(04-02-2020 11:27 AM)VA49er Wrote:  Ok, I finally decided to read up on Bismark. From what I gather, Bismark is similar to US style in that employers and employees fund the model.; however, different in that everyone must participate and the "insurance providers" do not make a profit. Isn't there still the issue of nonemployed folks not being able to get insurance? Just playing devils advocate in that would probable a concern for lots considering that model.

What Bismarck provides is universal very basic health care/insurance. Everybody has very basic insurance. It is either provided by the government, or funded by the government either directly or through a refundable tax credit. The Heritage plan used the refundable tax credit approach. The basic plan is designed to be cheap, and queues and waits are built into "free side" of the system. The scope of coverage in a basic plan provides for most normal uses, but is less extensive than a single-payer or single-provider system. The basic insurers are generally non-profit, although I believe that in Holland they are allowed to be profit-seeking.

That's where the "pay side" comes in. There are a large number of fee-for-service providers that you go see when you get stuck in a queue on the "free" side. You can buy supplemental insurance to cover those occasions. It is also fairly cheap, because you don't use it often. And employers typically provide supplemental coverage. The supplemental insurers may be non-profit or profit-seekeing.

A couple of statistics. In France the "free" side accounts for abut 70% and the "pay" side about 30% of health care costs (those percentages would be about 100-0 in a single-payer system and maybe 95-5 in a single-provider system). Also in France, 99+% of the people have "free" coverage (the only exceptions being people transitioning in or out of the country) and 90% buy supplemental coverage.

Conceptually, the "free" side works kind of like single-payer, and the "pay" side works kind of like our system. The "pay" side is enough like ours here that when my mother had her hip replaced in Paris, the hospital took Blue Cross.

(04-02-2020 11:39 AM)Owl 69/70/75 Wrote:  

(04-02-2020 11:27 AM)VA49er Wrote:  Ok, I finally decided to read up on Bismark. From what I gather, Bismark is similar to US style in that employers and employees fund the model.; however, different in that everyone must participate and the "insurance providers" do not make a profit. Isn't there still the issue of nonemployed folks not being able to get insurance? Just playing devils advocate in that would probable a concern for lots considering that model.

What Bismarck provides is universal very basic health care/insurance. Everybody has very basic insurance. It is either provided by the government, or funded by the government either directly or through a refundable tax credit. The Heritage plan used the refundable tax credit approach. The basic plan is designed to be cheap, and queues and waits are built into "free side" of the system. The scope of coverage in a basic plan provides for most normal uses, but is less extensive than a single-payer or single-provider system. The basic insurers are generally non-profit, although I believe that in Holland they are allowed to be profit-seeking.

That's where the "pay side" comes in. There are a large number of fee-for-service providers that you go see when you get stuck in a queue on the "free" side. You can buy supplemental insurance to cover those occasions. It is also fairly cheap, because you don't use it often. And employers typically provide supplemental coverage. The supplemental insurers may be non-profit or profit-seekeing.

A couple of statistics. In France the "free" side accounts for abut 70% and the "pay" side about 30% of health care costs (those percentages would be about 100-0 in a single-payer system and maybe 95-5 in a single-provider system). Also in France, 99+% of the people have "free" coverage (the only exceptions being people transitioning in or out of the country) and 90% buy supplemental coverage.

Conceptually, the "free" side works kind of like single-payer, and the "pay" side works kind of like our system. The "pay" side is enough like ours here that when my mother had her hip replaced in Paris, the hospital took Blue Cross.

You always do a better job explaining it than I do.

(04-02-2020 11:18 AM)b0ndsj0ns Wrote:  

(04-02-2020 10:35 AM)Eagleaidaholic Wrote:  

(04-02-2020 09:08 AM)b0ndsj0ns Wrote:  

(04-02-2020 09:03 AM)stinkfist Wrote:  

(04-02-2020 08:45 AM)b0ndsj0ns Wrote:  Reliance on employment for health insurance is going to look real foolish real quick (not that it already didn't).

it's amazing how fk'd that crew is in the moment and whenever this self-induced panic recovers...

we're concentrating aid to the whole when it should be geared to the most susceptible....

@bassAckwards

I agree, but our system is not geared to work that way. It should be, but it's so bloated with bureaucracy and waste that it can't be nimble and adjust on the fly to a crisis. If we already had universal UBI instead of all the useless and wasteful welfare programs we currently have it would be very simple to just adjust the amounts given out to those that need it the most. These unemployment numbers aren't even fully accurate, as there are a ton of people who haven't even been able to successfully file a claim yet.

But we want the Government to be totally in charge of our healthcare system? We wouldn't have enough body bags. He who writes the checks makes the rules.

I want what Owl wants, Bismarck, which is not full government control of the healthcare system. It would though prevent people from being scared they were going to go bankrupt from treatment for Covid, which I can promise you is gonna happen to a scary number of people.

Pretty sure in one way or another Covid patients are “covered” either through waivers by by the eviiiiie insurance Cos or through the rather insane spending splurge that was just signed.

Granted it may not cover every single instance, but I don’t think we’ll be seeing widespread bankruptcies from the virus. From the “cure”? Perhaps. Not from being a patient.

(04-02-2020 11:48 AM)b0ndsj0ns Wrote:  

(04-02-2020 11:39 AM)Owl 69/70/75 Wrote:  

(04-02-2020 11:27 AM)VA49er Wrote:  Ok, I finally decided to read up on Bismark. From what I gather, Bismark is similar to US style in that employers and employees fund the model.; however, different in that everyone must participate and the "insurance providers" do not make a profit. Isn't there still the issue of nonemployed folks not being able to get insurance? Just playing devils advocate in that would probable a concern for lots considering that model.

What Bismarck provides is universal very basic health care/insurance. Everybody has very basic insurance. It is either provided by the government, or funded by the government either directly or through a refundable tax credit. The Heritage plan used the refundable tax credit approach. The basic plan is designed to be cheap, and queues and waits are built into "free side" of the system. The scope of coverage in a basic plan provides for most normal uses, but is less extensive than a single-payer or single-provider system. The basic insurers are generally non-profit, although I believe that in Holland they are allowed to be profit-seeking.

That's where the "pay side" comes in. There are a large number of fee-for-service providers that you go see when you get stuck in a queue on the "free" side. You can buy supplemental insurance to cover those occasions. It is also fairly cheap, because you don't use it often. And employers typically provide supplemental coverage. The supplemental insurers may be non-profit or profit-seekeing.

A couple of statistics. In France the "free" side accounts for abut 70% and the "pay" side about 30% of health care costs (those percentages would be about 100-0 in a single-payer system and maybe 95-5 in a single-provider system). Also in France, 99+% of the people have "free" coverage (the only exceptions being people transitioning in or out of the country) and 90% buy supplemental coverage.

Conceptually, the "free" side works kind of like single-payer, and the "pay" side works kind of like our system. The "pay" side is enough like ours here that when my mother had her hip replaced in Paris, the hospital took Blue Cross.

You always do a better job explaining it than I do.

lol...yeah, he can make the avg. bear look like a cub....however, he's equitable if one is fair....that's gudenov in my book...

you're equitable and savvy as well...fwiw

(04-02-2020 11:52 AM)JMUDunk Wrote:  

(04-02-2020 11:18 AM)b0ndsj0ns Wrote:  

(04-02-2020 10:35 AM)Eagleaidaholic Wrote:  

(04-02-2020 09:08 AM)b0ndsj0ns Wrote:  

(04-02-2020 09:03 AM)stinkfist Wrote:  it's amazing how fk'd that crew is in the moment and whenever this self-induced panic recovers...

we're concentrating aid to the whole when it should be geared to the most susceptible....

@bassAckwards

I agree, but our system is not geared to work that way. It should be, but it's so bloated with bureaucracy and waste that it can't be nimble and adjust on the fly to a crisis. If we already had universal UBI instead of all the useless and wasteful welfare programs we currently have it would be very simple to just adjust the amounts given out to those that need it the most. These unemployment numbers aren't even fully accurate, as there are a ton of people who haven't even been able to successfully file a claim yet.

But we want the Government to be totally in charge of our healthcare system? We wouldn't have enough body bags. He who writes the checks makes the rules.

I want what Owl wants, Bismarck, which is not full government control of the healthcare system. It would though prevent people from being scared they were going to go bankrupt from treatment for Covid, which I can promise you is gonna happen to a scary number of people.

Pretty sure in one way or another Covid patients are “covered” either through waivers by by the eviiiiie insurance Cos or through the rather insane spending splurge that was just signed.

Granted it may not cover every single instance, but I don’t think we’ll be seeing widespread bankruptcies from the virus. From the “cure”? Perhaps. Not from being a patient.

Unless I've missed it I don't think anything has been guaranteed except for the testing being free. I hope you are right, but I very much have my doubts.