Sanders may not release health plan costs by caucus day

[brooklynite]

Source: Des Moines Register

News that U.S. Sen. Bernie Sanders may not release tax details of his universal health care plan before Iowans go to caucus on Feb. 1 sparked a heated back-and-forth between his campaign and that of his chief rival, Hillary Clinton.

As part of his populist campaign focused on working and middle-class Americans, Sanders is calling for a "Medicare-for-all" national health insurance program that would effectively negate the role of private insurers. While he had pledged to release full tax plans before Iowans vote, his national campaign manager on Wednesday told CNN that the specific tax implications of the health care plan may not be released this month.

Hillary Clinton's campaign wasted no time in pouncing on the announcement, slamming Sanders on Wednesday in a press call on the issue.

"I think one can only draw the conclusion that the Sanders campaign does not want to outline what would amount to a massive across the board tax increase," said Jake Sullivan, senior policy adviser for Hillary for America. "They want to essentially create a circumstance in which they try to lead voters to believe they can implement single-payer health care at no burden to anyone and everyone would be better off."

Read more: http://www.desmoinesregister.com/story/news/elections/presidential/caucus/2016/01/13/clinton-camp-sanders-needs-deliver-healthcare-details/78743204/

[retrowire]

1. Hmmm...

Cool with me. Tons of work to do right now.

[RobertEarl]

2. Better late than never

Weird how H doesn't want better health care for everyone.

[area51]

44. +1 n/t

[anigbrowl]

17. A strange response

So you think people in Iowa who are going to caucus don't need to know what they're voting for? In that case, why bother discussing policies at all?

[retrowire]

19. Strange response?

It's a response. That's my real reaction to this. Meh.

Do I think Iowa caucus goers need to know who they're voting for? Yes. They can find out plenty about Bernie's medical and health care stances online. He may wait to release his full and actual plan, but there is information already out for the voter to learn about him.

Are you suggesting that Iowa caucus goers need every single plan laid out before them before hand? Because none of the candidates have it all covered.

So yeah, big deal. He'll get to it eventually.

[Recursion]

53. I think he knows the cost of the plan will destroy his campaign

once he avows it. So he's delaying that as long as possible. The problem is we may wind up with a nominee who then either abandons the plan his core supporters want (my bet) or announces that he intends to increase government spending by more than a trillion dollars a year, at which point we might as well hand the GOP the keys.

[BeatleBoot]

3. He doesn't have the right staff to estimate the financial impact

He's running on ideas that aren't rooted in the real world.

Single payer would be a decade long slog and will cost the Dems the White House this year.

I agree with Dr. Dean.

[CTyankee]

6. funny how the rest of the advanced countries of the world has figured it out...

there are plenty of folks in the U.S. who have figured it out and I am confident Bernie has a plan. Good lord, if everybody else has it, then it's been worked out for lots and lots of people...

[pnwmom]

8. No, they haven't. Switzerland has a plan with both private and public insurance,

a lot like the ACA. And Canada has different plans in different provinces, again with a mixture of public and private.

Even when I visited in England years ago there was national health, but people could supplement it with private insurance.

I don't think that's what people here are envisioning when they talk about single payer.

[CTyankee]

9. at least they are on the right track and recognize the need for universal health care...

[pnwmom]

10. The ACA recognizes that need in the same way Switzerland's plan does.

It isn't the fault of the ACA that some states decided to turn down free Federal Medicaid funding -- so their residents are paying taxes subsidizing the states that DO accept the Medicaid expansion.

[ForgoTheConsequence]

12. There are major differences.

Swiss health insurers are NOT allowed to make a profit on primary insurance.

The Swiss use an all payer system instead of networks.

The Swiss government caps premiums.



The Affordable Care Act is like the Swiss health care system without any teeth

[pnwmom]

22. There are certainly improvements that SHOULD be made to the ACA.

But it's incorrect for someone to say that all the industrialized world has a governmental single-payer system. Switzerland, among other countries, has a system that combines public and private insurance.

[davidpdx]

42. South Korea has a national health insurance plan that covers everyone

Even if you are unemployed you can buy into insurance. In the past few years I have taken time off and paid about $70 a month for insurance. Japan's system is similar. There are quite a few expats on DU living around the world who could explain how the health care system works in the country they live in.

[Recursion]

48. Japan covers 70% of health care costs and the patient pays 30%

People can and do buy private insurance for that 30%, and there are clinics where poor people can have the fee waived for many services.

[davidpdx]

50. The same here

Some people buy supplemental insurance, but the national health insurance covers most of it.

[Helen Borg]

51. In England...

The private insurance biz is only the result of the constant attempt by right wing governments to destroy the NHS and to privatize health care.

[anigbrowl]

21. Oh dear

Look, I come from a country that has universal health care. I think it's great, but I also know it's very expensive and eats a huge part of the budget and as a result healthcare issues are very politically contentious even at the best of times. It's one thing to know that it's a good idea, it's quite another to know how to go about implementing it in any sort of foreseeable future. They spent decades kicking the idea around to little effect in the UK until the government ended up doing a de facto nationalization of health care as an emergency measure during WW2 and then decided to stick with it afterwards. I do not see anything like that sort of political momentum in the US at present.

I am confident Bernie has a plan

Religious people are always trying to tell me the same thing about their deity. They too are confident He has a plan which will be revealed at the proper time, although none of them seem to agree about when that will be.

When people tell you they have a plan but won't share any of it, they almost invariably turn out to be making it up as they go along. Bernie is proposing to spend about $1.5 trillion a year to extend medicare coverage to everyone. It's an intriguing idea I'd like to support, but generally when I hear someone propose spending large quantities of money I like to hear some detail about where they expect to get it from and stuff like that. Since it's a key part of his platform, I thought he would want to make sure voters have this information before voting starts so they can make an informed decision who to vote for.

I mean, people go into more detail on Kickstarter projects. It's not like the dates for the caucuses have suddenly moved up or the medical world was recently rocked to its foundations by some entirely new biological theory. Let me guess - Bernie was writing it out longhand when Debbie Wasserman Schultz snuck into his campaign bus and stole the only copy. Terrible tragedy.

[pnwmom]

23. He wrote a bill about it in 2013. You'd think he would have had the details ready by now. n/t

[davidpdx]

43. If you are an expat please feel free to drop by the Americans Abroad forum and introduce yourself

I've been trying to get people more active and sharing.

[anigbrowl]

47. Oh, I meant I come from there but live in the US now :-)

[Recursion]

39. Nope. Almost no other countries have single payer

I don't know why this zombie idea refuses to die among American liberals.

[underthematrix]

15. Yes. And if Iowa watched the righties, wingnuts and racists

reacted to the passage and roll out of Obamacare, they have enough sense to know Bernie is talking in and about an alternate universe. that does not exist in America.

[PSPS]

16. I disagree, I think.

While I can't speak about his staff, I can certainly speak about "the real world."

A single-payer system paid for out of the general fund would, of course, "increase taxes." However, people would come out with a net savings because they wouldn't have to make monthly premium payments to an insurance company anymore. Furthermore, the amount of money required to fund the single-payer system would be less than the current scheme because far more of each dollar would be paid out for actual service since the overhead of a federal system is a fraction of that of a private insurance company because there is no money laundering into campaign contributions, multiple mistresses, billion-dollar CEO salaries, etc.

[anigbrowl]

25. I can also speak about the real world

I come from a country with universal health care. but it's expensive, really fucking expensive, and I strongly suspect that Bernie is nervous about sharing any of his numbers because when people see them they'll get sticker shock and it will hurt his campaign.

As an example, income tax rates in Ireland are 20% (minus deductions) for married couple earning up to about $50,000 (I didn't bother calculating the exact Euro ollar rates so that could be off by a few %), and above that you pay 40%. Also almost all goods besides food and other basic necessities are subject to a VAT (sales tax) of about 20%.

Now I don't think that rates would necessarily be exactly the same in the US, it's a much larger and more complex economy. But federal income taxes would probably have to rise substantially to make the numbers add up and Sanders has avoided offering any specifics on that in debates so far, because big tax increases are a really hard sell in the USA.

the overhead of a federal system is a fraction of that of a private insurance company because there is no money laundering into campaign contributions, multiple mistresses, billion-dollar CEO salaries, etc.

Ahahahahahaha no. Government is perfectly capable of wasting huge amounts of money on stupid shit. Just look at the Pentagon, or indeed the first version of the Obamacare website. Don't make the mistake of assuming that just because something is done for a public purpose it will necessarily be efficient.

[Rilgin]

31. My god, you think Ireland's health care system is expensive?

The single problem with your argument is that you assume that the US currently, right now, in this moment, does NOT have a far more expensive health care system than your country.

That is the problem with only looking at one cost component in a balance sheet. Our (the United States) per capita spending on health care dwarfs the per capita spending of any other country. Any other system in the world would be less expensive than ours. Then you look at outcomes and our extra spending is not justified by results. We spend more than any other country for worse results than most other countries.

So you are right, your country has an expensive health care system. Any system will be expensive and people will always complain about costs. However, ours is much more expensive than yours which is why we need to convert to something that even though expensive is LESS expensive.

So taxes will certainly go up if our health care is funded through taxes but premiums, co pays and deductibles will go down. Taxes are not the whole measure of what we spend on health care now. We spend much more propping up private insurance company's overhead, advertising and profit.

So how will we pay for a universal single payer system. We already pay for it. We overpay for it compared to every other country in the world. We just do not get actually get what we pay for now.

[snort]

36. +1

[anigbrowl]

37. You misunderstand me

I am well aware of the differing value propositions and if you like I could go into quite a lot more detail about occupancy rates in acute vs chronic beds and other health care minutiae. I am very much in favor of universal health care from both and ethical and a purely economic standpoint. Even if I did not believe in the idea as a moral imperative I'd still support it on the grounds of economic efficiency.

But although people here are paying through the nose for healthcare and are mostly in some abusive three-way codependent relationship with their insurers and providers, and even though their costs would go down overall in a single payer system, they are still going to get sticker shock over higher tax rates and I think Bernie knows that. People are economically irrational in a lot of contexts and taxes are one of them. Hence Hillary's $250k tax pledge - I don't think she believes that $250k is anything like a typical middle class income (even in SF or Manhattan that would be regarded as pretty fat money), but she is immunizing herself early against Republican attempts to paint her as a 'tax and spend liberal' by making it part of her platform.

So I absolutely agree that Bernie's proposal makes basic economic sense, but I think the reason he hasn't advanced a detailed plan so far is that knows full well that putting up actual numbers will cause a lot of people to run away screaming and he doesn't want that to happen before IA/NH because having people run away screaming won't help his chances there, and if he doesn't win there his momentum will evaporate. So I think he's gambling that his supporters don't care about annoying things like numbers and math and policy documents, and that there are enough of them to give him an early win, and all that goes with it.

[Rilgin]

69. This is a more reasonable post but ignores half of your original

It is true that it requires some complexity (something the american voter is not great at) in understanding that an increase in taxes that is less than an existing premium, deductible, co pay cost is a net good.

It is clear there will be resistance on all levels to any change in the american economic or health system. I saw a clip of Bernie acknowledging that today. He said the equivalent of its not that we will get a single payer system on my first day in office, its just that I will not lose it as a goal and keep fighting for it. He is a political realist as are most of his supporters on this issue.

Your last post does identify one of the reasons that it will be a huge fight which we might lose for years. However, your original post also had anti-government rheteoric about governments wasting money as an attack on the efficiency of single payer. Both governments and private sectors have some inefficiencies, corruptions, and waste, just our current system without government involvement has more of these three items.

[anigbrowl]

70. anti-government rhetoric?

I simply observed that government is just as capable of wasting money as the private sector, and that a noble purpose is no guarantee of an efficient outcome. I did not attack the potential efficiency of moving to a single payer system, but rather the foolishness of undertaking such a large task without a proper plan in place. Look at the huge scale of Medicare fraud, which is estimated to consume up to 20% of the Medicare budget (about $100 billion a year) by the nonpartisan Congressional Budget Office. Even if you consider their estimates wildly pessimistic and cut it by half, that's still a lot of money, running into the hundreds of dollars for every American. Absent other reform, simply attempting to deliver Medicare for all would balloon that to several hundreds of billions every single year.

I have to stress again that I am not opposed to single payer or medicare for all, in fact I think I would prefer to see all hospitals run by government or nonprofits instead of serving as naming trophies for billionaires (at least where I live, where rich people seem intent on immortalizing themselves by putting their names on hospitals that were once considered publicly owned).

What I'm arguing for is the necessity of presenting voters with a comprehensive policy for how to switch over to such a system. Of course I don't expect most voters to read economic white papers or book-size legislative and administrative blueprints, only professionals and policy nerds have the time and expertise to pore over such details. But I think voters at least deserve a detailed outline of Bernie would go about implementing this major policy plank.

Call me unadventurous if you like, but my professional and life experience of people who talk about how great the end product will be but are vague on the how-to part is that their projects never come to fruition. Having been disappointed many times, I'm now very skeptical of grand plans and the rhetoric of inspiration. I like Bernie's vision of the future much better than Hillary's but I am a great deal more confident in Hillary's ability to notch up a sequence of small victories that can amount to a big win. I was particularly impressed by the success of her efforts to bring about a peaceful and democratic transfer of power in Myanmar, for example.

[joshcryer]

32. The "financial aspect" has been studied extensively.

This is Weaver playing it safe, imo. This will come up at the debates and Sanders will release it before the caucuses.

[anigbrowl]

38. I hope so

Honestly, I think it's a bit rude to the voters not to put it on the table with primaries so close, but I can see the strategic upside.

[joshcryer]

46. This is just people making a mountain out of a molehill.

Just to cause chaos. Weaver's actions aren't helping, but I know why he's doing it. It's causing fake controversy which in turn is allowing them to get media coverage and hyping up the base. But Sanders is a man of integrity and even if he wasn't prepared to do it before he said he would, he will. There will be a plan released before the caucus. Some "supporters" may not want it to happen, but it will happen.

[tazkcmo]

4. That does it.

I'm voting for Hillary.















sarcasm

[Feeling the Bern]

7. Taxes, free loaders, takers. Screw that. I'm going Republican!

Murika! BACON PANCAKES!! Warble Garble!

[bkkyosemite]

5. Boy she's on a roll.

[jalan48]

11. I'm still waiting for the numbers on trickle-down economics and those big trade deals.

So, right now I'm not too worried about Bernie's healthcare numbers.

[RandySF]

13. Nice deflection.

[jalan48]

14. Hey-we're all worried about numbers. Never too late to clear up some of those big ones from the past

[Crowman1979]

29. Not to mention the numbers from how much money was wasted at the Pentagon.

[geek tragedy]

18. presidents don't pass legislation.

In any event, Bernie campaigning for single payer is aspirational rather than a concrete plan of action. Everyone knows it won't pass Congress.

Also, primary voters don't pay attention to math.

[pnwmom]

24. Aspirational? How is that different from "empty promises"? nt

[joshcryer]

33. You start from a strong position.

Then you negotiate down to the better position.

If Obama allowed single payer advocates into the health care debate we might have the public option. Note: I am not mad at him for not doing it, as he didn't campaign on that, and I don't consider it hypocritical or "wrong" of him to disallow single payer to be on the table.

[geek tragedy]

35. He frames the goals and values, broad strokes.

How many primary voters pore over detailed tax plans?

[pnwmom]

49. They want to know the bottom line, which he promised to provide before Iowa.

That is, they want to know how much this is going to cost them. And now apparently they won't -- not till after they vote.

It seems strange since he vote a bill about this in 2013. You'd think he would have had enough time to gather the information since then.

[geek tragedy]

52. We'll see nt

[Beacool]

45. Ahhhh, that explains it. His proposals are "aspirational".

In other words, they have little to no chance of becoming law. The House has a Republican majority and the Tea Party crowd is not to be ignored. Republicans also have a majority in the Senate, although the Tea Partiers there aren't as many or as influential as in the House.

If Obama has had a hard time dealing with the Republican Congress critters, how is the far more liberal Sanders expect to get anything passed from the same Congress?

Promises are cheap........

[onehandle]

20. Unicorns don't have the necessary digits to run calculators. nt

[Dawson Leery]

28. LOL! LOL! LOL! LOL! LOL! LOL! LOL! LOL! LOL!

The Bernman needs to explain away that lower income people will pay more. Austin Goolsby ran the numbers.
And no my friends in the Bernie aisle, hope and change unicorn dust does not pay the bills.

[Bradical79]

66. Not sure why so many Democrats like yourself love the status quo

I mean, despite the ACA bandage health care costs are still increasing at an unsustainable rate. The rich get richer, the poor get poorer while drowning in debt, and the middle class vanishes. It's amazing that you can do nothing but make idiotic jokes on a Democratic message board. If that's what "real" Democrats are about, the maybe the party can just fuck off. I'm not at that point just yet, as hopefully putting you on my ignore list will clean up some of the worthless trash posts I see too much of on this site. I hope you figure out just how much people like you hurt the party and contribute to folks staying home during elections. That is if you even care. Goodbye.

[thesquanderer]

26. Can anyone point me to where Sanders "pledged" to release full tax plan by 2/1? (nt)

[pnwmom]

34. Yes, in this interview:

It seems odd that when he wrote the bill in 2013, he didn't have a detailed proposal with numbers then. And he's had more than 2 years to get the idea fleshed out.

http://www.cnn.com/2016/01/03/politics/bernie-sanders-tax-plan-iowa/index.html

The Vermont senator and Democratic presidential contender said Sunday on CNN's "State of the Union" that a full plan on how he'd change taxes to pay for a universal health care plan, free public college tuition and a lofty infrastructure plan are coming soon.

"We have been very specific. We have more to do, and we will be doing that in the very near future," Sanders said.

When CNN's Dana Bash asked if those details would come before the Iowa caucuses, Sanders said: "Yep."

He also said:

And Sanders didn't rule out a new tax to pay for his Medicare-for-all single-payer health care proposal, but said it'd be a net gain for middle-class families which would no longer have to pay for their own insurance.

If he had the numbers to back up this claim, why hasn't he released him?

[thesquanderer]

60. A statement of intent is not a "pledge"

I agree, if he said "yep," then we should expect to see it happen. But articles that say he is breaking a "pledge" are spinning it to sound worse.

[Agnosticsherbet]

27. If a pig in a poke does not have a price tag, that means we can't afford it.

And he damn well knows it.

[Kalidurga]

30. How much does it cost to not have everyone insured?

How many mothers are you willing to lose to cancer? How many people to easily treated diseases that don't get treated because of the fear of not being able to pay the medical bill? How many to heart disease because they can't afford the medication to keep their blood pressure under control? How much longer should people be treated in emergency rooms because that gets paid for but a doctors visit doesn't?

[Recursion]

40. Less, that's why we do it

It costs less for people to die from preventable diseases then to prevent them, for the most part.

[Recursion]

58. Oh, sorry, did we start giving the uninsured health care?

What the hell? Insurance companies deny treatment when they can because people dying is cheaper. Do you not get that?

[coyote]

41. Ahhh I love the smell of desperation in the morning

Is this what Hillary is going after Bernie for? Because he has not released specific numbers.

Maybe Bernie should apply Hillary´s bank plan towards the Health Care Industry: "Cut it out!"

[cannabis_flower]

54. I find it difficult to believe..

that my tax increase would be much more than the cost of my healthcare premium. And even if it was a little more and helped to pay healthcare for others that couldn't afford it themselves that would be okay. I like to think that if there was some kind of infectious disease crisis, the fact that people have health insurance ensures that they go to the hospital or the doctor before they infect all their coworkers, their family and perhaps anyone they come in contact with.

I'd like to add that plenty of other countries do it this way and it costs them way less than what we are currently paying.

[Vinca]

55. Since Medicare operates at much less of a cost than private insurance, it's

highly unlikely the cost per person would exceed current insurance premiums. Anyone who claims otherwise should be giving speeches for Hillary.

[Recursion]

59. About 20% less, all told

It's good, but that doesn't remotely get us into European cost levels. Plus we'd be treating 50 million or so more people than we are now; whether that actually ends up costing less overall is an open question.

[Elmer S. E. Dump]

64. And way more than that if he can get the drug prices lowered significantly.

[sonofspy777]

56. DEAD Horse Thread

[anigbrowl]

68. What's with the right-wing cartoons?

Michael Ramirez cartoons mostly for sites like Townhall, Investors Business Daily and so on. This cartoon is from September 2009, mocking Obama for devoting so much effort to pushing the Affordable Care Act through Congress in the face of GOP opposition. Just what sort of point are you trying to make here?

[rtracey]

61. Well

Well here it is.... ok so Bernie, Hillary, ...... so the real issue is not will this country get medicare for all, as Howard Dean stated on Chris Hayes, can this country afford the start-up money too do it. Vermont was going in that direction, but the 11.5 percent payroll assessments on businesses and sliding premiums up to 9.5 percent of individuals’ income “might hurt our economy.”, Single-payer advocates in Hawaii have seen halting progress.

Combine this..with a republican held congress, single payer may be dead on arrival.

[alarimer]

62. I guarantee that it would cost less than what we are doing now.

A simple fact is that without insurance companies' profit-taking, taxes for a Medicare-like system would be a fraction of what we pay in premiums, in co-payments, in co-insurance and deductibles (does anyone understand any of that bullshit anyway? I can't figure it out) and out-of-pocket expenses. The overhead costs of Medicare is something like 4%. For insurance plans, because their CEOs make gobs of money, it's got to be much higher than that. The fact is, health care should not be a profit center. It should be a basic guarantee for every resident of the US. Having "skin in the game" by paying a larger portion of the costs does not actually fucking matter when a person is sick. These "Wellness" programs that stick the insured with higher costs if they do not fill out some nonsense questionnaire are worse than useless and are only another way of shifting costs from the insurer. That would be gone too with single payer.

Of course the government would need to limit what hospitals, doctors and drug companies can charge. There is no reason on earth why Canada gets the exact same drugs at a fraction of the cost, except profits.

RIGHT NOW, you are paying for Medicare in payroll taxes that you cannot use if you are not old enough.

Hillary and her surrogates are liars. Liars and corporate shills.

[MADem]

63. The only people who find this plan viable are people without ANY money, who think Congress will

magically endorse the organized pickpocketing of the weathy.

They don't stop to think that Congress is STUDDED with wealthy legislators.

It's like expecting the chickens to vote for the Colonel!!

Those chickens won't vote for that Colonel....they'll vote to do what they always do--put the weight on the middle class. IF they do anything at all....and I don't find that terribly likely, either.

[Bradical79]

67. "Pickpocketing the wealthy"? Really?

Never thought I'd see raising taxes on the rich framed in that manner on a Democratic message board.

[MADem]

71. I am speaking from the perspective of the legislature that will vote on any

'tax raising.' Let's not play that "Your bona fides are suspicious because you used X term" argument because it's nonsense. I've been here since Day One and I'm a Democrat.

But the bottom line is that Congress will not allow THEIR pockets to be picked. The chickens do not vote for the Colonel in the Halls of Congress. Those chickens are sitting on golden eggs and they intend to KEEP their money. More to the point, they have lots of rich lobbyist pals who are very focused on keeping their exposure limited, too.

"Raising taxes on the rich" to pay for social programs is a dream. They just won't pass it.

[kacekwl]

65. Why rush a complicated issue

Better it be good than quick . I have full faith in Bernie.