What does that mean? Anyone got a concise link? (well, as concise as that thing can be)
Do we know? I’m curious as well what that could actually look like.
I don’t know much about it either. Why is it Medicare for all instead of Medicaid for all? Is Medicare generally better?
Idk. I assumed because everyone gets Medicare at 65. Medicaid is need-based.
So, you either lower the age restriction or you raise (is that right?) the need threshold.
It’s probably mostly that people view Medicare more favorably.
Personally, I’d like to see something akin to the French system.
Everyone has their health records on a card that they take with them to any provider and the prices for all services along with the amounts for cost sharing are listed right up front. There are no networks or discriminatory pricing.
The Healing of America is about 10 years old, but it is still a pertinent read. It outlines the healthcare/financing/insurance systems of the US, Canada, UK, Germany, France, Japan, and India. You guessed it. The US system is the most like India’s which is to say it’s a mish mash of a bunch of systems that are great for a few and lousy for most.
As a health actuary and having seen how the sausage is made, I’d have to say that pretty much any system is better than the system the US currently has.
Is the Canadian system “Medicare for all” but also with a private option? I had heard that.
Canadian Medicare is “Medicare for all”. Canada has private insurance available for uncovered elective procedures and drugs. I think drugs are covered for children, the elderly, and the poor. Their drugs costs are also much lower. I’m saying this from memory. Please correct me if I am wrong.
There is waiting for some non-acute procedures. This is by design to reduce cost. Their admin costs are also only around 5% which is on par with the rest of the developed world. In the US, our private system of insurance incurs admin expenses upwards of 15%. None of that added expense adds value. The added expense is for managing insurance company finances and shareholder profits.
I’m listening to T. R. Reid, the author of the book I mentioned above, on youtube. He brought up an interesting point that in Britain you don’t see women coming into the hospital about to deliver but not knowing they were pregnant because they have regular doctor visits. You also don’t see emergency appendectomies with burst appendixes because people go to the doctor at the first signs of illness because they don’t have to worry about paying doctor bills.
Canadian’s healthcare system is free; no copay, no deductibles, no networks. e.g. my daughter had an investigation done in Canada, with lab testing, then some further treatment done in the US, also with some lab work. Canadian cost: $0, no bill, nothing. US cost, retail was about $10K but she had decent insurance so IIRC it only cost us about a grand or two. I got invoiced a long list of procedures and lab tests with prices. A bit weird to see that.
In terms of drugs, many/most Canadians have a group drug coverage at work. Typical reimbursement type plan. And there’s provincial level social programs that kick in if your drug costs are higher than about 5% of your income. So for the most part, drugs aren’t a huge expense (exceptions exists). I’m self-employed and no drug plan so we just carry a stop loss drug plan; cheap and I don’t have to worry about it (though I’ve never been convinced that I could actually use the plan I pay for. If my drug costs got high enough that the stop-loss insurance kicked in, I’d probably be covered under the provincial social program).
People complain about wait times, and they exist. But it’s all triaged. If you need something now, you get it now. If you’re just being a big baby, then you’re at the back of the line. And then everything in between.
I worked at a prominent local health insurer for three years and was involved in creating the reimbursement schedules for providers, and it was mostly a question of how are we going dole out the inflationary increases.
Since customers are far-removed from the cost, it feels like there is a huge profit motive and no competition.
I went to the doctor once and while I was there they spent ten minutes removing some earwax - something unplanned. It cost $70! Even if the cost of a nurse were $90/hr, that would be $15 in labor, and if you charge me for the supplies and the overhead I could see it getting up to $25 or $30. We now take efforts to manage this at home.
But how to change the system? I almost think the government would have to take control in order for there to be any sort of reset.