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Well, we'll see what happens at the end of January.
Would ultimately love to see a new healthcare bill presented.
Quote:
Originally Posted by Precious_b
This is a pluperfect, ideal time for the dems and repubs to show how much they care about their constituents and display that they can make a bipartisan piece of legislation that truly helps this country concerning healthcare.
As a developed nation, we pay a high price with small returns. Should be easy to change with both teams working on it.
Fixed that for you, the red text.
Your optimism may be merited. Some Republican and Democratic Senators were discussing flexible health savings accounts as a way out of the shutdown mess. And Trump's talked about them the last couple of days as well. Maybe you'll see the idea kicked off in the legislation that Thune promised the eight brave Democratic Senators he'd bring to the floor by mid December. Initially perhaps the government would dump money into health savings accounts for people most affected by higher insurance premiums. They'd be free to use it to pay insurance, or pay out of pocket medical costs. This could be a good first step to migrate to a system like Singapore's, where you have universal healthcare at much lower costs than we do. That's because providers and hospitals have to compete. See post #16 for more info.
This could be a good first step to migrate to a system like Singapore's, where you have universal healthcare at much lower costs than we do. That's because providers and hospitals have to compete. See post #16 for more info.
I'd love to see those types of reforms, but you are dreaming in color. The democrats will NEVER vote to reform the system because their goal is single payer GOVERNMENT controlled Healthcare. Because once you control healthcare, you control nearly every aspect of human life. We can use healthcare to restrict access to firearms... you laugh? Why do you think the Dr's are asking your kids if there are weapons in the home? Why do you think the CDC is casting fire arms death as a "health" crisis?
If you understand the goals, everything the leftists do makes sense.
Tiny, Here is the wikipedia page on the Singaporean public health care system.
It sounds like a single payer government run healthcare system to me. It combines the benefits of a single payer system with the benefits of private healthcare providers. So as I said in my previous posts getting the private insurance companies out of the loop seems like the best option to me.
Healthcare in Singapore is under the purview of the Ministry of Health of the Government of Singapore. It mainly consists of a government-run publicly funded universal healthcare system as well as a significant private healthcare sector. Financing of healthcare costs is done through a mixture of direct government subsidies, compulsory comprehensive savings, national healthcare insurance, and cost-sharing.
The Singaporean public health insurance system is based on programs run by the Central Provident Fund, primarily Medisave, a mandatory medical savings account scheme. All working citizens and permanent residents are obligated to set aside a portion of their income into Medisave accounts, which they can draw upon to pay their own medical bills and those of their immediate family. The Central Provident Fund also manages the MediShield and MediFund insurance schemes, which cover people with insufficient savings or those who have depleted their savings. In addition, the government provides subsidies for the medical expenses of citizens and permanent residents who receive treatment in public hospitals.
Here's how it works TxDot. Twenty percent of your salary is withheld and an additional 17% is contributed by your employer, to fund your individual retirement and MediSave accounts. That's a total of 37% of your salary. If you're young, the split is 8% MediSave and 29% retirement, but as you age the Medisave share goes up to 10.5%. The maximum balance in your MediSave account however tops out at about $55,000, which is what the government believes you should maintain to cover non-major medical expenses. The excess rolls into your retirement account. An aside, you can use money in your retirement account, within limits, for a downpayment on a home and education.
Part of the money in your MediSave account goes to pay premiums for your MediShield Insurance Policy. MediShield pays for hospital stays, surgery, chemotherapy, dialysis and the like.
You use the the money in your MediSave account to pay for most outpatient treatments. You can also use it or cash to pay for things like a better hospital room or treatment in a private hospital. The public hospitals produce good outcomes, better than ours, but unless you've got the coin or private insurance or excess funds in your MediSave account, you could end up in a well-ventilated, unairconditioned ward with 8 beds.
So instead of a single payer, you've got millions of payers with millions of MediSave accounts, all shopping for the best deal. And you've got private insurers as well paying bills.
You're kind of right though, that MediShield is cutting out a lot of the inefficiency and rent seeking that we have in the USA with insurance companies.
MediShield Life, Singapore’s national health insurance, is compulsory for all citizens and permanent residents and is fully payable by MediSave balances.
Driven by rising healthcare costs and the need to provide more comprehensive coverage, MediShield Life premiums have increased, effective from 1 April 2025. Some age groups have seen premium increases of up to 86.3% compared to the rates in 2021. However, this is not a sudden hike but the result of gradual increases over several upward revisions in recent years.
Suffice it to say healthcare costs are rapidly rising in Singapore.
That's a deceptive table TxDot. It ends in 2020, during COVID, and note the rise in government health expenditure from 11.1 billion to 15.2 billion the last year. It doesn't account for population growth. It's probably in Singapore dollars, not US dollars. I wonder if the government's share of total health care expenditures increased during the period? The population of Singapore in 2020 was 5.7 million, and the forex rate was about 1.35 SGD/USD, so the per capita government spending in 2020 would have only been $2000 USD per person. And that's during the thick of COVID.
Yes, health care expenditures have grown a lot. Singapore's become richer and older, which correlates with higher health care expenditures as a % of GDP. But in 2022, the last year available from what I believe are World Bank numbers, total healthcare spending in Singapore in USD was $4320 per person, compared to $12,434 per person in the USA.
My point is that health care costs are going up worldwide because of the aging of our societies. The more elderly in your society the higher your healthcare costs are going to be.
The problem here in the United States appears to be the absence of a fiduciary responsibility on the part of the middlemen that riddle the American system. Too many of our healthcare providers have the profits of the drug companies and the healthcare companies and the private insurance companies in mind rather than the people that the systems are designed to serve.
The middlemen and the private insurers need to be removed from the business of providing basic health care services.
My point is that health care costs are going up worldwide because of the aging of our societies. The more elderly in your society the higher your healthcare costs are going to be.
The problem here in the United States appears to be the absence of a fiduciary responsibility on the part of the middlemen that riddle the American system. Too many of our healthcare providers have the profits of the drug companies and the healthcare companies and the private insurance companies in mind rather than the people that the systems are designed to serve.
The middlemen and the private insurers need to be removed from the business of providing basic health care services.
Yeah, the drug companies have gone crazy with price increases. Government should shorten patent lives. And along with insurance companies somehow encourage or make physicians prescribe substitutes or generics when they work about as well as the high dollar drugs. Better yet, let the consumers make it happen by spending their own money, through HSA's or whatever.
Getting the plaintiffs lawyers out of the picture would help a lot. Florida brought down the price of auto and home insurance a lot by doing that.
As you know I strongly prefer free market solutions. But must sadly admit that if government can't inject real competition into the system, which would lower prices, it's hard to criticize some of what you'd like to see.
Both teams will never work on it because the focus for democrats is single payer state run healthcare. The conservative case is for more competition. Leftists will oppose any reform that might make things better for consumers because their goal for consumers is to have the state run healthcare and to control the health choices of citizens.
The two goals are mutually exclusive.
We can all look around and see that increased competition reduces prices... see mobile phones, airline tickets etc... We can also look around and see what happens when the state controls anything... it gets worse, its corrupt, its wasteful, and we cannot reduce or get rid of it.
Leftists want control over your medical choices as just another way to control the population... don't like what someone posted online? Make sure their kid can't get that transplant...
Quote:
Originally Posted by Tiny
Fixed that for you, the red text.
Your optimism may be merited. Some Republican and Democratic Senators were discussing flexible health savings accounts as a way out of the shutdown mess. And Trump's talked about them the last couple of days as well. Maybe you'll see the idea kicked off in the legislation that Thune promised the eight brave Democratic Senators he'd bring to the floor by mid December. Initially perhaps the government would dump money into health savings accounts for people most affected by higher insurance premiums. They'd be free to use it to pay insurance, or pay out of pocket medical costs. This could be a good first step to migrate to a system like Singapore's, where you have universal healthcare at much lower costs than we do. That's because providers and hospitals have to compete. See post #16 for more info.
You probably did fix that for me.
It takes 2 to tango. And the party of no was repeatedly refusing to go on the dance floor. Guess they were afraid to show their moves below.
Adorable Care Act...rates about to sky rocket...so much for affordable care. UNaffordable care act is more intune with that nonsense that the Republicans knew was a disaster before the left shoved it down the throats of the American people. This is ALL laid at the feet of the LEFT not the RIGHT!!
How many Republicans went along with this COMPLETE disaster??...DO tell
No Republicans voted for it to become law. The Republicans had a chance to repeal the ACA during Trump's first term. The repeal failed when three Republicans voted no. They were Sen Murkowski of Alaska, Senator Susan Collins of Maine and the late Senator John McCain from Arizona. How son we forget.
The problem is that health care expenditures in the USA are 18% of GDP. That's much higher than any other country. The next highest in the OECD, Germany, clocks in at about 12.5%. Ireland at 7%. And we're not getting what we're paying for. The USA is 55th in the world in terms of life expectancy, behind Panama, Albania, and Costa Rica among many others.
The "temporary" changes to the ACA that are the subject of the dispute would provide tax credits, paid directly to insurers, to every American, regardless of income, who would pay over 8.5% of his income in health insurance for a silver plan. You do have some out of pocket payments when you're on Obamacare, but including those you'll end up paying maybe 9% to 12% of your adjusted gross income for health care, according to ChatGPT.
So, in other words, health care expenditures are 18% of GDP. But the maximum people will actually pay for their health care, including insurance, is 12%. Some, particularly those on Medicare and Medicaid and company-provided insurance, pay much less.
The government pays the Obamacare tax credits directly to the insurance companies. Do the insurance companies have any motivation to keep costs down? Well, yes. That will improve their bottom lines. But they have even more motivation to raise their premiums and grab more money from Uncle Sam. This is like government support for higher education through easy-to-get loans to students that later will presumably be forgiven. That enabled colleges to raise their tuitions sky high.
Stephen Moore was on CSPAN the other day, and he said all Americans should be covered by major medical insurance. And for non catastrophic medical care, they should pay out of pocket. Then they'd have the motivation to shop around. The free market would work. Costs would come down a lot. Hospitals and providers would have to compete on price.
You could marry Moore's idea to something like mandated HSA accounts, like what Singapore does, where employers and individuals mostly fund the accounts. You can withdraw money from your HSA investment account to pay for medical care. Singapore's health care expenditures are 5.6% of GDP, less than 1/3rd of the USA's, and life expectancy is 8th highest in the world.
So why don't the political parties do something? Why is there a shutdown? Well, Blackman knows more about Democratic Party politics than anyone here. He says Democrats have the motivation to draw the shutdown out as long as possible, because it will help them at the polls. Schumer's idea, to extend the credits for higher income taxpayers for a year, would fortuitously bring this issue to a head again just in time for the 2026 midterm elections, which would play into Democrats' hands. As to the Republican Party, a lot of the Congressmen and Senators correctly recognize the problem, but they're too busy addressing more important issues, like which bathroom shemales should use.
There are only two ways to Fix the ACA (Obamacare).
1. The riskpool needs a better mixture of low risk and high risk policy holders. Bring back the individual mandate.
2. Allow people who turn age 55 go on the Medicare System.
The above two items alone would keep premium rates fron skyrocketing year after year.
Trumps plan to give funds directly to the consumer will not work. Health Insurance companies are not in a hurry to sell health insurance to someone with pre-existing conditions or someone who is already sick. So, you will not see increased competetion. Rates will come down once the risk pools on the government exchanges(HealthCare.gov) have a better mix of low risk and high risk people.
There are only two ways to Fix the ACA (Obamacare).
1. The riskpool needs a better mixture of low risk and high risk policy holders. Bring back the individual mandate.
2. Allow people who turn age 55 go on the Medicare System.
The above two items alone would keep premium rates fron skyrocketing year after year.
Trumps plan to give funds directly to the consumer will not work. Health Insurance companies are not in a hurry to sell health insurance to someone with pre-existing conditions or someone who is already sick. So, you will not see increased competetion. Rates will come down once the risk pools on the government exchanges(HealthCare.gov) have a better mix of low risk and high risk people.
That isn't a fix but will worsen the problem.
There has been nothing to put downward pressure on prices.
Also, nothing to allow groups other than being employed by a large enough company to offer group plans.
Self employed and small business people are often members of trade groups for their industry. So farmers that are members of the Farm Bureau would be able to have a health insurance group instead of everyone having individual plans.
There has been nothing to put downward pressure on prices.
Also, nothing to allow groups other than being employed by a large enough company to offer group plans.
Self employed and small business people are often members of trade groups for their industry. So farmers that are members of the Farm Bureau would be able to have a health insurance group instead of everyone having individual plans.
I disagree. A balanced risk pool of policyholders will generate downward pressure on prices. With the removal of the individual mandate a younger healthy person between the ages of 27 - 40 are choosing not to be insured. (Keep in mind children age 26 and lower can be on their parent's plan). So, with the removal of the individual mandate you have unbalanced risk pools in many jurisdictions.
Allowing people that have reached age 55 to be eligible for Medicare will aid in balancing out the risk pools on the government exchanges (HealthCare.Gov) for most states. Some states like Kentucky have their own website, you would go there instead of HealthCare.Gov if you are in the individual market.
As for your last point a company or LLC that has at least 100 employees is suppose to offer their employees a group plan. If it's less than 100 you can tell the employee to go to HealthCare.Gov to purchase a health insurance policy.
All premium rate increases have to be approved by the commissioner of Insurance of each state that the health insurance company does business in. The health insurance company can't set the price of the policy on their own. Again, we are seeing large rate increases getting approved on the government exchanges due to UNBALANCED Risk Pools. It's as simple as that.
