think she can stand up to big Pharma. Hell, even Trump has criticized it as of late. I don't think there is anyone from either party who is advocating the US's continued subsidization of world pharmaceutical prices.

The 29 million uninsured is going down, and will accelerate this year as millions face IRS penalties. The 7 million not covered by Medicaid expansion will decrease dramatically if some of the Republican governors of the 19 states blocking Medicaid expansion (Texas and Florida are the largest) buckle under pressure. This could create a domino effect.

Private insurers could be further limited in terms of profit and administration costs. Deregulating the insurance companies so they can cross state borders might be a good idea.

All successful Universal Healthcare among industrialized nations feature some form of tort reform. Universal Healthcare is more important than being able to sue doctors.

Hillary will have to speak for herself, but strengthening ACA is possible, and likely more feasible than scrapping it in favor of Single Payer.

Bernie, on the other hand will have to flesh out his own proposal.

[daleanime]

5. 'Flesh out', there's not much more that can be said about his plans.....

And there's no force on earth that could change your mind. So have a lovely evening.

[ljm2002]

6. She's not trying for true universal healthcare...

...the last thing she said on the topic was that we will get universal health care coverage for every man, woman and child.

Like a true corporatist, she knows how to use weasel words even when trying to project the impression of giving a fiery populist speech.

[Recursion]

22. You know Medicare For All is just universal *coverage*, right?

As written it doesn't even guarantee providers will accept it.

[blue neen]

32. Indeed...and some providers do not accept it.

Medicare is very confusing, and trying to get it figured out is very stressful.

Medicare For All (as it's written) is not the answer.

[thesquanderer]

3. Yes, I do believe that Hillary wants to make the ACA better.

Better for whom, is the question.

[Recursion]

7. The candidate who made that the centerpiece of his health plan pulled 3% and just dropped out

You're right: it's a much better idea than either Clinton's or Sanders's plans. The voters just don't care.

[eridani]

9. They may not care about details, but they do care about values.

"Health care is a human right" is a statement of values. Sanders has cosponsored pretty detailed single payer legislation for many years.

http://www.healthcare-now.org/index.php?s=Bernie+Sanders+S.+1782

[Recursion]

10. And, like I said, I get why Sanders is saying what he's saying

He knows what he released isn't an actual "plan" in any real sense; he did it to throw some red meat to his supporters, and it's effective. I get that. Voters don't care about details, though politicians need to (and, yes, Sanders does care about details when he's writing amendments to bills rather than submitting quixotic "values" legislation -- his FQHC expansion he tacked on to ACA was brilliant).

[eridani]

12. His detailed Senate bill in fact IS a real plan

And it's no more quixotic than anything in the rest of the developed world. But as we both agree, voters aren't much interested.

[Recursion]

13. Oh it's massively more ambitious than most of the developed world's healthcare plans

Entirely government-funded free-at-delivery healthcare is really just Canada, the UK, and Austria. There's no other country that does that.

[eridani]

15. And Taiwan and South Korea

Not clear whether there would be copays, but there are in Canada for prescription drugs.

[Recursion]

17. Nope, Taiwan and SK both have copays

Though they're obviously closer to the UK/Canada end of the spectrum. Most of the world still needs health insurance to pay for health care, though.

[eridani]

30. Inusrance companies need to be eliminated except for supplying boutique policies

Even in countries where private insurance is part of the system, there is no way in HELL that they are allowed to do actuarial analysis to boost their profits--in fact, non-profit is an almost universal requirement.

[gyroscope]

18. You conveniently left out France, Spain, Italy, Norway

and a host of others with single payer systems.


https://en.wikipedia.org/wiki/Health_care_in_France

[Recursion]

19. None of those four are single payer or free at delivery

You should read that link you posted, for a start.

[gyroscope]

20. Yeah I did

The first sentence says,

"The French health care system is one of universal health care largely financed by government national health insurance."

Do you know what single payer is? It means one entity (the government) serves as the payer that pays for your healthcare. That's why its called single payer. In France the government covers 70 to 100% of your healthcare. You can buy optional private health insurance to make up the difference. This private insurance is cheap because healthcare prices are kept low and affordable to begin with.

[Recursion]

21. So we agree France is not single payer. Awesome.

Your own words:

Do you know what single payer is? It means one entity (the government) serves as the payer that pays for your healthcare. That's why its called single payer. In France the government covers 70 to 100% of your healthcare. You can buy optional private health insurance to make up the difference.

Exactly. France is a three-tiered system with global provider budgeting and rate setting. Which, as your accurate definition shows, is not single payer.

[gyroscope]

23. Every single payer country

has optional private health insurance, including Canada. that doesn't make them not single payer though.

[Recursion]

24. In Canada it's illegal to privately bill for a covered treatment. That's single payer.

Canadian private health insurance is for treatments that aren't covered, as well as some upgrades. You're right, that's still single payer, because for all covered treatments, the government is the sole payer.

In France the government, the individual, and their insurer split the cost of (most) treatments. It should just be glaringly, semantically obvious that a system with three payers for a treatment is not single payer.

[gyroscope]

25. Its mostly single payer

when most to all of your bill is covered by the national health insurance, I would consider that single payer. if you fall below a certain income level and don't have private insurance to cover the difference, then they cover all of it for you anyway.

Even in Canada not 100% of healthcare is covered by the national plan. But everyone still calls it single payer.

[gyroscope]

11. Sanders has the right idea.

Start from a position of strength (ie: single payer), not weakness,

lest you end up with something as weak and watered-down as the ACA.

[Lucinda]

8. She has plenty of specifics. Perhaps you should try her website? n/t

[eridani]

14. Her website has no specifics whatsoever.

What does "building on ACA actually mean? How does she intend to lower costs? Not a clue here.

https://www.hillaryclinton.com/issues/health-care/

Going forward, Hillary will build on these efforts and fight to ensure that the savings from these reforms benefits families—not just insurance companies, drug companies, and large corporations.

Defend the Affordable Care Act. Hillary will continue to defend the Affordable Care Act (ACA) against Republican efforts to repeal it. She'll build on it to expand affordable coverage, slow the growth of overall health care costs (including prescription drugs), and make it possible for providers to deliver the very best care to patients.

Lower out-of-pocket costs like copays and deductibles. The average deductible for employer-sponsored health plans rose from $1,240 in 2002 to about $2,500 in 2013. American families are being squeezed by rising out-of-pocket health care costs. Hillary believes that workers should share in slower growth of national health care spending through lower costs.
https://www.hillaryclinton.com/issues/health-care/

Reduce the cost of prescription drugs. Prescription drug spending accelerated from 2.5 percent in 2013 to 12.6 percent in 2014. It’s no wonder that almost three-quarters of Americans believe prescription drug costs are unreasonable. Hillary believes we need to demand lower drug costs for hardworking families and seniors.

Transform our health care system to reward value and quality. Hillary is committed to building on delivery system reforms in the Affordable Care Act that improve value and quality care for Americans.

Hillary will also work to expand access to rural Americans, who often have difficulty finding quality, affordable health care. She will explore cost-effective ways to broaden the scope of health care providers eligible for telehealth reimbursement under Medicare and other programs, including federally qualified health centers and rural health clinics. She will also call for states to support efforts to streamline licensing for telemedicine and examine ways to expand the types of services that qualify for reimbursement.

Hillary is continuing a lifelong fight to ensure women have access to reproductive health care. As senator, she championed access to emergency contraception and voted in favor of strengthening a woman’s right to make her own health decisions. As president, she will continue defending Planned Parenthood, which provides critical health services including breast exams and cancer screenings to 2.7 million women a year.

[Lucinda]

28. Ahh..The more detailed stuff is in her briefing area. Here is a link to reducing out of pocket costs

and another to the main briefing area that is searchable for a variety of her policy ideas.
It's sort of convoluted, but you can use the dropdown menu right next to the white box that says "The Briefing" or the search box link on the upper right which will search your term through all the options in the drop down menu.

Reducing Costs:
This breaks down several areas that can lower costs and provide consumer protection:
https://www.hillaryclinton.com/briefing/factsheets/2015/09/23/clinton-plan-to-lower-out-of-pocket-health-care-costs/


Main Policy Area:
https://www.hillaryclinton.com/briefing/



This also has comments on several health care issues with annotated source links for all the candidates:
https://ballotpedia.org/2016_presidential_candidates_on_healthcare

I especially like the idea of the three visits per year without meeting deductible costs first. I know people with ACA now, that cant afford to go to the doctor because of the deductible.

And I apologize...I really should have just linked you to my journal or taken the time to post these for you. I was just about to crawl off to bed when I answered your post.

Lucinda

[eridani]

31. Single payer does not dole out doctor visits. And how is a tax credi supposed to help--

--people who pay little income tax?. Especially since they have to wait a year to get it while being dinged for expenses right away. I can't find anything about exactly what the limits on premium increases would be either. All in all, really weak tea that will not prevent ongoing death and bankruptcy caused by insurance companies.

[MrMickeysMom]

16. One huge difference when you look through the years on what Clinton advocates...

None of it includes the basic liberties afforded to other industrialized nations. IOW, she has had more time to offer more than lip service to how health care delivery is budgeted.

Beginning in the 1990's, when I was finishing my degree, one of my assignments was to learn the internet before all the GUI was introduced by searching/reporting on her health care plan.

Choice was of utmost importance in what she presented in 1993, in alliance with Bill Clinton. Third party reimbursement was a given. Back then, working people had choice by having good benefits which included medical, dental vision plans. The concept of HMOs were seen as the bastion of healing in what had become an over-use of acute care services.

But as the good jobs went offshore, right along with tax havens, those choices were ripped out of the employee-based health plans. So, you would think that she rose to the occasion in recognition to the other industrialized countries who don't have people filing bankruptcy when they get major sickness. Well, she didn't offer anything of the sort. Go to her website and what you'll see is a lot of generalities and no substance.

Bernie Sanders plan on funding single payer is the only plan out there. I challenge anyone to cut and paste the Clinton plan here to address what's already been offered with the means to pay for it. You won't find it. It doesn't exist.

[Thinkingabout]

26. Then let it be said, she is for lowering the cost of health care and drugs.

[gyroscope]

29. When the drug and insurance companies want to raise prices 50%

Hillary will get them to raise it by 'only' 40 to 45%. Wow!

[mother earth]

27. She's a corporate candidate & is beholden to big money donors, for good reason, they know

the investment is peanuts compared to what they will get. Oligarchy rules in this nation right now, hence the outrage.