Australia's medicare doesn't cover ambulance transport. Medications are through a different program which is funded by the government and has seen drastic increases. Also Medicare costs have surpassed the levies and is also funded from general revenue. Which is why they have a 37% income tax on top of the levy that starts around 20k (or just under 14k in us dollars)
Their costs have skyrocketed anyway from 10.8 billion in 1981 to 82 up to 170 billion in 2017 to 18. And their medicare still has significant out of pocket expenses and there are still access issues and wait times that push people to get private health insurance on top meaning they are paying even more out of pocket. And this is all despite a health care worker shortage (what do you want to member wages play a role in this)
Self-righteousness of that poster aside, they are lying.
Since they take from general funds people don't realize it costs more than what the medicare tax on their paycheck saysSelf-righteousness of that poster aside, they are lying.
1301.0 - Year Book Australia, 2012
www.abs.gov.au
The medicare scheme only funds half of expenditures. People do have copays/deductibles for meds. And local govts have to chip in for hospital fees.
It costs FAR more than your 1.5% claim
www.publish.csiro.au
It gets old having a 2pack a day smoker tell you they can’t afford metformin
All the physicians who understand math would still be against it because they would realize that is an unsustainable premise unless taxes go up an enormous amount or the supply of doctors is drastically reduced (likely both).
It is unsustainable to pay physicians double what they currently receive which was what you proposed. As for your question about how other countries manage to do it, they do it by paying people less, rationing care, and increasing tax revenue. As to your question about bureaucracy, I am forced to assume you have never billed medicare or medicaid for any healthcare services because if you had you wouldn't be looking to a government option as the option with less bureaucracy. My assertion the supply of doctors would drop is in answer to your doubling of salaries proposition. Current tax revenues would not cover doubling salaries so they would only be able to pay those double rates to fewer physicians before bankrupting the program. You seem to be operating under a delusion that a single payer system will eliminate enough administrative costs that we can get the same level of care without a huge tax increase and without a great deal of rationing. You also seem to think that any rationing done will be purely related to urgency, but in fact will be based on what diseases or treatments have the best lobbying efforts and ultimately be a different form of rationing based on ability to pay that you scoff at now. Under our current system anyone with an emergency gets emergency care without regard to their ability to pay for it. Under a single payer system the decision might be to eliminate payment for that care if the patient is older than x years or has certain conditions such as cancer or other problems determined by the government to make their life span short enough that expensive treatments to prolong it are not worthwhile. While I as a doctor may end up making that determination after discussion with the family and the patient if they are able to participate, I don't want some administrator making that decision for me.
In an emergency my clinical decision is the only thing that is relevant under our current system where someone may have Medicare, Medicaid, private insurance, or nothing at all. What i get paid after may differ but I have a deal in place with the hospital where they pay me if the patient can't. For non emergencies I can discuss with the insurance if they happen to not authorize what I want but i actually haven't run into that scenario with private insurance though it happens often with my medicaid patients. My private insurance patients can get authorization for imaging quickly so i can manage things as an outpatient that I end up sending people to the er or directly admitting them for if they have medicaid. Turns out the same profit motive that makes private insurance want to avoid spending whatever money they can also keeps them from being too capricious with care lest people switch to a competitor. I wait days for an authorization from most private insurance. Weeks to months is what it takes to get money owed to me from Medicare or Medicaid on many claims for the emergency care I provide, and the same may happen on the front end if I see one of them in office for an elective case. Then of course I get to be paid a fraction of what I get from private insurance for the same care. So more hoops to get less money. And i am supposed to want to expand that?
There's truth to that, but not entirely why you think. Plenty of med students have 300k+debt. You can't pay that off at European salary levels.
Have you considered why that is?
Of course it doesn't have to.
So wait. The total US government budget for 2019 is around 4.4 trillion. You want to add another 35% on top of that? So now the deficit instead of being 1 trillion for 2019 will now be 2.5 trillion?
Well there's 2 parts to this. The first is why should the government cover education for everyone? We have lots of people going to college and getting degrees that don't help them get jobs. We should we, as taxpayers, cover that? Along that line, I wouldn't object to making technical schools' tuition be paid for. Most places I've been have a shortage of skilled tradesmen. Covering tuition to get more plumbers and electricians makes sense. Doing it to pay for more sociology and gender studies majors doesn't.
“We have lots of people going to college and getting degrees that don't help them get jobs. We should we, as taxpayers, cover that?” Not all the people who complete kindergarten-12th grade from public schools, don’t get jobs either. So, do you propose to close those schools? For a society move forward, education is most vital. Even the poor, third world countries seem to get it. God only knows why we don’t.
I was born and brought up from a poor country where the education is almost free in all public universities. In the early 60s, before I was born, the Governor of our state who was uneducated , made the education free even though it consumed 75% of the budget. When the Finance Secretary raised this concern, the Governor said “So what? We are spending only on our kids. Once they are educated, they will pay it back. Asking the kids to pay for the education is same as the mother asking her child to pay for the breast milk.” Thanks to people like him, people from that country compete with other countries in equal terms.
I'm not at all against publicly funding things (in real life I'm much more moderate than it appears here). But most of what we fund for public good has a public good. Police, fire, roads, military benefit everyone. Making sure everyone can read/write/do basic math benefits everyone. Making sure 100% of our children go to college doesn't. Slight tangent, but I firmly believe that 2 generations of telling kids that going to college was the only way to succeed has been fairly harmful. There is a huge shortage of skilled tradesmen in this country. Those are good jobs that pay well, and you can usually start earning around age 19-21. I have a number of patients in their 20s doing HVAC work, plumbing, electricians. Most are breaking $30/hour.
If we know with 100% accuracy that the child in question will never be able to contribute to society in some meaningful way I would be perfectly content not to spend a lot of resources giving them a k-12 education. But since the majority of cases that end up not being able to get a job or do volunteer work, or be a stay at home parent are not predictable with perfect accuracy (like even those with profound developmental delays may with help be able to hold a part time job or something) it is better to try to educate everyone to a minimum standard. I see no reason that we need to use taxpayer money to maximally educate everyone though. For countries that publically fund higher education they are selective about who gets to be taught past basic levels.
Of course not everyone can be a plumber. That's why 2 year degrees also get you dental assistant, RN, pharmacy tech, paralegal, rad tech, RT, surgical tech, lab tech, MA, you get the idea.
The attrition rate is often higher as well
I would still be against it
one of those options is to stop stealing money from people, the other option is to continue stealing from one set of people to buy college for people who don’t want to pay. The first option is clearly superior
College education for everyone, particularly the joke that is most undergrad today, is not at all vital
And before someone tries to claim it is because of costs, dialysis is one of those get medicare (and often medicaid) regardless of age diagnoses.
Or just remove the requirement for insurance and let everyone fend for themselves. A public option isn’t free market
If you assume everyone wants/needs the same thing and that everyone will pay, which they don't and they won't. As well as the assumption that 1 player will act more responsively and competitively than multiple, which isn't a good assumption either
You have good thoughts. I would add if you are a druggy skank you have made poor decisions for yourself and should not be given any rights to healthcare though. Once your doctor cares more about your health than you do you have become a lost cause.
