l*****9
发帖数: 9501 | 1 【 以下文字转载自 USANews 讨论区 】
发信人: lqm1989 (Jeremy Lin), 信区: USANews
标 题: Obamacare要崩盘
发信站: BBS 未名空间站 (Sat Dec 28 21:38:18 2013, 美东)
结果是全民医疗single payer system
GOP 20年之内不用考虑白宫了 | l*****9
发帖数: 9501 | 2 http://www.dailykos.com/story/2013/11/24/1258135/-Obama-just-la
SUN NOV 24, 2013 AT 03:36 PM PST
Obama just launched single-payer in America
byWillinoisFollow
Email 560 Comments / 560 New
Did you notice? Did you see what happened when everyone was complaining
about a website? Single-payer got started in America.
Vermont is using authority granted under the Affordable Care Act to start a
single-payer system. Most Americans still don't know what the phrase "single
-payer" even means. It had little support in Congress in 2009 and Senate "
Democrats" like Nelson and Lieberman even killed the public option. But, ACA
had this sweet little provision that allowed states to set up a single-
payer system and now people will see it in action. You know what that means.
As Senator Bernie Sanders (I-Vt.) opines, "The quickest route toward a
national health care program will be when individual states go forward and
demonstrate that universal and non-profit health care works, and that it is
the cost-effective and moral thing to do.”
Oh I know this is hard to swallow. Obama is third-way! He's dismantling the
safetynet! A corporatist! He killed the public option!
Whatever else he is, Obama is a President who acts in a thoughtful,
deliberate way that the chicken little headlines of the day often miss. As
many predicted, ACA is already leading to the kind of transformative
progressive change Obama promised. The progressive movement will be
responsible for showing the nation how well single-payer works after the
Vermont system goes into effect. When public and non-profit insurance
becomes the national norm, we'll know where it began. | l*****9
发帖数: 9501 | 3 http://www.opednews.com/articles/Bernie-Sanders-Introduces-by-B
General News 12/12/2013 at 13:25:01
Bernie Sanders Introduces Single Payer Bill: American Health Security Act of
2013
Summary of S. 1782, The American Health Security Act of 2013
The American Health Security Act of 2013 (S. 1782) provides every American
with affordable and comprehensive health care services through the
establishment of a national American Health Security Program (the Program)
that requires each participating state to set up and administer a state
single payer health program. The Program provides universal health care
coverage for the comprehensive services required under S. 1782 and
incorporates Medicare, Medicaid, the Children's Health Insurance Program,
the Federal Employees Health Benefits Program and TRICARE (the Department of
Defense health care program), but maintains health care programs under the
Veterans Affairs Administration. Private health insurance sold by for-profit
companies could only exist to provide supplemental coverage.
The cornerstones of the Program will be fixed, annual, and global budgets,
public accountability, measures of quality based on outcomes data designed
by providers and patients, a national data-collection system with uniform
reporting by all providers, and a progressive financing system. It will
provide universal coverage, benefits emphasizing primary and preventive care
, and free choice of providers. Inpatient services, long term care, a broad
range of services for mental illness and substance abuse, and care
coordination services will also be covered.
A seven-member national board (the Board) appointed by the President will
establish a national health budget specifying the total federal and state
expenditures to be made for covered health care services. The Board will
work together with similar boards in each of the fifty states and the
District of Columbia to administer the Program.
A Quality Council will develop and disseminate practice guidelines based on
outcomes research and will profile health care professionals' patterns of
practice to identify outliers. It will also develop standards of quality,
performance measures, and medical review criteria and develop minimum
competence criteria. A new Office of Primary Care and Prevention Research
will be created within the Office of the Director of the National Institutes
of Health (NIH).
The Program is designed to provide patient-centered care supported through
adequate reimbursement for professionals, a wealth of evidence-based
information, peer support, and financial incentives for better patient
outcomes. The Program seeks to ensure medical decisions are made by patients
and their health care providers.
The Program amends the tax code to create the American Health Security Trust
Fund and appropriates to the Fund specified tax revenues, current health
program receipts, and tax credits and subsidies under the Affordable Care
Act. While the final structure of the financing component is still under
consideration and is subject to change, the tax revenues in the draft
include a new health care income tax, an employer payroll tax, a surcharge
on high income individuals, and a tax on securities transactions.
The federal government would collect and distribute all funds to the states
for the operation of the state programs to pay for the covered services.
Budget increases would be limited to the rate of growth of the gross
domestic product. Each state's budget for administrative expenses would be
capped at three percent.
Each state would have the choice to administer its own program or have the
federal Board administer it. The state program could negotiate with
providers and consult with its advisory boards to allocate funds. The state
program could also contract with private companies to provide administrative
functions, as Medicare currently does through its administrative regions.
State programs could negotiate with providers to pay outpatient facilities
and individual practitioners on a capitated, salaried, or other prospective
basis or on a fee-for service basis according to a rate schedule. Rates
would be designed to incentivize primary and preventive care while
maintaining a global budget, bringing provider, patients, and all
stakeholders to the table to best determine value and reimbursement.
Finally, the Program also relieves businesses from the heavy administrative
burdens of providing health care coverage, puts all businesses on an even
playing field in terms of healthcare coverage, and increases the
competitiveness of American companies in the global marketplace. Every other
industrialized nation has been able to use the power of a public authority
to provide universal health care. The American Health Security Act of 2013
seeks to do just that for all Americans and their businesses.
reprinted from healthcare-now.org | a**********2
发帖数: 3726 | 4 Daydreaming! In addition, anything like this run by the government will be
inevitably bad! So, it's impossible to pass such a bill. Don't daydream! | l*****9
发帖数: 9501 | 5 you are being delusional.
美国已经有medicare and medicaid, 所有其他发达国家都是single payer system,
vermont已经通过法律要搞single payer, MA, MN, IL, NY, CA 很感兴趣
【在 a**********2 的大作中提到】
: Daydreaming! In addition, anything like this run by the government will be
: inevitably bad! So, it's impossible to pass such a bill. Don't daydream!
| l*****9
发帖数: 9501 | 6 Next time before open your mouth, get yourself educated at the topic first
http://www.healthcare-now.org/whats-single-payer
【在 a**********2 的大作中提到】
: Daydreaming! In addition, anything like this run by the government will be
: inevitably bad! So, it's impossible to pass such a bill. Don't daydream!
| a**********2
发帖数: 3726 | 7 Are you a doctor or want to be? Why do you care so much about medical
profession? 你很多帖子在攻击医生收入和医生数目，懒得和你争辩。版主应该直接封
之。是不是医生收入降到和你一样高或者等医生数目无理性增长时你趁机混入医疗行业
，你就会封口了？无聊
【在 l*****9 的大作中提到】
: Next time before open your mouth, get yourself educated at the topic first
: http://www.healthcare-now.org/whats-single-payer
| l*****9
发帖数: 9501 | 8 美国医疗系统最大的问题是for-profit insurance.
在其他发达国家眼里，美国医疗保险体制是一大笑话。
美国经济已经撑不住了 | l*****9
发帖数: 9501 | 9 你真给医生丢人
【在 a**********2 的大作中提到】
: Are you a doctor or want to be? Why do you care so much about medical
: profession? 你很多帖子在攻击医生收入和医生数目，懒得和你争辩。版主应该直接封
: 之。是不是医生收入降到和你一样高或者等医生数目无理性增长时你趁机混入医疗行业
: ，你就会封口了？无聊
| l*****9
发帖数: 9501 | | | | l*****9
发帖数: 9501 | | l***l
发帖数: 1138 | 12 我赞成single payer，但是灰常有难度
single payer能把现行医疗系统最不合理的两个毒瘤挤掉，一个是吃人不吐骨头的保险
公司，一个是price shift的药品价格
现在任何一个医疗活动都伴随着无数的paper work，来往于医疗机构和保险公司，这中
间不知道浪费了多少资源
药品价格在其他国家比在美国国内低一半都不止，药公司基本靠国内市场挣钱，美国实
现single payer，其他国家的药品统统大涨
只是这两块，就足以把医疗成本降低一大截了 | l*****9
发帖数: 9501 | 13 私营保险公司overhead 31%, medicare overhead 3%
所有研究都得出结论， single payer = less cost, better coverage
美国的医疗花费已经不sustainable, vermont 已经决定搞 single payer
MA, MN, MI, CA, IL, NY 盯着VERMONT
潮流已经很明显了
【在 l***l 的大作中提到】
: 我赞成single payer，但是灰常有难度
: single payer能把现行医疗系统最不合理的两个毒瘤挤掉，一个是吃人不吐骨头的保险
: 公司，一个是price shift的药品价格
: 现在任何一个医疗活动都伴随着无数的paper work，来往于医疗机构和保险公司，这中
: 间不知道浪费了多少资源
: 药品价格在其他国家比在美国国内低一半都不止，药公司基本靠国内市场挣钱，美国实
: 现single payer，其他国家的药品统统大涨
: 只是这两块，就足以把医疗成本降低一大截了
| l***l
发帖数: 1138 | 14 可是single payer系统保险公司不拼了老命反对吗，这等于虎口夺食啊，我觉得难度挺
大的。希望这股潮流能在可预见的将来实现，我真是想到现在的医疗制度就郁闷 | l*****9
发帖数: 9501 | 15 正是因为保险公司拼了老命反对，single payer推迟了20年，现在才刚刚开始
transition
【在 l***l 的大作中提到】
: 可是single payer系统保险公司不拼了老命反对吗，这等于虎口夺食啊，我觉得难度挺
: 大的。希望这股潮流能在可预见的将来实现，我真是想到现在的医疗制度就郁闷
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