The Key to Selling Medicare for All to Voters Is Simple

[MineralMan]

Here's the basic message that will need to be used. the actual message will depend on how the system is configured, but will look something like this. It's easy to understand and makes sense.

Learn The Basics of Medicare for All

With Medicare for All, your healthcare will work much like it does now, but will cost less!

1. If your employer currently pays part of your health insurance premium, that will continue. Your contribution will also continue as it does now. Due to the savings of a single-payer system, however, the cost will be lower in almost all cases.

2. If you currently pay 100% of your health insurance premium, you'll continue to do so, but the amount of that premium will be lower in almost all cases.

3. If you currently are covered by Medicare, you won't really notice any changes. Your basic premium will be automatically deducted from your Social Security benefit, and you can purchase supplemental coverage as you do now.

4. Medicare for All pays 80% of medical costs in almost all situations. If you wish, you can purchase a supplemental insurance plan from any available provider to cover the remaining 20%, just as Medicare recipients have been doing for many years. Generally, premium costs for supplemental coverage are very affordable and most people will take this option.

5. If your income is below a selected multiple of the poverty line, government subsidies will be available to reduce your premium costs to a level you can afford. In some cases, you will pay no premium at all for coverage.

For more details on Medicare for All healthcare coverage, please click this link.

[Hoyt]

1. Not a bad approach. It is significantly different from Sanders' plan which has no coinsurance

or deductible requirements.

[MineralMan]

2. My real point is that, no matter how the system is configured,

A simple explanation that demonstrates to people that it's nothing to be afraid of should be the first step in convincing voters that they will benefit from the program in many ways, and that it will be simple and easy to understand.

Most people do not want to know the details. They just want to know that they will have coverage and that it's not going to cost them more money.

If the program can't be described simply, as in my example, it will fail. People will not support anything they can't understand easily and that will not take more money from them.

Unless it can be simply explained, like I did in my sample, it will simply fail to gain enough support to be implemented.

The details will be available, of course, but almost nobody will go dig them out. You should hear what people ask me when they're almost at Medicare age. I can explain it really, really simply for them. When I do, they relax, choose a supplement provider and go on about their business.

Complexity is the enemy when it comes to convincing people that change is good.

[Hoyt]

5. I agree. It's got to be simple, show real savings, and make the change palatable/unconcerning.

I do think Sanders' plan is getting very close to that, especially when there is a creditable analysis of what it will cost the average Jane and how it impacts the economy overall.

[MineralMan]

7. Whatever system is proposed and whenever there is a realistic

chance that it might be adopted, selling it to voters is going to be the big challenge.

Frankly, there's zero chance of this happening right now. Until we have Congress and the White House in solid Democratic hands, it's really premature to talk about this in anything but general terms, I think. I wish the discussion were more on the basics at this point, and focused on selling the simplicity, lower cost to the individual and improvements in healthcare access.

It's not time for the details right now. Everyone knows this is not going to happen under the Republicans. It simply will not. So, let's sell the basic concepts, instead of trying to sell a detailed proposal.

People in general are scared of changes. We need to allay their fears about such a system, not talk about things like taxes. How will it affect people from paycheck to paycheck? That's the question that stalls these discussions over and over again. We need to sell simplicity, savings, and better access and leave the details alone right now, since nothing is going to pass at this time.

Just my opinion.

[Hoyt]

9. To move it forward, I think you need to be able to tell the Average Jane about what it

will cost them.

Say all the things you mentioned, then add --
Rather than what you are paying right now of $950 a month (with employer contributions, copays, deductibles, etc.), you'll pay no more than $700 for a much more stable plan.

That will sell, if true.

[MineralMan]

13. Well, if a single-payer concept is what it's supposed to be,

then it will lower individual costs, simply due to the reduction in administrative costs alone. It will also equalize revenues for providers. Will there be adjustments to be made on the healthcare industry. Damned straight! Good.

But, for the average Jane, the whole healthcare thing should cost less. If there is one payer, that payer can dictate what can be charged for pretty much everything. That's the equalizing factor. It's going to be a revolutionary change, but one that will be adapted to.

For example, the multi-specialty clinic where I get primary care has its own freaking MRI machine. A block away from it is an imaging center with three of the damned things. My clinic does not need its own, nor do its patients. There is massive duplication of technology that has to be paid for. Screw that. I can go down the block for an MRI if I need one.

The whole thing is going to require many changes, but individual voters don't care about any of that. They just want to know that they'll get the care they need without paying lots more for a more effective, efficient system. If whatever is proposed can't provide that, then it's the wrong system and should be changed so it can.

To succeed, any system that is proposed is going to have to ensure access to care at a lower price than the current system. If it doesn't do that, then it's the wrong proposal, frankly.

[Hoyt]

15. I don't buy that reduction in admin cost. Fact is, docs submit the same claim to any payer and

put the same charge on the claim. The payer pays and the doctor's office writes off any difference between the plan's allowable and the charge the doctor sent.

Some people think that if we remove requirements for getting plan approval -- called prior approval or pre-certification -- that will save a lot of admin time. Well, you do that on everything and you'll have the same issue Medicare does now -- overutilization.

The reason there are all those MRI machines is that Medicare pretty much pays for them without checking for medical necessity until years after that fact, if at all. If that is not controlled, the cost for Medicare-for-all will be astronomical.

Overtime, we are going to have to get doctors away from owning all these ancillary billing schemes. I know for a fact that when doctors profit from ordering tests, they order them more often than when they don't profit.

There should be savings in the system, but we are also picking up a bunch of uninsured (which is good); supposedly doing away with the 20% Medicare charges or the higher copays private insurers often require; dental and vision care; etc. I just don't see how it is going to be a lot cheaper to the average Joe who will have to pay the majority of the cost, especially short-term.

You are exactly right, to make this thing work a lot of changes have to be made. Everyone -- providers, equipment manufacturers, nurses who work in provider offices/facilities, and even patients -- are going to have to change their expectations. I'm not sure the desire is there to do that. Hopefully it is.

[MineralMan]

20. Medicare sets the amount they will pay for procedures, etc.

So will Medicare for All. Then, providers will have to make their own decisions. If the only coverage for healthcare is Medicare for All, then that will be that, and you can either provide care or not provide care. It will be up to the providers to decide whether they want to be in the healthcare business or find another occupation.

In a universal healthcare system, the questions of payment to providers is not the choice of the providers. It is the choice of the system. Then, it's up to the providers to deal with that.

For too long, we've let the providers set the price of everything, from office visits and hospital fees to pharmaceuticals. That will end with a universal healthcare system. They'll get paid according to a fee schedule.

That's where the change will be. For patients, that won't matter, since they'll be able to get the care they need. Patients don't care how much money the provider system makes, and should not have to.

[Hoyt]

22. Today, most insurers pay a percentage of Medicare's Fee Schedule. Providers don't set the payments

anymore.

Providers charge what they want, but because most have signed a contract with an insurer or Medicare, they get paid what the plan's fee schedule allows and it's not a lot different from what Medicare pays. In fact, one reason so many providers don't accept ACA patients is because the exchange plans' fee schedules are often less than Medicare.

The savings everyone thinks is there, really isn't unless we slash Medicare's rates. That is going to affect nurses, physical therapists, house keeping, and everyone else in the chain. That might be good, but it ain't gonna be seamless. I think we need to shoot for it, but anyone who thinks costs will be a lot less, is going to be disappointed.


I'd also suggest looking at the Urban Institute's analysis last year of Sanders original plan.

https://www.democraticunderground.com/10029596950

[haveahart]

6. Your points are well taken. If only we all will have the patience to work through the political

obstacles that are out there. There will have to be some give and take. It can be done. "Patience, Grasshopper, patience."

[TreasonousBastard]

3. Not quite that simple-- who actually analyzes costs/benefits when making decisions?

Not the people lining up to buy a $1,000 iPhone. Not the people who immediately hit the Amazon app when they could go down the road to a K-Mart and get it cheaper today. And not the people who automatically head to a Toyota or Honda dealer because Fords and Chevys are deemed to be junk.

The trick in sales is not to get into the details, but to manufacture a want. Sell the sizzle, not the steak.

Medicare is saving your grandmother's life. All the cool people head to the government for health care... Whatever it takes to remove the stigma from government health care and make it desirable.

Then it will be a breeze to get it passed.

[MineralMan]

4. What I wrote has no details at all in it.

It's a bone-simple explanation of what it will mean to various groups of people. Grandmother is already on Medicare and she loves it. Almost everyone who has Medicare and a supplemental policy likes Medicare. You get healthcare when you need it. It's very simple, really.

Selling the sizzle is good, but some basic information on how it affects you is also essential. That's what my sample does. Of course, it's based on a general concept, and would have to be changed to match the proposed program, but that's the idea.

[leftofcool]

8. But it isn't quite that simple Mineral Man

You don't address that many doctors are moving away from taking Medicare at all. Here is an example: In our county, we have 14 doctors. Only two of them take Medicare patients. One of them is no longer taking any new Medicare patients. What that means, is if you are a recently retired Senior to our county, you will probably have to drive 45 miles to the nearest doctor who will take you as a Medicare patient. What happens to someone who is disabled, gets on the Medicare for all program and can't find a doctor? You say Medicare pays 80% but that is not quite the case. They pay 80% of an amount "they" allow for a procedure. Medicare does not cover much chemotherapy for cancer patients. They do not cover vision or dental. I have to disagree with you on supplemental policies. The cheapest one we could fine was 262.00 per month for each of us. That is another nearly 600.00 per month on top of the 267.00 we already pay each out of our Social Security checks for Medicare because it is means tested. Medicare as we now know it would have to be drastically revised for it to work for everyone. The government would have to step in and insist that all doctors take Medicare. How does that work? I would love to see a Medicare for All plan in this country but only if all the details are worked out on paper, only if all doctors are required to take it, only if all Seniors are completely covered and that includes medicine, vision, and dental, nursing homes and assisted living, only if all children are completely covered including medicine, dental, and vision care, and only if the premiums are lower than what my Social Security income is, and only if no taxes are raised on Seniors, ever!

[MineralMan]

10. Here's the thing. No.

you're confusing Medicare and Medicaid. I know of no doctors or hospitals or clinics in the Minneapolis St. Paul metro that do not welcome Medicare patients. Some hate Medicaid, but not Medicare. That may be different in rural areas. I don't know.

Besides, once a universal healthcare system is in place, what are those people going to do. That will be how healthcare is delivered. If they don't accept it, let them move to some other country.

Universal health coverage is, well, universal. If it is implemented, doctors and medical facilities will have no choice but to accept it. Period. That's why it's called universal. It will mean changes for the healthcare industry. I don't care. They'll figure it out. I'm not interested in their welfare. I'm interested in providing universal healthcare on a national basis.

[leftofcool]

11. No, I am not confused at all

We have doctors right here that not only do not take Medicare, they take no insurance at all. Our hospital does not take Medicaid but they do take Medicare patients. Like I said, Medicare as we know it would have to be revised.

[MineralMan]

14. If everyone is covered by Medicare or any universal system,

the providers will have no choice in the matter. What is happening now is due to there being a choice for providers. Screw them. Make the change and let them figure it out. Here's the system, providers. Deal with it!

[Hoyt]

12. I hear you. I do think that if everyone, but a few, had the standard plan -- Doctors

would have little choice but to accept Medicare. The reason most doctors aren't taking new Medicare patients is that they make more seeing those with private insurance in most cases.

I don't think most areas of the country have the extent of the problem you describe -- only 1 out of 14 docs seeing Medicare. Plus, Medicare is on the verge of paying for telehealth encounters across the board, rather than just in very special circumstances. With today's digital connectability, one can "see" that physician 45 miles away without leaving their homes except for maybe a few times a year.

[Grammy23]

16. Mineral Man, my husband and I have been on Medicare for several years.

I confess that before we enrolled and began using it for our health care needs we knew very little about it. I knew my mom had that plus a continuation of her Federal Blue Cross from her days working at the VA. I knew between those two things, she had no co-pays.

Before we retired, my husband and I had our health insurance through my husband's employer and had always had deductibles and co-pays. We were insured by United Health Care and later Cigna. Even when I was diagnosed with breast cancer in 1990, we understood little of how it worked, but eventually figured it out. We understood rather rapidly that had we not had insurance, we would have been bankrupt or saddled with enormous debt. Losing our insurance or being dropped because of my health history was always in the back of our minds. When the ACA passed and pre-existing conditions ceased to be a concern for having insurance, it was a huge weight lifted off of our shoulders.

Now that we are on Medicare, I have had two knee replacements and thanks to Medicare and the AARP supplemental through United Health Care, our cost (beyond premiums) has been almost zero. We had some prescription costs not covered by my drug plan, but even that was not a lot. We pay for our Medicare part B through deductions from our Social Security. The supplemental we pay ourselves that costs $383./month for both of us. So our preminums are not cheap, but part of that is because we chose the most expensive supplemental plan F because it had the most generous coverage. If we had to cut costs, we could drop back to a cheaper plan, but then, our out of pocket costs would rise. So in some ways, the higher priced Plan F has proven to be a more cost effective option for us.

We have a good example of the plan you have outlined. A Medicare plan as the basic health care for all, plus the OPTION to purchase a supplemental to cover more expenses. I think the basic plan needs to cover drugs, vision and dental needs. The idea of having separate policies for drugs, vision and dental is only good for the insurance companies. It bumps up the cost to consumers and means some will not get that coverage and will neglect to get their teeth and eyes checked as they need to do. Those things need to be included in basic health coverage so that a person's whole body is under that umbrella policy. Separating those things out is dumb and is not taking care of critical health needs like teeth or medications needed to treat an illness.

It is not hard to explain a Medicare for All plan that works like Medicare for seniors does currently. Plus, you have a bunch of current enrollees who use this method and are happy with it. We will be happy to share our knowledge with younger people who may have questions and concerns. We have real world experience using our Medicare (plus supplemental insurance in some cases) and know how it has worked for us. If we golden oldies can figure it out, the younger whipper snappers can, too.

[SharonClark]

17. Thank you for this post.

I've had some recent experience with Medicare since my Dad's death last December and my enrollment last month. As I was pouring over all the literature I received to determine my supplemental policy, my Mom reminded me "you paid into this program for over 40 years, now it is yours to use". I am grateful for Medicare and support Medicare for All.

[Grammy23]

18. Yes, I failed to mention that the Part A Medicare is already paid for.

All those years we worked and had withholding on our paystubs was the proof we were paying into something that we'd use if we lived long enough. Most of us probably didn't quite understand but once we get old enough to enroll, we figure it out. Part A we pay while we're working. Part B we pay now out of our Social Security. Once you start reading and using it, it is easier to figure out.

No one has to buy supplemental but if you can, you should. It just helps pay some (or nearly all) of what your Medicare does not pay. Medicare covers 80%, leaving you with 20%. You can pay the 20% yourself or buy a supplemental policy to cover it. Not so hard to understand.

I think the average American would not hesitate to go for Medicare for All if they really understood how it works. Most of us seniors would fight anyone who tries to take it away! We are an army of people who know how it works and will be happy to explain it to those who are afraid of "Government Run healthcare"!

[MineralMan]

19. Yes, thanks. That's how most people on Medicare see it.

It's simple and works quite well, I think. We need to roll vision and dental into that and change how pharmaceutical pricing works. Those three will be high priority items, I think.

But, the simplicity of Medicare coverage is a big selling point. You don't really have to make any decisions on your basic medical coverage. The supplemental thing is fairly easy, too, once you understand that all of the (cost) plans are pretty much the same. I'd like to see supplements work everywhere, so traveling isn't a problem, but that's about it.

[Grammy23]

30. Yes, yes, yes to everything you said.

And the test case is already done. We KNOW how it works and anything that needs improvement, such as making it include vision, dental and drugs. The Congress could utilize those of us who already know how well it works. The problem, as I see it, is that the misinformation and propaganda against an insurance program run by the government has got a lot of people biased against it without knowing the facts. In truth, a surprising number of the elderly have no idea that their Medicare is a government run program. But most of us DO know and they'd have a real fight on their hands if they ever try to take it away.

[MineralMan]

32. Ask People on Medicare What They Think of Medicare!

That would be an excellent slogan. We'll tell anyone who asks that it works.

[berni_mccoy]

21. Sorry but that IS NOT AT ALL what the proposed plan does.

You are spreading mis-information. Please stop.

[MineralMan]

23. I'm not talking about any specific plan.

I'm talking about Medicare for All in general. I have not looked at the Sanders proposal, because it will not be adopted by this Congress. There is zero chance of that happening.

So, the plan that will eventually be adopted will probably look very different from this doomed proposal.

You'll notice that I included no details at all in my post. My post was about a strategy for selling any such plan to the voters. I do not have a Medicare for All plan. I'm not competent to create one. I am competent at marketing, however, which is what my post was about.

I'm not spreading mis-information. I'm making a marketing proposal.

Please read my posts for understanding of what they are, not what you think they are. Thanks.

[berni_mccoy]

24. You are talking about selling Medicare for All in the context of Bernie's plan being released

yesterday. Please stop. You are not helping the conversation. You are creating confusion about the topic. And if that's how you'd sell it, then you must not be in sales.

[MineralMan]

26. Thanks for your advice. I choose to ignore it.

There is no Medicare for All plan that can be passed in Congress at this time. Therefore, there is no plan to discuss. Once Democrats have strong majority control of both houses of Congress and a President in the White House, a plan can be designed that will pass and will be adopted.

Parts of Bernie's plan might be in that plan. I don't know yet, and neither does anyone else.

Before any plan gets adopted, though, the general public must approve of it and support it. For that to happen, they will have to understand it in terms that make sense to them and that can be compressed into a small enough space to be presented in all media and short enough for people to bother reading or listening to it.

Without strong public approval, no plan will succeed. The details of how it is implemented will be of interest to those of us who are willing to look closely at those details, but we are not a large enough group to pass anything.

No, I will not stop, thank you very much. I'm part of the conversation, and will continue to be.

[MineralMan]

34. Again, I am not talking about "Bernie's Plan" at all.

It doesn't even have the full support of a majority of Democrats in the Senate. Bernie's plan is not what Medicare for All will be. It cannot be enacted by the existing Congress, and we probably won't have a large enough majority of Democrats in both houses until 2020, if we work our asses off and manage to get that.

You apparently like Bernie's plan, but it will not be what is adopted, so I'm not discussing it. I'm discussing the general concept of Medicare for All. Bernie Sander does not own that phrase.

[berni_mccoy]

25. The REAL Key to Selling Medicare for All

https://www.democraticunderground.com/10029597033

[Eliot Rosewater]

27. One GREAT way to sell this to those who cant be sold, is to relieve employers entirely

of providing the coverage.

Employers would pay into the system instead via special tax but the cost would be far less. I now of which I speak, this would help a lot.

[MineralMan]

28. Yes, a simple payroll tax, and an end to paying an insurance company

an ever-increasing amount. That's easy to understand for the business community. Also, a huge paperwork reduction and and end to choosing plans to offer employees. Also easy to understand. The benefit to employers is easily understood. They're already doing that to the IRS and others. It's simple and clean.

[Eliot Rosewater]

29. This whole thing can work, I am not a fan of doing it without full party support but that aside

for now, this can work.

It hast to, when you think about it.

Now you know me, I am pretty sure he is gonna get us all killed tomorrow in a world wide thermonuclear war, but if we somehow manage to avoid that, I am SICK of dealing with healthcare cost issues.

I suppose if he does get us all killed, he will have long last finally solved the health care crisis.

[MineralMan]

31. Something certainly can work, whatever it is called.

As soon as we can elect strong majorities in Congress and a Democratic President, a plan for some kind of universal healthcare, probably government administered will emerge and be implemented. Until then, no plan will.

Building support for such a plan is the thing that will put it over the top, once we have a government that will enact it. Most people have no idea how such a plan will affect them and their paychecks. That's something we can begin to address now, simply and understandably.

The "tax" word is poisonous, since a majority of people will see that as meaning less money in their pockets. We also have to make it clear what they WON'T be paying out of their paychecks. They already know that their employer is paying part of the cost of their healthcare insurance. The employer will also be paying part of any new plan.

People in the individual health insurance market know what they're paying for insurance. They'd like to pay less. Show them that they will pay less in the new plan.

Poor people can't afford to pay. Show them that they'll be covered anyhow.

People already on Medicare and Medicaid will worry that they'll have to pay more. Show them that they will not.

And, yes, include vision, dental, and low pharmaceutical costs as well. Tell them about that, which they don't necessarily have now.

We need to sell the concept, whatever actual plan is proposed and adopted. Bernie Sanders' plan is not going to become the actual plan. It can't pass anything and won't be adopted. When something can be passed, a new plan will be designed, not by one Senator, but by Congress, after hearings, meetings, committees and much much more.

Right now, we can work with a Medicare for All concept that is not completely defined. We can sell the concept. The rest will come when it can actually happen, which is not right now.

[Eliot Rosewater]

33. We are our own worst enemies; same reason trump has the ability to cause

irreparable, nightmarish harm to our institutions and our people, is why we cant have nice things like single payer.

The brainwashed, lied to, rightwinger who votes.

You can prove to them that it works everywhere else, and it does, but they wont listen.

They dont NOT believe in climate change because of science, they dont believe in it because the spokesperson for it is Al Gore, a liberal.

But now they have gone too god damn far, for me at least. They have been told our enemy hacked this election, that our enemy WANTS their guy in power, and they dont care.

Too far.

Too far for me.

[MineralMan]

35. That's a different issue, but it's the issue we should all be

looking at. We absolutely must elect strong majorities in both houses of Congress and a strong Democratic President. We won't accomplish that until 2020, I'm sure. Even that will require a massive effort and extraordinary solidarity among Democrats.

Right now, Medicare for All, in any form, is impossible. So, we need to work on making such a thing possible, and there is only one way we can do that.