Hacker News new | past | comments | ask | show | jobs | submit login

Medicare pays primarily for emergency hospitalization scenarios (referred to as Part A). Anything that happens outside of a hospital stay (called outpatient services) and medications come from Parts B, C, and D. Coverage for parts B, C, and D is insanely complicated and involves some means testing and who knows what else. There’s private health insurers involved too, and if you can’t afford that, then you can go to the state’s Medicaid, which is also means tested.

The whole thing makes you want to kill yourself, which might be the objective.




Yep. I would rather have them give me that 3% to invest myself. Investing $2k annually for 40 years could yield me $250k-$350k at retirement age. But I guess I'm just a dumb peasant who can't take care of myself.


I believe Medicare is funded like Social Security, where the money you pay in pays for benefits right now, and when you retire, other people will be paying the money that actually goes to you.

They can't give you that 3% to invest yourself because then they have nothing to give people that are already retired.

> But I guess I'm just a dumb peasant who can't take care of myself.

Here's the rub. You, and many people, are likely able to manage that yourselves. Some people can't. They may already be poor and behind on their bills, so they'll put that 3% towards fixing the transmission in their car that hasn't worked for 3 months. They might be an entrepreneur with a poor sense of risk, that empties that money to start an underwater basket weaving college. Or they might just be bad for money.

If we let people manage that themselves, what do we do when someone has to retire because of medical issues, but can't afford health insurance or the medical care they need? Do we just let them die? If we treat them, then everyone is subsidizing their healthcare, at which point you're investing 3%, but you're also paying a 1% tax to help cover all the people that didn't invest their 3%. At a certain point, the most sensible thing is just to not save your 3% and join the people the government takes care of. At some critical mass, we're just back to Medicare.

Of course, if we're willing to tell people "You should have saved money, we're not going to help you. Please die close to the graveyard to make our lives easier." then that arithmetic changes dramatically, but I don't think that's a world I care to live in.


It's not really supposed to go to other people. It's currently working that way because congress "borrows" from the system. What was the surplus they said should exist right now, 3 trillion or something huge like that?

People who can't afford medical care can sign up for Medicaid. In fact, people on Medicare who can't afford it also sign up for Medicaid.


And "Medicare for all" is a serious proposal?


I don’t think people mean copy it in it’s current form, at least not forever. It’s just a catchy name to refer to a program where the government pays for healthcare, even though the current iteration of Medicare is hardly that.

The idea is probably to expand the current system to everyone, which is better than nothing, and then work on improving it.


I would image that's the plan, although with different motives. By placing a majority of the people into a broken system, you bring the people's attention to it and force a new system into existence using that public support. If you look at the strategy behind the ACA, it is intended to lay the framework for a replacement by a federal plan/system.


Hard to get velocity behind improving something half the voting population would rather be rid of, even if it's against the very same voting population's best interest. So it goes in the US.


Well it makes sense if you have politicians consistently selling you misrepresented ideas like "Medicare for all" or "Defund the police". Of course you will start to lose trust in the system and the officials.

I think the bigger issue is how the divide between the parties happens. People seem to demonize the other side based on a specific issue that is important to them and then extrapolate that view to all positions held by the party on the basis that "all [party] politicians are stupid because of their stance on [issue] so their ideas on other issues are stupid too".

For a generalized example, the divide is mostly urban vs rural (even in other countries). A major single-issue voting topic would be gun rights vs gun control. A rural person thinks a new gun control law is stupid because the law seeks to ban certain items that statistically don't cause many problems and they find utility in their gun rights (more likely to hunt, slow police response, etc). An urban person would think the new law is good because "why does anyone need that item" and they find little to no utility in those rights (less likely to own a gun, carry a gun, hunt, faster police response, more exposure to the negative news/affects just due to population density). Each side thinks the other is stupid on this subject. People then think, hey the urban person wants to take away my rights on guns on (what appears as) stupid reasoning, so I don't trust their proposal to federalize healthcare because their logic/brain must be deficient. Then urban people will say these dumb hicks "...are clinging to their guns and bibles..." so they must be too stupid to know what's good for them. Which leads to neither side actually listening to the concerns of the other like a community should and instead just trying to gain full control of the government to ram through whatever laws their side wants.


Yeah, I don't really get it. I imagine it's just catchy marketing like the defund the police movement (it's really about adjusting their duties in specific situations by augmenting the force with civil servants of different training).

You spend 40ish years working and funding Medicare with a 3% tax to use it for 20ish, with still paying these costs. I don't see how it would be feasible to extend the plan to everyone under that system (kids never paid in, how do they get coverage; what about young adults with no work history nor the savings to pay the premiums?). So the proposed systems must be fundamentally different from that.




Consider applying for YC's Spring batch! Applications are open till Feb 11.

Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact

Search: