[b9a2cab5]

> I strongly suspect that a socialized medical program in the US would not actually cost individuals any more than they're paying now

The definition of progressive taxation means this is not the case for anyone making more than 100-150k, given current tax brackets.

Medicare already is 1/3 of the federal budget and I can assure you someone making low 6 figures definitely pays more in tax than 3x $900.

[arcticbull]

> Medicare already is 1/3 of the federal budget and I can assure you someone making low 6 figures definitely pays more in tax than 3x $900.

Well the first step is redirecting all the premiums paid by employers on behalf of employees into the federal pot. That should net ~$5500 per taxpayer or an additional ~$1.8T per year. That will sort out the bulk of it with no additional cost visible to individuals.

[b9a2cab5]

That is not the plan put forth by Medicare for All advocates. There is a strong undertone of income redistribution in progressive proposals for single payer.

I would also expect that if the government was taking that money my health benefits would be at least as good as they are now. And I don't think that will be the case. When I was a kid there was a period where I was on California MediCal and I distinctly remember getting glasses with _super_ thick lenses because all MediCal would pay for was the cheapest frames and lenses.

[arcticbull]

> That is not the plan put forth by Medicare for All advocates.

I'm almost 100% confident it is. That money is currently being paid on behalf of individuals to insurers. Take the insurers away that money either goes to individuals and gets taxed, or gets sent directly to the feds. Either way it's a no-op.

> There is a strong undertone of income redistribution in progressive proposals for single payer.

Healthcare is the great equalizer. It's not insurance - everyone needs it and everyone will use it. There's not really a strong correlation between more spend and better outcomes past a certain point. Except in the rarest of cases you can't cure cancer with fat stacks. What offering healthcare does is give low income folks the opportunity to found companies without the fear of death. It dramatically reduces the burden on all businesses and especially small businesses by killing a massive cost center.

> I would also expect that if the government was taking that money my health benefits would be at least as good as they are now. And I don't think that will be the case.

Every healthcare system that ranks above America's is single payer or two-tier socialized. MediCal is set up to be punitive to the poors like all Medicaid programs. A Medicare system isn't. There's a reason not a single AARP member is advocating for eliminating Medicare. What getting everyone on the system does is it makes the political class beholden to the needs of the individuals.

I watched Donald Trump in front a group of older folks literally hug a flag and say he'd do whatever it took to keep the Democrats away from their Medicare. That doesn't sound like a system itching to be upturned does it?

Socialized medicine is no more a partisan issue in most countries than a socialized fire department or sidewalks.

[b9a2cab5]

> Healthcare is the great equalizer

By income redistribution I mean most progressive proposals aim to heavily tax high earners to fund healthcare for lower income individuals. That money would otherwise be used by those earners to buy their first home, build retirement wealth, etc. Ever heard of HENRYs?

> MediCal is set up to be punitive to the poors like all Medicaid programs. A Medicare system isn't.

Citation is needed here. A lot of good doctors in my area won't take Medicare patients because Medicare reimbursements are too low. We also know from European systems that because everything is triaged based on need that wait times end up being very long if you don't have a life threatening condition. You also need to consider that American doctors make substantially more than European ones. If you compare the pay of specialty doctors in the NHS to ones in the US the difference is something like 5x.

> What getting everyone on the system does is it makes the political class beholden to the needs of the individuals

That is your perspective, and I think it's a naive one. I think it would prevent reforms that drive efficiency. Think of what happens when anyone talks about making Medicare more efficient: they get attacked as anti-elderly and portrayed as wanting to cut benefits. Or the same for military spending. At least the free market (which healthcare is not right now, but it could be) is ruthless about creating efficiency.

> Socialized medicine is no more a partisan issue in most countries than a socialized fire department or sidewalks.

Funny that the UK argues about NHS funding a lot then.

[arcticbull]

> By income redistribution I mean most progressive proposals aim to heavily tax high earners to fund healthcare for lower income individuals.

As someone who would be on the giving end of that, I'm fine with it, honestly. I won't always be on top.

> We also know from European systems that because everything is triaged based on need that wait times end up being very long if you don't have a life threatening condition.

We don't know that at all. Triaging based on need is a feature, not a bug - and a super easy way to save a ton of money! All of these criticisms were made up by the marketing department at insurers to fleece Americans. That's not hyperbole, and don't take my word for it. Here's an interview with one of the Cigna guys admitting to doing it, and apologizing. [1]

  "Here's the truth. Our industry PR and lobbying group, AHIP, supplied my colleagues and me with cherry-picked data and anecdotes to make people think Canadians wait endlessly for their care. It's a lie. And I'll always regret the disservice I did to folks on both sides of the border"

> You also need to consider that American doctors make substantially more than European ones. If you compare the pay of specialty doctors in the NHS to ones in the US the difference is something like 5x.

Ok, and they shouldn't. I'm sorry. It's not sustainable, it's not affordable. They're taking pay cuts. Nobody is entitled to a certain salary, standard or lifestyle in perpetuity no matter how unsustainable. BMWs for doctors while 10% of Americans are told to die or pick their favorite finger after an accent is unconscionable. America pays more than anyone else anyways, and would still after cuts, where would they go?

However, this is also simply not true for every system. Most similar countries socialize malpractice insurance which is a huge cost for US doctors. US OBGYNs pay up to $200,000 per year in malpractice insurance. In Canada, $40,000CAD. In the UK I think it's 0GBP handled by the CNST. That goes a long way to balancing out pay differentials.

In the US anesthesiologists make 400K USD median, in Canada 335K CAD median.

> Funny that the UK argues about NHS funding a lot then.

They argue about funding and prioritization and all sorts of stuff, sure, but it's not a partisan matter that the NHS should exist and be the status quo. The NHS was literally in the opening ceremonies of the 2012 olympics. 87% of British folks are proud of the NHS. [2]

Canada's Conservatives support single-payer medicine too.

[1] https://www.npr.org/2020/06/27/884307565/after-pushing-lies-...

[2] https://yougov.co.uk/topics/politics/articles-reports/2018/0...

[b9a2cab5]

> As someone who would be on the giving end of that, I'm fine with it, honestly. I won't always be on top.

And I and many others are not. You should recognize that this is a _political_ issue where there is no objectively better outcome. Higher taxation has long run drags on innovation and wealth building. The tradeoff is yes, we don't have universal healthcare. I'm okay with that if it means I have more job opportunities and ability to build my wealth.

> In the US anesthesiologists make 400K USD median, in Canada 335K CAD median

Just because the gap isn't 5x doesn't mean there still isn't a huge gap. $335K CAD is $235K USD. And Canada has comparable CoL to major US cities so you're losing real purchasing power there.

> That's not hyperbole, and don't take my word for it

Take a look for yourself at the data in Table 4 [1] sourced directly from each country's government reporting infrastructure and decide for yourself whether you would accept those wait times. I wouldn't accept a 2 month average wait time for something as simple as cataract removal, that's for sure. The quality of life loss in that time is immense.

> Ok, and they shouldn't. I'm sorry. It's not sustainable, it's not affordable. They're taking pay cuts.

Good luck passing any legislation over the lobbying of the AMA then. You're suggesting fundamentally untenable legislation that will never pass in the US. Aka bikeshedding. This is exactly the reason progressives can't get any legislation passed in Congress.

[1]: https://www.sciencedirect.com/science/article/pii/S016885101...

[arcticbull]

> And I and many others are not. You should recognize that this is a _political_ issue where there is no objectively better outcome

Luckily the rich are a minority and this is a majority rule system :)

There is 100% an objectively better outcome. Better care for more people, fewer people falling through the cracks is objectively better. There are objective rankings of healthcare system quality.

> Higher taxation has long run drags on innovation and wealth building.

And not dying if a small business owner gets sick has a long run boost to the economy. Individuals being able to take risks without fear of death and pestilence has a long run boost to the economy. A carpenter having all their fingers re-attached instead of just some of them has a long-run boost to the economy. Small and mid-size businesses not having to administer health plans is a boost to the economy.

> I'm okay with that if it means I have more job opportunities and ability to build my wealth.

You'll still have your chance lol.

> I wouldn't accept a 2 month average wait time for something as simple as cataract removal, that's for sure.

Cataracts develops slowly over a period of years. It's explicitly one of the lowest priority surgeries you can get for that reason. It took you 10 years to develop you don't need it out by Monday, late February is fine. (NOTE: In some provinces your data shows you can get it out in 2 days in Canada). It's nuts to think that you should be able to pay more to get your decades old cataract out by Monday so that someone who was in a car accident can get in line lol.

So yeah you absolutely would, and you wouldn't care at all.

Either way, America will almost certainly land on a two-tier system where you can still get your way.

> The quality of life loss in that time is immense. This is exactly the reason progressives can't get any legislation passed in Congress.

It's simply not. Sorry. Data and satisfaction surveys disagree, but also - only for the few who can afford to jump the queue. There's very few of those so they're not really represented in surveys.

> Good luck passing any legislation over the lobbying of the AMA then.

Single payer in Canada passed explicitly against the wishes of the entire North American medical establishment. "The organized medical establishment was not nearly so reticent and mounted a ferocious propaganda campaign fronted by the local College of Physicians and Surgeons with the support of the Canadian Medical Association (CMA), the AMA, the local economic elite and most of the media in the province." [1]

We got it done before, we'll get it done again.

You've been fed a crock. Sorry.

[1] https://canadiandimension.com/articles/view/the-birth-of-med...

[Talanes]

> By income redistribution I mean most progressive proposals aim to heavily tax high earners to fund healthcare for lower income individuals. That money would otherwise be used by those earners to buy their first home, build retirement wealth, etc.

This is the most transparently selfish thing I've read in a while. Congratulations.

[refurb]

”Socialized medicine is no more a partisan issue in most countries than a socialized fire department or sidewalks.”

That’s a disingenuous statement since most countries have a mix of public and private care and many folks rely on private insurance and private care. Canada is one where private care is almost non-existent, but the UK, Switzerland, Australia have a significant private segment.

What Medicare for All suggests (and a few Democrats have said it explicitly) is that private insurance would disappear.

So Socialized medicine isn’t a partisan issue in most countries, but neither is private medicine.

[jollybean]

A few years ago, in Canada, we were paying $4500 per person - and everyone was covered.

The US was paying $5K public per person and $5K private per person.

Meaning - the US is already paying more per capita in public healthcare spending, than Canada, and for that price in Canada - everyone is covered.

This kind of means, the US could literally give all of its citizens 'Canadian Quality Universal Coverage' and literally save a few dollars in public spending, and wipe out the need for private spending.

So 'cost' and 'profit' are different things.

The US HC system is a giant elephant of inefficiency.

This is not a small thing:

'Healthcare' is a 'Pillar of American Decline'. I don't mean that America is falling apart, but rather, it's having less influence in the world.

50 years ago, you went to the Hospital because you were hurt. Now - it's all about aging people who are elderly who see the doctor 20x a year and it's why costs have skyrocketed. It's also when people are the least productive and less likely to be working with good insurance.

HC is a disaster that makes the US a 'much less attractive place to live' for one's entire life, unless one is rich - whereas that was not the case before.

It really needs to be sorted out.

The Media Left, by highlighting Woke issues, instead of things like outrageous healthcare, has completely lost their minds. MSNBC was calling Elon Musk 'racist and misogynist' for his completely benign comments about this giant tax bill. Instead of looking at inequality issues through economic lenses, they're committed to throwing around gender and racial slander. The HC system is a soft, easy target because there are unlimited stories of people getting huge bills, unfair pricing. But you won't see to many stories, because "Sponsored by Phizer".

[erichocean]

> 50 years ago, you went to the Hospital because you were hurt. Now - it's all about aging people who are elderly who see the doctor 20x a year and it's why costs have skyrocketed. It's also when people are the least productive and less likely to be working with good insurance.

Literally 100% of the elderly in the US are already covered by the socialized medicine you seem to be advocating for. It's not optional.