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Where is the plan for medicare for all? all talk and no concrete fiscal plan

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I am so tired of lazy politicians who do not drill down to detail.  I like Bernie, but after almost ten years of listening to him on lunch with Bernie on the Thom Hartman radio show on Friday afternoons, I must say he is incapable of doing the heavy lift and presenting a fiscally sound path to medicare for all.

He says 1.3 trillion a year, and other experts say around 3 trillion a year to implement a medicare for all for every American.  I roughly calculated that Americans are paying 1.5 trillion on insurance premiums for health.  That means that about 1.5 trillion is the difference between two sides in the debate.

Our defense budget is close to 800 billion a year, so this gap in fiscal accounting for Medicare for all is twice the defense budget.  I also do not understand if any of these calculations take into account that employers and employees will stop paying the 1.5 trillion in premiums.  So in Bernie's calculation Medicare for all would save money for America, but the other side argues that 1.5 trillion a year deficit with Medicare for all without revenue would grow the deficit.  So my question is how much of a tax raise per year would be required to stabilize medicare and provide medicare for all?

Trump's tax cuts are losing revenue at about 500 billion a year, so now we are down to a trillion dollar deficit on the worst case.  So we simply return tax rates to before the george Bush tax cuts and we will be about 500 billion short per year.   A 200 billion cut in defense spending with us getting out of Korea would leave us 300 billion short a year which is much better than the current medicare system and private insurance.  This is doable but where is the detailed fiscal plan for this platform item which would help every American and cut our deficit?   Nothing.  Large general platforms with no realistic sacrifice by the American people to pay for the same.  We are screwed until honest people work the numbers and communicate clearly that there is no free lunch and medicare for all will involve sacrifice financially by all Americans in the short term, but will reap huge savings in the long term.  Where is the plan?
https://www.msn.com/en-us/news/factcheck/democrats-seize-on-cherry-picked-claim-that-%e2%80%98medicare-for-all%e2%80%99-would-save-dollar2-trillion/ar-BBLAWPs?li=BBnbcA1

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https://finance.yahoo.com/news/medicare-save-businesses-trillions-dollars-190500400.html

American businesses, now the biggest source of health care coverage in the United States, could completely exit the business of providing health care, if national or even statewide single-payer coverage ever takes root. That could make American firms more competitive globally and leave a lot more money for employee raises and other benefits.

The United States is the only advanced economy where employers are the primary source of health care. Famed investor Warren Buffett has called employer-provided health care the “tapeworm of American competitiveness,” because it forces American firms to bear a costly bureaucratic burden their foreign competitors don’t have to deal with. As health care costs have soared during the last three decades, employers have set aside more and more for benefits, leaving less for raises. In theory, there are reasons for the business community to support a single-payer system that would relieve them of an onerous obligation completely unrelated to most companies’ business models.

The enormous cost

But first, the eye-popping price tag for Medicare for all. New analysis by Charles Blahous of the libertarian Mercatus Center at George Mason University found that single-payer health care for all Americans would cost at least $32.6 trillion during the first decade, or $3.3 trillion per year. Total federal spending now amounts to $4.2 trillion per year, so adding Medicare for all spending to that tally would nearly double federal outlays. Other analyses of Medicare for all have put the cost of the Sanders plan in the same ballpark.

That might seem outrageous, but it’s worth keeping in mind that a Sanders-style single-payer system would transfer all health care spending to the federal government. “I’m scoring the federal cost here, and it’s enormous,” Blahous told Yahoo Finance. “The other side of the coin is businesses, individuals, states and others are not going to be paying these costs. They’re going to be given to the federal government.”

On the whole, the Blahous analysis finds that total health spending would actually decline under the Sanders plan, compared with the status quo, with the feds paying a lot more, but everybody else paying nothing. And more people would get coverage, since everybody would be eligible. As the only buyer of health care, the government would have the power to demand deep discounts, and there would be lower overhead because there would only be one administrative structure. Of course, we’d all have to get care through the government, and deal with the pitfalls that would entail.

Still, the tradeoffs for businesses could be attractive. Federal tax revenue from individuals and businesses will total about $3 trillion this year. So taxes would need to more than double to cover a giant new health care plan. Doubling everybody’s taxes sounds like a death wish for politicians. But it might not be as crazy as it sounds.

Businesses now pay about $1.2 trillion in health care costs per year, which provides coverage for about 49% of the American population. Federal income tax payments for businesses will only total around $243 billion this year. So corporate America pays 5 times as much for health care benefits for employees as it pays in federal taxes. If you tripled or even quadrupled corporate income taxes, while eliminating all their spending on health care, it would still amount to a net savings for businesses.



Last edited by PkrBum on 8/7/2018, 2:19 pm; edited 1 time in total

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Funding HR 676: The Expanded and Improved Medicare for All Act
How we can afford a national single-payer health plan

Gerald Friedman, Ph.D.
Professor
Department of Economics
University of Massachusetts at Amherst

http://www.pnhp.org/sites/default/files/Funding%20HR%20676_Friedman_7.31.13_proofed.pdf

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Again I want simple numbers:

Bernie says 1.3 trillion a year,
the experts say 3.3 trillion a year,

1.5 trillion is what is being paid by individuals, and PK has pointed out 49% of the private premiums for health insurance are about 1.5 trillion paid by employers, so we are getting a number close to 3 trillion a year on private insurance premiums. So I think Bernie's number has to be closer to the truth. If Americans quit paying private health insurance and pay the exact same premium into medicare, it sounds like it would be a wash. I like the idea of raising corporate taxes tied to each employee who goes to medicare for all. Throw in the 200 billion from military cuts and you probably are very close to covering the realistic number of 3.3 trillion.

So my wife and I pay a supplemental policy with medicare and a very small premium on our actual medicare. Simply increase the medicare premiums to match what the premium is in the private marker, and make those contributions on a sliding scale based on income.

The problem there is not bipartisan discussions to actually talk about real numbers and real proposals, when one group wants not help to Americans on health care, and the other group wants a free lunch. We need a bipartisan commission to actually design a system which breaks even based on premiums and tax increases. It does not work talking fantasy numbers. We need objective numbers put in the calculation so priorities can be set by the politicians from each party. We have the highest health care costs in the world, and in order to hold down profiteering in big Pharm and health providers, we need a strong objective negotiation with the profiteers which brings our numbers in line with Western Europe and Canada. Real numbers and not more rhetoric.

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You're nationalizing it. The semantics are lovely... but it's going to the Medicaid for all... the va on steroids.

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Personally, I think there are a variety of ways our country could ensure just as good or better health care for all Americans for cheaper.  But, I'm not so sure any kind of Medicare-For-All is just around the corner as soon as the Demos can get control of the reins again as many on the left seem to think.  Otherwise they would have done it when Obama first got into office instead of the ACA.

What are you going to do with all the health insurance companies and for-profit medical industries?   How will you get past the resistance of medical/hospital groups, the medical equipment industry, doctor & nurses groups, and ... the pharmaceutical industry?

And how are you going to convince the millions upon millions of Americans with employer sponsored health care the system will be better and cheaper for them?

How are you going to politically pass any kind of Medicare For All given the political resistance, political money, and scare mongering that would be encountered?

If you're gonna have a plan that gives all Americans just as good or better healthcare for cheaper ... it's gonna have to come out of somebody's pockets ....   and they're not going to take that lying down.  That's the first problem universal health care advocates are going to have to address.

Suffice it to say, I'm fairly skeptical that Medicare-For-All is just around the corner.

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How are you going to politically pass any kind of Medicare For All given the political resistance, political money, and scare mongering that would be encountered?

I agree that caution and a gradual plan which can be modified as the numbers are worked. Therefore I would suggest a ten year process of dropping the age of eligibility. Start at 55 and drop it 1 year per year, so in a decade all 45 year olds would be eligible. As you take the old people out of the markets, the rates would drop for young families. In ten years America could have a pretty good idea on the numbers, and they would have a decade to plan the final transition.

I think health care could end up like Trump's tariffs......sound good in general, but when the complexities hit the fan, you actually hurt the very people you wanted to help. So I agree. Caution.

You will never get the people who are raping the health care system with costs above Western Europe and Canada. However, the power to negotiate the American market will be huge. It is an exciting time as people are getting smart about how Dixiecrats only care about hate, and health care is going to make my neighbors in Milton and Navarre very happy that somebody is looking to make the quality of life for their families better. Hate can only get you so far.....at some point you have to govern.

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2seaoat wrote:How are you going to politically pass any kind of Medicare For All given the political resistance, political money, and scare mongering that would be encountered?

I agree that caution and a gradual plan which can be modified as the numbers are worked.  Therefore I would suggest a ten year process of dropping the age of eligibility.  Start at 55 and drop it 1 year per year, so in a decade all 45 year olds would be eligible.  As you take the old people out of the markets, the rates would drop for young families.  In ten years America could have a pretty good idea on the numbers, and they would have a decade to plan the final transition.

I think health care could end up like Trump's tariffs......sound good in general, but when the complexities hit the fan, you actually hurt the very people you wanted to help.  So I agree.  Caution.

You will never get the people who are raping the health care system with costs above Western Europe and Canada.  However, the power to negotiate the American market will be huge.  It is an exciting time as people are getting smart about how Dixiecrats only care about hate, and health care is going to make my neighbors in Milton and Navarre very happy that somebody is looking to make the quality of life for their families better.  Hate can only get you so far.....at some point you have to govern.

I recall when McCain was running for the Republican nomination once, he suggested some kind of plan to somehow gradually shift the the insurance premium tax deduction employers get to the employee.  The idea I think was something along the lines was that it would encourage employers instead to put the money in the employee's paychecks instead and then employee's would have more of the premium money and could buy their insurance somewhere other than the plan the employer had hooked them up with.   In essence, the idea was to shift from our current paradigm where so many are trapped in their jobs (and their plan & cost)

McCain was positively raked over the coals about it by his opponents scaremongering that he was going to take everyone's health insurance away.

I don't really know if it was a workable idea or not, or all the details of McCain's plan, not really using this example to debatet,  but point being .... so much for trying to change things in any kind of meaningful/structural  way.  Rolling Eyes

Probably the first thing that needs to happen (not only on healthcare, but a lot of other issues as well) is we need to get a lot of the corporate and special interest money out of our politics. You can ask your buddy Bernie about that ... as I recall he had a lot to say on that count too.



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I voted for McCain, and I am tremendously sad that his bipartisan instincts will be lost in the senate. Health care and medicare for all will take bipartisan support. However, until you get good numbers, how can people talk rationally. Get the proposals on the table and work the numbers.

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2seaoat wrote:I voted for McCain, and I am tremendously sad that his bipartisan instincts will be lost in the senate.  Health care and medicare for all will take bipartisan support.  However, until you get good numbers, how can people talk rationally.  Get the proposals on the table and work the numbers.

That's why the older I get the more I have a tendency to support/vote for candidates on the basis of their personal character and experience rather than their particular policy ideas or rhetoric.

I'm not one bit ashamed to say out loud I worked for the Jimmy Carter campaign back in the day as a teenager ... and I wasn't quite yet old enough to vote then.

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Pharmaceutical company to pay Texas $110 million in Medicaid fraud settlement

A pharmaceutical company has agreed to pay $110 million to the state of Texas to settle lawsuits alleging the company falsely and misleadingly marketed two of its drugs, according to the attorney general’s office.


Pharmaceutical giant AstraZeneca is accused violating the Texas Medicaid Fraud Prevention Act by engaging in false and misleading marketing schemes while under a 2010 federal “corporate integrity agreement” resulting from prior allegations of Medicaid fraud.

In the lawsuit, Texas alleges the company continued to promote its antipsychotic medication Seroquel and cholesterol-lowering statin drug Crestor for uses not approved by the FDA—an illegal pharmaceutical promotion commonly referred to as “off-label marketing,” according to the news release.

The company is accused of promoting the antipsychotic drug to Texas Medicaid providers, “who primarily treated children and adolescents when those drugs were not approved as safe and effective for use in that vulnerable population.”

“Texas leads the country in protecting its Medicaid system from pharmaceutical fraud,” Attorney General Ken Paxton stated in the news release. “The allegations that led to this settlement are especially disturbing because the well-being of children and the integrity of the state hospital system were jeopardized. The cooperation and support of the Texas Health and Human Services Commission was essential in achieving this outstanding outcome for Texans.”
https://valleycentral.com/news/local/pharmaceutical-company-to-pay-texas-110-million-in-medicaid-fraud-settlement


What we need to do is put some of these medical-miscreants in jail, rather than just fining them.



https://www.psychologytoday.com/us/blog/charting-the-depths/201404/10-troubling-facts-about-antidepressants

.....
2. A recent study found pharmaceutical companies spent 5 billion dollars on direct to consumer advertising on antidepressants in a single year.  One reason behind high prescription rates: The customer asks for it by name.

.....
8.  No data exist to show increases in the clinical efficacy of antidepressants over time; despite the fact that 26 different antidepressants have been brought to market since imipramine was developed in the 1950s, contemporary antidepressants work about as well as imipramine!

9. According to the largest antidepressant effectiveness study ever conducted, the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, the majority of depressed patients do not experience long-term remission with antidepressant treatment .   .....

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The Medicare-for-All thing is a nice idea, but I haven't been convinced yet that it'll actually be workable. That was one of my problems with Bernie -- he never convinced me he actually knows economics. But I don't claim to be an expert in that area, either, so maybe it's workable, I don't know. I'm not against the idea, but so far I'm not sold.

Then again, a lot of the people I see complaining that they'd have more money taken out of their checks for health care are the same dipshits who spend thousands so they can "roll coal" (i.e. blow thick black smoke on passersby) with their pickup trucks, which is one of most useless, stupid asshole behaviors ever. I can't really take their complaints seriously when they throw away money on modifications that do absolutely nothing but make 'em get worse fuel consumption and wreck their engine, plus get $400 tickets every time the cops catch 'em. If it's worth a couple thousand bucks just to be jerks to people they don't even know, then I'm not gonna cry over 'em having to spend a few extra dollars to help sick people get better. Fuckin' take all their money.

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zsomething wrote:The Medicare-for-All thing is a nice idea, but I haven't been convinced yet that it'll actually be workable.  That was one of my problems with Bernie -- he never convinced me he actually knows economics.  But I don't claim to be an expert in that area, either, so maybe it's workable, I don't know.   I'm not against the idea, but so far I'm not sold.

Oh, please, if friggin' Slovenia can do it, we can.


All the Countries That Have Universal Healthcare

And we're not on the list.

Universal Healthcare is Not That Hard

Just look at all these countries that have it:

Australia
Austria
Bahrain
Belgium
Brunei
Canada
Cyprus
Denmark
Finland
France
Germany
Greece
Hong Kong
Iceland
Ireland
Israel
Italy
Japan
Kuwait
Luxembourg
Netherlands
New Zealand
Norway
Portugal
Singapore
Solvenia
South Korea
Spain
Sweden
Switzerland
United Arab Emirates
United Kingdom

Did you notice anything? Maybe perhaps that the United States is one of the only first world countries to not offer universal healthcare as a right for its citizens.


https://www.nasdaq.com/article/all-the-countries-that-have-universal-healthcare-cm757323

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Deus X wrote:
Oh, please, if friggin' Slovenia can do it, we can.


Like I said, it's possible. I'm just a tetch stubborn at knowing if it'll work here. Our population has a lot more dumbasses in it than a lot of the rest of the world. But, I'm not opposed... just not yet convinced.

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zsomething wrote:
Deus X wrote:
Oh, please, if friggin' Slovenia can do it, we can.


Like I said, it's possible.  I'm just a tetch stubborn at knowing if it'll work here. ...  .

Well, I for one, have little doubt a  universal health care system that provides better for cheaper will "work" in the USA.  And our current system is terribly financially inefficient .... so the money is there.

We could go with a near entirely nationalized system or some kind of public-private partnership as some other nations do .. whichever way you want to do it.   We could look at what other nations do and take the best of those systems, throw in a few "American" twists of our own to give a nod towards free-market capitalism.  Whatever.   There's more than one way to skin a cat, as they say.

The big problem though is overcoming the political and structural obstacles to get from what we have now to a different system/paradigm. Any plan that doesn't address those things, the political and structural resistance that will b encountered, is doomed to never get off the ground.

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