Does this bother you?

Recent Gallup poll, don't know the exact date. When asked, 13% of those polled said they knew someone who had died because they couldn't afford needed medical care. The poll also asked if the respondents knew details such as the person's age at time of death, why they were unable to get the care they needed, etc.

Interestingly, very few of the respondents said the person they knew was 65 or older when he/she died. Also, the most common reasons given for inability to pay was that a person's private insurance plan had reached a lifetime or yearly cap; they were no longer able to afford premiums; or they were unable to afford deductibles and/or copays.

This indicates that Medicare, which anyone 65 or older would be on, is effective insofar as its basic objective of keeping people alive. People who can't afford Medicare copays/premiums get it for little or nothing; the point is, they're covered no matter what.

The number of 13%--pretty high when you think about it--indicates that the health insurance market is a failed market. Many people can't afford premiums. And before anyone starts yeeping about Obamacare, its tax credits are only helpful if you owe enough income tax to be offset by those credits. It's reduced the number of uninsured deaths, but hasn't eliminated them. The problem, therefore, is working poor who make too much for Medicaid but not enough to be able to afford premiums and copays (Obamacare or private). They're stuck in the middle.

So I consider it outrageous that people in this country die because they can't afford health care. I don't think being poor should carry the death penalty. A government-administered single-payer health plan would eliminate that problem for good. And yes, there's no reason why you couldn't still buy private health insurance. And yes, your taxes would go up. How much depends on the scope and extent of the program.

So what I'm wondering is: how much does it bother you that thousands of people die each year from being unable to afford medical care? A lot? A little? Not at all? And how much more in taxes would you be willing to pay to stop that from happening? 1%? 5%? 10%? Not one freakin' dime?

I'd prefer if this discussion didn't get political and if we could stay out of the "people (who don't deserve it, according to my personal wisdom) getting free shit" Republican trope. People in this country needlessly dying isn't and shouldn't be a political issue--it's a humanitarian problem.

This is why I think Democrats are misguided in their holy-grail effort to chase single-payer healthcare.     

The biggest problem with our system is not insurance (although that is a problem too).    The biggest problem is the price gouging and ala-carte care system.

An Ambulance ride should not cost $3000.    An overnight stay in the hospital should not cost $10,000.   A bag a saline water should not cost $100.    And our prescription drugs should not cost twice as much as the rest of the free world.    But we seem to give a free pass to this outrage because - um- "free markets"  or something.  

The rest of the world has very little or no "out-of-pocket"  expenses.    They dont have people who forego paying the electric bill in order to pay for medicine.

Wouldn't a single-payer system eliminate the gouging, because there would essentially be a single customer--the government--and that customer, as opposed to individuals today, would have more negotiating power?

I mean, yeah, that's why the medical companies pay Republicans so much to destroy Americans' health care--they want to keep on ripping people off. The fact of the matter is that probably two-thirds of the populace couldn't afford a major medical procedure if they had to pay for it out-of-pocket. So either those people roll the dice and hope they're never sick or injured, or they have to be insured--and at current prices for medical treatment, the premiums aren't enough to pay the providers what they want.

Private medical insurance markets go into a "death spiral," inevitably, because the young and healthy don't want to pay the premiums that everyone else does--so, eventually, only the older and less healthy would have insurance, and premiums would skyrocket. The solution for that was the individual mandate--just like car insurance--but the Republicans killed that, and premiums are indeed going up.

You would think that Republicans would have a shred of decency or humanity. But they're just whores for big business, in this case, the medical and pharmaceutical industries. They don't care if people die for lack of medical care. I do.

PJ, the biggest problem with our system is the conflation of health care and insurance. Health care is not insurance.  The average out of pocket premium for employer-based plans is now 12k a year. The average out of pocket cost on the same plans is $17.5k leaving anybody that is or has a family member with a chronic condition to pony up $29.5k a year just so they can get treatment in our system. (Not to mention all of the uncovered expenses they have to come up with.) 

Those costs you mention will go down when we convert to a single-payer.  If the for-profit ambulance service wants to stay in business, they will have to accept a take it or leave it payment in a single-payer system. The same goes for prescription drugs.

If we allow people to continue to live in the fantasy world that insurance is healthcare we are going to continue to have outrageous costs. 

I won't vote for a Democratic candidate that doesn't endorse some kind of universal healthcare system that eliminates these massive out of pocket costs. If they can come up with a plan that does this with private insurance, show me the numbers and how it will work if you want my vote. Mayor Pete won't even admit his Medicare for some has a buy-in let alone address what that buy-in would be. 

Medicaid reimburses well below cost.  Medicare pays hire, but also reimburses below cost.  Medical companies make their money in the private sector.

Using your example of ambulance costs.  If the ambulance company is reimbursed below cost, they will have to go out of business, leaving less ambulances to service the sick.  With less ambulances, wait times will increase, & people will die.

Your first two sentences are not based in any fact.   But feel free to refute that with actual statisitcs (not an anecdote you got from one instance).

But you are on to something.

People with no insurance of any kind not only reimburse below cost - they frequently reimburse nothing.   

As it turns out - uninsured people in a bad car accident have a hard time raising income to pay for their body cast and emergency care.     And requiring them to buy insurance to avoid being that situaion ahead of time is an anethema to the Republican party (unless proposed by Mitt Romney).

Doctors and drug companies get paid more than twice as much in the UNited States compared to the rest of the modern world.    And our private sector insurance has 20% profit margins.

Putting those two things in line with the rest of the world will lower costs, no doubt.   but the former has a bigger impact than the latter.   Thats just math.

Re: "20% profit margins"

From:

National Association of Insurance Commissioners 2018

December 23, 2016 - Medicaid and Medicare reimbursement in 2015 was under actual hospital costs for treating beneficiaries by $57.8 billion, the American Hospital Association (AHA) recently reported.

According to data from the AHA’s Annual Survey of US Hospitals, Medicare reimbursement fell below actual costs by $41.6 billion, while Medicaid reimbursement was $16.2 billion short.

The survey results showed that Medicaid and Medicare payments do not cover the amounts hospitals pay for personnel, technology, and other goods and services required to provide care to Medicare and Medicaid beneficiaries.

“Payment rates for Medicare and Medicaid, with the exception of managed care plans, are set by law rather than through a negotiation process, as with private insurers,” wrote the AHA. “These payment rates are currently set below the costs of providing care, resulting in underpayment.”

You're conflating (big word; look it up) stated costs with actual costs. Medical providers don't bill anybody, private citizen or government, by the actual cost of services. They bill at cost + whatever profit they want to make. Therefore, the reimbursements they got from Medicare were "short" because they didn't contain as much profit as the payments they get from individuals and insurers.

Or maybe you believe that that $3000 ambulance ride PJ referred to or the $57 butterfly bandage I got at the emergency room (which was billed separately from the cost of the visit itself) actually cost that much.