Study: 'Medicare for all' projected to cost $32.6 trillion

[SunSeeker]

Sen. Bernie Sanders' "Medicare for all" plan would increase government health care spending by $32.6 trillion over 10 years, according to a study by a university-based libertarian policy center.
...
Sanders' office has not done a cost analysis, a spokesman said. However, the Mercatus estimates are within the range of other cost projections for Sanders' 2016 plan.
...
The Mercatus analysis estimated the 10-year cost of "Medicare for all" from 2022 to 2031, after an initial phase-in. Its findings are similar to those of several independent studies of Sanders' 2016 plan. Those studies found increases in federal spending over 10 years that ranged from $24.7 trillion to $34.7 trillion.
...
After taking into account current government health care financing, the study estimated that doubling all federal individual and corporate income taxes would not fully cover the additional costs.

https://abcnews.go.com/Health/wireStory/study-medicare-bill-estimated-326-trillion-56906940

So under this worst case scenario study, if we cut out the middle man (insurance companies), it amounts to $3T/year to cover everyone for everything. That equates to $10k per person. Right now I pay $16k per year for a family of 3. But on top of that I pay thousands in copays and deductibles and even then it does not cover everything. Paying $10k per person to me means instead of paying $16k in premiums, plus thousands more in copays and deductibles, and arguing with my insurance every time I need referrals to specialists or coverage "out of network," I will now just pay $14k more for the three of us pand never stress about any of that. Sounds like a deal to me.

And this study assumed doctors and hospitals won't take less than they are getting now, which seems highly unlikely. If there are no more uninsured, hospitals won't have to jack up the rest of our costs to cover them. If we want European style single payer health insurance, we must pay European style taxes. I'm fine with that. People would still save money in the long run, and most important, we would finally end the uninsured/underinsured crisis and the horrific human death and misery caused by it.

We have to be real about what the tax increases will be and be prepared to justify them. I am convinced we can justify the increases. Sadly, must politicians aren't. When it came time to finance Vermont's single payer law with tax increases, ALL of Vermont's politicians ran for cover, and VT single payer died. Same thing will happen with national single payer unless we get real about the tax numbers and get a backbone to argue for them.

[unc70]

1. Study funded by Koch brothers

Done by a "libertarian", so it is probably more than a worst case scenario.

[WePurrsevere]

5. As soon as I saw the word libertarian I saw it as a very biased study...

Anyone who took stats or has been paying attention for a bit knows that data can be manipulated and spun to suit an agenda.

[SunSeeker]

18. So what is the correct cost figure? Got a link?

[pazzyanne]

95. The article at the link goes into more detail, not just showcasing the $32.6 figure

"Federal health expenditures refer to health spending from the federal government in particular. Since the federal government takes on nearly all health spending under Medicare for All, federal health expenditures will necessarily go up a lot, $32.6 trillion over the ten-year period according to Blahous. But this is more of an accounting thing than anything else: rather than paying premiums, deductibles, and co-pays for health care, people will instead pay a tax that is, on average, a bit less than they currently pay into the health care system and, for those on lower incomes, a lot less."

https://jacobinmag.com/2018/07/medicare-for-all-mercatus-center-report

[SunSeeker]

97. Yes, other outlets have analyzed the study, everyone from Wonkette to Think Progress.

But I would love a link to another recent study that calculates total costs, from a more neutral research institution.

[pazzyanne]

100. Reading the article at the link brings in the weakness in the $32.6 trillion

It breaks down some of the costs advantages which I found interesting and meaningful, especially because it was on a site that had the headline: "Even Libertarians Admit Medicare for All Would Save Trillions".

[SunSeeker]

102. Well of course. But to get those savings we need to raise taxes.

Unless we are prepared to argue what those taxes will be and that those taxes are justified, instead of running for cover, we are never going to get single payer.

[pazzyanne]

103. The answer to the question lies in a study that puts together a full picture

of what is being paid with private insurance companies with a comparison of what is paid under a Medicare like system. The proof is in the pudding.

[SunSeeker]

106. I agreee. We need a neutral study, otherwise this Mercatus study fills the vacuum. nt

[SunSeeker]

6. What cost do you think is more accurate?

I'd love a link.

[onit2day]

80. If study says it cost $30 trillion u can b sure overall we save $40 trillion because

Private ins operates at between 20 % 40% overhead whereas Medicare operates at 3% overhead. No more billion dollar McGuires as greedy private insurers can no longer profiteer from our health care.

[SCantiGOP]

84. Simple economics:

Generally accepted figure is that 1 in every 3 dollars of health care spending today goes to the insurance companies. Cut that out and you have a lot of dollars to re-allocate.

[greymattermom]

2. This needs to be compared with what folks are paying now.

Employer contribution, employee contribution, copays, self pays, the works.

[Recursion]

3. It's more than we pay now, because we have drastic underservice

Even if you make every single treatment cheaper, we need to be doing a lot of medical care that we aren't. And that's going to cost money.

[KY_EnviroGuy]

121. Then a logical, rational comparison would factor underservice in...

but I suspect that would be very difficult, as would be factoring in the losses from a collapsed insurance industry (including all their dependent corporations). This may be the most complex proposal our nation has ever tried to evaluate and it should be carried out by an independent commission.

IMO, the media needs to shut the hell up about this until it's properly researched......

[Recursion]

122. 100% agree with that last sentence

There's a lot of shooting from the hip going on.

[SunSeeker]

4. Exactly. That is why I think it is a deal, because I do take that into consideration. nt

[PoindexterOglethorpe]

20. Yep. And include the costs

of the inflated salaries of the CEOs and executives of the current companies providing "health care".

[Honeycombe8]

45. I'm retired, but paid zero for my medical when employed.

I always chose the option of the lower coverage, where employee doesn't need to pay part of the premium. Because I was healthy. Although I did have some copays and such. Not much.

This was part of the problem with the ACA, BTW. Coverage for all, treating it like a group policy when it's really a bunch of invidiaul policies, does punish the healthy people.

If I don't eat pizza, walk every day, go on a diet & lose weight, give up beef and pork, cut way down on sweets...my reward is that I'm healthy as a horse. My punishment under the ACA was that I was hit with an enormous cost to get a substandard policy, to cover the costs of coverage for unhealthy people (who paid LESS than I had to). Some of those people were unhealthy thru no fault of their own, but many had diabetes or other conditions caused by an unhealthy lifestyle.

I'm about to get Medicare. I have priced it out. I'm not sure why, but the effect on healthy people is not the same with Medicare & the supplemental policies. Getting full coverage under Medicare will cost less than half, for better coverage, than what I could get in the ACA. And I have a choice of insurers, unlike the ACA. And a lot of doctors take it, unlike my experience with the ACA policies I have had. Not sure why. Is it because certain things aren't covered that were required to be covered by the ACA? Like maternity? Not sure.

[mythology]

60. All the healthy living only partially protects you

Anybody can get hit by a car, get cancer in spite of a healthy diet etc. I live a healthy lifestyle, and had 3 knee surgeries before age 25. It's a crapshoot

[treestar]

64. True. If far, everything wrong

With you is attributed to that. How do doctors explain thinner people with high blood pressure or the like?

[7962]

71. Yep. I'd say genetics is 1/2 the battle. Lifestyle & luck being the rest.

But we DO have way too many people who just dont give a shit. Look at how large so many people are these days. Plus people who STILL smoke in 2018. The worst thing you can do to your body.

[Honeycombe8]

75. True. I've been lucky. But I've ALSO tried to be healthy.

Those who are healthy should not have to pay triple rates because someone else is not. We're not talking somewhat higher. We're talking a LOT higher...not because of my health. But because of someone else's health. And the real kicker is...they pay LESS because they're younger. Very unfair.

I'm dinged because of my age, although I rarely use the coverage. It's also a substandard policy. AND those who are sicker get the good policies because they are younger and pay a fraction of what I was charged with.

The ACA let ins. cos. charge higher rates for two things: age and smoking. I don't smoke, but my age got me a bad policy for an astronomical amount.

I tried to warn people about this problem with the ACA. No Democrat listened to me. This was a problem that hit many middle class people...and they voted accordingly. (I stayed true to my liberal roots, though. I knew the alternative was much worse.)

[Delmette2.0]

57. Don't forget the extra coverage we pay for...

On medical coverage with auto insurance and home owners insurance. Medical coverage is included on employer costs for everything we buy.

[JustABozoOnThisBus]

7. It might require some sort of "liability limits" in order to pass

Republicans seem to like the idea of limiting liability. If it would lower the cost of malpractice insurance, then doctors and hospitals might accept some sort of lower payment.

But, in any case, the insurance companies will fight this, since it is the definition of their business. Single-payer would eliminate health insurance.

Just envision the fight the pharmaceuticals put up during Medicare Part D negotiations, the congressmen who got paid off, the funny business of keeping the vote open until it passed in the wee hours, then quickly closed the vote. Multiply all that by 100.

[TygrBright]

8. Well, MY study says it'll cost $3.87.

I think we should go with my "study".

It's exactly as unbiased and scientific as the Koch's.

I allowed for factoring in negotiating drug prices, changing to a health improvement compensation model for primary care providers, enabling telemedicine, massive amounts of free preventive care and the consequent offset in savings for preventable chronic disease averted.

So let's go with my numbers.

ironically,
Bright

[jodymarie aimee]

9. I'm going with Bright

like usual...as his name says he is not someone who wants to fall into the trap to keep fighting the primaries RE: that Bernie guy !! Who I also think is tops !!

[SunSeeker]

19. What do you think is the correct cost figure? Got a link?

[SunSeeker]

13. We do need our own current study to counter this one.

It would help our case if it was done by Harvard or similarly regarded research institution.

And what if our study similarly said it would cost 3 trillion per year? Would you still support single-payer universal coverage? I would.

[mwooldri]

72. I think this study is definitely wonky.

$2 Trillion/yr for healthcare for everyone in the USA at present standards I can believe and I think that could be quite generous.

I'm basing this number on how much the budget for the UK NHS is in England, multiplying by 5 to factor for population, then doubling that to allow for the fact that there are more doctors and nurses and they are paid better. Even then that gets me to 1.5 trillion, so an extra 500 billion to allow for some nice stuff... yeah... 2 trillion a year is doable and yes I'd support that.

3 trillion a year is IMO a wonky number - it is convenient that this is the amount the USA spends on health care each year... both with government spending and private spending...

[luvtheGWN]

83. Don't forget one of the costliest:

private, for-profit hospitals. Once you do away with the profit motive, and coupled with single-payer insurance, your costs will come way down.

Funny how that works in other first-world countries, isn't it? But gosh, the purported wealthiest country in the world can't afford it.....

[erronis]

90. Many of the most expensive hospitals are now "non-profit"

But check on the "administrative" costs such as multi-million CEO and officer salaries. A lot of the hospitals also have spin-off centers of profit such as labs.

503C has become another way for greedy people to make money without paying fair taxes.

[renate]

10. I learn so much from reading Wonkette (seriously)... helpful analysis here:

What if the Koch Brothers funded a big ol' report scoring the costs of Medicare for All, and it accidentally revealed US of America would save two trillion dollars with a T? Would that be bad? Well, sure it would, if their press outreach didn't fix it by focusing only on VERY LOUD NOISES MEDICARE FOR ALL COSTS BIG NUMBERS OF MONEY ... and leaving the two-trillion MORE our healthcare already costs in the equivalent of a FISA application footnote.

snip

Mercatus focuses on HOLY SHIT MEDICARE FOR ALL WILL COST ALL THE WORLD'S MONEY -- instead of that it would be $2 trillion less -- because otherwise they might lose their hack license; the total cost of healthcare in the USA is already HUGE, and instead of being paid out by our existing cat's cradle of private insurance, government programs at the state and federal level, and people paying out of pocket, the whole shebang would be shifted to the federal government and paid for by taxes, like in socialist hellholes like Canada. The total is actually deceptive, because we're already paying that and more through a whole lot of sources, and not everyone is covered, as Breunig explains.

snip

...Even with the increased demand, those "increased" costs would still be lower than the price of our current hodgepodge of unsystematic systems that leaves millions with no coverage at all. The Associated Press version -- which Fox News's report draws on -- at least provides more details about the savings, and notes the proposal would cover 30 million people who currently have no coverage, and that the plan would eliminate copays and deductibles, as well as covering dental and vision care.

Nonetheless, the AP headline and lede focus on that great big number, SO SCARY, long before mentioning the savings. You might think the lede could compare the cost of doing nothing -- again, trillions of dollars more, and 30 million uninsured -- to the cost of Medicare for All, huh?

https://www.wonkette.com/medicare-for-all-savings

[SunSeeker]

15. Yup. Like I said, even at $3T a year, it is a deal. nt

[gratuitous]

24. So, more people would be covered at lower cost

But other countries might point and laugh and yell "Socialism!" at us. Well, nuts to that!

[lagomorph777]

39. "Other countries" already are Socialist.

They might stop laughing at us.

[paleotn]

110. Actually, the industrialized world...

would welcome us to the 21st century with a hearty "what took you so long?"

[lamsmy]

11. The maximum individual rate in B.C. is $84 monthly

Canadian $.

Not including dental or prescription options - though those are cheap too. Every other wealthy nation has proved it can work. Kenya, (KENYA!) has rolled out a national health care programme.

For US to change systems now would be expensive and people will lose jobs. Yes. But not switching means ever growing costs and an ever bigger gap between those who can and those who cannot afford it.

You either care about the health of the nation enough to get this done, or you don't.

[SunSeeker]

17. Well, that's in addition to the taxes they pay to finance the system.

But I agree, it really is a matter of what our priorities are.

[Honeycombe8]

49. California has more people than the entire country of Canada.

I think that's part of the difference.

And Americans are unhealthier. AND go to the doctor a LOT.

[lamsmy]

65. That's another reason universal coverage is cheaper - prevention

The US currently has the worst mother/child mortality rate during pregnancy of all wealthy nations. That's a fact.

Not only do many die unnecessarily, but children are born underweight and do not get primary care check ups and vaccinations. When poor people get sick, they wait until they are desperate and then go the emergency room - hands down the most expensive access point for care.

Providing every expecting mother and young child with affordable care greatly reduced long term costs.

[AllyCat]

74. I disagree about the jobs.

More health care workers would be needed. We would need a slew of new workers experienced with managing the system at the government level. More clinics would need to be built. More pharmacies needed. They would be DIFFERENT jobs. But jobs working to help, not hinder.

[miyazaki]

12. That figure is a substantial amount of the entire networth of the usa.

I'm dumbfounded.

[SunSeeker]

21. US net worth is about $124T, if you just count assets and assign $0 worth to the actual humans.

The financial position of the United States includes assets of at least $269.6 trillion (1576% of GDP) and debts of $145.8 trillion (852% of GDP) to produce a net worth of at least $123.8 trillion (723% of GDP) as of Q1 2014.

[unblock]

14. weeeeeee! making up numbers is fun!

i remember this sort of thing from high school debate.

we used to challenge each other to logically (well, rhetorically) link any policy proposal to dead babies, which was the holy grail of debate for defeating any proposal.

kinda like a policy wonk's version of six degrees of kevin bacon.

the idea is that any proposal can lead to this, which leads to that, which ultimately results in dead babies. so you can't vote for that policy proposal because you'd be killing babies!


this strikes me as similar, pick a progressive policy proposal and just find a way to claim it bankrupts the nation. there's always a way if you're willing to ignore facts and logic.

[SunSeeker]

16. Do you have a link to a study that gives a lower figure?

I'd love to have it. Just saying the numbers are wrong is not enough. We have to get serious. This really is a matter of life and death. If we can't figure out a way to justify single payer/universal coverage, thousands of people will continue to die each year, and hundreds of thousands more will live in misery without the care they need.

[KPN]

104. +100!

[uponit7771]

22. That's 1/7th of the current GDP that's kind of a strange number

[SunSeeker]

27. It would be 16.8% of our GDP. That is high compared to other single payer countries.

The gross domestic product of the United Statesin 2017 amounted to around 19.39 trillion U.S. dollars.

Health spending is lower in Canada. In 2017, total health expenditure in Canada was $242 billion, or $ 6,604 per person. Overall, health spending represents 11.5% of Canada's gross domestic product.

[uponit7771]

30. +1, It's because the doctors Pharmaceuticals in hospital groups charge outrageous

... fees compare to other nations also.

I've always understood getting right at the middle person would only bring down to cost around 10%

[KPN]

107. Right! Doctors, nurses, health care administrators

pharmacists have seen ridiculous salary and wage increases in the past 40 years compared to other workers and many professions in America. All enabled by a rapacious for profit health insurance system. Capitalism run amok.

Why do you think everyone wants to be a nurse or physicians assistant these days?

[fescuerescue]

117. Whats wrong with working people getting raises?

Especially nurses. The aren't exactly rich and the only ones that touch 6 figures are the ones working insane overtime.

The problem is that everone else isn't getting raises.

[KPN]

118. Nothing -- if other workers are also being

rewarded at an equitable rate for their skills, effort and abilities. But that’s not the case with the health industry generally. I personally know two young nurses, married to one another, who are both making 6 figures plus (close to a quarter million combined according to them). I don’t begrudge them personally, just saying that the health industry in America is a great example of capitalism running rampant.

[fescuerescue]

141. HMmm

I'd rather have a nurse making good money than one making minimum wage.

But thats just me.

[matt819]

23. Consider the source

Interesting. Take a look at this: https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html

Looks like Medicare costs 3.3 Trillion dollars a year now. So, are we to conclude that Medicare for all results and no additional cost to the government?

[sandensea]

32. Exactly.

The added is cost appears to be virtually nil - and in return we'd have universal coverage without the two-tier, world-class-for-me-Tijuana-clinic-quality-for-thee system we have now.

Not to mention a chance to end the paperwork hell you have to go through these days because providers won't share anything with each other lest you stop being ther cash cow.

[KPN]

108. Bingo. Not to mention that the current overall cost of Medicare

is associated with people 65 and older — the age group with the greatest medical needs.

[lagomorph777]

25. Of course: Koch "studies" ALWAYS omit the cost savings part of the analysis.

As if there is no reason to compare one cost against another. I suppose the Despicables lap that shit right up. We're not so easily fooled.

[SunSeeker]

33. Well, they did include costs saving, but low-balled them.

For example, as I note, they claim hospitals and doctors will not lower their rates. But they do take into account not having to pay premiums and deductibles.

[lagomorph777]

38. Odd that the headline didn't say "Medicare For All Projected To Save $2 Trillion"

[SunSeeker]

43. It is hard to quantify the value of a saved life, so it appears we just give it $0.

Yes, we will probably save money by going to single payer. But that is not the only saving. We will save thousands of lives each year and prevent hundreds of thousands of people from living in horrific misery due to lack of adequate care. That is almost unquantifiable because it is so huge. Yet it appears this study, and the MSM, just assigns it $0 value.

[lagomorph777]

47. A human should at least be worth the average value he/she adds to billionaires' pockets.

A not insignificant amount, especially now.

[workinclasszero]

93. Yea and just think of the hundreds of thousands

Last edited Mon Jul 30, 2018, 06:47 PM - Edit history (1)

Of medical bankruptcy cases avoided.

Think of the billions upon billions of dollars the American public and employers for that matter could spend on productive endeavors.

Think of the possibility of moving anywhere in this country, knowing you have health insurance taken care of regardless of the state or job.

But yeah the Koch bros aren’t going to talk about all that.

[sandensea]

26. That's what we're paying ALREADY

And for what? For a two-tier system with a gap bigger than the one in Tiffany trump's legs.

World-class care for the elite and foreign despots; Tijuana clinic-style care for the rest of us (to say nothing of paperwork hell).

[SunSeeker]

29. Exactly. nt

[vi5]

28. "what the tax increases will be and be prepared to justify them"

Ha! If we had enough people on our side who had the political will and ability to justify and fully explain what needed to be done, we probably wouldn't be in the mess we're in now.

"backbone"

Double HA!

[dpibel]

31. Some actual numbers

Total US spending on healthcare as of 2016 was $3.3 trillion per year.

Spending on Medicare and Medicaid is currently about a trillion.

The CBO estimates that the cost of subsidies for the ACA in 2018 will be $685 billion.

So the goverment is currently paying almost $1.7 trillion of the annual $3.3 trillion total in the US.

Assuming, just for ease of calculation, that the Koch Brothers numbers are flat across the 10 year period of their projection, that's an annual increase in government spending of 3.26 trillion.

So, according to the Kochs, under Medicare for all the total spending on healthcare in the US will be right around $5 trillion. That's an increase of about 52%. Now, assuredly, there will be more people insured (although the difference in cost should be marginal, since even the un- and underinsured get catastrophic health care). But there are now only (or were at the end of 2016, before the dismantling of the ACA began) 28 million uninsured Americans. That's 8.5% of the US population.

So it seems that, either adding 8.5% to the insurance rolls will increase medical costs by 52%, or the Koch brothers and their think tank are full of, pardon the French, Trump.

[The Liberal Lion]

35. Full of trump

I like that

[SunSeeker]

36. Thanks. What do you think is the correct cost figure if not $3.26T? Got a link?

[dpibel]

55. Hmmm...

Got a link, eh?

To a different projection of the actual cost of Medicare for All?

I'm kind of thinking that taking the existing cost of US healthcare and adding 8.5% to it would get you a pretty good ballpark figure of the actual cost. That, of course, is without considering the savings from cutting administrative costs and taking insurance-company profit out of the picture.

But maybe you can check into Physicians for a National Health Program. They say (and there's a hyperlink at their website to the independent analyses):

Over the past several decades, more than two dozen independent analyses of federal and state single-payer legislation by agencies such as the Congressional Budget Office, the General Accountability Office, the Lewin Group, and Mathematica Policy Research Group have found that the administrative savings and other efficiencies of a single-payer program would provide more than enough resources to provide first-dollar coverage to everyone in the country with no increase in overall U.S. health spending.

[SunSeeker]

85. That PNHP link does not give anything recent, and no total cost figures.

Most of the studies are state-only studies, and quite old. The newest national study is from 2013, addresses HRH 676 cost savings, and does not offer a total cost figure, at least not on the PNHP website:

July, 2013: Economist Gerald Friedman, Ph.D., University of Massachusetts, Amherst

“Under the single-payer system created by HR 676 [the Expanded and Improved Medicare for All Act, introduced by Rep. John Conyers Jr., D-Mich.], the U.S. could save an estimated $592 billion annually by slashing the administrative waste associated with the private insurance industry ($476 billion) and reducing pharmaceutical prices to European levels ($116 billion). In 2014, the savings would be enough to cover all 44 million uninsured and upgrade benefits for everyone else.

“Specifically, the savings from a single-payer plan would be more than enough to fund $343 billion in improvements to the health system such as expanded coverage, improved benefits, enhanced reimbursement of providers serving indigent patients, and the elimination of co-payments and deductibles in 2014.

“Health care financing in the U.S. is regressive, weighing heaviest on the poor, the working class, and the sick. With the progressive financing plan outlined for HR 676, 95% of all U.S. households would save money.

“HR 676 would also establish a system for future cost control using proven-effective methods such as negotiated fees, global budgets, and capital planning. Over time, reduced health cost inflation over the next decade (“bending the cost curve”) would save $1.8 trillion, making comprehensive health benefits sustainable for future generations.”

http://www.pnhp.org/facts/single-payer-system-cost

[dpibel]

98. OK

So something has drastically changed in the last five years, mooting that estimate?

Frankly, when it comes to refuting this Koch study, I'm satisfied with pointing out its inherent absurdity.

But I do think I see where you're coming from.

[The Liberal Lion]

34. This is one of those things

where I say cost does not matter. Whenever there is one of these phony wars no one stands up and says "but what will it cost". I refuse to engage in the nonsensical debate about cost of socialized medicine. I refuse to engage in the know-nothing debate about socialism either. Republicans LOST the right to complain about socialism with the many, upon many corporate bailouts which has done NOTHING to advance the economic interest of the common man. Socialized medicine is an investment in the people, and those investments always produce bountiful returns. It's foolhardy on our part as liberals/progressives to even sit down to debate this. A healthy worker is a productive worker, a healthy citizen is a good citizen. End of debate, and I'll hear nothing else. The only debate we should be having is whether our resources should be dedicated more towards preventative care or curative care.

[SunSeeker]

37. I agree it's a litmus test of our humanity.

But if we shy away from these arguments, we won't be able to convince the general public.

[TrollBuster9090]

40. All talk of 'how much will it cost' is meaningless, unless compared to how much it costs NOW.

Every other developed country has some form of a single-payer healthcare system, and every other country pays LESS THAN HALF THE PER CAPITA AMOUNT ON HEALTHCARE.

That sounds like they're actually SAVING money. A HELL OF A LOT of money.

Therefore, cost-effectiveness isn't in question. There are only two questions left:

1. Will the quality of healthcare be as good? The answer is: 'yes, for the overwhelming majority of people, health care outcomes would be as good or better than they are now, while costing less. For a handful of wealthy people, they wouldn't be as good. And it's that small handful of people who are funding all this propaganda against single-payer.'

and,

2. While it would be significantly more cost effective, HOW would it be paid for, and WHO would pay? At present, the middle class, upper middle class, and the wealthy pay out of pocket, while the elderly (Medicare) and the poor (Medicaid) are paid out of TAXES and FEES. If you add all that money together, it adds up to a lot more than if everybody was simply paid out of taxes to begin with.

I'd also point out that Medicare has an overhead administrative cost of about 2%, compared to private HMOs that have a minimum overhead of 20%.

Let's not talk about how much single payer WOULD cost without asking how much NOT having single payer CURRENTLY costs.

Some answers are here:

http://www.pnhp.org/facts/single-payer-faq

[bucolic_frolic]

41. Please apply Supply-Side thinking

The citizenry would be so much happier and worry-free, they would be free to pursue their best initiatives in personal and home businesses, and would be very productive indeed.

In other words, we would GROW our way out of the $3 Trillion per year.

Medicare for all does not repeal the profit motive in the private sector, people would still want to earn more money, and they would because they would be unburdened.

Get the Medical Bills off peoples' backs!!

[KPN]

111. +1000!

[PaulX2]

42. Tax Sugar Grease Oil And Processed Food To Pay For All Of It

If people stopped eating garbage they wouldn't need to see doctors.

Sugar should be $50 a lb.

[former9thward]

73. Since you are eating perfectly what are you going to die from?

[PaulX2]

79. Old Age

After not spending a half a million dollars on my care.

[former9thward]

82. It is probaby been a hundred years since they stopped putting "old age"

on death certificates. People die of something.

[Hortensis]

44. All projections are irrelevant right now.

Discussion of the best form(s) national healthcare systems may take can be tabled until we find out if we will have any national healthcare of any type.

The people controlling the Republican Party, and thus our federal government, intend to repeal ALL social network programs, very much including all healthcare programs such as the ACA, VA, CHIPS, Medicare, and Medicaid and make sure they cannot be replaced.

Cases are on their way to the Supreme Court right now to try to make key provisions of any national healthcare program unconstitutional, including such things as means of financing them and required coverage for preexisting conditions, .

As for cost estimates, any form of nationalized healthcare would both cost far less and provide far better coverage than none. That's what we need to keep in mind while we find out IF Democrats win or lose the current battle for the future of our nation.

[Blecht]

46. This might help with your "confusion"

Here is another thread that might enlighten you:

https://www.democraticunderground.com/100210942372

[SunSeeker]

51. So it appears Thinkprogress accepts the numbers from this Mercatus study.

Please stop with the insults. I am not "confused" nor lack "enlightenment." I am saying we need to address these issues.

So the OP you link to basically accepts the costs savings figures of this Mercatus study. I thought they were kinda low-balled myself.

Did you have any other point to make, other than insulting me?

[George II]

48. As you've pointed out (and asked for) several times here, we need out OWN number. Until then....

....the only number out there is this one, and this is what people will rely on as "fact".

To be honest I don't think anyone knows or can reliably determine what it will cost. Whatever that number turns out to be though, it's going to be higher than many will be willing to accept.

[Turbineguy]

50. What? And live in a civilized country?

Trump supporters won't have it.

[Honeycombe8]

52. If that was funded by the Kochs, then it's not true. nt

[SunSeeker]

54. What do you think is the correct cost figure? Got a link? nt

[Honeycombe8]

63. I'm not an actuary. But I have common sense. A Koch brother is on the board of that co.

Therefore, the study isn't true. They would not release a study that would get one of the Koch Bros angry.

I also have enough common sense to know that there is more than one way to craft a plan. Do the users pay premiums? That article says no. Why not? Medicare users do.

Does the plan take into account the removal of a hefty part of our medical costs that currently go to ins. co. profit? Don't know.

Medicare isn't full coverage. Is Medicare for all the same? So that individuals would have to buy supplemental coverage for the rest? I bet not.

There should be several alternate plans in the study, to get any hope of accuracy. But that's expensive.

No candidate should be touting a program they don't the cost of. It should be fleshed out. No Medicare for all plan will be inexpensive, that's for sure.

[SunSeeker]

112. Until we are able to present another, more neutral study's cost total, Mercatus fills the vacuum.

I totally agree with you:

No candidate should be touting a program they don't the cost of. It should be fleshed out. 

[Honeycombe8]

120. I'm afraid so. This study will rule the roost during 2020 campaigns.

Unless there's another one that concludes differently, which it most certainly would. No two studies are the same.

[Joe Nation]

53. Assuming noting else is cut from the budget,....

of course taxes would have to increase. The more and larger social programs you have the more money you need to fund them. Look at any country with generous social programs and you can see they pay a lot more in taxes than we do. That isn't rocket science but you have to ask yourself, what are you getting for those increases in taxes. I would happily pay more for a health care system that covers everyone for everything. I think most people would....well maybe not the wealthy, they can afford any health care they want already.

[dpibel]

66. Taxes increase; premiums and copays decrease

The issue is the net result. It's not just taxes going up. It's expenses going down.

Of course the fly in the ointment is American predatory capitalism: People who are getting employer-paid or subsidized insurance would see their taxes go up. But there's no reason on Earth to believe that the employers would pass along their savings to the employees. It'd just be another nice little slice of profit.

[Liberalagogo]

56. Smoking gun:

"... according to a study by a university-based libertarian policy center."

[Hoyt]

58. It's a pretty good estimate. We spend $3.3Trillion yearly for health care, with a lot of uninsured

who forgo care.

But trying to explain Medicare-for-all could be financed by taxes and actually save most people some money is impossible because there are so many stupid people in this country. The best approach is a Public Option which would probably turn into Medicare-for-almost-everyone pretty quickly, if it works like we think.

[SunSeeker]

101. Yep. nt

[Honeycombe8]

59. One thing I noticed different in the article: Premiums

The article says that people won't pay premiums. But Medicare users DO pay premiums.

So there's a difference right there.

I wonder if they removed the cost of insurance companies from estimates of cost of medical care? Because our medical care now includes a hefty profit for insurance cos.

[Chris Studio]

61. Does it cover...

The vast overcharging by hospitals etc.?

[Downtown Hound]

62. The Kochs...

Now how about you post a Trump funded study that proves their was no Russian collusion?

[mwooldri]

67. Then how does the UK do it so cheaply?

NHS England budget for 1 year - £125 billion. Approx $165 billion. Multiply by 5 - $843 billion could cover 310 million people if the USA wanted UK style NHS health care.

Now US doctors and nurses are paid more than their UK counterparts. There's also no "waiting list" in the USA (if you got the money and there's the doctor who can fit you in, you got an appointment). So let's say for arguments' sake we double that 843 billion to account for having more doctors/nurses and higher paid ones... that's still 1.6 trillion.

So what's the other 1.5 trillion being spent on?

[Recursion]

94. UK doctors start at $55K and max out at $90K

If we had the political will to cut doctors' pay like that we would save a lot, too.

They also do a lot less extend-the-dying-process interventions than we do. That is, "death panels"

[pnwmom]

68. Most people would not be happy to pay "just" $14K more for a family of three

in order to not stress out.

Also, people on Medicare often have things that aren't covered or get denied and they stress out about that. Anyone with a relative on Medicare has seen that.

[SunSeeker]

89. Exactly. nt

[tymorial]

91. That's why many people on medicare have supplementary insurance

To cover the loss and there is often still some cost sharing, deductible, copays etc.

If we as a people are going to have honest discussions about healthcare reform, the subject of taxes and budget increase is only part of the equation. It is not my intent to insult anyone but I sometimes wonder how educated people are on how healthcare is billed, paid.. hell even deliveres. It is not as simple as services cost X and providers deliver Y. Do they understand fee schedules, negotiated rates, the shift away from fee for service to advanced payment models. How many are familiar with Medicare Access and CHIP Reauthorization Act of 2015 and Merit Based Incentive Payment System. That is JUST medicare. Medicaid has Meaningful Use still. Some commercials have their own requirements. Providers are paid less than the "sticker price" and medicare pays less than commercials. I fully support extending access to care to everyone. Some providers have quotas whether they admit it or not. Specialists have waiting lists due to demand. Medicare requires prior auths just like commercial insurance.

NHS type reform can happen and I expect it will overtime if the stars align. The conservation doesnt even begin with what it costs. The whole entire system will have to change.

[pnwmom]

92. I agree. The entire system has to change. Also, a key part that you haven't mentioned

is escalating drug costs.

[tymorial]

114. Oh yes indeed. Absolutely

Thank you for pointing that out. I cant believe I failed to mention drug costs and predatory behavior of the pharmaceutical industry.
Before I joined this practice the free lunch was a weekly thing. I lobbied hard to put an end to it .


My thought process was how "we" as providers and care givers navigate the "system" from receiving referrals for patients, scheduling them, registering them, Intake, consultation, diagnosis, documentation, treatment, coding and submission, convincing payors (including medicare) that the patient needs a particular service. Having to submit arbitrary quality and performance data that has absolutely nothing to do with out specialty just so we can hopefully receive a percentage or two in return from medicare (only to find out that what was promoted as the likely return) was way way off. Wanting to actually get something out of quality performance initiatives but medicare doesnt offer measures that would result in either an increase in quality of care not to mention an ROI for the workflow changes. Ugh, it's so frustrating.

Yes though you are right. As a patient myself and a parent, I am keenly aware of drug costs. I have had medications removed from the formulary recently. I had a couple of patients struggle with this. Many many medications just cant be stopped so what is a patient to do even if there is an alternative, we still have to bring the patient down to manage levels and mitigate withdrawal (I am not even talking about narcotics).

You are so right

[pnwmom]

115. I just had that happen myself. Our major insurer

just took one of my meds off the formulary.

And I have an extra problem. They are always trying to force me onto generics, but none of the generics will state that they don't contain gluten (just the amount in a daily pill has caused intestinal bleeding for me, my worst symptom from gluten exposure). When a law was passed requiring the labeling of certain allergens, they excluded gluten from the list of ingredients that had to be labeled, and they didn't require drug manufacturers to comply.

So my doctor has been stuck writing letters on my behalf, but it's getting harder and harder.

[tymorial]

119. Has your physician worked with your pharmacist?

They may abe able to obtain a generic which does not contain fillers of which you are allergic. Another option (depending on your insurance and financial considerations) is a compounding pharmacy. I have had patients use a compounding pharmacist for various reasons. Using a compounding pharmacy for a hypoallergenic formulation is not uncommon. I dont know your medication, benefits or your situation but you may consider looking into this. The pharmacist will work with your provider to determine the dosage requirements and prescription form that best suits your needs.

[pnwmom]

123. Thanks for the compounding pharmacy idea. My pharmacist has tried to help me,

has called them himself and has given me phone numbers.

They won't put anything in writing -- if you email them they make you call them. Then they may tell you that wheat isn't one of their ingredients, but they can't control how their manufacturers process them -- which of course isn't true. Or they say that they reserve the right to change their filler at any time, without notice.

The government doesn't require drug manufacturers to label their products to cite their fillers, or whether there may be contamination, so they don't.

But I've always assumed that a compounding pharmacy would charge as much as a brand name. Is that not true? Because the brand names never seem to contain gluten. It's only when the generics alter the original formulations that that happens.

[tymorial]

124. It depends on the pharmacy and your insurance.

Some insurances will cover all or a portion of the prescription. If the compounding pharmacy is in network then you may only have to pay the copay for the tier under which the compound formulary exists. Other plans would require that you pay for the medication up front but then you can submit a claim personally and be reimbursed.

I would call around to a few compounding pharmacies in your area and see if they can help you. Also call your insurance company and investigate your benefits. Because you have a documented allergy and a prescription, the insurance company may be able to help you. Also, you should be able to request a case manager from the insurance company to help you.

[pnwmom]

139. Thank you -- this is good advice for my other prescription. With this one, unfortunately,

they've taken a perfectly good blood pressure medication off the formulary, so they won't pay for it anywhere. And I don't want to swap one that's working well for something else (a generic, of course) just because the insurer won't cover it anymore.

I'm considering just paying for it and asking if my doctor will prescribe a higher dose and let me split them in half.

[tymorial]

142. Your high blood pressure medication could still be compounded

In a hypoallergenic formulation. The other option you should look into is a prescription savings program like goodrx. There are other. I have a couple of patients who have used that to fill prescriptions at substiantlally less cost than what the pharmacy charges. You basically setup an account, type in the prescription exactly as prescribed (quantity and dosage). Print out the page with the "coupon" and bring it to the pharmacy listed. Participating pharmacies have obligations with the program and will sell the medication at the negotiated rate associated with the card/coupon that you printed. If your doctor has a card, dont necessarily use it. Go to the website or dow load the app. You want the most recent rate more than likely.

I had a patient that was prescribed Nuvigil for shift work but their insurance didnt cover the medication. They went to goodrx and saved hundreds on the medication by using the coupon and going to the local drug store which had the cheapest rate. It was 30 bucks and it would have cost him hundreds going to cvs.

I cant believe I didnt think of this until now. I dont lnow your medication but it may be worth looking into.

[pnwmom]

143. Thank you, tymorial! I just checked and goodrx DOES cover my med.

it's still not cheap, but it's a help!

[idahoblue]

69. Thanks

For doing the math. I thought it would be something like your results.

[elmac]

70. Fake news! nt

[procon]

76. Why would anyone give any credence to a study from a rightwing think tank?

Republicans hate all the New Deal social programs. This is not news. The idea of expanding the successful and wildly popular Medicare program must be driving them mad. They jimmied some numbers to fit their cherished goal of killing the social safety net, but we've been through this before, haven't we? We know their doom and gloom con game, we know all their tricks, right?

It’s not exactly breaking news that Republicans and their big bucks donors spend money to manipulate public policy and make sure their crappy ideas have a disproportionate impact on the people. Please don't believe this schlock. Just delete it and find a better source.

[SunSeeker]

87. Apparently Think Progress gives it credence.

It accepted it's cost saving numbers. https://www.democraticunderground.com/100210942372

We can't just dismiss it because it was funded by an academic board the Kochs sit on. We have to say why it is wrong. Or at least why paying that much is still worth it (because it is!!!).

[SunSeeker]

136. BTW, Bernie gave the study credence:

http://thehill.com/policy/healthcare/399625-sanders-thanks-koch-brothers-for-accidentally-making-argument-for-medicare

[0rganism]

77. and yet that same study says it would save us TRILLIONS each year

https://www.democraticunderground.com/?com=view_post&forum=1002&pid=10942389

for some reason, major media presents these budgetary figures with respect to their 10 year impact, without comparing the annual costs, the annual impact to taxpayers vs. current out-of-pocket and employer-handled expenses.

maybe the insurance companies buy a lot of ads on the news networks...

[SunSeeker]

88. Yep. But to get those savings, we need to increase taxes.

Instead of avoiding the subject, we need to explain, with numbers, that even with increased taxes, it is less than what they are paying now for inadequate, stress-inducing, people-killing health coverage.

[c-rational]

99. Agreed. They say we now spend 15-20 of our GDP. That comes to between 3 and 4 trillion

annually assuming a GDP of 20 trillion. You got the figures right. At 3 trillion it is a steal. And with preventive care and less stress it could go down. I say we create national medical schools and train our own doctors who would graduate without debt and could earn a good wage at 250-500K. We spend that much now, including overhead/administrative costs and profit.

[SunSeeker]

137. Exactly. Then we could attract people who actually want to heal people instead of be rich.

I remember reading a psych profile of various professions, and it determined the average doctor is more into money than the average CEO. You would think doctors would share the same nurturing psychological profile as nurses since they are in the same field, but nope.

[elmac]

78. a transaction tax on wall street would take care of most of the costs

and the costs wouldn't be anywhere near what the fake news article implies.

[SunSeeker]

96. Please don't use Trump's language. This is not fake news.

This is a real news story about an actual study. The study obviously has flaws and is connected to the Koch brothers, so you can criticize the study, but not CBS for writing about it.

Think Progress wrote about the study too.
https://www.democraticunderground.com/100210942372

[Yavin4]

81. How much would we spend on healthcare if we did NOT do Medicare for all?

Without that context, this is nothing more than a scare tactic.

[yellowwoodII]

86. Health Care Abuse

I think that health care providers and pharmaceutical corporations are allowed to abuse the system, making health care more expensive. Too many tests. Expensive pharmaceuticals. Over medication, etc.
Start by making TV pharmaceuticals illegal. I think that they promise more than they provide. And then more drugs are prescribed for the side effects.

[applegrove]

105. With a value added sales tax the people who shop alot pay the most. The people shopping

only for necessities pay much less. You pay taxes on restaurants and hairdressers and Mayfair.

[Bernardo de La Paz]

109. Increase spending, but save money too. It's the net that counts. Plus quality of life counts too. nt

[SunSeeker]

113. Yep. nt

[radical noodle]

116. Medicare doesn't pay everything for everyone

You have to buy a supplemental plan in addition to paying the Medicare payments.

[tymorial]

125. Sadly, a lot of people dont lnow this.

[radical noodle]

129. Obviously not...

and no one who pushes Medicare for all will bother to tell them.

[DeminPennswoods]

126. Universal medicare would give cost certainty to hospitals

and other medical-related companies.

[MichMary]

127. You can pay $30,000

annually, but there are many, many people who can't. The cost to cover them is still going to exist, even if they ca't pay. Add in the additional taxes you will pay to cover them and you will probably be paying waaaaaay more than $30,000/year.

Also, good luck on getting people who spend many years (and much money) preparing for careers in medicine (who have an expectation of a certain lifestyle) to take less money

[SunSeeker]

131. Yes, that is a problem. Our doctors are different. They expect to be wealthy.

Not sure what to do about that.

[ehrnst]

128. Interesting.

If a Democratic politician had praised a Koch Bros. funded study, they would be pilloried here on DU as being complicit or pandering, and should instead be fighting on "our side."

Independents? Not so much.

[SunSeeker]

130. I don't know of any Dems praising this study. Did Bernie praise this study?

[ehrnst]

132. Yes, Bernie praised this study. (nt)

[SunSeeker]

133. ...

[ehrnst]

134. ....

http://theweek.com/speedreads/787724/bernie-sanders-thanks-koch-brothers-accidentally-making-case-medicare-all

[SunSeeker]

135. Is this "thank you" what you are referring to?

http://thehill.com/policy/healthcare/399625-sanders-thanks-koch-brothers-for-accidentally-making-argument-for-medicare

[BSdetect]

138. Every other social democracy can do it but not this country?

Bollocks.

[SunSeeker]

140. It's all a matter of priorities, and ours are pretty screwed up right now.

Too many of us would rather let a neighbor die of a treatable disease than pay more in taxes. Until we hone our message about why increased taxes to pay for single payer is a deal, we will never be able to get with the rest of the civilized world.