Five Decades Later, Medicare Might Cover Dental Care (nytimes.com) 158
Tens of millions of older Americans who cannot afford dental care -- with severe consequences for their overall health, what they eat and even when they smile -- may soon get help as Democrats maneuver to add dental benefits to Medicare for the first time in its history. From a report: The proposal, part of the large budget bill moving through Congress, would be among the largest changes to Medicare since its creation in 1965 but would require overcoming resistance from dentists themselves, who are worried that it would pay them too little.
This actually makes sense, conservative or liberal (Score:5, Insightful)
Given you have a healthcare plan of some kind, it doesn't make sense to say "this system covers any medical issue - unless the issue is in your mouth".
One can point out flaws in how Medicare is administered, and there are certainly valid criticisms. There are things that need to be improved.
One can argue it shouldn't cover cosmetic procedures, and that's a reasonable viewpoint.
To say it covers all parts of the body except the mouth just doesn't make sense.
Re:This actually makes sense, conservative or libe (Score:5, Insightful)
Or given that poor oral health can lead to a number of other health problems [nih.gov], it doesn't make sense not to cover dental care.
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Even Alzheimer’s may result from dental bacteria. Reference: https://advances.sciencemag.or... [sciencemag.org]
Re: This actually makes sense, conservative or lib (Score:2)
That's a bit of a stretch -- nobody really knows what causes Alzheimer's. All we really have are educated guesses at this point.
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Add hearing and sight to the list of things that should be covered. Increase the premiums as needed for all covered people to make up for it. You need to be able to see and you need to be able to hear. Hearing aids and glasses are at least as ridiculously overpriced as dental work.
While that's a good point, it's a separate issue (Score:2)
Sure there are some benefits to having the consumer have some idea what the cost is, and some motivation to care about the cost of different treatment options. One can come up with formulas such as:
They pay 10%, but never more than $1,500
We discuss all day about what the best method is. But how is that different for something in your mouth vs your foot, back, shoulder, or anywhere else? That's the discussion today - covering health problems in the mouth or not.
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Right well dental care is the one area of medicine that actually isn't radically unaffordable without some subsidy.
Most employers don't really 'contribute' much to dental coverage if anything - they merely offer a plan. If you run the numbers you will probably find that over a decade or so your portion of the costs for dental insurance + whatever co pays and non covered procedures work out to something pretty close to what it would cost to just pay out of pocket.
Once you dump medicare / medicaide money into
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Right well dental care is the one area of medicine that actually isn't radically unaffordable without some subsidy.
Tell me you've never had a serious dental problem without telling me you've never had a serious dental problem.
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Why is why price controls are needed. Medicine should not be a for profit industry.
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Because doctors won't work for free.
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They don't work for free in any other country either. Gee, where is all that money going???
In the US, bureaucratic salaries are capped at about ~$140k by law. There is no upper limit on executive salaries at insurance companies. Nor is there any upper limit on what they pay to healthcare providers (hospitals, etc.)
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It is funny where a lot of the money goes in healthcare that isn't as much profit as people will expect.
A common example of overpriced medical treatments is the $10.00 aspirin while in the hospital, where you can buy a whole bottle for that much.
However...
You push the call button saying you are hurting.
A nurse will need to come over and ask you what the issue is and put the order in the system 5 minutes of their time ($40 an hour for 5 minutes $3.34)
A doctor will review the nurses order making sure the pati
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Well it's not all profit, we know this because we can look at the hospital and insurance companies financial statements.
The issue is that the way the system is set up, there is no pressure to keep the costs low at any point, plus there's significant overhead of managing it all. Doctors are extremely expensive because there's a limited supply of them and their education is expensive. The medicine is expensive because each insurance company negotiates separately. They over-prescribe expensive procedures becau
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How does one decide which industries should be for profit, and which should not?
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âoeIf you think health care is expensive now, wait until you see what it costs when it's free.â
â P.J. O'Rourke
When discussing these things, distinguish carefully between the cost (the amount of money needed for a service), and the price (the amount of money you pay, usually less than the cost, with the balance paid by suckers). The government generally fixates on the price, while not giving a shit about the cost.
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you think those things are expensive now just wait until providers can bill medicare for them!
According to the summary, the providers oppose the proposal because they think prices will go down.
Re: This actually makes sense, conservative or lib (Score:4, Informative)
Not sure of your age, but I'm not retired yet and need trifocals to work all day on a computer, read, and see to drive. I think you'll find the cost of tri-focals - even one pair - pushes the cost up quite a bit - google says average U.S. price is $260 per pair or more if you add protective coatings (or add clip ons as a sunglasses alternative). As you age, you frequently need better than simple lenses which agreed aren't high priced although the markup is still high.
The big killer is hearing aids though. Hopefully with a bigger market, the price would come down, but aids that actually help you hear can run at least 5 to 6k. You can get cheaper ones that just amplify everything, but they really don't help in crowds like the more expensive pairs do.
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Congrats on your simple prescription. Some of us have more complicated ones.
Re:This actually makes sense, conservative or libe (Score:4, Interesting)
Re:This actually makes sense, conservative or libe (Score:4, Insightful)
I could almost believe that with regard to Romney, who basically implemented Obamacare at the state level.
Trump? No way. He might have had intentions of being a working-class hero to start with, but when he realized that his survival was fully dependent on right-wing interests he went all-in on destroying Obamacare as the greatest failure in American history.
Ask your "staunchly pro-medicare" friends how they feel about Medicare-for-all. What you will find is they want it for themselves but nobody else, particularly not those people.
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Given you have a healthcare plan of some kind, it doesn't make sense to say "this system covers any medical issue - unless the issue is in your mouth".
Private dental "insurance" doesn't really do anything anyways. $1500 maximum benefit per family. Two cleanings per year covered. I'd probably come out ahead to just pay cash.
Example: I broke a tooth. Dental plan paid about 1/3 the cost to pull it and exactly nothing to replace it. So one of my molars is missing and I'll get it fixed when I can justify spending $5000+ for an implant.
Yeah dental insurance is mostly a rip-off (Score:3)
True, for most people you're better off just taking the money you would have spent on dental insurance and sticking it in your savings account. Even more so for vision. Our family gets our glasses at 39dollarglasses.com or Zenni. Not because we're broke - we're doing quite well financially BECAUSE we don't pay $250 for something we can get for $45.
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Typical vision plans cover up to $250 for frames. So guess what all frames cost: $250.
* unless you're planning on major work (Score:5, Insightful)
I meant to say, if you are planning on spending over $1,500 in dental in the coming year, you might come out ahead by buying the "insurance" that year.
I put insurance in quotes because it isn't, really.
Think about your car insurance. Does it cover oil changes?
Do you have to fill out insurance forms every time you replace the tires?
How about home insurance. Does your home insurance get involved with replacing a toilet flapper, or fixing a leaky faucet?
Insurance is a system that covers the costs UNEXPECTED events that are TOO COSTLY to cover with your checking or savings accounts.
Car insurance covers if your car gets in a major wreck, possibly causing significant injury. An unexpected event, and you can't just use your checking account to cover it. Home insurance covers if your home gets hit by a tornado, or burns down. Unexpected events that your checking and savings account can't cover.
With a cap of $1,500, dental "insurance" isn't covering things that your savings can't cover.
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Those sites are fine for bog standard glasses but if you need/want any kind of extra features be prepared to pay at least 3x more than the base $39 dollars at 39dollarglasses.com.
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Crowns are not implants, and are a much simpler (and thus cheaper) procedure than implants.
Getting a crown on the implant is the last step in the process, and by far the cheapest step in the process.
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The question is what would constitute cosmetic vs medially necessary. I have a couple of crowns installed, while they look like normal teeth, and make sure my smile doesn't have gaps, they do make sure my mouth keeps its shape and my other teeth stay in line.
But get a set of golden teeth just for show, or whitening slightly yellowed teeth, (vs brown or black teeth) would fall under misuse of tax payer funds.
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> The question is what would constitute cosmetic vs medially necessary.
That is a question that comes up any time you have kind of system of paying for medical procedures, other than "the consumer pays everything".
I was born with significant facial deformities. The system accounts for the difference between that and Kim Kardashian's latest facelift or whatever. Anything related to dermatology, you can ask that question.
It's a question. Fortunately, questions are often followed by answers.
I am making a big
Re: This actually makes sense, conservative or lib (Score:2)
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Veneers are cosmetic, sure.
Dentures and implants are two options for when you don't have teeth. Teeth are needed for eating, for speaking, and here's a big one - preventing the jaw bone from withering away to nothing. That's medically necessary.
Dentures don't do as well as slowing bone loss, vs implants.
Dentures are medically sufficient for up to about 10-20 years. So they are suitable for a 72 year old. Put dentures on a 40 year old and twenty years later what's left of their jaw will break. For a 40 year
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Re:Or does it? (Score:5, Insightful)
dental care is the only field of medicine that has very reasonable costs
If dental medicine had reasonable costs there would be no need for dental tourism [washingtonpost.com]. This [agd.org] article estimates the costs of dental treatment in other countries to between 40% and 75% cheaper than in the US/Canada. And, if you're worried about the quality of care, you can get your dental treatments in developed countries, like Spain, Poland or Hungary.
I think you consider dental costs in the US to be reasonable only because you compare them to medical costs in the US which are even more amazingly unreasonable. That doesn't make them OK though.
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And why is US dental care so expensive? Do a little research into the costs of American dental schools vs. anywhere else. You will be astounded.
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This [agd.org] article estimates the costs of dental treatment in other countries to between 40% and 75% cheaper than in the US/Canada. And, if you're worried about the quality of care, you can get your dental treatments in developed countries, like Spain, Poland or Hungary.
Here in Arizona, the international option is available at an exit on I-8 just west of Yuma. Algodones is a border town consisting entirely of dentists.
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You are complaining dental services are 2x higher here than elsewhere... how will you feel when they are 10 times higher? 100 times higher? Because that could be the case when you plug in medicare to the equation. It certainly is true for other forms of health care.
So are you saying that the only reason health care in the US is so expensive is because of Medicare? The fact that every other major country has a form of Medicare and still has lower health care costs would argue against your assertion.
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Who are these "so many people"? I've never met one.
Well, this [forbes.com] recent article puts the number of Americans that traveled abroad for medical and dental care in 2020 to 290,000, while the estimated number for 2021 is 650,000. The pre-pandemic number was even higher, at 780,000 in 2019. That none of them was in your circle of friends doesn't mean they don't exist.
You do realize that most of the work done overseas is cosmetic and not necessary work, right?
Do you have any source for this statement? The article above quotes the cost of a root canal in Mexico as being 75% cheaper than in the US. A root canal isn't cosmetic, and if you need it, then it's ve
Re: This actually makes sense, conservative or li (Score:3)
They're really not bad considering how manpower and equipment intensive it is to run a dental office. Vets cost just as much.
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Good point. Kind of like has basically happened with eye care. They've got Costco Optical. Now try Costco Dental.
Only 56 years too late (Score:5, Insightful)
Absolutely ridiculous that this has taken so long. Dental care is absolutely medical care and we know even more now how periodontal issues with your gums can affect a lot of other health concerns as well. Nevermind the high cost of fixing issues like dental implants and the quality of life loss of having dentures. The list goes on and on and dental care is all about prevention. Just making sure people have regular cleanups will likely pay for itself down the line.
As was described to me "your mouth is largest part where your insides meet the outside". It's an important thing to be taken care of. Now this just needs to extend to all health insurance. Vision too (are glasses for a nearsighted person really considered "optional")
Dentistry as Medicine (Score:2)
I have a dentist friend in Japan. I think they treat it just like another specialty. i.e. like "podiatry" "cardiology" "dentistry". He had the same "base" training as any other specialty before going into the specialty training.
How it's broken out separately in the US is quite odd.
Re: Only 56 years too late (Score:2)
And from what I deduce, Iâ€(TM)m not sure I want to…
at last (Score:5, Funny)
Finally, a plan with some teeth in it. //try the veal
Why is dental not considered medical? (Score:4, Interesting)
I never understood why dental work is not automatically included in medical insurance. If your teeth or gums get infected you'll have a whole slew of medical problems. Left untreated an infected tooth can become fatal. Makes no sense to me.
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Same with vision coverage. Figure if I'm blind as a bat without my glasses that likewise is a medical issue. Last time I checked my eyes are part of my body!
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Last time I checked my eyes are part of my body!
Transhumanism will change that. Well either that or Minority Report.
Re: Why is dental not considered medical? (Score:2)
Medicare covers cataract removel (Score:2)
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Oh dear (Score:4, Informative)
There will be a heap of misinformation and conspiracies posted about it on Facebook
Uneducated dumfucks will lap it up
In the end, nothing will change only Statesian health care will still suck 'cause thats how it's always been.
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It might save money... (Score:5, Interesting)
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However, since Medicare covers the elderly, we might see in increase in life expectancy instead.
Well we can't have that.
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Also, it may make dentists more money overall, despite the objections. Many elderly completely avoid dentists altogether, or avoid any procedures beyond cleaning and fillings, because it's unaffordable. So some money to dentists from medicare can be better than no money at all if there's an empty time slot.
just wait for GOP crap to hit FOX news with this (Score:2)
just wait for GOP crap to hit FOX news with this.
they can run an ad that shows the big book of british smiles and say coming soon to US is the GOV takes control of dental.
Those are some dumb dentists (Score:2)
but would require overcoming resistance from dentists themselves, who are worried that it would pay them too little.
Get only 80% of the profit you currently make on a procedure. Get 300% increase in customers. Think that you'll lose money.
This is like the people who think taxes mean a raise will cause them to make less money.
Without teeth, you can't eat (Score:2)
Without a dental plan, one of the more common causes of poor health is malnutrition: if you can't chew, you're not going to eat well.
Many seniors end up not replacing lost or pulled teeth, leading to worse and worse eating habits.
This isn't Dentalcare for All (but it should be), but it's' a good step.
Note that a number of Medicare Replacement Plans do include dental care, so if a private insurance can afford it, likely so can Medicare. Preventative care could save a lot of costs in the long run.
Re: If it doesn't bankrupt us, it's not good enoug (Score:2)
https://youtu.be/DNCZHAQnfGU [youtu.be]
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Long as we don't exceed our GNP.
Re: If it doesn't bankrupt us, it's not good enou (Score:2)
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It can't run out of money, we'll just print more. At some point if the government can't back people's risky behaviors anymore, all hell will break loose.
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Going to the dentist is a risky behavior?
Re: If it doesn't bankrupt us, it's not good enou (Score:2)
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Going to the dentist is a risky behavior?
Dental care for children is an investment. They will have better health and higher productivity over their lifetimes, which, in theory, should recoup the investment.
Dental care for seniors is not an investment, it is consumption. There is no payback. There is nothing wrong with consumption. In fact, producing goods and services to consume is sorta the whole point of life.
But paying for consumption with debt is neither wise nor sustainable.
If we want dental care for seniors, we should raise taxes to pay f
That's a misleading way of putting it. Greenspan s (Score:3)
Greenspan said that the government can create as much CASH as they want. He went on to say the problem is if there aren't useful resources created to match, the cash has no value.
All they've done in that case is dilute the value of the money you've saved.
1% of the dollars in the country REPRESENTS 1% of the assets.
By producing more dollars, you just make it so that BytePushers 401K is a smaller percentage, meaning it then has less value.
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1% of the dollars in the country REPRESENTS 1% of the assets. By producing more dollars, you just make it so that BytePushers 401K is a smaller percentage, meaning it then has less value
Completely false. 1% of the dollars REPRESENTS 1% of the country’s assets, foreign debt held in dollars, foreign assets held in dollars, foreign markets forced to trade in dollars, and foreign fiat held to fixed exchange rates. This is why we can print so much money and never see inflation, it’s pretty hard to dilute the entire world.
Re: If it doesn't bankrupt us, it's not good enoug (Score:5, Informative)
Funny how this never seems to be an issue when spending money to occupy far-off countries for no purpose whatever. Trillions of dollars and the internet economic wizards can't think of a single objection along the lines of not being able to "afford" it.
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Funny how this never seems to be an issue when spending money to occupy far-off countries for no purpose whatever.
So your best argument for this proposal is that we have spent money on other things that are even stupider?
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How much does it cost us for people teeth to rot, vs having them stay healthy?
If you look at Taxed funded services as an investment, you realize things may not go bankrupt, as long as you fund properly.
For many of these people who can get medicare, (often older people), Their teeth is important for them do do their work, especially jobs that older people can still do, these jobs often require a lot of talking which teeth are important, also if they are in pain they won't be able to work, even the Walmart g
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Why is it a disaster? It's a major lifesaver to the elderly. Yes, I know there are some idiots out there who think the elderly should just die to make things easier for younger and richer people, but in a civilized country we don't operate that way. It's still vastly cheaper than the military which gets huge support from the "government should never spend money!" crowd.
Re: medicare is a disaster, and they want to add M (Score:2)
No one thinks the elderly should just die, its just something democrats accuse republicans of based on their desire to pass unpopular legislation. (Care to quote any politician or leader putting forth that the elderly don't deserve medical care? The only one I can come up with is Dr. Emanuel and his "whole life" approach to healthcare expenses.)
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How about the Texas politicans who said grandma would be willing to take one for the team so that we don't have to wear masks or do social distancing? Ok, it's not medicare related. But, abolishing medicare without a replacement is the equivalent of saying one doesn't care what happens to the elderly. A lot of politicians make a big show of wanting to abolish things but at the same time they fail to provide reasonable replacements or fixes. Witness this with Obama/Romneycare; lots of moves to try to abo
Re: medicare is a disaster, and they want to add M (Score:2)
Medicare fraud is a thing, and refusing to better manage costs is troubling to many taxpayers.
Re: medicare is a disaster, and they want to add (Score:2)
Medicare fraud is about 15%, that's kind of a big loss rate, especially at the dollar levels we're talking about.
https://safeatlast.co/blog/med... [safeatlast.co]
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Where do you get 15% when the article you link says "Fraud, abuse, and waste account for up to 10% of overall healthcare expenditures."?
And the entire health insurance industry has the same issue, with up to 10% estimated loss due to fraud, abuse, and waste. See: https://fortunly.com/statistics/insurance-fraud-statistics [fortunly.com]
So, Medicare fraud is about the same as overall industry fraud, including all non-gov't run. That means your scare numbers about Medicare being a disaster are bullshit. They're no better or
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The capitalist way of dealing with fraud is to ignore it. That's essentially what happens with the credit card industries; they will assume x% loss is acceptable because it was cheaper than going with something more secure, which is why we didn't get a chip system (not even chip and pin) until after the major hack of Target.
So, pay higher health insurance premiums to deal with fraud, ok. Pay higher taxes to deal with fraud, no way Jose! The difference is partly because corporations hide things and govern
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Re:medicare is a disaster, and they want to add MO (Score:5, Insightful)
Medicare administrative costs are between 2-4% compared to private insurers rate of 12-18%. Medicare also pays lower rates than most private insurers.
Medicare also has a 75% approval rating from the people who use it as of 2019.
Medicaid and the VA also have similar high approval ratings. Social Security is even higher.
The myth of these programs being "disasters" is a myth perpetuated by elite Republicans orgs like the Heritage foundation to serve their ideological goals. That's not to say these programs could not be improved but people very much approve of these programs and they have been very successful in achieving their goals.
Re: medicare is a disaster, and they want to add M (Score:2)
Private health insurance is guaranteed 15% profit, thanks to PPACA (obamacare), Medicare has a 15% fraudulent payout amount.
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Sure but that was an improvement to 20-40% profit margin they had before the ACA.
If we are really concerned about Medicare fraud we can just extend Medicare coverage to cover everyone. I like where you are going with this!
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Fraud in both Medicare and private insurance runs at about 10%.
The ACA capped "non-medical expenses" at 20% (employer-based) or 25% (individual), which is profit and salaries for people not directly involved in claims. So its a "guarantee" of 20% profit, but only if the CEO cuts way back on hookers and blow.
Re: medicare is a disaster, and they want to add M (Score:2)
Medicare reimbursements don't cover the cost of delivering covered care, remove private healthcare coverage from the market and doctors offices, hospitals will be shuttered. Medicare reimbursements could be increased, but the actual cost of providing covered care will be politically unsustainable.
Look at NHS, Canada, where funding levels create scarcity for services Americans take for granted.
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NHS and Canada eh? Where people have longer life expectancies, better approval ratings and better overall health outcomes and an overall lower medical-cost-per-capita than the USA?
Medical cost per capita:
USA: $10,966
UK: $4,653
Canada: $5,418
Healthcare in the USA is fantastic if you can afford it
Re: medicare is a disaster, and they want to add (Score:2)
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Oh, yes. Republicans paid by the healthcare companies will make it difficult politically. Otherwise it has overwhelming support from the public, and nearly universal support from the people who are aware of the details.
QAnon believing vaccine denying dimwits, and those who exploit them, are the ones who oppose it.
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If that is true, and it could be, what's broken about US healthcare?
Our per-capita healthcare costs are the highest in the world, and our outcomes are about average for developed countries. We are paying more,
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Medicare is projected to run out of $ by 2026. 5 years from now. Add in this dental and it will be 3-4 years from now.
CONgress should be looking at how to shore it up, not how to spend faster.
Re: medicare is a disaster, and they want to add M (Score:2)
Medicare is funded primarily via payroll taxes. Any projected funding problems is a math problem. Increase the tax to keep up with funding needs. We have an ageing population, it makes sense it needs more funding. It doesn't come out of the general fund. Combine that with other improvements like prescription negotiating. If it's more efficient than private insurance what's the actual problem with the program?
Re:medicare is a disaster, and they want to add MO (Score:4, Insightful)
Medicare works pretty well actually. We need to bring down healthcare costs but that will never happen due to lobbyist groups. Same goes for prescriptions. I can fly to Germany to buy insulin and it’s still cheaper than the out of pocket costs.
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Medicare works pretty well actually. We need to bring down healthcare costs but that will never happen due to lobbyist groups.
Also note that Congress doesn't allow [commonwealthfund.org] Medicare to negotiate medicine prices with the producers. As a result, Medicare has to pay whatever the producers (or some middleman for-profit companies, like the Pharmacy Benefit Managers) want. To me this sounds beyond ridiculous: a big customer like Medicare has a lot of leverage with the producers, and should be able to get better prices (this is what the free market is all about, after all). However, the lobbyists in Congress are blocking this.
Other organizations,
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Negotiating prescription prices was one of the few good things Trump tried to do but we saw how quickly that was killed and buried.
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Negotiating prescription prices was one of the few good things Trump tried to do
Was it Trump though? IIRC, Medicare freedom to negotiate was included in a Pelosi bill in 2019; the bill was passed in the House, but, to nobody's surprise, Mitch McConnell never brought up it for a vote in the Senate. The Senate came up later with its own version, (the Grassley-Wyden bill) which didn't include negotiation; instead it had some complicated mechanism for setting something called "inflationary price caps".
Initially Trump tweeted support for the Pelosi bill, but when the Senate bill came out he
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CONgress, esp. the GD dems, are doing all the wrong things. They have control. NOW, they should be focused on how to keep medicare working for at least 20 years, when it is about to become insolvent in 3-5 years.
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Let's assume for a moment that Medicare has a lot of problems.
Which of those problems would be fixed by saying "Medicare no longer covers problems related to your feet?"
While I'm sure you can come up with some specific problems related to Medicare, I'm not sure that "it covers too many body parts" is one of those problems.
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Let's assume for a moment that Medicare has a lot of problems.
Let's not assume that. Medicare HAS SERIOUS PROBLEMS. Here is Kaiser showing how bad of shape they are in [kff.org]
Here is a forbes article about it. [forbes.com]
LOng before we start spending things, we need to deal with this funds, and balance the gd budget. That means tax reforms are needed, and they need to be FAIR, not the current BS that is going on (GOP cuts on wealthy, increasing deficits; Dems want to increase wealthy taxes, decreasing middle; increasing deficits).
We need FUCKING LEADERSHIP from CONgress and the
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Don't worry, we're DECADES away from anything resembling universally available healthcare in America. Maybe centuries. There's too much money being made the way things are now. And a lot of that money circles right back into lawmaker's pockets via "lobbying." Granted, knowing a few insurance folks and how much money their companies throw at them to "keep them happy," it's not like the companies don't lavish their employees. Not many other jobs where the typical traveling salesman gets to take a trip to
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In a past life, I worked at a company that made scientific instruments. One of our clients was a dental research lab for the US Navy. On one of our sales visits, I asked about why the military had "dental research facilities" expecting some glib answer. What I was told was shocking. At any one time, nearly 20% of active duty military personnel are unable to perform combat duties due to dental diseases and injuries.
The people who enlist,
Re: Medical tourism -- a great solution (Score:2)