Trump Administration attacks Medicare For All; fails badly

Submitted by gjohnsit on Wed, 10/24/2018 - 3:15pm

Remember when the Koch Brothers attacked Medicare For All, and instead proved that it would save money?
So now it's Trump's turn to attack MFA, and you can probably guess how this one turned out.

Earlier today, the White House released a paper titled “The Opportunity Costs of Socialism.” Weirdly, it contains a chart that actually makes a pretty decent argument for single-payer health care.

The chart compares wait times for seniors in countries like Canada, the United Kingdom, Switzerland, and the United States. It purports to show that seniors in single-payer countries wait much longer than those here in the United States.

single_payer.jpeg

Looks pretty clear.
The American system is clearly better.

Except that those are seniors, and seniors are on Medicare!
Thus we should all be on Medicare, duh!

And if you really want to compare wait times from the United States to other single-payer countries, you should probably look more broadly at our wait times — not just comparing seniors in our two countries, but comparing the entire population. And, luckily, the Commonwealth Fund publishes a report that does just that!

What is says — and I’ll dive into the numbers in a moment — is that American wait times look a lot worse when you add in all the people with private insurance or no insurance at all. Instead of having the shortest wait times, we’re more like middle of the pack.

This all means that the people in Medicare, our government-run program, are doing just fine on waits. But the people who have to shop for coverage in the private market? They’re waiting longer.
...
All these figures and data points tell me that the Trump chart doesn’t say what the White House seems to think it says. It isn’t telling us that single-payer health care has long wait times. If anything, it says that it is possible to build a single-payer system with short wait times — and our Medicare program has already done it.

At this rate we should applaud the right-wing's attempts are "disproving" MFA.
So who wrote this laughable piece of trash?

The report is titled "The Opportunity Costs of Socialism," and it reads like it was written by the guy who wrote the Dow: 36,000 book published right before the dot-com stock market crash — oh wait, turns out the co-author is now chair of the CEA. What fun times we live in.
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Submitted by dkmich on Wed, 10/24/2018 - 3:43pm

improve dramatically since hospitals and doctor offices will be pretty much empty.

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Submitted by gjohnsit on Wed, 10/24/2018 - 3:45pm

Not the leadership, but a lot

Democratic candidates for the House are backing a Medicare for all approach to the nation’s health care system in just over half the races in which a Democrat is on the ballot, according to a new survey provided first to USA TODAY.
...
In the National Nurses United survey, candidates were not counted in support of Medicare for all if they merely said they were open to considering the idea or that they support "universal health care," which may still include private insurers. They also were not included if they backed a scaled-back version, such as expanding Medicare to those over 49 or allowing it as a “public option” that would still have to compete against private plans.

By that definition, the group found Democratic candidates supporting Medicare for all in 223 of the 431 House contests in which a Democratic candidate is running. But Republicans are likely to win 79 of those races, according to the nonpartisan Cook Political Report. Democrats are expected to win 127. The remaining 17 are highly competitive.

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Submitted by divineorder on Wed, 10/24/2018 - 5:19pm
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@gjohnsit

PNHP
@PNHP

Single payer, national health insurance advocacy organization with more than 20,000 physician members.
#MedicareForAll
#SinglePayer
USA
pnhp.org

...

..

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Submitted by UntimelyRippd on Wed, 10/24/2018 - 4:01pm

of Canadian seniors would have waited 4+ weeks to see a specialist if Canada spent as much per capita as we do?

you will also note that, not insignificantly, the results exclude "respondents who never attempted to get an appointment." -- so we'll never know how many american seniors waited FOREVER because they knew they couldn't afford whatever treatment would be recommended (in particular, prescriptions) by the specialist. hell, we'll never know how many of them couldn't afford to take a day off work to get to a clinic.

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Submitted by doh1304 on Wed, 10/24/2018 - 9:46pm

specialist appointments made just to milk Medicare or private insurance. I used to be a taxi driver. Every day I took an elderly person to their weekly appointment to some doctor, often a podiatrist who's office was a third floor walk-up. Medicare can be easily gamed, and private insurance will simply pass the costs on in higher premiums, so they have no incentive to fight fraud unless it gets really egregious. (the aforementioned podiatrist was thrown in prison eventually)

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On to Biden since 1973

Submitted by gjohnsit on Wed, 10/24/2018 - 10:53pm

@doh1304

Medicare can be easily gamed,

Someone would have gamed it by now.

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Submitted by doh1304 on Thu, 10/25/2018 - 2:38am

@gjohnsit
Medicine is actually a difficult way to get rich - med school leaves you with a huge debt and office and insurance costs are huge. If you're honest you really have to work.
OTOH, If you cheat, price gouging and fraud and such, you still have to work hard, but the return can be enormous.
Big incentive.
Now let's compare with a reformed system. little or no school debt, much lower insurance costs (85% of malpractice awards go to repairing the damage done by the malpractice, but with single payer the repair costs would be "free") The reduction in paperwork, etc from private insurance would reduce office costs by nearly 50%. Suddenly a doctor can make a decent living with only a normal workload, reducing the incentive to criminality. (rhetorical question: How many Canadian doctors make a senior citizen come in every week for a 10 minute "appointment" just so he can charge the government $500?)

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On to Biden since 1973

Submitted by Amanda Matthews on Thu, 10/25/2018 - 1:52am
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On Thursday, Reuters-Ipsos released a poll that shows (what I believe to be) an unprecedented level of support for Medicare for All, the American left’s brand-name for a single-payer, national health-insurance plan. The survey found a whopping 70 percent support for the proposal, with 84.5 percent of Democrats — and 51 percent of Republicans — voicing their approval.

http://nymag.com/intelligencer/2018/08/new-poll-majority-of-gop-voters-s...

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Submitted by Not Henry Kissinger on Thu, 10/25/2018 - 2:42pm
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skews the numbers even more.

For profit health care systems encourage referrals to Specialists because they generate more revenue than the same treatments administered by General Practitioners.

So yeah, wait times to see Specialists are shorter because we have more of them, but that doesn't say anything about the number of patients in those other countries who didn't need to see a Specialist in the first place because the GP treated the issue.

There is a really nice HuffPo piece from 2016 about the rise of the US specialist-oriented health system and how self-serving it all is.

We Have Too Many Specialists and Too Few General Practitioners

...It all started with the Flexner report in 1910. Previously, medical education in the United States was a disorganized mess that promoted, rather than prevented, quackery. Rarely has one report had so much influence. Admission and graduation requirements became stringent. Medical education was based more on science, less on anecdote. Medical school teaching was standardized and quality controlled. More than half of then existing medical schools were closed.

...

Flexner based his ideal model on the medical school at Johns Hopkins University, then and now a leader in medical education. Hopkins was one of the first universities in the US and placed great emphasis on departmental specialization and research productivity.

The most powerful departments in any medical school became the ones that attract the most research dollars and produce the most clinical revenue by doing highly reimbursed medical and surgical procedures. Primary care teaching and practice has always been deeply devalued by medical centers because it does neither.

Primary care is best at the unglamorous and financially unrewarding task of taking good care of patients. Primary care is worst at promoting institutional prestige and profit.

We have too many specialists and too few primary care doctors because specialists are highly valued by medical institutions, even though primary care doctors are more important for good patient care.

...

Dr Munshi writes: “In 1961, almost half of US physicians were general practitioners; by 2014 the fraction had declined to one third.

The extreme shortage of primary care doctors around the world requires a strategy that addresses the workforce needs of each country, not just the preferences of its medical schools and training hospitals.

...the optimal ratio of primary care doctors to specialists has not been precisely determined, but a system in which at least 50-60% of the physicians are primary care doctors is likely to have better health outcomes, fewer medical mistakes, lower cost, and higher patient satisfaction.

This is what patients want and deserve — easy access to health care; time enough with the doctor to know what’s going on and participate in decisions; lower cost, and a workforce that is well distributed by specialty mix. When the health care is dominated by specialist practice, families are not regularly followed up by a primary care physician and treatments become atomized. This also places a burden on secondary and tertiary care doctors to do primary care work they are poorly trained to provide and substantially increases the overall cost of health care.

Specialty dominated practice also leads to inadequate preventive health services, late detection of diseases, and difficulty managing common chronic conditions such as obesity, diabetes, hypertension, and heart disease.

None of that shows up in Trump's chart.

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The current working assumption appears to be that our Shroedinger's Cat system is still alive. But what if we all suspect it's not, and the real problem is we just can't bring ourselves to open the box?