Maybe I am mistaken, but I believe that, in addition to proposing his Medicare

[Atticus]

For All legislation, Bernie has also proposed SEVERAL options to fund the plan. He suggests that the actual method of paying for the healthcare expansion be chosen after a full and public discussion of his options plus any others that are proposed.

Will Barasso's flashy request for a CBO score on the Sanders legislation even mention that he has, in fact, proposed funding sources? Are DU folks even aware that these options have been offered by Sanders along with his bill?

Keep in mind that while taxes will go up, most insurance premiums will disappear.

Is the above correct or am I off base?

[Lee Adama]

1. Got a link to this alleged funding proposal?

I've seen absolutely nothing about such a thing, which is precisely why Barasso called for a CBO score. The last plan of Sanders for Medicare for all was scored at a cost of $32 trillion over ten years. This is a political gold mine for the Republicans and they damned well know it.

This CBO scoring scares the shite out of me for our prospects in 2018.

It can easily be explained that there are many options for funding, but in politics, if you're explaining you are losing.

[Atticus]

4. Try this link:

https://www.sanders.senate.gov/download/options-to-finance-medicare-for-all?inline=file

Hope that works for you.

[Lee Adama]

10. So nothing in the bill he put forward.

Just a Word document on his Senate website.

Figures.

The CBO scoring will be a disaster, and Barasso knew it.

So we'll be explaining, which means we'll now be losing on this one.

[Atticus]

15. I see that you make no comment on the actual funding proposals. And, my OP

specifically stated that the proposals were "in addition" to his actual bill, so what's with this "---nothing in the bill---Just a Word document on his Senate website. Figures." nonsense?

The CBO scoring will be a disaster ONLY if we allow it to be. How is pointing out that, yes, as a matter of fact, Bernie DID state how we could pay for this "explaining"?

I would hope that most who post here---some for quite a bit longer than you---are not willing to so easily concede defeat on what we, as a nation, should be demanding.

[Lee Adama]

18. In politics, if you are explaining, you are LOSING!

The CBO scoring CANNOT take into account anything in a Word document on the Senator's web site, it can ONLY take into account the language of the actual bill put forth.

So yeah, the CBO scoring is going to be a fucking DISASTER!

It will make the scoring on the ACA repeal efforts seem to be the only way forward.

It was fucking DUMB to put forth something like this without funding it in the language of the bill. That's what Republicans do, NOT Democrats.

[Atticus]

20. (could you stop yelling?) We disagree, but I will not call you "fucking Dumb".

Have a wonderful evening.

[Lee Adama]

21. I never called you "fucking DUMB".

I called putting up a bill like this that does not have the funding built in fucking DUMB!

Why did you take that personally?

[Atticus]

24. You seem to have a hard time responding to what was ACTUALLY written.

I never said nor understood that you called me "fucking DUMB". I understood that you were calling Bernie that.

We're done here.

[Lee Adama]

28. OFFS!

Good!

[Demsrule86]

7. Going for single payer at this moment was incredibly stupid.

[Lee Adama]

22. It could have been brilliant.

All it required was to have the funding built in.

[Demsrule86]

44. Nope. We have no chance at the moment...the GOP are already using it against us with a CBO score

and old video of Sen. Sanders saying single payer will cost to much...it was the 80's Sen. message was different...had to be back then I guess. We need to keep what we have the ACA and this is a distraction. This could cost us any shot at taking back the House.

[Lee Adama]

55. I agree with everything you said except for one thing.

If Sanders had presented a bill that could stand on its own that fully lays out how it would be funded and got sign off from dozens of Democrats, the CBO score would show it was budget neutral and even though it would never even be brought to the floor, it would be a hammer to pound Republican candidates with in many swing districts and purple states.

Of course, such a piece of legislation, by necessity, would require several volumes of text.

Rhetoric is never good policy.

[Demsrule86]

57. I don't think it is budget neutral as it calls for tax hikes.

But maybe.

[tymorial]

54. And a comprehensive transition plan that addresses all points of fallout

Retraining opportunities for employment loss and assistance with relocation if the job could be absorbed under medicare for those who are willing to accept the opportunity.

Addressing the disparity in reimbursement rates between medicare and commercial payers. Without this transition healthcare providers will need to reevaluate the services they offer

Providers do have the opportunity to increase their reimbursement rates through participation in MACRA but for some they may need time to increase their investment in EHR software and engage in workflow changes to meet requirements.

Without the second item being addressed there will be a reduction in services and some healthcare providers will shudder or be forced to join larger healthcare provider organizations, this could also result in further loss of employment.

[Lee Adama]

56. Yep, instead it's nothing but a piece of paper with empty rhetoric.

[Watchfoxheadexplodes]

2. Fox playing up hard bernies 1987 interview

Where he states single payer Medicare will bankrupt the federal government.

[Demsrule86]

5. We have no chance of getting single payer and now we handed the GOP something to attack us with.

[Atticus]

11. Yeah, we should just play it safe and hope that we can salvage a few

scraps of the ACA after they butcher it. You know---"keep our powder dry" and all that.

NOT!

[Demsrule86]

45. We should be realistic, and yeah when the damn Republicans have all power, we should think

long and hard if we want to risk losing in 18 and 20...by putting forth legislation that has no chance of become law and will be used against us...while ignoring the 'fixes' needed to improve the ACA which has become quite popular.

[Demsrule86]

3. A big who cares...it is a plan that won't happen and a complete waste of time...work

on the only plan we have: the ACA

[Atticus]

6. We are all entitled to our opinions. nt

[Demsrule86]

46. Of course you do...and my only hope is this doesn't cost us any shot at Congress...a CBO

score is on the way...the GOP is preparing for battle...and all over a bill that hasn't got a snowball's chance in hell.

[Control-Z]

38. I wonder how much it would cost

and how difficult it would be to add a public option to ACA. Instead of a subsidy for private insurance one could choose a lower premium to begin with while getting a plan that covers more. Wouldn't that be great! And for all those counties that only have one plan in the exchanges it would offer a second choice. It could also have the added bonus of giving insurance companies the impetus to be competitive by lowering their premiums and improving their plans.

[Demsrule86]

47. That is how it could happen down the road when we are back in power...but if we lose the ACA, it

won't happen.

[Demsrule86]

59. That is definitely the way to go...if you try a big stand alone bill like this one

and go after workplace insurance, single payer will fail and take the ACA and any shot at universal coverage with it.

[NurseJackie]

8. Looks like it requires a COMPLETE rework and overhaul of the tax system. Pie. In. The. Sky.

This isn't going to happen.

It's a lost cause. It's wasted time. Efforts that protect and strengthen and improve the ACA will be time better spent.

[ProfessorGAC]

23. So?

Would you have said that FDR's recovery ideas or JFK's challenge to go to the moon?

[NurseJackie]

35. LOL

[leftstreet]

25. Good. Let's cut out tax theft from the military contractors n/t

[NurseJackie]

36. LOL

Sure. Do that.

[Warren DeMontague]

9. I stand with Booker, Harris, Warren, Franken, and Gillibrand!

[Voltaire2]

12. me too

We can change the narrative or we can continue the same failed strategies of the last 10 years.

[Warren DeMontague]

14. I wonder what'd happen if he who shall not be named wasn't associated with this particular proposal.

I'm sure the discussion on DU would be exactly the same.

Don't you?

[QC]

27. But the Republicans might say something mean!!!

It's best not to do anything. If we sit here quietly they might go beat up some other kid.

[Voltaire2]

40. its been working well so far.

[Demsrule86]

48. I stand with winning in 18 and 20...and we all know the Democratic Senators

felt pressured to support this because those on your list want to run for president and they are already considering a primary. I am proud my senator Sherrod Brown has been talking about the ACA.

[Warren DeMontague]

53. Or, maybe they believe in it.

If, as you seem to believe, it is positioning for some hypothetical future primary, then apparently a lot of voters believe in it too, huh.

[Demsrule86]

58. Every Senator is running for president...coincidence?

[Warren DeMontague]

66. Uh, actually, there are 13 or so co-sponsors. And no one has announced for 2020.

Have they?

[Hoyt]

13. He has proposed "taxes," not how much the average Joe will pay, but "taxes."

That's not really a detailed proposal. California, Vermont, Colorado, and every mention of single payer elsewhere, is based upon taxes replacing premiums. I think people want to see the numbers. even if it is a rough estimate. If they are really low enough, even GOPers will jump on it.

Right now it's like talking to a car salesman, although a nice one, who wants you to fall in love with a particular car before getting serious on price.

Although it doesn't have to be exact, something like this: The total cost is projected to be XX trillion vs. YY trillion we are spending now. To cover the cost -- If you make $50,000, you will pay a tax of X, if married y, if you make a million z, if retired on SS B. You will also pay C if you smoke. Corporations will pay D percent of payroll. A range would be fine.

Doctors will get paid 85% of Medicare Fee Schedule, etc., and must take Medicare patients. Hospitals will be paid Zz.

CBO would add the potential impact on employees working for docs, hospitals, etc. What the government will have to come up with for infrastructure, etc.

Sure, it is going to be an estimate. But the first thing those opposed are going to say is that you will end up paying a lot more and end up with a system like the VA. We need something to counter that that is creditable.

[Atticus]

16. Thank you for a thoughtful response. Perhaps I am naive, but this proposal is---

what?---48 hour old? Is it unreasonable to believe that the type of analysis you suggest will be brought forward?

It seems to me that insisting that we have 100% of our waterfowl in sequence---have all the answers to all possible objections and all the votes we need absolutely guaranteed---is the surest way to insure that NOTHING will get done.

Thanks again.

[Hoyt]

26. I hear you. He did have this same basic proposal over a year ago, so it's not that new.

It is a good aspirational Bill as it stands and it is getting people to talk about it. More importantly, he has a number of Democrats supporting it. I remember Sanders said during the ACA debates that he doubted there were "8 senators that supported it," when asked about support for Single Payer and Public Option. He's already doing better than that.

John Conyers has had a similar Bill for several years.

The sooner some creditable numbers are put on it, the better. Again, it's good to be talking about it and getting interest where we can, but these Senators aren't going to be able to run on it very long without more details.

[yallerdawg]

17. The problem is...

we don't know what his proposal will cost.

In 2015, U.S. health care spending increased 5.8 percent to reach $3.2 trillion, or $9,990 per person.

The House today voted to pass a total budget of $1.2 trillion.

A huge number of Americans resent the hell out of the bills we have today!

Now we're going to add a program that just cost $3.2 trillion in real money? If we squeezed 50% cost reduction out of it, we'd still be looking at least doubling our annual budget?

THIS is the program we want to sell to America now?

When we're fighting tooth and nail to salvage the freakin' Republican (ACA) plan we have in place?

[Voltaire2]

41. It won't cost 3.2T. It will cost less than that. As a nation we will realize substantial savings.

Nothing we have done so far has controlled health care costs, mostly because our government has been captured by powerful corporations and "regulates" for their benefit not for ours. This proposal will change that for health care by eliminating the for-profit basis of the health insurance industry. That alone will represent a 15-25% reduction in what we pay. The "all in" factor will give the system the power to regulate prescription costs as well, bringing our costs in to line with the rest of the world.

The doubling of the budget would indeed happen, and it will be paid for by increasing taxes. For wealthy americans their costs will go up, as they should. For everyone else, health care premiums, deductibles, and co-pays will disappear in exchange for a modest increase in the payroll tax. Most people will have more money in their pockets.

More importantly everyone will have health insurance regardless of their employment status or their ability to pay. Nobody will have to keep working while dealing with a serious disease because that is the only way they can keep their insurance. Nobody will be locked into a job they hate for fear of losing their health insurance. Nobody will be bankrupted by medical bills.

This program will make our country a better place to live for everyone. Get on board.

[Demsrule86]

49. Exactly right, putting this bill forward now is madness.

[TCJ70]

19. Pretty sure the senator asked to include the funding proposals:

Additionally, Barrasso is seeking an analysis of the economic impact of the bill and a revenue estimate on Sanders’s proposals to finance the new system, which were released in a separate document Wednesday.

http://thehill.com/policy/healthcare/350734-senator-asks-for-cbo-score-of-sanderss-single-payer-bill

[Hoyt]

29. Oh, here is something that came out today that is getting there.

Payment is unclear. A generous plan that covers all Americans is going to require more revenue. There's no exact plan for how to pay for Sanders' bill, but he did on Wednesday afternoon release a list of potential payment options.

Among the proposals: a 7.5 percent payroll tax on employers, a 4 percent individual income tax and an array of taxes on wealthier Americans, as well as corporations. In addition, Sanders' plan says the end of big health insurance-related tax expenditures, like employers' ability to deduct insurance premiums, would save trillions of dollars.

http://www.npr.org/2017/09/14/550768280/heres-whats-in-bernie-sanders-medicare-for-all-bill

[TexasBushwhacker]

39. I think those numbers are realistic

and they will still save workers and employers money. When you consider that there would be no more deductibles or copays, I think you could even go 5%. Keep in mind that the first $29K for a family of 4 is not subject to the tax.

If you download they whole plan from the link provided you will find this:

Progressive income tax rates. Under this plan the marginal income tax rate would be:

* 40 percent on income between $250,000 and $500,000.

* 45 percent on income between $500,000 and $2 million.

* 50 percent on income between $2 million and $10 million. (In 2014, only 136,000 households, the top 0.1 percent of taxpayers, had income between $2 million and $10 million.)

* 52 percent on income above $10 million. (In 2014, only 16,700 households, just 0.02 percent of taxpayers, had income exceeding $10 million.)

Currently, a married couple with a net income of $250K has a top marginal tax bracket of 33%. There is no fucking way Congress would pass and increase of 7% to raise it to 40%. I don't have a problem with adding some additional brackets, but $250K in some parts of the country is just upper middle class. Even a top bracket of 45% is a big jump but doable. If they did that plus taxing capital gains and carried interest as regular income that would be plenty.

[Demsrule86]

50. Really, screwing with workplace insurance will get a party tossed out of power and if you are

already out power more years in the wilderness...just ask Hillary. She can tell you all about Hillarycare. I can't believe such ammunition is being handed to the GOP who are now going for a CBO score.

[Hoyt]

60. That's a good point. At one time, unions were opposed to meddling with an area

where they could show real benefits to their members -- negotiating for better health insurance plans. I think now, they publicly support health care/insurance reform, but I'm not so sure they are behind it. Employers also use these plans to retain workers.

A couple of differences this time -- if you think Sanders' plan is financially viable, not just needed -- is that there would be no co-insurance or deductibles and dental care is covered. Employer plans usually have significant co-insurance and deductibles. Although some employers offer dental, it's usually limited coverage. If Sanders' 7.5% payroll tax on employers is sufficient to fund much of the single payer system, that would be a reduction in cost to businesses at least for people making less than $100K or so. That might persuade them.

[OneBlueDotBama]

30. Barasso Just Wants His Cut

and can't figure out where it's going to come from.
Typical sleazy repub

[TexasBushwhacker]

31. From his primary website

https://berniesanders.com/issues/medicare-for-all/

HOW MUCH WILL IT COST?
This plan has been estimated to cost $1.38 trillion per year.

THE PLAN WOULD BE FULLY PAID FOR BY:
A 6.2 percent income-based health care premium paid by employers.

Revenue raised: $630 billion per year.
A 2.2 percent income-based premium paid by households.

Revenue raised: $210 billion per year.This year, a family of four taking the standard deduction can have income up to $28,800 and not pay this tax under this plan.A family of four making $50,000 a year taking the standard deduction would only pay $466 this year.

More at the link.

*******************

I will say this. I think this plan relys too much on tax increases on the wealthy. I think people should pay more than 2.2% of their income. He says a family of 4 making $50K a year would only pay $466 a year for the whole family. As it stands now, they probably pay more than that a month. So I think it would be more realistic for it to be somewhere in the middle.

[Atticus]

32. Thanks for the link and info. We have to be sure this is publicized nationally.

Emails to Rachel, Lawrence and all the usual suspects are needed AND we should let our Senators and Reps know that WE know that funding proposals have been made and we should insist they tell us which they prefer.

[Not Ruth]

33. This pricing is extremely fair IMO

I would love to see a comparison to ACA

[Demsrule86]

51. The American people will not support such taxes. And poor people would have to be subsidize for the

80% and that is not even included in the cost...and any party that scews with jobs insurance will squashed like a bug. That is the reality we face.

[Hoyt]

61. Apparently, Sanders' more recent proposals are bit higher than that.

Among the proposals: a 7.5 percent payroll tax on employers, a 4 percent individual income tax and an array of taxes on wealthier Americans, as well as corporations.

http://www.npr.org/2017/09/14/550768280/heres-whats-in-bernie-sanders-medicare-for-all-bill


I do think, if those numbers pan out -- 7.5% and 4% -- it would add something to the Single Payer proposal.

But until I see a CBO or other creditable analysis, I'm skeptical. I'm also hopeful that folks who came up with those numbers are close, because I think most people would have a hard time opposing that.

I also want to see CBO or someone study the other impacts on the economy, including what decreased provider reimbursement might do to salaries of nurses, aides, janitorial staff, people working in health care computer systems, etc. But, I am encouraged by those numbers and hope Sanders isn't being a bit optimistic.

[guillaumeb]

34. Far too many are "explaining" how it cannot be done.

So we should wait another 10 or 20 years for real change.

[yallerdawg]

37. It's not like this is something new.

A lot of us considered it, for years and years - and concluded this has no chance in hell of passing into law regardless of its merits!

Just fixing ACA can get us to a form of universal coverage, at least!

Then - pragmatically and incrementally - we can begin to work towards the goal of a single-payer, government-managed, Medicare-type healthcare system for all - when ALL of us are in it!

We are getting there, and, yes, it might take 10 or 20 more years! We are talking about transforming almost 20% of the American economy.

That is no small thing - and there will be many, many "unanticipated" consequences as it evolves.

[Voltaire2]

42. Just fixing ACA - it actually can't be fixed.

It will continue to rely on mandates that punish small businesses and working people without employer health insurance. It bakes in for profit insurance. It separates people by income and employment status rather than being a comprehensive universal system. It will continue to be a wedge issue that the Republican Party can exploit for as long as it exists and that they can sabotage at the state level.

The ACA was a good start. It needs to be defended against repeal, but we need to move forward.

[Demsrule86]

52. Yes it can...and such remarks give the GOP joy because he even Democrats say" it can't be fixed..."

and they can kill it and block any sort of health coverage...thousands will die for nothing...because we won't get single payer now and if we lose the ACA, we won't get anything to replace it; we will be blamed. We are handing the GOP a victory over their determination to stop universal healthcare ...next stop Medicare and Medicaid.

[Hoyt]

62. A Public Option is the answer to that. If that is as good as we hope, people will take it

overtime without having to cram it down the throats of those too stupid to see the benefits of a government plan. I bet you in 5 years, most people would be under the Public Option (essentially Medicare-for-All-Smart-Enough-to-Sign-Up). Then, if it really is popular, everyone else can be moved into it.

[guillaumeb]

67. To summarize your position as I read it:

Medicare for All or something similar is the end goal, but incremental progress is better than no progress?

[yallerdawg]

69. We HAVE progress...

and we are fighting to save it.

Around 8% of Americans are uninsured. That's a manageable and moral goal. That's achievable. That would be MORE progress. The Republicans are fighting MORE progress tooth and nail!

Our goal is affordable universal health care. It will never be free. We'll pay one way or the other. When EVERYBODY has skin in the game, then we can start addressing pricing and profits. Government management.

Let's see if we can save ACA now.

[guillaumeb]

70. We agree. eom

[MichMan]

63. How much of employer savings would go to workers?

What is the confidence level that whatever amounts that employers might save on premiums is going to be given directly to workers as higher wages?

Just saying that the total amount paid for current insurance would go down doesn't mean it will offset any higher taxes directly

President Obama was on record many times in the campaign saying that premiums would drop $2500 a family with passage of the ACA. We all know that never happened for a variety of reasons and people are very hesitant about believing what politicians promise

[Voltaire2]

68. You understand that employees pay premiums, copays, deductibles, and shit insurance didn't pay,

Right?

It is irrelevant what businesses do with their savings.

[Snotcicles]

65. Another cost savings that is overlooked with Medicare For All is

the need for medical liability coverage on Auto and Home Owners Insurance will be eliminated.