There must be a pony in here somewhere.

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Mo
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Re: There must be a pony in here somewhere.

Post by Mo » 27 Feb 2018, 17:02

Pham Nuwen wrote:
27 Feb 2018, 16:36
Well mainly it's because we are okay with our neighbors paying for us. And we have endless reasons why its okay for you to pay for me but not the reverse. But also things like this, yes.
Things like this make UMC people more amenable to it. That's despite the fact that they would be net paying. People will pay more not to deal with inscrutable bullshit. My understanding is that for all of its faults, Medicare is relatively low on the inscrutable bullshit scale of medical care in the US.
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Re: There must be a pony in here somewhere.

Post by Jennifer » 27 Feb 2018, 17:10

Pham Nuwen wrote:
27 Feb 2018, 16:36
Well mainly it's because we are okay with our neighbors paying for us.
I've heard other people make similar claims but I don't buy it (for the most part; of course you can find individual examples of selfish facepalmery for any political or economic opinion). You don't find overwhelming numbers of Americans making similar demands regarding (for example) food or electricity, which arguably are far more important than health care (at least in terms of how long and how many people could expect to maintain an ordinary life and lifestyle without them)--but those costs can actually be handled by a sane person. I know how much my food costs in advance, and it's not possible for grocery stores or restaurants to pull some bullshit stunt like telling me my meal will cost ten bucks and then, after I've already eaten it and it's too late to refuse it, only then am I told "Did we say you owe ten bucks? Just kidding; you actually owe us a thousand." If that were SOP, you would indeed find large numbers of American clamoring about their Right to Eat and demanding the government Do Something about it -- and I'd say "Don't blame Americans for getting pissed off about their inability to afford food; blame the shithead grocery stores and restaurants who keep pulling sleazy nontransparent billing stunts like this."
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Re: There must be a pony in here somewhere.

Post by JasonL » 27 Feb 2018, 17:27

If you don’t think other people paying is a nontrivial to dominant feature of those preferring single payer your head is in the sand. The difference is the sudden potentially large cost of life saving care. A burger or a kilowatt doesn’t seem impossible to plan for or unfair when the charge comes. Healthcare things that are expensive are unfair and impossible to deal with so make everyone else pay. As I alluded to above, try showing a real single payer person how much poor Germans pay for healthcare and see how they take it. There’s a fantasy that universal coverage is cheap or can be funded with barely noticeable increases on most people. We are allowed to imagine someone else paying for everything and no paperwork and no downside. Like, you know, doubling or more payroll taxes yes on poor working people.

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Re: There must be a pony in here somewhere.

Post by Jennifer » 27 Feb 2018, 17:38

JasonL wrote:
27 Feb 2018, 17:27
If you don’t think other people paying is a nontrivial to dominant feature of those preferring single payer your head is in the sand.
What I'm saying is that much of the current American support for single payer would go away if ordinary Americans did NOT have to deal with such nonsense as "this ordinary urine test which your doctor ordered turned out to have multiple unnecessary extra tests added to it and you're on the hook for five figures as a result."
The difference is the sudden potentially large cost of life saving care.
Don't forget the potentially large cost of bog-standard urine tests, cholesterol tests and the like. Which is only potentially large because of the fucked-up system we have now: no price transparency, no discovering how impossibly large a given bill is until it's too late to refuse the service -- and too many intelligent people who ought to know better nonetheless keep sneering that the people fed up with this status quo must be overly entitled demanders of free stuff at other people's expense, and if you think you can disagree with this point without sneering your head is in the sand.
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Re: There must be a pony in here somewhere.

Post by JasonL » 27 Feb 2018, 19:31

So, right. The current system has lots of bad features. Have you seen the Sanders campaign thing with the Canadian cancer patient and her sister? The sell is everyone else pays for everything you never see a bill you shouldn’t have to worry. That’s the official view of the largest single payer advocacy group in America- the dem socialists. I can go with you pretty far down the road of how our system sucks - until the inevitable part where you act like obvious features of the discussion are not really things because people don’t really want free stuff forever. Ugh. Yes they do. What’s the national rate of medical savings? Near fucking zero. Before HSAs it was indistinguishable from zero. What’s the rate of voluntary opt out of coverage then use of ER? Fucking high before ACA. Still fucking high. What happens in every damn poll about universal coverage when you specify that people have to pay themselves an amount they’d notice? Support evaporates. I have one toe in this space from the benefits side. Freeee!!!!

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Re: There must be a pony in here somewhere.

Post by lunchstealer » 27 Feb 2018, 23:46

JasonL wrote:
27 Feb 2018, 17:27
try showing a real single payer person how much poor Germans pay for healthcare and see how they take it.
I run across these people pretty regularly. Am I right that the public insurance that the low-income Germans would use is a theoretical tax of 7.5% plus an employer-payroll component of a second 7.5% for a total of 15%? So to port that directly to the US, someone making the 'living wage' of $15/hr would be dropping $195/month seen from their paycheck?

I'm not sure that's going to scare Bernistas.
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Mo
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Re: There must be a pony in here somewhere.

Post by Mo » 27 Feb 2018, 23:59

The additional rate would be 12% because the Medicare tax would presumably be rolled up into it.
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Re: There must be a pony in here somewhere.

Post by Pham Nuwen » 28 Feb 2018, 02:08

Additional rate? As in 27% total?
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Jadagul
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Re: There must be a pony in here somewhere.

Post by Jadagul » 28 Feb 2018, 02:11

No. Mo is saying that currently everyone pays about 3% into a medicare tax, and in the German system everyone pays about 15%. So the increase would be about 12%.

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Re: There must be a pony in here somewhere.

Post by Pham Nuwen » 28 Feb 2018, 02:15

Jennifer wrote:
27 Feb 2018, 17:10
Pham Nuwen wrote:
27 Feb 2018, 16:36
Well mainly it's because we are okay with our neighbors paying for us.
I've heard other people make similar claims but I don't buy it (for the most part; of course you can find individual examples of selfish facepalmery for any political or economic opinion). You don't find overwhelming numbers of Americans making similar demands regarding (for example) food or electricity, which arguably are far more important than health care (at least in terms of how long and how many people could expect to maintain an ordinary life and lifestyle without them)--but those costs can actually be handled by a sane person. I know how much my food costs in advance, and it's not possible for grocery stores or restaurants to pull some bullshit stunt like telling me my meal will cost ten bucks and then, after I've already eaten it and it's too late to refuse it, only then am I told "Did we say you owe ten bucks? Just kidding; you actually owe us a thousand." If that were SOP, you would indeed find large numbers of American clamoring about their Right to Eat and demanding the government Do Something about it -- and I'd say "Don't blame Americans for getting pissed off about their inability to afford food; blame the shithead grocery stores and restaurants who keep pulling sleazy nontransparent billing stunts like this."
It's what I dealt with/deal with now. It's always "they". "They" don't want to pay for this. "They" don't want me to live. "They" don't care. All "they" want is my money. You try telling these patients/nurses/providers "they" is a tax base. Because the vast majority are people who are on medicare/medicaid.

Combined that with pricing shenanigans I don't really blame the single payer Bernie types.

Single payer. It's coming.
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Re: There must be a pony in here somewhere.

Post by Pham Nuwen » 28 Feb 2018, 02:17

Jadagul wrote:
28 Feb 2018, 02:11
No. Mo is saying that currently everyone pays about 3% into a medicare tax, and in the German system everyone pays about 15%. So the increase would be about 12%.
Ah. 3%? I really thought it was higher. Gonna need to spend some time with the googles.
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Re: There must be a pony in here somewhere.

Post by Pham Nuwen » 28 Feb 2018, 02:20

Further ah. I was lumping SS in there as well.
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Re: There must be a pony in here somewhere.

Post by lunchstealer » 28 Feb 2018, 03:21

Pham Nuwen wrote:
28 Feb 2018, 02:15
It's what I dealt with/deal with now. It's always "they". "They" don't want to pay for this. "They" don't want me to live. "They" don't care. All "they" want is my money. You try telling these patients/nurses/providers "they" is a tax base. Because the vast majority are people who are on medicare/medicaid.

Combined that with pricing shenanigans I don't really blame the single payer Bernie types.

Single payer. It's coming.
Yeah, I think we need to get out in front of it and find the least bad option. Is there anything better than Germany out there? No interest in Britain's NHS, and Canada's system seems only-ok-at-best. I assume that the Frenchies are kind of like the NHS only with baguettes or some shit. What do the Swiss do?
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Re: There must be a pony in here somewhere.

Post by Jadagul » 28 Feb 2018, 05:51

lunchstealer wrote:
28 Feb 2018, 03:21
Pham Nuwen wrote:
28 Feb 2018, 02:15
It's what I dealt with/deal with now. It's always "they". "They" don't want to pay for this. "They" don't want me to live. "They" don't care. All "they" want is my money. You try telling these patients/nurses/providers "they" is a tax base. Because the vast majority are people who are on medicare/medicaid.

Combined that with pricing shenanigans I don't really blame the single payer Bernie types.

Single payer. It's coming.
Yeah, I think we need to get out in front of it and find the least bad option. Is there anything better than Germany out there? No interest in Britain's NHS, and Canada's system seems only-ok-at-best. I assume that the Frenchies are kind of like the NHS only with baguettes or some shit. What do the Swiss do?
I think the libertarians point at Switzerland and Singapore.

Neither is Perfectly Nozickian but they (allegedly) have rather more market components than, say, Britain does.

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Re: There must be a pony in here somewhere.

Post by JasonL » 28 Feb 2018, 08:21

Dude they think it will cost less to them than the ACA penalty. 2.something percent. A $20k household would be paying an additional $200 per month. You think they won cry? Try selling it like that.

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Re: There must be a pony in here somewhere.

Post by Eric the .5b » 28 Feb 2018, 08:36

lunchstealer wrote:
28 Feb 2018, 03:21
Yeah, I think we need to get out in front of it and find the least bad option.
Libertarians can totally do that.

Nobody else will actually care what we support or pay any attention, though. The effect well be exactly the same as if we advocated "two men enter; one man leaves" for cost control.

ETA: Let's be real. This is the libertarian anti-moment. Both sides of the aisle in this country are loudly, vigorously rejecting almost all the stances we ever agreed with them on. In my lifetime, I've never seen the right so nakedly bigoted with so little interest in markets or individual rights. I've never seen the left so hostile to civil liberties. The things we care about and stand for mean nothing to them, right now.
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Re: There must be a pony in here somewhere.

Post by JasonL » 28 Feb 2018, 09:23

The most important feature to me is the preservation of the market incentive to innovate. I think any advocate of a system that wipes that incentive out, no matter how mad they are about their current bills or access, is morally accountable for the pile of bodies and suffering they would create over the long run. If you hated the pricing of the Hep C cure and you impose a model that makes development of that delayed or forever unprofitable - you own all the Hep C suffering.

The second most important feature is cost containment. The third is universality of catastrophic coverage. Someone has to be the bad guy and say "no that's not covered". It is not obvious to me that making that party the government is better than making it a private party. My preferred model is something like universal catastrophic coverage supplemented by private supplemental with government aid to purchase the additional coverage for the poor, but things like Singapore are okayish under my set of guidelines. The government setting prices model is a really bad version of this for all the regular reasons politically determined pricing usually entails.

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Re: There must be a pony in here somewhere.

Post by Dangerman » 28 Feb 2018, 10:16

lunchstealer wrote:
27 Feb 2018, 23:46
JasonL wrote:
27 Feb 2018, 17:27
try showing a real single payer person how much poor Germans pay for healthcare and see how they take it.
I run across these people pretty regularly. Am I right that the public insurance that the low-income Germans would use is a theoretical tax of 7.5% plus an employer-payroll component of a second 7.5% for a total of 15%? So to port that directly to the US, someone making the 'living wage' of $15/hr would be dropping $195/month seen from their paycheck?

I'm not sure that's going to scare Bernistas.
It's more like an additional $300/month on top of existing taxes. Currently I pay about $75 a month to SS/Medicare in the 30k-40k salary range. An additional 12% tax is $300, then deduct FICA et. al.

It's 50% more than my current share of my bottom tier insurance though work, which includes some (up to $1000) dental and vision. I could get better coverage if I just paid the extra for the next highest plan.

Ofc, I'm a SINK so there's that.

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Re: There must be a pony in here somewhere.

Post by nicole » 28 Feb 2018, 10:32

Dangerman wrote:
28 Feb 2018, 10:16
lunchstealer wrote:
27 Feb 2018, 23:46
JasonL wrote:
27 Feb 2018, 17:27
try showing a real single payer person how much poor Germans pay for healthcare and see how they take it.
I run across these people pretty regularly. Am I right that the public insurance that the low-income Germans would use is a theoretical tax of 7.5% plus an employer-payroll component of a second 7.5% for a total of 15%? So to port that directly to the US, someone making the 'living wage' of $15/hr would be dropping $195/month seen from their paycheck?

I'm not sure that's going to scare Bernistas.
It's more like an additional $300/month on top of existing taxes. Currently I pay about $75 a month to SS/Medicare in the 30k-40k salary range. An additional 12% tax is $300, then deduct FICA et. al.

It's 50% more than my current share of my bottom tier insurance though work, which includes some (up to $1000) dental and vision. I could get better coverage if I just paid the extra for the next highest plan.

Ofc, I'm a SINK so there's that.
How does it compare to your total premium?
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Re: There must be a pony in here somewhere.

Post by Aresen » 28 Feb 2018, 10:36

Eric the .5b wrote:
28 Feb 2018, 08:36
The effect well be exactly the same as if we advocated "two men enter; one man leaves" for cost control.
Hey! We could halve the cost of health care right there! :twisted:
Eric the .5b wrote:
28 Feb 2018, 08:36
ETA: Let's be real. This is the libertarian anti-moment. Both sides of the aisle in this country are loudly, vigorously rejecting almost all the stances we ever agreed with them on. In my lifetime, I've never seen the right so nakedly bigoted with so little interest in markets or individual rights. I've never seen the left so hostile to civil liberties. The things we care about and stand for mean nothing to them, right now.
I agree with you, mostly, but the hard-liners on both sides are alienating a lot of people. Unfortunately, Two-Party Manicheanism is the ascendant political system, so people tend to hold their noses and vote for the 'lesser' of two evils.
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Re: There must be a pony in here somewhere.

Post by Ellie » 28 Feb 2018, 10:50

Aresen wrote:
28 Feb 2018, 10:36
Eric the .5b wrote:
28 Feb 2018, 08:36
The effect well be exactly the same as if we advocated "two men enter; one man leaves" for cost control.
Hey! We could halve the cost of health care right there! :twisted:
:lol: :lol:
lunchstealer wrote:
28 Feb 2018, 03:21
I assume that the Frenchies are kind of like the NHS only with baguettes or some shit.
God dammit, why did I have to lose that bet to Warren? I wanna sig this!
I should have listened to Warren. He was right again as usual.

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Re: There must be a pony in here somewhere.

Post by Sandy » 28 Feb 2018, 11:32

IIRC, the Swiss are basically Morbamacare. A Swiss guy explained it to me and it sounded very much like the ACA. He was not a fan.
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Re: There must be a pony in here somewhere.

Post by Warren » 28 Feb 2018, 11:36

Ellie wrote:
28 Feb 2018, 10:50
God dammit, why did I have to lose that bet to Warren? I wanna sig this!
Let this be a lesson to you. Never give over four to one odds on anything.
I'll allow a one week addition to your sig because I'm generous like that.
THIS SPACE FOR RENT

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Re: There must be a pony in here somewhere.

Post by Ellie » 28 Feb 2018, 11:43

I looooooovvvvvvve yooooooooouuuuuuuu
I should have listened to Warren. He was right again as usual.

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Re: There must be a pony in here somewhere.

Post by Dangerman » 28 Feb 2018, 12:48

nicole wrote:
28 Feb 2018, 10:32
Dangerman wrote:
28 Feb 2018, 10:16
lunchstealer wrote:
27 Feb 2018, 23:46
JasonL wrote:
27 Feb 2018, 17:27
try showing a real single payer person how much poor Germans pay for healthcare and see how they take it.
I run across these people pretty regularly. Am I right that the public insurance that the low-income Germans would use is a theoretical tax of 7.5% plus an employer-payroll component of a second 7.5% for a total of 15%? So to port that directly to the US, someone making the 'living wage' of $15/hr would be dropping $195/month seen from their paycheck?

I'm not sure that's going to scare Bernistas.
It's more like an additional $300/month on top of existing taxes. Currently I pay about $75 a month to SS/Medicare in the 30k-40k salary range. An additional 12% tax is $300, then deduct FICA et. al.

It's 50% more than my current share of my bottom tier insurance though work, which includes some (up to $1000) dental and vision. I could get better coverage if I just paid the extra for the next highest plan.

Ofc, I'm a SINK so there's that.
How does it compare to your total premium?
I pay about $140/month, which is half of the total iirc.

(EDIT: my math is wrong then, my cost would double.)

Not very good coverage / limits beyond basic prevention and checkups.

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