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[–] 102 points 4 months ago* (7 children)

First and foremost this would be a HUGE boon for small businesses. They are currently hugely outclassed in offering benefits which hampers hiring. It's also significantly more costly per employee for them.

Second, huge boon for employees who can change jobs left and right regardless of life circumstances. Currently the best way to improve your wages and/or get promoted to a bigger position is to get a job at a new company.

Third, huge boon for entrepreneurs who can now take bigger risks to start a new business because regardless of what happens, they don't have to worry about losing their healthcare

All of these things will have long term knock-on effects of leveling the opportunities for non wealthy people as well.

I'll say it for the millionth time. Every single stance the GOP takes is bad for small businesses, bad for the economy, bad for the country.

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  • [–] 7 points 4 months ago

    Very well said. My old man can attest to the struggle of running a small-business with a couple employees while managing the overhead of health insurance both for himself, and them.

    This is honestly how Democrats should be pushing it: We're Pro Small-Business. (1) Entrepreneurship, (2) Innovation, (3) True competition, (4) Keeping money within communities... I could go on.

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  • [–] 6 points 4 months ago (3 children)

    Don't forget, the Democrats have never put universal healthcare on their agenda and they've rigged multiple primaries in order to prevent candidates who would put it on the agenda from winning.

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  • [–] -1 points 4 months ago (1 child)

    thats because thats thier only carrot(single issue that convinces people to vote for them), they would lose that power overnight). thats why they always tease public heatlcare for all, and conspire with the republicans to derail those plans.

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  • [–] 56 points 4 months ago (3 children)

    I'd probably go to the doctor.

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  • [–] 6 points 4 months ago (2 children)

    I've got a bowel obstruction 2 years ago and i had to pay 6k for my deductible and my insurance paid 12k. I got a tube down my nose, some xrays and stayed a night. I currently know its going to happen again any day now and it almost happend two nights ago and I was in horrendous pain. I could go to the doctor and they could probably help me and stop it from happening again. However, I dont have 6k to spare to find out. So until it is debilitating, we'll just have to see what happens.

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  • [–] 4 points 4 months ago (1 child)

    That sucks.

    Ive got shitty US insurance. Had to have the ol' gallbladder removed. Hospital charged $40k. After insurance, my bill was less than $3k. Lots of people would be financially ruined by that math. Im thankful I had the $3k to pay.

    It's hard out there, but at least we're letting gun owners carry into Hawaiian grocery stores.

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  • [–] 49 points 4 months ago

    A better life for 99.999999% of the country.

    The other 0.0000001% are already so wealthy that their life will be exactly the same except that they will be furious about the 99.999999% having an easier life.

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  • [–] 84 points 4 months ago (1 child)

    Global warming would probably be solved, because hell would also have frozen over.

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  • [–] 35 points 4 months ago (1 child)

    everyone would be in better shape health-wise.

    but also billionaires would lose money, which is why it'll never happen as things are now

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  • [–] 3 points 4 months ago* (last edited 4 months ago)

    they would stop applying to grueling service/retail jobs/technician jobs, and probably focus career paths even if they already graduated with a degree, more money goes into taking more classes, or saving money for something else. i think these are one of the reason people are not in a field they supposedly studied in, of course you would need a efficient train/fast rail system in most states for it to work as well since most degree'd jobs are outside large cities most of the time, besides the job market being very poor for many different fields.

    most people are probably paying 600-1000+/month in premiums anyways, and they have to spend down thier DEDUCTIBLES and OOP to be fully covered, which most people cant unless you are chronically sick. the current subsidies make it less than that per month.

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  • [–] 33 points 4 months ago (4 children)

    More entrepreneurship. Plenty more people would work for themselves or start businesses if they didn't have to worry about healthcare.

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  • [–] 12 points 4 months ago

    This. I've said for years, it'd be a Renaissance of entrepreneurship and craftsmanship.

    I've known so many people over the years that would have been fine getting by selling things they've made, or fixing others things, if they didn't need employer based Healthcare.

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  • [–] 11 points 4 months ago (2 children)

    UBI would be good for this also.

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  • [–] 31 points 4 months ago (1 child)

    If healthcare were decoupled from employment, Americans could protest in much larger number and for a longer period of time.

    A general strike would become viable.

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  • [–] 8 points 4 months ago

    and suddenly many people who have been wanting to start their own businesses, make that career move, or move to where the jobs are would finally feel secure enough to do so. I suspect this would boost the economy everywhere in ways it would be hard to predict.

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  • [–] 28 points 4 months ago

    People would have more job mobility. You could quit (or get fired) and not have to worry about becoming bankrupt due to healthcare.

    People that don't have insurance will be able to seek aid. Less people will die of preventable illness. People can focus on getting better without the stress of "how will I pay for this? I'm ruined"

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  • [–] 21 points 4 months ago (3 children)

    US would start catching up to the technologically advanced nations in life expectency. A lot more people would start businesses or take a chance on dream jobs. The us would become more competitive with other countries as businesses would no longer have it as a cost. Its essentially like subsidizing your whole economy and many of our competitors do just that so we have to compete with that.

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  • [–] 0 points 4 months ago (2 children)

    The major factors in the US's low life expectancy are guns and automobiles. Because the required medical care for the damage those things cause is already guaranteed, universal healthcare would have a relatively small impact on life expectancy, especially in the short term.

    It's possible infant mortality would benefit. Major reasons for our (the US's) poor performance there are people that do not seek medical care (polling suggests about 2/3 of this is either driven by or related to cost concerns), and differences in how we track infant mortality statistics (for example, the US counts all infants, even if they are born severely premature, while most countries exclude some prematurely born infants from their statistics).

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  • [–] 4 points 4 months ago (1 child)

    Because the required medical care for the damage those things cause is already guaranteed

    Lol, no, you're still going to have to pay for that.

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  • [–] -1 points 4 months ago

    The (lifesaving) care is guaranteed, whether you are able to pay or not. The resulting debt could cause a lot of problems, but few of them contribute immediately to life expectancy.

    Quality of life, sure. Feeling financially secure in your present position, absolutely. But not how long your ticker keeps ticking.

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  • [–] 19 points 4 months ago (4 children)

    Several people I know would retire from management level positions. It would energize upward advancement in a number of institutions.

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  • [–] 0 points 4 months ago (3 children)

    Well, we'd retire. We have enough saved to manage þrough to our deaþs, except for healþcare. It'd be retiring early, and in all likelyhood we'd take different jobs which aren't as high-stress; let someone younger deal wiþ þe bullshit þat Management is. So maybe not full-on retire. We continue to work mainly because healþcare in þe US is stupid.

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  • [–] 16 points 4 months ago (2 children)

    my friend would get the blood pressure meds he needs instead of searching for magic pills at the health food store.

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  • About half the US would declare civil war because they are so fucking stupid?

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  • [–] 26 points 4 months ago (1 child)

    The economy would skyrocket. Everyone, and I do mean EVERYONE would benefit. And there are people in this country so vile they would lose out on billions or trillions in profits just to screw over the masses. Imagine companies not having to pay 10-20k+ per employee for healthcare. Employees getting preventative care, being healthy, and being more .. PRODUCTIVE!

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  • [–] 4 points 4 months ago

    The health insurance industry is half a percent of the whole US economy ($1.6tn of $32tn). Pulling out the rug under it would almost certainly cause a recession in the short term. Probably still worth it imo

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  • [–] 12 points 4 months ago

    Hope would exist again and every american could get back to pursuing happiness rather than lock in on survival mode only.

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  • [–] 12 points 4 months ago

    Many companies would lose profit. Many greedy fucks would not be able to afford their third yaht and fifth house.

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  • [–] 11 points 4 months ago (1 child)

    FWIW universal healthcare is not single payer. Its nationalizing healthcare providers and doing away with health insurance entirely. Which is better than any single payer plan IMO. Hospitals have never really been successful profit generating ventures.

    The entire health insurance industry would be deleted along with all the jobs and stock value it produced. And yeah fuck'em but there's going to be knock on economic effects from deleting an entire industry.

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  • [–] 4 points 4 months ago

    Health insurances go bankrupt... but the rest have more money, workers don't need to be tied to a job to have healthcare and they can go to the doctor when they fell they need to, not when there is no other way.

    Speaking as a Spanish citizen, I've gone to the doctor even for a drop of concrete in the ear (I was lucky and the ear was clean) or for a simple pain in my forearm. Cost: 0€.

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  • [–] 7 points 4 months ago (4 children)

    Things happening to you medically would stop defining your life. I called for a check on something, get a date in 2 days and be scheduled for a radiology, all 100% free.

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  • [–] 2 points 4 months ago (3 children)

    In Canada it's more like 30 days or more, and you could expect a US single.payer system to be less efficient since it hasn't been refined for several decades

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  • [–] 3 points 4 months ago* (2 children)

    The US would be switching to an entirely different system, but wouldn't be able to "refine" it? What a bunch of unprovable bullshit.

    Also, if you think the US doesn't already have waiting lists for specialists, then I honestly do not know what to tell you. Wait times are not a uniquely socialized medicine thing.

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  • [–] 0 points 4 months ago

    The US would be switching to an entirely different system, but wouldn't be able to "refine" it? What a bunch of unprovable bullshit.

    Not 10 minutes after they implement it, no. Canada has a mature system that's been worked on for decades. Are you suggesting the US would be automatically better just because it's the US? What are you, a MAGA?

    Also, if you think the US doesn't already have waiting lists for specialists

    I've been to a variety of specialists, it's never taken anywhere near a month. My understanding is that in Canada a month is the norm, sometimes longer.

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  • [–] 6 points 4 months ago

    We all saw the Regressives cut Medicaid without caring that it meant millions of citizens losing their health insurance. With universal coverage we’d see similar but on a bigger scale. Regressives will always play up spite and self-righteousness , will always find a scapegoat who is “cheating”, will always play up high taxes being “bad for business”, plus of course we’d all like to pay less in taxes. We would still need the “face eating leopard” meme. Even then, it would be better for the rest of us, but it would still be the same fight

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  • [–] 11 points 4 months ago (4 children)

    Lots of people would exit the traditional job market, millions would start small private business. Pay would go up both because of the healthcare savings to companies and because people would stop working shit jobs for shit pay just to keep health insurance.

    It might also lead to a massive recession as for profit healthcare providers and services last l lay off workers and go bankrupt.

    So mixed bag probably good overall for workers, very bad for capitalists. But there would be a massive labor disruption and lots of people would be on the losing side initially.

    I would support a transitional system where every say 5 years we lower the age for Medicare access so we gradually ween off the old system and the healthiest most profitable pool stays in the old system the longest.

    It still screws over the next generation which I don't love or think it's fair but the ACA created a system so entrenched I don't think there is a way to roll it back without causing pain.

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  • [–] 9 points 4 months ago

    While I don't think this is a really big thought in the minds of CEO of large corporations but by tying healthcare to work it does keep potential competition from growing in the marketplace. More difficult/impossible to start your own competing produce/service without healthcare.

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  • [–] 1 point 4 months ago*

    i would prefer a hybrid of private and public, which would mitigate problems. i think 11+mil are on ACA plans, likely alot of them are in gop states, which is why REpublicans constantly teasing to repealing every election cycle, they know they cant or they would lose thier elections.

    also medicaid has this wierd rule, that recoup losess on 65+ people who pass away.

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  • [–] 5 points 4 months ago

    According to magats the gates of hell will open and demons will spew forth.

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  • [–] 5 points 4 months ago* (2 children)

    Realistically there would be fox news blasting propaganda on how much the country is going into debt to fund the madness. "People are going to the doctor for everything now! Back in my days when we fell with our bike we put a plaster on it, we didn't burden the healthcare system with a few scrapes. Our mom gave a kiss on it and we'd be okay. A kid on our block Jimmy broke gis arm once and his mom did surgery on the kitchen table. But now? What do you think putting a plaster on by a doctor costs? 500 dollars. Yes, that's right. It's madness, Trump would have never stood for this, God bless his soul. We had it good under him. Now look. Wars, famine, heat waves, our economy is in shambles! And why? People don't live like they do no more, sad. Do you wish we could go back sometimes? I do. I sit on my front porch and I wonder... what would life be if our great leader would still be here with us. I think we need to all channel our inner Trump tonight. We need it. America needs it. You need it."

    realistically that's what's going to happen on fox

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  • [–] 13 points 4 months ago* (last edited 4 months ago) (6 children)

    Approximately 1-2 million people employed in the mass bureacracy of claims processing and validation would lose their jobs.

    That's how much of a gargantuan amount of bullshit the healthcare industry is, its so big that at this point, assuming the rest of the economy was doing fine, switching to universal health care would create a moderate recession, because so many bullshit jobs would no longer need to exist.

    Obviously it would be a massive net economic benefit, but at this point, medicine is gonna sting a bit.

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  • [–] 8 points 4 months ago (4 children)

    Approximately 1-2 million people employed in the mass bureacracy of claims processing and validation would lose their jobs.

    Those "same" (number of) people would be needed to process the claims that needed to be approved by the nationwide system that replaced "for profit" healthcare.

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  • [–] 11 points 4 months ago* (last edited 4 months ago) (1 child)

    I'm from Canada, and I know a surgeon and he has one admin. One (1) secretary that handles patient booking, billing, and payments. The benefit of a single payer system is there's one payer. The government. One set of forms to comply with. No rejections (almost always. Rejections come from foreigners or out of province coverage when determining which province is responsible for paying)

    His software system (government provided) auto fills 99% of it. That's why he can have one (1) secretary. The government side Idk but it's certainly not insane ratios like the US since the process is far more streamlined and doesn't rely on appeals or rejections to racketeer more money out of doctors and patients. What's really sad is Americans are so conditioned to believe their way of life is somehow normal, that orphans must also be crushed somehow in Europe or Canada.

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  • [–] 5 points 4 months ago

    Yeah, you go into a doctor's office and they'll have 5 secretaries to handle all that paper work. I didnt do Healthcare, but for a minute I was a service administrator for a car dealership who's job, among 7 of us, was to do the billing and warranty/insurance claims. The paperwork was insane and had to be presented in a precise way or it wasn't accepted. I can only imagine what hoops health insurance makes these offices jump through.

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  • [–] 7 points 4 months ago

    That's not quite true. Medical billing here is hopelessly complicated, a universal system would likely have universal rules, and streamline the process of billing and payments.

    So if a medical practice now needs 5 people to do the insurance billing, it might need only one if there was one payer (Medicare) or two if there was a German sort of system, but not 5.

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  • [–] 5 points 4 months ago

    No. Wrong.

    As others have outlined in greater detail... no, you'd have a massive simplification and standardization of such forms, thus a massive reduction in the amount of 'needed' work of such kind.

    The entire way the modern US healthcare system works is by making there be so many abstract layers and processes going on at the same time, that it requires an inordinate amount of time and effort to even actually map out what those layers and processes are, much less who is actually responsible for what particular decision or mistake.

    And that is the point of it. Its is insanely complex and opaque by design, because it allows them do functionally do whatever they want, and be able to say its all done for compliance's sake.

    So, yeah, if you just flatten all that... ~90% of it no longer needs to exist.

    Or... the real funny part here is... if we stick with the system as it is, well, this kind of shit is gonna be done by LLMs. So we will probably end up having the same employment void developing under the current hypercapitalist paradigm as well.

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  • [–] 4 points 4 months ago*

    you can have both private and public, private if you want to see someone faster or more specialized care. and everyone gets public regardless of income. most states have very small maximum limit on if you can get medi-caid. funny how military service members have universal healthcare, a "public version of them" and they arnt in debt. it can be done, the us chooses not to because GOP/DNC would start to lose alot of political power.

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  • [–] 4 points 4 months ago (1 child)

    Maybe I could get the therapy and medicine I need.

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  • [–] 2 points 4 months ago

    You would not. Mental health professionals are already on huge waiting lists, if everyone got coverage that waiting list would only get longer. The solution, of course, is more people entering the field being incentivized by higher pay, but that could take years to work out.

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  • [–] 7 points 4 months ago (1 child)

    Instead of making people contractors to avoid paying benefits companies would make people employees to have more control over them.

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  • [–] 3 points 4 months ago* (last edited 4 months ago)

    If we're handwaving the whole transition, nothing too dramatic. It would be more like Canada. People would be healthier and not stressed about the costs of seeing a doctor.

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  • [–] 5 points 4 months ago (2 children)

    I don't think the positive differences would be as dramatic as some here are proposing.

    It would immeditately benefit a lot of people with existing large medical bills or chronic health conditions. But this probably wouldn't be an immeditately noticeable economic boon - instead, it would take the form of these people unburying themselves from debt and building up savings.

    Over the long term, I would expect more small businesses, more people starting families, and more people choosing to retire earlier. But I think it would probably take a decade or more for this change to really be felt by those not directly impacted.

    In the short term, there would be a massive economic restructuring as the entire health insurance industry collapsed overnight. Literally millions of people would be out of work. In the long term, this would be a good thing - but short term, it would be a very big problem.

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  • [–] 1 point 4 months ago* (1 child)

    nurses, and doctors would likely have to take paycuts, or move somewhere else, wors they end up unemployed themselves. right now doctors and nurses are making bank in areas that are underserved(usually states that have largely ignored healthcare).

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  • [–] 1 point 4 months ago

    The problem is that the shortage of qualified nurses and doctors is still going to be there.

    What I expect is that the role of nurse practitioner would become a lot more inflated if universal healthcare would become a thing for routine check ups and general practitioners. You may not see a doctor for your physical any more.

    Beyond that, a lot more roles would likely be opened up to cheaper staff as a way to relieve more qualified staff for specific tasks.

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  • [–] 4 points 4 months ago

    Insurance companies would find some way to have record profits. No one spends money more frivolously than the US federal government. Most likely the government would make deals with preexisting medical care providers instead of building out their own national healthcare.

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  • [–] 2 points 4 months ago (6 children)

    I would like to point out that the two need not be connected. We could unmarry healthcare and jobs by making it a law that you could cash out your healthcare coverage. This would open the market for more competitive nealthcare administrators as the people using the insurance would be the ones choosing. I think it would also increase the popularity of paying direct for the simpler stuff and only carrying insurance for the big stuff. This I think is an important step as it would realign what medical care actually costs when you take out all the middlemen taking their cut. And then, when you do move to universal healthcare, the prices would be more accurate. Otherwise we are going to end up with nationalize anthem or united healthcare for determining what medical care you get, which will be a nightmare.

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  • [–] 3 points 4 months ago (5 children)

    Can you not? My ex has always opted out of health insurance because mine was much better. Now that she needs her own, she had to choose between getting it through her employer and getting it through the ACA marketplace

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  • [–] 1 point 4 months ago (4 children)

    So my point was if they just go straight to universal, it will end up underpaying doctors, which will lead to further shortages of doctors. So by doing it in two steps, we can hopefull preserve the doctors we have, and maybe even make it a progession people want to be in again.

    But why is your ex getting insurance through her employer now bad. Neither path is going to change the current system before that happens.

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  • [–] 1 point 4 months ago* (last edited 4 months ago) (3 children)

    You said people should be allowed to cash out of their employer provided healthcare, but you can already opt out. My ex has a smallish employer with expensive plans, so even after the employer contribution, it wasn’t clearly better than marketplace plans. We already are at a place where you can choose the public option.

    Or do you mean specifically bringing the employer contribution with you? That would destroy the marketplace for people who can’t bring their employer contribution. It’s also likely to result in employers very quickly giving up those benefits

    There is also the HSA which arguably could be called a step in that direction. Employers providing much less of an insurance plan but in conjunction with savings that can be used for medical care. The problem with the current implementation is it doesn’t serve well the people who need it most. People with existing conditions can not afford them without savings and people with lower incomes can’t save.

    But yeah, thinking about that more, that may be a path. Allow/define a bare bones high deductible insurance plan which can eventually become universal, then encourage employer HSA contributions, including with fairness tests. Now basic and catastrophic care is covered for everyone universally and the employer benefit is on top of

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  • [–] 2 points 4 months ago (2 children)

    By cashout, I meant employers pay cash to people who choose not to have the insurance. It would require some rules that set mins, and for large companies say the value has to be based on the plans people who are using the insurance choose to avoid them creating a shit option just to cash out less.

    HSA's aren't what they appear to be. They are actually retirment saving plan for those who can afford to fund them and not use them. They grow tax free, can be invested in the market, and you don't pay any tax if you spend them on medical expenses years down the line. It is also designed to transfer cost from the employer to the employee. Some employers will put money in the hsa to soften the transfer, but many do not.

    The only reason I suggest the middle step is to try and protect the numbers of medical professionals. If we just swap to universal, the gov will try to lowball everything. That will cause smart people to avoid the profession. And of course they will probably make striking illegal, so the balance of the union will be mostly gone.

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  • [–] 2 points 4 months ago (1 child)

    I disagree with HSA being a retirement plan, but yes, they give the person more control, something for the long term. There are some tax advantages to building it as retirement savings that streamers like to focus on, but that really should be a second priority to covering a lifetime of healthcare

    Last time looked closely, the tradeoff in my company was that for an identical cost for me, I could choose

    1. Traditional ppo with low copays and deductibles
    2. High deductible health plan (HDHP) plus HSA to fully cover the annual deductible

    That made it very compelling: the coverage should almost always be equal for equal cost. But unusually we don’t need that much medical care so I’d have something left over to help pay for next year. If we were able to start with just a couple healthy years, it would really make a difference in health costs. If you started young, it’s true that you build up a lot of savings for retirement, but it would only take a few healthy years at any age to cover, say a major operation (always in conjunction with HDHP). Or I don’t know if you could use it for COBRA if between jobs, but if you had enough you could cover even uninsured healthcare. The trick of course is how do you keep making an optional contribution when money is tight?

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  • [–] 2 points 4 months ago

    Think of it this way. What is the difference between putting money in a savings accout vs an HSA.
    First it is pretax money so you get some savings there. Second no tax on growth.

    I am sure you can guess which is a bigger financial gain overall.

    But now think about this. You have a $1000 medical bill. Do you pay it from the hsa or you savings account. Well both are getting interest, but the HSA is probably getting a higher rate if invested in the stock market. And the HSA has tax free interest unlike the bank account. So the correct financial answer is to pay it from your savings account, and leave the money in the HSA for retirement. Thus it's really a retirement plan. The key thing is that only people who have the extra money can afford to use it. So poorer people don't get any benefit from it at all.

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  • [–] 2 points 4 months ago

    Curling the monkey paw a little bit...

    A single payer system will likely try to look for some efficiencies since they can track everyone. One thing I expect will happen is that care will shift regarding the homeless population.

    A small minority of homeless often rely on hospitals as a shelter of last resort in cases of severe weather. There are also cases where homeless only interface with the emergency care system since it is the only care they can get.

    I can easily see a government run system pushing these people into "more cost effective" options, including the immediate movement from emergency rooms into "specialty facilities" for "long term care".

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  • [–] 2 points 4 months ago (7 children)

    Honestly, a ton of people in the health insurance industry would become unemployed. As well as a lot of hospital/clinic administrators.

    A lot of stocks that are held by pensions and mutual funds would become worthless causing chaos in the stock market and destroying peoples retirements.

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  • [–] 8 points 4 months ago (1 child)

    I feel like that sort of highlights exactly how bloated our private system is, and how much the older generations are profiteering off the younger generations future.

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  • [–] 1 point 4 months ago (3 children)

    The NHS has hospital administrators too (too many of them, even). And pensions somehow manage to invest well enough, probably because they have experts.

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  • [–] 1 point 4 months ago (2 children)

    Did those pensions have large stakes in stable, profitable, health insurance companies that suddenly went poof? Or was that never the case?

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  • [–] 1 point 4 months ago* (1 child)

    While I entirely agree with all the benefits posted under here, we’d also be subject to the tyranny of regressives. That face eating leopard would feast on those red state seniors focussed on cutting health insurance to “those” people.

    Take education as an analogy. That’s mostly run by individual states, and there is a huge range of outcomes. Massachusetts is typically rated as or near the best education system but we pay for it. We recognize it as something valuable and as a good investment. Meanwhile many states/locales seem to see education as only a cost to be minimized. This is one of the reasons I live where I do. But if it were national, we’d lose that choice. One downside of universal healthcare would be that we’d no longer have the choice of investing in something better

    I work in tech and have better health insurance than most. I want the same for everyone, not less for everyone, even when that comes with voting for higher taxes

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  • [–] 4 points 4 months ago

    Universal healthcare doesn't mean you can't pay for private healthcare. The UK has both. Jobs can often come with health insurance. It's typically much cheaper as well because it doesn't cover emergency services.

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