ANALYSIS: Bernie's Single Payer Healthcare Proposal

[rsacamano]

[George II]

1. How does he plan on paying for it? Conyers details how he'd pay for his proposal.

[Progressive2020]

2. Paying For It

The cost and payment for the program is addressed in the video around the 6 Minute mark, based upon the Plan that Sanders promoted in his campaign. The legislation is being split into two components: the first bill will outline the Plan, and the second will fund the Plan.

The Plan that Sanders promoted in his campaign was to be funded by an increase in Income Tax (about 2.2%) and a tax on employers (around 6%), as well as a third funding source by increasing taxes on the very rich. The net benefit to taxpayers would be that the cost of the new Insurance Plan (via Taxes) would be far less than what people pay for Health Care right now.

So, rather than a Tax Increase, what you will have is a net benefit to the average Taxpayer who will be covered and see their net Health Care costs go down. Everyone gets covered and there is a net benefit/reduction in health care costs. This is what is being proposed. It is clearly described in the video.

[George II]

3. The video is one thing, the written bill is another. The members of the Senate will not....

...bother watching a video, that won't be memorialized in Federal law.

[Progressive2020]

4. Public Hearings

The Senators will not have to watch a video. This stuff will all be hashed out in public. There will be hearings and what is described in the video will be discussed publicly. So certainly the Senators will hear about the details, unlike the Republicans, who pushed Repeal and Replace without any discussion or debate. This will be an open and transparent process of trying to pass Legislation.

[George II]

5. But Senators can only act on what's actually contained in the document before them.....

...If this was so important why couldn't funding be addressed in the bill? The Conyers House bill does that.

[Progressive2020]

7. Funding

I think that the Plan and the Funding were split into two parts because it is makes the Bills easier to pass politically. There are two separate Issues: Do we need a Plan/Universal Health Care? and How do we fund it? As two separate questions, it may be more expedient to debate them separately.

Some may agree on the first question, yet differ on the second. Once we all agree that we need and want a Plan (the first Part), we can then work on the Funding mechanism(the second Part). Mixing the two questions muddies the issue, whereas separating them brings more clarity, IMO. If we put the Funding in the first part, disagreements about Funding might block the Bill.

So, first we must agree that we want Medicare for All, and once we have determined that, then we can debate how to fund it. They are two separate questions. Separating the two issues makes the overall Plan more likely to Pass, I think. So, separating the two is a Legislative Strategy to facilitate passing the overall Plan. I think that it is a smart strategy.

[George II]

12. That's not the way legislation is normally introduced. The Senate won't consider...

...the bill without knowing, even conceptually, how it will be funded.

And they won't pass the plan first and then the funding. What happens if the plan becomes law and then there is a long delay in passing funding?

[wasupaloopa]

6. It is not proven that taxes will work. A lot of ducks have to be lined

up in a row and at least half of them will refuse to get in line.

Bernie's plan is good for uninsured and working class but that is all. Wealthy people who can afford the best treatment will not want to be in a Medicare type plan.

The problem of doing away with the insurance industry is never addressed.

They surely aren't going to take their stockholders and physical plant and employees and just disappear into the night.

Another problem never talked about is how providers are going to be talked into getting lower reimbursements and the need to increase the number of providers with the lower reimbursement rates.

At this point we see the glitter but none of the work involved.

I know the short answer around here is that other countries do it which is to take no personal responsibility to understand the problems involved.

[beachjustice]

8. providers will have to negotiate with the government if they want business

An insurance pool containing everyone has a lot of negotiating power with respect to price.
And do we have much talked to do with insurance companies? Once the laws are passed, nobody's going to want to pay twice (taxes and premiums) for the same level of coverage, so people will then cancel their policies and only buy private insurance for whatever extra coverage they want on top of what's paid through the government.
I suppose there might be a delayed implementation until the government is able to negotiate contracts with providers.

[wasupaloopa]

10. You talk as if we are just going to pass this law and everyone else will have to deal with it.

You need to convince them before a law can be passed.

Unless we have a super majority in Congress and a President willing to sign a bill and a Supreme Court that will defend it you aren't going to force people to negotiate.

I wish we could talk about the problems involved rather than ignoring them.

[Progressive2020]

9. Wealthy People

Wealthy People will still be free to spend their money on advanced medical care. Medicare for All is a baseline. It provides basic care for all Americans. Plans that offer more than baseline coverage will probably still be available to people who want to pay extra for extra coverage. I believe that these are called Medicare Advantage Plans under the current Medicare system.

If the wealthy want to fly to Switzerland to get highly advanced medical care unavailable to others, no one is stopping them. Furthermore, the wealthy would probably also save under Medicare for All. Basic care will be provided to all, and will be more cost effective with a reduction in administrative costs and a focus on preventive care versus more expensive sick care.

I am not saying that Medicare for All would be a magic bullet, but I am really not concerned about the health care for the Rich. They are going to continue to do well. They already have access to the best care, and that would not change if average people get covered under Medicare for All. The wealthy will do fine under any circumstance. They are wealthy, and will have the resources regardless of what everyone else has.

[mdbl]

11. Nor am I concerned about the insurance industry

It's a huge albatross around the neck of 90% of Americans being able to afford any healthcare - and what's worse is the insurance industry already rips off doctors and hospitals for it's own profit margins lowering the quality of care for all of us. I have pretty decent healthcare plan but try to find a doctor's office who isn't always over-booked and handling 6 patients at once make you sit for hours waiting to see him/her. If you are sick all of a sudden, too bad, you'll have to wait all day for a last minute appointment they really didn't have time to handle. Why anyone thinks it could get worse than that is beyond me.