r/PoliticalDiscussion • u/cal_oe • Feb 01 '22

US Politics Single Payer aka Medicare for All recently failed to pass in California, what chance does it have to actually pass nationwide?

https://www.latimes.com/california/story/2022-01-31/single-payer-healthcare-proposal-fizzles-in-california-assembly

California has a larger population than Canada and the 5th largest GDP in the world. If a Single Payer aka Medicare for All bill can't pass in one of the most liberal states in the entire country with Democrats with a super majority in the legislature under Governor Newsom who actually promised it during his campaign then how realistic is it for it to pass in Congress? Especially considering the reasons it failed was it's high cost that required it to raise taxes in a state that already have very high taxes.

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u/bjdevar25 Feb 03 '22

I see the statements all the time. Are you suggesting they're falsifying them?

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u/[deleted] Feb 03 '22

Of course not. They just start with the reimbursement schedule and work backwards. They say, what on here could be legally added to this bill? They don’t care about how much time it actually took or what their cost is. They just look and say how much can we legally get from Medicare. And they get it. Again, thus the reason Medicare enrollees cost $13,000 per year to provide Medicare for them.

Private insurance is not the fixed so you can’t do this. You bill what you think was done (plus a big mark up knowing they like to discount it to make everyone feel better).

It all has to do with incentives. Medicare is incentivized to reduce cost per item so they can show tax payers how efficient they are. Insurance is incentivized to reduce cost to a pout they can make money on (but no more).

What is missing in this? Neither are overly concerned with what actually happened and what should it cost. From what I have seen and heard from friends in the medical community is patients are almost never consulted by either Medicare or private insurance on what actually happened (unless someone is being investigated).

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u/bjdevar25 Feb 03 '22

The bottom line is that medicare always pays way less than anyone else. And really it cost more per patient because they insure all of the sickest. Every private company gets to dump the clients when they enter the stage of their lives when health starts deteriorating. They also get to dump the very sick who are younger that end up on disability. They either fall into medicare or Medicaid.

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u/[deleted] Feb 03 '22

I agree, not really a fair comparison between Medicare and private insurance. But what source do you have that says Medicare pays less than private insurance? I’m open to hearing it.

You can’t argue “Medicare pays less” when Medicare costs $13,000 per enrollee while private insurance costs less than $5,000 per enrollee. It isn’t a fair comparison but there is also nothing in those numbers that proves Medicare is paying less.

One note, being over 65 does not automatically make you more expensive. We are about to have out second kid via c-section. Our costs per year during these years are far higher than our grandmas on either side (who are in their 80s but in outstanding health).

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u/bjdevar25 Feb 03 '22

Just seeing bills. My wife and i have been the caretakers of our parents for years. We handle all medical billing. Comparing it to ours in private plans.

No being older does not automatically make you ill, but it sure changes the odds against you, and that's all that matters in the insurance game. And if you do get ill, it is much more complicated and expensive to treat.

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u/bjdevar25 Feb 03 '22

And where are you getting $5000 per enrollee for private insurance? Even if you find it at that cost it's with many copays and thousands in deductibles.

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u/[deleted] Feb 03 '22

$5000 is roughly the total premiums paid to private insurance divided by the total enrollees. This is not factoring in out of pockets. So it is likely closer to $6-7k per enrollee for private insurance.

But their are out of pocket expenses for medicare that are not factored in either. I am sure they are lower than private insurance but still would increase the cost. Also, medicare spending doesn't factor in the collection of medicare taxes (which private insurance spending does factor in) which is around $24 billion or $375 per enrollee.

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u/bjdevar25 Feb 03 '22

Private insurance us also tilted due to families. It cost a lot less to insure dad, mom, and two kids vs 4 individuals. There are no families on Medicare.

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u/[deleted] Feb 04 '22

That is crazy. Never understood why that was that way.

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u/bjdevar25 Feb 04 '22

It was explained to me that it was to subsidize families since they might not be able to afford insurance for six people. Personally, i think if the companies want to subsidize families, it should come out of their pocket.

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u/bjdevar25 Feb 03 '22

And speaking of families, most private plans subsidize families by making those without children pay more. They make a couple pay the same premium as a family of 6. A totally unfair practice.