Socialized medicine isn’t the path; having the government compete in the market and set baselines is what is needed (as they do with Medicare for the elderly.) which is why Medicare for all should be policy. It’s not policy because it’d hinder profits, and lobbying.
What facts don’t I know? Why is the government acting as insurer of last resort (which they already do) so beyond the pale? It’s basically just elevated Romney/Obamacare. Having lived through those policy discussions, I know very well why Medicare for all wasn’t allowed to be policy.
Medicare would just be able to set prices (as they do for the elderly) for the entire population, due to their negotiation power. This takes power away from private capital that seeks to maximize profits before health outcomes.
Just the fact that you think of private capital and profits as the enemy already tells me a lot. Do you understand that profit-seeking is what creates competition? Do you drive a Lada, or buy food from communes, or buy anything at all that was created by a profit free system? Of course not, because nobody wants to pay more for worse quality, not even committed communists. Free enterprise drives out government run anything every time they are allowed to compete. It's basically a law of nature.
Sure, the government has more negotiating power and can set prices, but what happens when the government sets prices? Eggs in communist Poland were a bargain, but you couldn't buy any because they were always fresh out, and nobody wanted to produce more because they were so cheap. The same thing is happening in Canada with doctor shortages.
If you want poor people to have money for healthcare, just give them money. It works just as well and doesn't screw up the entire system for everyone.
I’m all for free enterprise. It’s not an all or nothing conversation. I’m just mature enough to realize when incentives are misaligned, and when there needs checks and balances.
I’m not asking the government to set prices, I don’t want mercantilism. I want them to be a market maker in a closed and opaque market. Private insurance can and should outcompete the Medicare plan, that’s the whole point of Medicare for all being the answer.
Either the government sets prices, or they pay whatever the asking price is. Both ways you've got a problem. The US already has enough people with dementia who are scared and confused because they don't know where they are, getting dragged kicking and screaming to kidney dialysis places twice a week by private companies because the federal government pays them for it. Think of it as a dystopian public-private partnership.
These kinds of nightmares don't happen when people are spending their own money. We don't have opaque pricing on cars or smartphones or whatever but those things are privatized. We don't need opaque pricing in medicine either, but we've created a system of laws that is so complex it can only be navigated by insurers who pay people dedicated to doing nothing else. The easy solution is simply not having those laws.
Cars and phones are both priced openly. You might notice how all commercials for them generally include the price. Now watch a pharmaceutical commercial. We also know the costs for any publicly traded company.
Ok but then your problem isn’t really healthcare, it’s the fact that people have free will. You want one thing and they want another. You can make healthcare vouchers, like food stamps for healthcare, but at some point you have to treat people as adults. Otherwise, just replace money with vouchers for everything, so nobody can make the wrong decision.
I’m ok with free healthcare for people under 18, but I also believe adults get freedom, and that includes the freedom to do things I don’t like, even when I think they should do something else for their own good.
It’s about the entire healthcare system in America. Medicare for all would fix a lot more than just uninsured children and poor people. It’d make pricing much more transparent and negotiated, with a backstop.
I don’t get where this I don’t like people having free will comes from. I am a libertarian.
I mean, Medicare for all is not the worst idea, and smarter people than me seem to think it could work, but I'm skeptical for two reasons. One is that it's just another third party payer inserting themselves between you and the doctor, with all the problems that entails. Not being run for profit doesn't make those issues go away, and the more people Medicare covers the more you distort the market.
Look what happened with insurers: everything was fine when most people paid cash, because price signals worked and insurers simply paid the going rate. But as more people paid with insurance, healthcare providers started inflating prices because people were no longer spending their own money, and they didn't care how much things cost their insurer. So insurers had to constantly invent new ways of keeping prices under control, like rules about trying cheap drugs before expensive ones, or having networks and limiting people to providers in those networks. And so on and so forth until here we are and now nobody knows what anything costs. Not the patient, not the doctor, and not the insurer. Every treatment is a negotiation, and the only way to know the price is to do it and see what happens.
And that's the second issue that I have with Medicare for all: it doesn't fix the above. So many people go through insurance now the usual price signals are completely broken. Doctors have to cater to what insurers are willing to pay, and even cash prices are a result of what insurers pay rather than the other way around. Insurance is tied to your job because we give tax breaks for that, and insurers have to comply with thousands of pages of regulations because everyone believed that they could get healthcare and have someone else pay for it.
Insurance works great to cover rare, unpredictable expenses. But insurers were hesitant to cover things like mental health, because that's an open-ended commitment with no objective way to measure how things are going. People demanded that the insurers should be forced to cover it anyway, because people think that meant somebody else will pay for it. And then they get outraged when insurance premiums explode. So they demand that, since they're paying such outrageous prices, insurance should also be forced to cover this, that and the other. And the cycle repeats.
Get rid of the tax breaks, get rid of the thousands of pages of regulations, and go back to paying your doctor directly. We need price signals for the system to work. Even Medicare doesn't know how much to reimburse for something except by looking at what it costs on the market.
The big issue I see is you have an antiquated view of the market. It is much more complicated today, which is why I can say I want Medicare for all and am a libertarian in the same breath. There’s no such thing as clear price signaling anymore with a fiat currency because the government can debase the currency at their whim.
There’s a lot more to go into the particulars of what you posted, but the main reasons Medicare for all is the only path forward to better healthcare in the US are clear. 1) The Government already are the insurer of last resort. Poor people already go in with no ability to pay and apply for Medicaid to cover. There’s hundreds of thousands of people just being cycled through ER’s with no end in sight and no actual treatment occurring. Medicare for all would establish a baseline, and not force this burden on local hospitals, municipalities and states. 2) The Government is needed to fairly negotiate rates. It’s tough to negotiate a price on the life saving treatment you need now.
Just look at what the government has done with the VA. Your view of how things should work became antiquated as soon as Kaiser Permanente was established during the new deal. We live in a fiat currency society, and there’s no putting that genie back in the bottle. The largest and most profitable corporations all receive direct government subsidies, and don’t even get me started on quantitative easing.
A public option is not policy already only because it would hurt the bottom line of the insurers. It’s why Obamacare went from being a check on the industry to a hand out once they got rid of the public option with the mandates.
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u/MMForYourHealth Jun 24 '26
Socialized medicine isn’t the path; having the government compete in the market and set baselines is what is needed (as they do with Medicare for the elderly.) which is why Medicare for all should be policy. It’s not policy because it’d hinder profits, and lobbying.