How many patients can one doctor take care of per year? How many people can one farmer feed a year?
Was just thinking that there should be doctor clubs, where a bunch of people pool their money to hire a dedicated general physician. Or to have a shared tailor, or group cafeteria, or whatever.
The ratio of people covered to specialists would probably determine whether it's feasible. You'd want the specialist to still get paid a healthy (and guaranteed) salary and to have a more satisfying relationship with customers. And the members of the club to get better service / product than they would otherwise with middlemen taking a cut.
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I want universal healthcare. I was thinking about this since maybe a town or community could actually get something in place while nationwide universal healthcare seems decades away in the U.S.
It would be cheaper than paying insurance actually by a lot
Reading into your intention, this is actually more like health insurance than single payer healthcare. Not quite a million little coops, more like a few dozen. And it would end up having most of the same problems of modern US health insurance.
You'll need someone to administer the program, so you have to give them some power over your money. That means they'd need the power to say "no" to people who are seeking healthcare resources for invalid reasons--things like Munchausen's syndrome at first, but eventually they'd have to make calls about things that people actually need but can't prove they need, just like health insurance does now.
If you don't want do these things, I guarantee your neighbors will insist they be done (ever hung out on nextdoor? those are the people you'll be pooling your money with). And you'll go along, because it's a hassle not to, and hey at least you're getting your needs taken care of most of the time. If you manage to keep your program free of capitalist influences, you're going to have to fight corruption instead: "Slip me some dough and I'll make sure you get seen next."
So in time you just end up with health insurance, and most of its flaws, if you don't very carefully watch the people administering your program, if you don't very carefully fight against the perverse incentives.
The biggest problem, of course, is that existing health insurance would fight it like penicillin fights bacteria. They have had decades to do regulatory capture in their benefit, and if another group comes along that's almost-but-not-quite health insurance, they're going to make sure that the regulations they captured keep it from going anywhere, up to the point of trying to make it explicitly illegal.
I think we're in agreement about single payer, but this ^ is how it benefits us. The government has actual power to fight corruption and isn't beholden to capital. Now if we only had a way to create a just government.
Not saying it would work, but what I'm describing is more bite size than a full health system. So if a group only committed to "everyone gets to see a general practitioner" then people are on their own for MRIs and chemo. Figure out how many patients a type of practitioner can handle in a year, then pool that many people to hire one. Same idea for any other role, like how many cars can one mechanic fix a year?
I'm not married to the idea, but more thinking about how could we take concrete steps towards universal health care, other common services, democratic workplaces. If people see a micro version working then it may inspire more ideas, attract more effort.
Maybe.
You mention farmers. They already have co-ops. If you've lived around those communities you know people can get apeshit about a semi of corn that might be a little wet.
I wouldn't want to be on the local board that has to settle the account for aunt murtle's 5th round of lung cancer while she's on O2 and still on a pack a day. It's easier to set guide rails - actually moral and responsible ones like not giving liver transplants to people with bac - when you didn't grow up with aunt murtle's kids.
Sure, if we can get universal let's do it. Don't have to sell me on it being better.
Do you have thoughts on how to move the ball from our current situation to something closer to the ideal?
Nobody can tell how many doctors are needed for the whole universe.
/SCNR
Also not thinking just about healthcare...
I support single payer. Just realize your taxes will go up significantly in a single payer system. At least 20%.
Everyone will have to pay to make it work but I hint it’s a solid investment in our country
But your insurance premiums will go down by more than your taxes go up, for most of us working shulbs, anyway.
No. Not even close. I pay 100 dollars a month for insurance.
If my taxes go up by 20%, that’s more than 100 dollars a month.
That's where it gets complicated. Your employer pays a lot more than $100. Your taxes would go up and your employer could be mandated to pass the healthcare savings on to you to largely offset your tax increase. The Wyden-Bennet plan predated the Affordable Care Act and would have mandated that. Obama's healthcare people were concerned that would be very complex and would go back on his promise to allow people to keep their current doctors and insurance. So we ended up with a huge expansion in Medicaid instead (which was great but didn't give us the systemic change we really needed).
Or the employer would have to pay more to balance the system.
All the plans show a large tax increase which I am fine with if we keep a stable system. Doctors have to be paid, along with nurses and that isn't cheap.
I think employer insurance is an odd system but I get why it happened. I just think it is time for it to die.
Yeah they were trying to keep it cost neutral. Bennett was a conservative republican.
Employer based insurance is possibly one of the worst systems we could have come up with if we were designing it from scratch.
I think we have to accept everyone will pay more in taxes but there will be surprise bills if there is an emergency, no delayed care while you switch jobs or the plethora of stupid issues that come up when it's tied to an employer. People need to stop thinking it will cost less. It won't and that's Ok.
Taxes go up, but money paid to health insurance goes down.
And you're already paying most of the operating costs of universal healthcare in the form of Medicare/Medicaid administration taxes, you're just not eligible to benefit.
So your taxes will increase, but not as much as you expect, and your total deductions will decrease unless you opt to keep private insurance.
Every analysis of the topic inevitably concludes that we're currently using the most expensive method of providing healthcare.
I’d expect about 20%. That seems to the number floated around by most the think tanks.
20% of my taxes is much less than my current employer plan cost.
You are wrong. Costs will go down compared to health insurance costs in United States right now. Might end up taxing currently uninsured more but for most will be less and folks in poverty will gain more than they lose anyway
You have a cite that it’ll cost me less? I have never seen a study that suggest that.
All of them actually. The talking point from the right (in the US) is that is will increase debt on the federal level. While this is true, they always leave out the fact that no one will be paying for regular health insurance anymore, which actually costs American tax payers more than what single payer would cost.
It would be more difficult to find one that disagrees with what I am saying
CIte one. I pay 100 a month for my insurance. Cite me where I will pay less under a single payer system.
Every legitimate cite I have seen says about a 20% tax increase which I am fine with.
If you are arguing that we have a lot of folks living in poverty and their taxes might increase a bit I believe that is a bad faith argument.
If you get health insurance through your employer like most Americans then the employer paid parts will also disappear… but folks are so uninformed that they can’t see it
Facts are not bad faith. Pretending it will not cause taxes to increase is just silly, and why we have never been able to get it passed.
People like the idea until they find out their taxes will go up considerably. I am fine with that but stop trying to be dishonest. The money has to come from some place to fund the system. That means taxes will increase.
It’s bad faith to lie about total costs. Period. Our current system leaves tens of millions uninsured (most especially children, and many more millions underinsured.
United States is a third world country when it comes to health care for the poor.
Total cost will go down unless you pay basically nothing for health insurance.
Then cite something.
https://www.rpc.senate.gov/policy-papers/medicare-for-all-higher-taxes-fewer-choices-longer-lines
Here is a cite using the Democrat Medicare for all numbers. gasp! It shows 20% like all the other cites I have seen.
You are the only one lying about cost. Your claim is that it will cost be less and it won't. It won't cost anyone less unless they don't pay taxes. Otherwise, it will cost them more.
You said you pay 100$ per month for a 250$ deductible. My employer pays 500 per month for a 1500 deductible and I know I have one of the best plans
Well, it appears mine is better.
Neither of us would have copay or deductible if we actually had to use our insurance
I don’t pay anything. I could have the one hundred per month plan and have the 250$ deductible as well or similar etc, but then my employer would be paying like 600-800 per month I believe so yours is actually more expensive as far as the whole system is concerned.
I doubt you get much of anything for 100$ a month; I have a free plan at work but my employer pays way more than 100 a month for that one… which is a high deductible plan
250 dollar deductible. 20-dollar co-pay for specialist. 2250 out pf pocket max. Coinsurance 10%. Emergency room 100 dollars
I’m sorry but you’re lying. Or leaving something out.
No, that is taken right off the web page.
Maybe if you’re on Medicare or you are ina blue state and you are one welfare and completely broke… but that doesn’t add up. You may be forgetting your employer contributions