[Frondo]

Not free and no one's saying that. Free at point of service, like the NHS or the Canadian health care system, yes, but obviously everyone knows we'd pay for it with taxes.

We could just do it, cover everyone, for less than we're paying now, by rejiggering the system under a "medicare for all" banner. There aren't any other serious options on the table. (replace and repeal, or whatever, is not a serious option.)

[ssambros]

Medicare currently pays less than what it costs to provide for a lot of services. And providers are either declining medicare alltogether or recouping the missing funds from the other patients. Where would all those other patients come from if medicare will be "for all"?

[maxxxxx]

"Medicare currently pays less than what it costs to provide for a lot of services"

Is that even true? Personally I have my doubts.

[ssambros]

American Hospital Association: Underpayment by Medicare and Medicaid Fact Sheet, December 2017 Update [0]

FINDINGS

In the aggregate, both Medicare and Medicaid payments fell below costs in 2016:

- Combined underpayments were $68.8 billion in 2016. This includes a shortfall of $48.8 billion for Medicare and $20.0 billion for Medicaid.

-For Medicare, hospitals received payment of only 87 cents for every dollar spent by hospitals caring for Medicare patients in 2016.

- For Medicaid, hospitals received payment of only 88 cents for every dollar spent by hospitals caring for Medicaid patients in 2016.

- In 2016, 66 percent of hospitals received Medicare payments less than cost, while 61 percent of hospitals received Medicaid payments less than cost.

[0] https://www.aha.org/data-insights/2018-01-03-underpayment-me...

[maxxxxx]

After having dealt with billing from hospitals for services they never delivered or obscenely overpriced I am inclined not to trust them on statements about their actual cost. In my view the billing practices of most hospitals are very dishonest and intentionally confusing and opaque.

[ssambros]

"billing practices of most hospitals are very dishonest and intentionally confusing and opaque."

Is that even true? Personally I have my doubts.

[maxxxxx]

Check out some hospital bills for major procedures and there is a good chance that you will find things like charges for services nobody remembers or a doctor who was in the room for 3 minutes charged $1200 or receiving an aspirin costs $80. Maybe my experiences are all anecdotal but when I put my own experiences together with what I hear from others and things I read I am pretty convinced that something is going very wrong.

[SketchySeaBeast]

> For Medicaid, hospitals received payment of only 88 cents for every dollar spent by hospitals caring for Medicaid patients in 2016.

Is that the actual cost of the item or the obscene markup? Is medicare only paying $2.20 for the $2.50 saline bag, or are they only paying $176 of the $200 charge?

[frockington]

As a taxpayer I would be in favor of a more equitable system where everyone has a line item brought to their attention. There may be a use case for UBI here, everyone gets a stipend or a tax cut that they can use to either get healthcare or not. I'm getting tired of all of the taxes and how easy it is to paint tax payers as evil rich people who need to give more with their hard earned money