How Much Could Medicare for All Save You?

The government put a key piece of Obamacare back on the shelf last week, when it announced that companies employing more than 50 workers will have an extra year to begin offering health insurance without facing fines.

Whether you consider this good news or bad news probably depends on whether you were a fan or a foe of the Affordable Care Act in the first place.

But could it be that the ACA isn't really needed at all? Could an alternative idea -- "Medicare for all" -- actually do a better job of controlling medical costs, and making health care affordable for Americans?

Obamacare -- but cheaper 
A new survey released by the number-crunching technocrats at NerdWallet last month clearly illustrates how extending Medicare coverage to all Americans might cut costs for everyone. According to NerdWallet, Medicare generally pays out no more than $0.27 for every dollar that hospitals bill it for medical services -- a savings of 73%. Put another way, an uninsured patient receiving the same care as is provided to a patient covered by Medicare can expect to pay nearly four times as much.

And that's just the average. Echoing the findings of a Time magazine report earlier this year, NerdWallet's health-care survey noted that the prices charged by various hospitals offering the same procedure can vary widely. As you can see in the far-right column of the pricing chart, you could easily end up paying 30 to 40 times as much for a stay at one hospital than at a hospital down the road, for the same treatment.

Obamacare -- but more efficient 
How does a 73% discount on medical bills compare to what's promised under the ACA?

Well, under the current structure, Obamacare works as a plan to require patients to sign up for private health insurance plans. Yet according to Forbes, many of these private insurers offer their members discounts of as little as 20% off hospitals' ordinary pricing.

One of the standouts, Blue Cross plans from WellPoint  (NYSE: WLP  ) , is sometimes able to negotiate discounts as large as 60% -- still far short of the average discount of 73% with Medicare.

Obamacare -- but better 
Harvard Medical School visiting professors David Himmelstein and Steffie Woolhandler recently noted on the pages of The New York Times that a Medicare-for-all health care system -- known commonly as "single-payer" -- is an incredibly efficient operation, in terms of costs.

On average, only 2% of the revenues that flow through Medicare are needed to cover overhead costs. In contrast, patients who subscribe to private health insurance spend 14% of their money -- seven times as much -- just paying for the overhead costs doctors incur from juggling the multitude of insurance procedures required for different patients subscribing to insurance plans.

Other commenters, such as Dr. Dave Dvorak, writing in the April 2013 issue of Minnesota Medicine, put the cost of Obamacare even higher, arguing that "a staggering 31% of U.S. health care spending goes toward administrative costs, rather than care itself." As Dr. Dvorak notes, while "Obamacare ... is expected to extend coverage to 32 million more Americans," it does so by "expanding the current fragmented, inefficient system" and is likely to "do little to rein in health-care spending."

In contrast, the U.S. government itself agrees that the ACA -- the system we've settled upon instead of offering Medicare for all -- costs more than a move to a cheaper, more efficient, and better single-payer system. The U.S. Government Accountability Office calculates that a switch to single-payer would shave $400 billion a year off the national health-care bill.

Little wonder, then, that a 2008 survey published in the Annals of Internal Medicine found that 59% of physicians polled support Medicare for all.

A government takeover? 
So Medicare for all is cheaper, more efficient, and better than Obamacare -- but isn't it a "government takeover" of health care?

It needn't be.

If an individual consumers think they're better off with a private health insurance plan from WellPoint -- or from UnitedHealth GroupAetna, or Cigna -- then fine. They could still sign up for one of those, either as a supplement to Medicare-for-all or, if they prefer, as an exclusive plan, and choose not to participate in Medicare at all. For that matter, there should be no need to require anyone to buy any insurance whatsoever.

All that's really required for Americans to begin reaping the 73% savings of a Medicare-for-all plan is to open up Medicare enrollment to everybody. Give everyone the right to sign up for Medicare, rather than requiring us all to sign up for a private insurance plan under the ACA. And then let the marketplace decide if Medicare for all is really as good an idea as NerdWallet's survey makes it sound.

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Help us keep this a respectfully Foolish area! This is a place for our readers to discuss, debate, and learn more about the Foolish investing topic you read about above. Help us keep it clean and safe. If you believe a comment is abusive or otherwise violates our Fool's Rules, please report it via the Report this Comment Report this Comment icon found on every comment.

  • Report this Comment On July 21, 2013, at 8:21 AM, ProfEm wrote:

    Well, of course! But isn't the ACA a step in the right direction?

  • Report this Comment On July 21, 2013, at 8:41 AM, GT6 wrote:

    Medicare for all would be far superior to any other plan, which was why it was killed before it could get out of committee. But there is still a way it could come about. As states put together their exchanges, a few states may offer a medicare buy in as an option. If this happens, and it gets a chance to prove just how powerful an idea it is, other options will either have to compete or be beaten. Push your states to offer a medicare for all buy in.

  • Report this Comment On July 21, 2013, at 9:10 AM, PBerg1 wrote:

    ahh, if only the Republicans had not fought the entire idea so hard, that would have been the ideal solution. Already set up with benefits and participating Providers, Medicare for all would have been so easy to merely open to all. And as Insurance is based on the law of large numbers, it would only have helped keep Medicare alive and thriving for seniors. Time to vote Republicans out, and start with some help for the American people

  • Report this Comment On July 21, 2013, at 9:13 AM, Artemis56 wrote:

    A big concern, that not a lot of people know about-more and more doctors are refusing to take on new Medicare patients. Why? Because of those deep discounts. If all doctors accepted Medicare, many wouldn't be able to meet expenses. (It was a more family friendly work schedule than a hospital.)

    As a registered nurse who worked in a physician's office-a very busy family practice-I was already making less than your local garbage man. Those working the front desk made less. They stopped taking Medicaid and new Medicare patients because those who had it tended to have more complex problems and took the most amount of care and treatment. Around here, there are phsycians who still take it, but those aren't rated well in patient care.

    I honestly think you'll see fewer people going into medical careers and we'll still have difficulty getting quality care.

  • Report this Comment On July 21, 2013, at 9:23 AM, LOSMTJohn wrote:

    Medicare operates on a "Cost-Plus" basis, familiar to anyone involved in government contracts. So when Doctors and Hospitals say they can't "afford" Medicare, it's actually cutting into their profits is all. "Cost" in the "Cost-Plus" world is your totally burdened cost--direct costs, indirect costs, depreciation on buildings and capital equipment, etc. etc. The "Plus" is an allowable profit above all that--usually about 15%. Medicare is an existing program that could simply be expanded and fixed a bit where necessary. This seem like a much much more common sense approach than a whole new bureaucracy. This actually seems obvious. I'm surprised this is the first time I've seen this idea well articulated in print. Kudos to the authors.

  • Report this Comment On July 21, 2013, at 9:25 AM, MinnMomma wrote:

    I have lng thought that medicare for all might be an answer.

    The other big thing I'd do is eliminate the VA health care system, for the most part...

    Give medicare benefits to all veterans,,,it would be cheaper, better access to all forms of heath care, there is no real reason to make vets go to only VA hospitals.

    "Offer" medicare for all, maybe a monthly fee based on income,,, low income, no fee, high income, bigger monthly fee. With a co-pay, too many people run to the doctor for every little thing.

  • Report this Comment On July 21, 2013, at 9:26 AM, mcbridefutures wrote:

    Let's start from the beginning. All these articles debating charges by hospitals and actual payments by medicare are misleading to the general public. These articles as well as the government study are written by people that have no IDEA of how the medical field operates. Start: all insurance companies have some what different fees that they pay for procedures. So that hospitals and surgery centers don't have to put a separate charge in for each insurance company (which could be hundreds and they change constantly) they just put in a fee somewhat higher than the highest fee they receive and leave it at that. It also serves another purpose. It makes it look like to an insured that the hospital took a huge hit. Here is a start surgery center's are paid approximately 63% less than hospitals for the very same procedure and have no pass through cost or balance billing available to them. However, in the hospitals defense the regulations imposed on them (and the government has been doing the same to surgery centers for the past 4 years now) is killing them and our healthcare. I could keep going on forever but maybe this shines a little light on why there is a huge difference between the charges and the actual payments. I will say the government usually has good intentions they just don't have the time or listen to the right people to implement such complex programs with any positive lasting results.

  • Report this Comment On July 21, 2013, at 9:37 AM, Veritas177 wrote:

    Authors often site Medicare's discount rate and admin cost. Both are a mirage. The Medicare discount rate is so low that it does not pay lights on costs. Doctors and Hospitals charge insured patients more to pay the bills that Medicare's low rates do not cover. This is called the Medicare "cost-shift." Medicare's low rates are just an underpay that is subsidized by over-charging insured patients. Eliminate private insurance (and its subsidy of Medicare) and the Medicare discount rate will quickly be unsupportable, and Medicare will have to pay in line with current insured rates or the Doctors and Hospitals wont have enough to operate.

    Similarly, the admin rate is distorted. "Overhead costs" are a ratio of admin costs to medical costs. Medicare's costs look so low not because their admin is low, but because, having the sickest population in the country, their medical spend is absurdly high by comparison. Healthier populations always have a higher admin ratio, just because their medical spend is much lower. The seemingly great Medicare admin ratio is merely a coincidence of the specific, very sick, Medicare population. If Medicare were to take on the whole national population, their admin cost ratio would quickly fall in line with what we see with current private insurance.

    There are reasons to discuss a single-payer model. But the Tom Foolery of extrapolating what we see with Medicare today without considering the change in the healthcare marketplace that would come with a single-payer system is not helpful.

  • Report this Comment On July 21, 2013, at 9:43 AM, Dunc9602 wrote:

    The issue is not what Medicare or other insurance pays but what the hospital charges - why does it have to be so different? My son had an appendectomy. He was in the hospital for 18 hours. The hospital bill (not including surgeon, recovery room, etc., etc.) was $24,000. The agreed to charge by the insurance company was 4200. I didn't have to pay any of the difference. That's a 82.5% "discount". That is laughable. Separately, my insurance company was billed 3500 for his Catscan. End charge to me (insurance didn't cover it-long story) was 700. Again, an 80% discount. Every doctor bill sent to insurance is marked WAY down. We need market based pricing of medical services the public can reference. The pricing presented to us is absurd for WHATEVER reason they may want to present that price.

  • Report this Comment On July 21, 2013, at 9:44 AM, jamesmmm wrote:

    It's true that Medicare is already set up very well and that a minor legislative action could make it available to all...ObamaCare puts more power into the hands of private insurance companies and BigPharma, and how do you think those will use it? And if everyone were vested in Medicare, there would be greater ability to monitor the fraudulent activity. Since Medicare is Title 18 of the SS Act, strengthening Medicare wlll also serve to strengthen Social Security.

  • Report this Comment On July 21, 2013, at 9:49 AM, columbiaeddie wrote:

    Of course "single payer" would be better, but was not proposed in anticipation of Republican opposition to "socialized medicine" and their insistence on the primacy of a role for the private health insurance companies. (Some have called this an example of Obama's "unilateral disarmament" when it comes to his dealings with Congress.) Obamacare is based on the proposals of the very conservative Heritage Foundation.

    As to Medicare for all on a voluntary basis, it still does not answer what to do about the uninsured who get sick. Who pays for them?

  • Report this Comment On July 21, 2013, at 9:50 AM, VRSEFgold wrote:

    DUH! How soon could America deal Rich Smith and "Medicare for All" for Ovomit and OvomitCare?

    Our Blue Cross Family Insurance Premium has risen 286.5% since Sept. 2010.

  • Report this Comment On July 21, 2013, at 10:05 AM, Albert0Knox wrote:

    Of course Medicare for all makes sense. That's why the entire civilized world except the US has some form of it and spends less on healthcare than we do. Drug manufacturers and insurance companies will nevr let it happen, but it's a nice idea. Rather obvious, really.

  • Report this Comment On July 21, 2013, at 10:07 AM, Scanner89 wrote:

    Regarding hospital charges vs. what insurers pay ($24,000 vs. $4000). . .that is a HUGE problem in healthcare that in a way, single payer WOULD correct. Since everyone would be insured (theoretically), the days of soaking "cash patients" would come to a close.

    Having a "Sticker Price" for a product may work okay in the world of automobiles, but it is completely inappropriate for the world of healthcare.

    Single Payer was kind of a misnomer anyway and it was enough of a misnomer to scare moderate Conservatives away. It should be thought of as "Primary Payer." Like the author noted, an employer can still offer you a generous supplemental plan, or you could buy a private plan and opt out of Medicare if the thought of it gives you the eeby-geebies.

    There was this idea that scared Republicans. . .that insurance companies were going to go away if we adopted Single/Primary Payer. . .it just wasn't true. Yes, they would haven't controlled as much money, but there would still be a market there.

  • Report this Comment On July 21, 2013, at 10:11 AM, ykaplinsky wrote:

    You are dreaming in theory. In the real world, premiums for 20 and 30 year olds are up 75% and our doctor quit medicine altogether because the system requires him to spend $50,000 a year on BILLING and as a small business person, he can't afford to do that just for billing. In the real world, with not just the IRS privy to all your medical records and financial records (10 years worth), so is the DHS, the NSA, the EPA, etc through what the gov. calls a HUB. The system is geared also to implement The Complete Lives System that withholds medical care from infants, special needs children and reduces the amount of medical care available each year by a dollar amount to anyone over 50. The system is evil to its core. This careful analysis of its real costs has escaped you so I also have to wonder how many of your financial recommendations are similarly flawed.

  • Report this Comment On July 21, 2013, at 10:13 AM, vet212 wrote:

    I thought what was intended was insurance for the uninsured, yet we got so unnecessarily much more. the money saving answer is to repeal the ACA and start over with insurance pools and letting those who could afford insurance and don't have it suffer for their sin

  • Report this Comment On July 21, 2013, at 10:14 AM, jamesmmm wrote:

    PS: don't forget that Obamacare expands IRS and gives IRS much control over your healthcare

  • Report this Comment On July 21, 2013, at 10:19 AM, danehoy wrote:

    This never addresses the concerns of the physician. Physicians often limit total Medicare patients, and broadening the program will just further stratify medical care from those who have the money to pay and those who do not.

    If you want to lower costs, target the expensive things, such as diabetes. End subsidies for high fructose corn syrup, look at federal taxes on high calorie-poor nutrient food content, and give breaks for preventative care. This is the $245 billion dollar monster ($176 billion in direct costs, $69 billion in indirect costs).

  • Report this Comment On July 21, 2013, at 10:29 AM, grumpf52 wrote:

    Medicare for all would work but only if the discounts were renegotiated . In order to make any money medical facilities overcharge people with insurance.Of course Medicare taxes would have to rise but that would be offset by not having to buy insurance. Supplemental insurance could be purchased to help cover major expenses incurred with major surgery. Everyone would be able to see a doctor when they are sick and the medical facilities and insurance companies would not go broke.This would also free businesses from the headaches and expenses of providing health insurance and would make them more competitive in the world markets.

  • Report this Comment On July 21, 2013, at 11:12 AM, Firebloom wrote:

    This is a great idea, right up until you actually talk to any doctors about it. More and more doctors are refusing new Medicare patients since the pay is too low and it takes too long to get reimbursed.

    Do a search for "doctors refusing medicare patients" and you'll see all sorts of articles from Forbes, Washington Post, USAToday, NYTimes, etc. discussing this growing trend.

    If we moved to a Medicare-based system, what would happen? We would all have insurance, but it would be next to impossible to find a doctor that accepts the insurance. Yeah, that's smart. Real smart.

    CNN ran a story a couple months ago about a doctor that gave up his practice in Colorado after 16 years. He moved to Australia where he began practicing medicine again. From the article:

    "In America, Snyder hardly ever took time off. In Australia, Snyder is contracted to work only 36 weeks a year, plus he gets four weeks' paid vacation time. That's given him time to travel -- he and his wife have visited Sydney, Malaysia and elsewhere in the region.

    Even with a much lighter schedule, Snyder is making the equivalent of U.S.$250,000 a year -- $100,000 more than he made practicing in Colorado year round."

    Try to shove Medicare-style payments on doctors here in the US and we'll see a lot more stories like this one. For some reason doctors like to be paid for their services and when the incentive is big enough -- say, $100k/yr extra while handling only 60% of the workload -- they'll pick up and move.

  • Report this Comment On July 21, 2013, at 11:12 AM, inreality01 wrote:

    What would save us all a lot more would be a dramatic reduction in the size & scope of the federal government, minimizing/eliminating most entitlement programs, dramatic cut in taxes and move to a small flat tax and more individual freedom and economic liberty.

    We don't need more of anything the government is doing. To say more Medicare is going to save us something is absolutely ridiculous. Maybe in comparison to a different out of control government program like Obamacare but not in the grand scheme of things.

    We need less government and more freedom.

    States need to have more control and we need less federal government.

    We need individuals to be more prosperous so they can save for themselves.

    Social Security is a scam. Medicare and Medicaid are not sustainable. We simply have too much government.

    And finally, there is no Constitutional right to marriage, healthcare, a retirement, housing, or most of the things people whine about today.

    You don't have the right to infringe on someone else's liberties and that is exactly what happens when the government taxes one person to give it to another.

    Freedom is the answer.

    God Bless America.

  • Report this Comment On July 21, 2013, at 11:37 AM, warriorgeorge wrote:

    if they could offer medicare for all the people , but still give those who want to pursue other insurance that would be great , or if they converted Medicaid to a public program and put back all the things they took out of it and say change the average person , say 5% of their wages in pretax dollars that would be great also or even say not charge over 7% for a family , it would not cost any more that from 1500 to 2000 a year to be on it , and still retain the option to pursue insurance on your own if you want , but republicans and the tea party and the insurance companies would never allow this because the insurance companies would have to compete with these plans , and they don't want any competition at all , they want all the profits and they don't want to give up or compete for business against a lower plan that offers more than they will , they don't want to have to lower prices

  • Report this Comment On July 21, 2013, at 11:45 AM, djrichbourg wrote:

    This is exactly what Dr. Ben Carson has been proposing the past two years. EACH and every American citizen would have a medicare spending plan and credits to that fund would start immediately upon birth. Kinda like an EBT card. Take your benefits and shop around for the most cost saving service. You choose which doctor you prefer and use it. Doctor's would go back to private practice and allow the 'customer' to shop around for services. This would cause competition and result in lowering costs. The benefits would add up over time on YOUR card and when you die the left over benefits on your card would be redistributed to your beneficiaries. Individuals and corporations would still be able to purchase and/or offer a private plan if they so choose. We need to hear more from Dr. Ben Carson on his plan...

  • Report this Comment On July 21, 2013, at 11:51 AM, djrichbourg wrote:

    Warriorgeorge: I take offense at your comment about tea partiers & republican's. That is the stage we promote each and every day. COMPETITION in the private sector lowers cost on everything. Giving the individual the opportunity to shop around INDEPENDENTLY without government interference into your choice.

  • Report this Comment On July 21, 2013, at 12:06 PM, georacer wrote:

    Let examine some rough numbers here to see why a 70% reduction across the board for medical reimbursements just is not feasible. A physician netting $250k typically has a fixed overhead of 50% so before he pays his staff, rent, malpractice insurance, electronic records et cetera is grossing 500k in reimbursements. So a theoretical 70% cut of 500k would now have him grossing 150K and his overhead is fixed at 250k so he would be operating at a loss.

  • Report this Comment On July 21, 2013, at 12:09 PM, RHO1953 wrote:

    How can any rational human being think ACA is "a step in the right direction"? It is an unmitigated disaster. And the people who think expanding Medicare to everyone will fix it all are fools. Doctors are already limiting Medicare and Medicaid patients. If you change the dynamic, physicians will react. They lose money on Medicare patients now. What are you thinking? There is no easy solution. Nobody is talking about the root of the problem and the solutions. We have a dead economy, there isn't enough economic activity and enough jobs to pay for our health care. Shuffling paper around and trying little tricks won't generate enough money to pay for health care. We have too many unemployed and underemployed people. People who make even fifteen bucks an hour are not capable of paying for food, housing, transportation and medical care. The cost of basic human needs exceeds the income generated for about sixty percent of the population.

  • Report this Comment On July 21, 2013, at 12:21 PM, phatandfoolish wrote:

    i think eveyone knows that single-payer is the only efficient answer, but the scum in washington d.c. won't allow it - they their souls to big pharma

  • Report this Comment On July 21, 2013, at 12:29 PM, syzygysyzygy wrote:

    all this ridiculous american agonizing over heallthcare is amusing

    europe is 30 years ahead of USA and all has to be done is copy Uk system with a few adjstments fr US environment and have done with it

    study their NHS and copy it but oh no capitalists dont like THAT!!!

    gotta give caitalists credit tho---- for over 200 years they have sold millions of "sheeple" a REAL bill of goods

  • Report this Comment On July 21, 2013, at 12:51 PM, bobschu wrote:

    Great article. This is so straightforward anyone could understand it. Maybe even congresspeople?

  • Report this Comment On July 21, 2013, at 1:17 PM, pacmo wrote:

    Thanks' to the TP?GOP this option was ruled out at the start. They want to privatize Medicare. Not make it available for every one. Another example of theirs to take care of the wealthy and to hell with everyone else..

  • Report this Comment On July 21, 2013, at 1:21 PM, larrymb wrote:

    ALL THIS GOOD INFO DOES NOT ADRESS THE ISSUE OF "CUSTOMARY AND REASONABLE CHARGES". BY WHO'S DEFINITIONS? THERE ARE NO COST CONTROLS IMPOSED ON HOSPITALS AND DOCTORS!!! THEY CAN CHARGE WHATEVER THEY WANT AND BILL THE INSURANCE COMPANIES THEN BILL YOU FOR THE DIFFERENCE. IF YOU DONOT PAY THEY SIMPLY "WRITE OFF" THE DIFFERENCE. IMAGINE HOW MUCH TAX SAVINGS IS GENERATED BY "WRITING OFF" MILLIONS OF DOLLARS IN PUMPED UP MEDICAL CHARGES!!! A FRIEND OF MINE SELLS MEDICAL EQUIPMENT AND SHOWED ME A TITANIUM SCREW HE SELLS FOR $1100, WHAT DO YOU THINK THE HOSPITAL CHARGES? NO WONDER INSURANCE PREMIUMS ARE SO HIGH!!

  • Report this Comment On July 21, 2013, at 1:44 PM, Sully9173 wrote:

    Of course this is a step in the right direction, and someday a single payer system will prevail. This would not be necessary if it were not for the absolute greed of the private entrepeneurs.

    When my mother was sick oh so many years ago, a specailist who charged a terrible price for that day and age, He was the only one who made a wrong diagnosis.

    That was before Medicare etc. We paid the entire bill, for a wrong diagnosis. My own bills today if I ever bet the all together in one place and at one time, with realistic billings. I find is overpriced before Medicare and my co-insurances pays off.

    What we have is massive fraud and people taking advantage of the Emergency Laws, and pay none of their obligations.

    Those folks should be imprisoned not treated. The world is upside down, something had to be done. This ACA is a start.

    The very people who say Medicare would be cheaper are the same people who sunk that option to start. Hypocrites and fraudsters, Republicans.

  • Report this Comment On July 21, 2013, at 1:59 PM, rehcnarami wrote:

    Here is the problem. Hospitals accept 23% because if they do not take Medicare patients they will receive no funds from the government. NONE So the rest of us, especially uninsured patients with money to pay a mortgage and therefore ineligible for medicaid and unfortunate enough to come down with cancer lose their homes in order to pay for chemo. Medicare also pays for a surprisingly large amount of the decorations at a hospital. TV's don't make you well but if you have a 50% patient census of medicare patients the government pays 50% of the cost of the amenities. And buildings in some cases. And everything that relates to that 50% in some way or the other. If everyone is on medicare there is really no one to make up the difference and the government is going to stop paying for TV's and new lobbies but will probably pay for the Cat scanner at a few hospital centers. I wish it was do-able but I don't see how. People are not willing to give up 500 per person to pay for insurance. And if everybody did then the cost of care would go up to 600 per month. I was around before medicare and after. All costs doubled the day medicare started due to the huge increase in paperwork and government regulations. None of which helped patients in any way.

  • Report this Comment On July 21, 2013, at 2:02 PM, Firebloom wrote:

    "The very people who say Medicare would be cheaper are the same people who sunk that option to start. Hypocrites and fraudsters, Republicans."

    How did Republicans sink the Medicare option to start? Democrats controlled the House and Senate. Not one Republican voted for Obamacare. Rather than giving us a single-payer system, Democrats gave us Obamacare. Why? Why didn't they give us a single-payer system instead? No Republican was going to vote for either plan anyway, but that didn't matter since Democrats had the majority.

    Turns out, there wasn't enough DEMOCRAT support for a single-payer system. We ended up with Obamacare because that was the compromise AMONGST DEMOCRATS to get it passed through.

    You cannot blame the Republicans when it was the Democrats that passed Obamacare without a single Republican vote. If all Democrats wanted a single-payer system, we would have one now instead of Obamacare. When Obamacare was passed, Republicans were just spectators. Democrats held complete control. The American people got the plan Democrats created, supported, and voted for.

  • Report this Comment On July 21, 2013, at 2:26 PM, airjackie wrote:

    Nixon set the blueprint that others have followed. Mitt Romney use it successfully in Mass. and even ran for President in 2009 using the health care plan. But insurance companies and hospitals felt it would end their large profits and health care companies were afraid they would get caught stealing. Medicaid has 60% of the funds stolen. One of the larges Medicaid fraud cases was Rick Scott who's company admitted to stealing 1.7billion in Medicaid funding. Jeb Bush suggest his friend move to Florida after the scandal and help Rick become Governor. With no way to steal from Obamacare many Republican Governors are refusing to accept it for their State.

  • Report this Comment On July 21, 2013, at 2:38 PM, GuitarJim wrote:

    If everyone was on Medicare then hospitals would go broke. Medicare doesn't pay enough to cover the cost of services. Hospitals depend on patients with private health insurance to make up the difference. Remove private health insurance from the equation and either Medicare will have to pay a heckuva lot more, or the hospitals go broke.

    The problem with single payer systems is it put the one payer in the position of dictating prices, and they will always dictate a lower price than the service provider wants. This leaves the service provider trying to figure out how to provide the same service for less money.

  • Report this Comment On July 21, 2013, at 2:57 PM, roger142 wrote:

    I agree offering medicare to everyone would be better than Obamacare, but people have been complaining to our politicians since the 1980's about health care cost, and Obama is the first President to actually do anything.

    As for doctors and Medicare, in my area there is a large number of seniors on it, and the doctors and hospitals both are building bigger offices and expanding hospitals.

  • Report this Comment On July 21, 2013, at 4:12 PM, Dadw5boys wrote:

    My mother just got a letter from Medicare they disallowed a bill from 2 years ago where she was Hospitalized for server problems with Diabetes. They told her all the way everything was clear with the Insurance.

    So they whole bill has be denied by Medicare and the Insurance will most likely kick back to on the bill ! I have no idea what to do here. She is in the middle stage of Dementia and can't even remember more than 20 min. She needs constant care and if I am force to pay this bill for her my only option is to put her in a Nursing Home on the Poor American Plan ! It takes all I can at present to provide her the care and support she needs . I can't absorb anymore debt or I will go bankrupt in 18 months.

  • Report this Comment On July 21, 2013, at 4:40 PM, EdHamox wrote:

    ''It is amazing that people who think we cannot afford to pay for doctors, hospital and medication somehow think that we can afford to pay for doctors, hospitals, medication and a government bureaucracy to administer it''. ~ Thomas Sowell''

  • Report this Comment On July 21, 2013, at 5:56 PM, Freddbe wrote:

    Something has to because, these doctor have all the answer and can fix anything till you run out of money or insurance. They also refer you to there buddies so they help take you and your insurance to the cleaners. The only real fix is universal healthcare , everything else is a snow job. Defence, healthcare and Education should the first three things your tax dollars pay for. Some doctor charge a lot to pay for there education but a 100 times over and they never stop.

  • Report this Comment On July 21, 2013, at 7:40 PM, logiet wrote:

    If prices for the care of all are capped at the 27% rate, you will have extremely scarce medical care and many untreated patients who need care. Some will die of treatable diseases with productive life still medically expected. Or doctors will take only private fee-paying patients and by-pass all forms of insurance. And such a system will suppress innovation as well. We will be taking medical tourism not for cost reasons as at present but because a reasonable standard of treatment is not available in the USA. Single-payer systems have created shortages of medical care abroad. We are not immune to the law of supply and demand.

  • Report this Comment On July 21, 2013, at 8:08 PM, Chiara2 wrote:

    How come every single one of your articles is propaganda? Everyone isn't a low information "SHEEPLE."

  • Report this Comment On July 21, 2013, at 11:26 PM, JustHad2Say wrote:

    Medicare imposes a rate schedule.

    Insurance companies negotiate rates that are a percentage of Medicare fees. ( 140% or so )

    Hospitals do not have profit margins of 40%.

    They lose money on Medicare patients. This loss is offset by the higher rates agreed to by insurance companies.

    If you just put everyone on Medicare, you would have to have someone else pay the difference, or the hospitals would go out of business.

    It is similar to a lunch counter that offers a 50% discount to officers in uniform.

    At an average location, they might do just fine doing this. If they were the cafeteria at a police station, they could not possibly do this.

    If you pass a law saying that the lunch counter had to charge everyone the same rate as an officer in uniform, then the lunch counter would go out of business.

    Not only do we (workers) pay taxes to pay for medicare, it is also subsidized by the rates we must pay insurance companies, so that they can pay higher amounts to the hospitals.

    Obamacare was decided by the Supreme Court to be a tax bill, taxing those who do not get insurance, or can not get insurance under its labyrinth of rules, which are not yet decided, let alone understood.

  • Report this Comment On July 22, 2013, at 12:16 AM, mushrumps wrote:

    This guy must think that the remaining $0.73 is pure ripoff from the providers. Else, who will make up for the gap?

  • Report this Comment On July 22, 2013, at 2:30 AM, genseric wrote:

    Obama made a deal with Big Pharma at the beginning of the entire process (google is your friend), so the blame gets shared on why SP didn't happen.

    I prefer a German model, single payer but you can buy more insurance if you like. You deserve choices in a free society.

  • Report this Comment On July 22, 2013, at 12:26 PM, jamesmmm wrote:

    One of the other great things that is already happening at Medicare is that Preventive Services (helping people in order to help those NOT get sick in the first place) and Hotspotting (emphasis on the sickest patients to help those achieve lifestyle changes to minimize/eliminate their illnesses) are already well underway. Combined with the dietary enhancements, these are certain to dramatically curtail medical expenses in a consistent way. For a somewhat technical but thorough 1page analysis of benefits, please type this short URL into your web browser--> "sdrv.ms/1bK4MEO"

  • Report this Comment On July 22, 2013, at 12:51 PM, jamesmmm wrote:

    One of the other great things that is already happening at Medicare is that Preventive Services (helping people in order to help those NOT get sick in the first place) and Hotspotting (emphasis on the sickest patients to help those achieve lifestyle changes to minimize/eliminate their illnesses) are already well underway. Combined with the dietary enhancements, these are certain to dramatically curtail medical expenses in a consistent way. For a somewhat technical but thorough 1page analysis of benefits, please type this short URL into your web browser--> sdrv.ms/1bK4MEO

  • Report this Comment On July 22, 2013, at 1:04 PM, jamesmmm wrote:

    There is a post above referring to 'doctors not taking on More new Medicare patients' Part of that is due to Medicare Advantage (managed care) selective enrollment--Managed care plans advertised to healthier seniors and got a much higher percentage of 'healthy enrollees' which left Medicare with more of the other (not so healthy). And now, even though that selective enrollment ocurred, Medicare continues to be a better deal for most...

  • Report this Comment On July 22, 2013, at 1:12 PM, jamesmmm wrote:

    Attention: here's a warning for people contemplating enrolling in the Medicare Advantage (Managed Care) programs:

    many of you will remember that your employers began to offer Managed care plans in the late 80s, and that the managed care plans offered lower premiums and lower out of pocket expenses as well as claiming to improve quality of healthcare. 25 or so years later, look at what has happened to the cost and quality of healthcare! Is managed care now offering you a better deal than the traditional Medicare program? Be careful, it seems this has been promised before...?

  • Report this Comment On July 22, 2013, at 1:44 PM, jamesmmm wrote:

    While Medicare Parts A (Hospital charges) & Part B (Doctor charges) impose limits on how much can be collected from patients by doctors and hospitals as well as the amounts that Medicare pays to doctors/hospitals, Medicare Part D (prescription drugs) does not afford similar protections yet, but putting greater controls in place is currently being considered.

  • Report this Comment On July 24, 2013, at 8:54 PM, singlepayerfool wrote:

    The article gets one thing totally incorrect: It claims that under a Medicare-for-All program, individuals would still be free to purchase private plans outside the system.

    Not so much, actually. Medicare-for-All (a.k.a. Single Payer) requires that everyone is included. The simple reason for this is to ensure that the healthiest as well as the unhealthiest are included in the largest pool of contributors to maximize the spread of risk. The more people paying in, the more money there is for payouts when necessary.

    To include private insurance in a Single Payer system like Medicare-for-All would be to undermine the very foundation of the concept. It is not only that SP would like to cover everyone for as many procedures and therapies as possible, it is also that it relies on the widest array of financial sources possible in order to spread risk the most efficient way possible. That is how REAL insurance works.

    I'm a bit surprised that Motley Fool would trip themselves up on this point, being that it is so innate to risk aversion and risk minimization, a topic I am sure they are more than a bit familiar with!

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