The Problem With Obamacare Is Obamacare

Well, we'll see what happens at the end of January.

Would ultimately love to see a new healthcare bill presented. Originally Posted by Precious_b

This is a pluperfect, ideal time for the dems and repubs to show how much they care about their constituents and display that they can make a bipartisan piece of legislation that truly helps this country concerning healthcare.

As a developed nation, we pay a high price with small returns. Should be easy to change with both teams working on it. Originally Posted by Precious_b

Fixed that for you, the red text.

Your optimism may be merited. Some Republican and Democratic Senators were discussing flexible health savings accounts as a way out of the shutdown mess. And Trump's talked about them the last couple of days as well. Maybe you'll see the idea kicked off in the legislation that Thune promised the eight brave Democratic Senators he'd bring to the floor by mid December. Initially perhaps the government would dump money into health savings accounts for people most affected by higher insurance premiums. They'd be free to use it to pay insurance, or pay out of pocket medical costs. This could be a good first step to migrate to a system like Singapore's, where you have universal healthcare at much lower costs than we do. That's because providers and hospitals have to compete. See post #16 for more info.

This could be a good first step to migrate to a system like Singapore's, where you have universal healthcare at much lower costs than we do. That's because providers and hospitals have to compete. See post #16 for more info. Originally Posted by Tiny

I'd love to see those types of reforms, but you are dreaming in color. The democrats will NEVER vote to reform the system because their goal is single payer GOVERNMENT controlled Healthcare. Because once you control healthcare, you control nearly every aspect of human life. We can use healthcare to restrict access to firearms... you laugh? Why do you think the Dr's are asking your kids if there are weapons in the home? Why do you think the CDC is casting fire arms death as a "health" crisis?

If you understand the goals, everything the leftists do makes sense.

Tiny, Here is the wikipedia page on the Singaporean public health care system.

It sounds like a single payer government run healthcare system to me. It combines the benefits of a single payer system with the benefits of private healthcare providers. So as I said in my previous posts getting the private insurance companies out of the loop seems like the best option to me.

https://en.wikipedia.org/wiki/Healthcare_in_Singapore

Healthcare in Singapore is under the purview of the Ministry of Health of the Government of Singapore. It mainly consists of a government-run publicly funded universal healthcare system as well as a significant private healthcare sector. Financing of healthcare costs is done through a mixture of direct government subsidies, compulsory comprehensive savings, national healthcare insurance, and cost-sharing.

The Singaporean public health insurance system is based on programs run by the Central Provident Fund, primarily Medisave, a mandatory medical savings account scheme. All working citizens and permanent residents are obligated to set aside a portion of their income into Medisave accounts, which they can draw upon to pay their own medical bills and those of their immediate family. The Central Provident Fund also manages the MediShield and MediFund insurance schemes, which cover people with insufficient savings or those who have depleted their savings. In addition, the government provides subsidies for the medical expenses of citizens and permanent residents who receive treatment in public hospitals.

Here's how it works TxDot. Twenty percent of your salary is withheld and an additional 17% is contributed by your employer, to fund your individual retirement and MediSave accounts. That's a total of 37% of your salary. If you're young, the split is 8% MediSave and 29% retirement, but as you age the Medisave share goes up to 10.5%. The maximum balance in your MediSave account however tops out at about $55,000, which is what the government believes you should maintain to cover non-major medical expenses. The excess rolls into your retirement account. An aside, you can use money in your retirement account, within limits, for a downpayment on a home and education.

Part of the money in your MediSave account goes to pay premiums for your MediShield Insurance Policy. MediShield pays for hospital stays, surgery, chemotherapy, dialysis and the like.

You use the the money in your MediSave account to pay for most outpatient treatments. You can also use it or cash to pay for things like a better hospital room or treatment in a private hospital. The public hospitals produce good outcomes, better than ours, but unless you've got the coin or private insurance or excess funds in your MediSave account, you could end up in a well-ventilated, unairconditioned ward with 8 beds.

So instead of a single payer, you've got millions of payers with millions of MediSave accounts, all shopping for the best deal. And you've got private insurers as well paying bills.

You're kind of right though, that MediShield is cutting out a lot of the inefficiency and rent seeking that we have in the USA with insurance companies.

Here is a page I found on health care costs in Singapore.

https://smartwealth.sg/healthcare-co...ics-singapore/

External sources estimated that Singapore’s medical inflation rate for 2019 and 2020 was 10% per year.

Financial Year Government Health Expenditure ($ Million)
2020 15,202
2019 11,147
2018 10,122
2017 9,764
2016 9,307
2015 8,639
2014 7,233
2013 5,938
2012 4,837
2011 4,091
2010 3,856
2009 3,745

MediShield Life, Singapore’s national health insurance, is compulsory for all citizens and permanent residents and is fully payable by MediSave balances.

Driven by rising healthcare costs and the need to provide more comprehensive coverage, MediShield Life premiums have increased, effective from 1 April 2025. Some age groups have seen premium increases of up to 86.3% compared to the rates in 2021. However, this is not a sudden hike but the result of gradual increases over several upward revisions in recent years.

Suffice it to say healthcare costs are rapidly rising in Singapore.

That's a deceptive table TxDot. It ends in 2020, during COVID, and note the rise in government health expenditure from 11.1 billion to 15.2 billion the last year. It doesn't account for population growth. It's probably in Singapore dollars, not US dollars. I wonder if the government's share of total health care expenditures increased during the period? The population of Singapore in 2020 was 5.7 million, and the forex rate was about 1.35 SGD/USD, so the per capita government spending in 2020 would have only been $2000 USD per person. And that's during the thick of COVID.

Yes, health care expenditures have grown a lot. Singapore's become richer and older, which correlates with higher health care expenditures as a % of GDP. But in 2022, the last year available from what I believe are World Bank numbers, total healthcare spending in Singapore in USD was $4320 per person, compared to $12,434 per person in the USA.

https://www.macrotrends.net/global-m...hcare-spending

https://www.macrotrends.net/global-m...hcare-spending

From the same links, please note Singapore was at 4.9% of GDP and the USA at 16.50% percent of GDP.

Here are some comparisons of outcomes from AI:

Singapore:

Life expectancy 83.5 years
Infant mortality rate, deaths per 1000 live births: 2.2
Maternal mortality: 2.8 per 100,000

USA:

Life expectancy: 78.4 years
Infant mortality: 5.6 per 1000
Maternal mortality: 20 per 100,000