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US single payer

65 million Americans are on Medicaid. (Precise number is in PDF linked by the article.)

49 million are on Medicare.

So 36% of us are on one of two socialized insurance plans already.

Edit to add: plus 9 million in the NHS-like VA system, bringing Americans on government-run or -paid health care up to 39%. Granted the VA has some recently infamous flaws. Could get some more by counting Indians (but they get screwed) or government employees (but that might be indirect enough to not count.) 2.7 million federal employees, that's about 0.85% of the population, though dependents might take that to 2% of Americans getting government health care that way.

See the comment count unavailable DW comments at http://mindstalk.dreamwidth.org/393775.html#comments

Comments

( 8 comments — Leave a comment )
martianmooncrab
Jun. 4th, 2014 09:55 pm (UTC)
dont forget the Americans who use the VA medical system as their primary care.
mindstalk
Jun. 4th, 2014 10:06 pm (UTC)
I was thinking mostly of single-payer / socialized insurance style, rather than full socialized medicine, but yeah, that'd add another 3% of the population, as I edited to show. VA's less of a role model right now, though...
houseboatonstyx
Jun. 5th, 2014 01:27 am (UTC)
There's overlap between some of these. A qualifing person on Medicare can get Medicaid to pay Medicare's co-pays, etc. A person with complete VA care can use Medicare too, and Medicaid if zie qualifies.
mindstalk
Jun. 5th, 2014 03:19 am (UTC)
Can they, the latter? My father had to trek across Chicago to the VA hospital for his cancer treatment, despite being old enough for Medicare and quite possibly poor enough for Medicaid, which did end up paying for hospice care for both my parents, I think.
houseboatonstyx
Jun. 5th, 2014 11:07 am (UTC)
My partner treks (well, I drive him) to the VA hospital for in-patient care, and much out-patient, because Medicare only pays 80% of the cost for civilian care. He gets almost all his prescriptions from the VA pharmacy by mail, free, though some veterans have a co-pay for VA meds.

He is not poor enough for Medicaid, so I don't know whether having VA would disqualify him for Medicaid.

The VA hospitals he's used have seemed good. They are very generous with scans and tests, and have given him pacemakers since 2002. The problem has been not enough specialists. He was diagnosed with Type 2 diabetes in 2002, their 'primary physicians' have been supplying insulin and needles etc -- but it has taken 12 years and some pull for him to FINALLY see an endocrinologist! He was always told that the endo's refused to see him because his condition was not bad enough.

Requests for other VA specialists have bogged down in red tape and long waiting periods, which does not happen when a civilian doctor refers to a civilian specialist. Sometimes a civilian doctor will tell him about a treatment, which he then manages to get from the VA, though the VA had never informed him about it before.

Aside from the 20% co-payment, Medicare has been much better than VA, or than what I've heard about private insurance.

I've been on some international diabetes forums, and the members from Germany, NZ, Australia, Canada, and most from Britain, were quite happy with their own systems, and felt sorry for the USians.


Edited at 2014-06-05 11:08 am (UTC)
mindstalk
Jun. 5th, 2014 06:19 pm (UTC)
Ah. There's Medigap policies that pay deductible and co-pays, my mother had one, but I can see my father sticking with the free VA, they didn't have much money.

Biggest problem I noticed, besides the distance and obnoxious transportation (which might have been the CTA/RTA paratransit, not the VA), was that they didn't pay enough to keep doctors. Seems a bunch cycling through shortly after residency, before going into private practice. I guess that's one problem a NHS-scale system would avoid through being the majority of the employment.

AFAICT Canada (just Canada) really does have a waiting lists problem, but diabetes might be urgent enough to not suffer from that.

Heh, I'd forgotten about the drugs coming in the mail.

Good luck!
houseboatonstyx
Jun. 6th, 2014 06:00 am (UTC)
Turnover of doctors was a big problem in both the VA hospitals he used also, both specialists and 'primary care'; the primary clinic often went months without any MD at all. Luckily the person (not an MD) handling his heart problems(excellently!) has been here at least since 2006; I suspect she is a civilian.

Our experience suggests that the best care comes from private doctors and hospitals, paid for by single-payer -- as Medicare and Medicaid are doing (with very low deductables). None of this 'in network' or 'lifetime caps' or 'try the cheap drugs first' etc that the private insurance companies require.

Edited at 2014-06-06 06:13 am (UTC)
harimad
Jun. 7th, 2014 12:38 am (UTC)
I would not, for the purposes of this exercise, count goverment employees as part of this system. Their options are similar to private sector employees, and the format is exactly the same: the employeer pays most of the cost, the employee pays some, and the employee chooses from a variety of providers, plans, and price points.
( 8 comments — Leave a comment )

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