"Medicare for All" - Do your homework people...

[MadDAsHell]

Response to another post, posting as an OP for discussion's sake:

As first a lurker and then an occasional poster, I've seen "Medicare for All" being bandied on DU for years. It's a bumper sticker slogan that people hear and love to repeat, especially well-meaning people that have never taken even a moment to look into the math of Medicare.

My sister is an RN at a not-for-profit brain-injury rehabilitation facility providing about 300 jobs. In a good year, they may end up in the black $50,000 to cover raises, new equipment, new positions, etc. NO ONE within 100 miles provides the specialized type of care they provide.

Their allowable cost-per-day (as calculated by Medicaid) is somewhere around $850. While her organization still takes a bath on Medicaid (considering there are other healthcare costs that Medicaid doesn't consider reimbursable PLUS Medicaid runs, at a minimum, a year behind on cost calculations), they get a handful of patients per year with commercial insurance that make up the difference.

Medicare on the other hand pays them $350 a day for the exact same care, an amount that would shut the program down within A YEAR if all their patients were reimbursed by Medicare.

When I hear "Medicare for All", what I'm really hearing is "I want 90% of the small not-for-profit healthcare providers in this country to go out of business."

But the "Medicare for All" bumper-sticker defenders don't even know this or care, because they've never taken the time to even look.

UNIVERSAL HEALTHCARE: YES

MEDICARE FOR ALL: NOT IF YOU WANT TO HAVE A HEALTHCARE PROVIDER THAT WILL ACTUALLY SEE YOU

[ViseGrip]

1. My homework has been done reviewing 29 other developed countries, with like plans.

[Human101948]

23. The entire healthcare system needs to be revamped...costs are out of control...

This entire argument about paying for healtcare is based on the idea that U.S. costs are necessarily sky high to provide good care. They are not!

The United States health care system is the most expensive in the world, but this report and prior editions consistently show the U.S. underperforms relative to other countries on most dimensions of performance. Among the 11 nations studied in this report—Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2010, 2007, 2006, and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last or near last on dimensions of access, efficiency, and equity.

http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror

Even Cuba with a very, very poorly funded system does better!

Figures from the World Health Organization clearly show that The United States lags behind 36 other countries in overall health system performance ranging from infant mortality, to adult mortality, to life expectancy.

20 countries in Europe and four countries in Asia have a better life expectancy than the U.S. If you are a male between the ages of 15 and 59, your chances of dying are higher in the U.S. (140 per thousand) than in Canada, 95, Costa Rica 127, Chile 134, and Cuba, 138.

http://www.huffingtonpost.com/blake-fleetwood/cuba-has-better-medical-c_b_19664.html

It is not about money, it's about capitalists sucking the blood out of the populace like the slimey leeches they are.

[MadDAsHell]

28. Agreed! nt

[enid602]

83. single payer

I rather like the French system, where all medical costs are administered through 5 large insurance companies. You won't hear many complaints out of the French. They do not have single payer there.

They do of course, have single payer in the UK and Canada. No other developed countries have single payer as far as I know. In fact, Medicare/Medicaid/Tricare is ALREADY the largest single payer in the world. I don't think anyone would say they do a less than stellar job. Still, tripling them in size to cover all US health is simplistic, and a very risky experiment. If it's such a good idea, why hasn't the European Union (whose GDP approximates that of the US) widened the role of NIH (in Britain) to include the entire EU?

[Cassiopeia]

2. I imagine your friend would be shocked at some of

the salaries that management makes at the "non profit" organization.

I know people well up in the medical field working for small and large non profit organizations. There's 10's of millions that management sucks out of the system.

[Recursion]

3. Make less money *and* treat more patients

There are still 30 million uninsured and another 30 million that can't afford to use their insurance. That means a 20% increase in patient load on the optimistic assumption that they will use medical services at the same rate as the currently-insured.

So, yeah: 20% increase in patients treated, with providers receiving about 40% less reimbursements.

That's going to be a really hard sell...

[Armstead]

71. How awful -- patients being treated.

Maybe if instead of defending a rotten systemn that screws people for profit, you might advocate for universal insurance that also addresses the problems in the present system.

[Recursion]

80. Defend? You think that's a defense of the system?

I think I see the conceptual problem here, then.

[Gidney N Cloyd]

4. Some people may just like 'Medicare for All' as an access concept and figure adjustments will be...

...be made financially when scaling it up.

[EdwardBernays]

5. Almost all Healthcare would essentially be

Not for profit in a Medicare for all system.

Go look at the systems other countries have that are essentially Medicare for all and you'll get a better idea of how it works.

Unlike Obamacare it would not be trying to weld universal health care onto a for profit system.

[Recursion]

7. No, nothing Sanders is proposing forbids for-profit providers

Where on earth did you get that idea?

Canadian physicians' practices, for instance, are for-profit (though AFAIK none of their hospitals are).

[rhett o rick]

12. Of course Sanders isn't proposing forbidding "for-profit providers". No one has suggested such.

STRAWMAN? If you have the money and can afford a "for-profit" coverage, go for it. Other countries have additional insurance for those that can afford it.

[Recursion]

15. Strawman? Read the damn post I was replying to

He said single payer would remove profit from US health care.

[rhett o rick]

21. And most of us understand that he means BASIC HEALTH CARE. Seems you misunderstood

and therefore the Strawman.

[Recursion]

24. If he means basic health care, he's completely wrong

Basic health care providers (say, GPs) would remain private and largely for-profit.

[EdwardBernays]

17. I didn't say

It prohibited it.

Lots of places with Universal Healthcare have a private option.

But that's not what the majority use and the majority shapes the overall system.

[Recursion]

20. I think you're confusing health insurance and health care

Canada has a public health insurance system.

Germany has a private health insurance system.

Both have private providers (UK, for instance, has public providers).

Physicians in both Germany and Canada incorporate their practices as for-profit entities.

[EdwardBernays]

26. I'm not

Go to the UK.

Public Healthcare and private options.

The rich can buy privilege in private hospital or wait in the public queue. Almost every aspect of the system is basically non profit however.

[Recursion]

33. OMG this isn't difficult

You said "almost all healthcare would be be not for profit in a Medicare system"

This is simply false, and I have no idea why you're doubling down on such a silly claim.

Just like in Canada, nearly all physicians would still be in practices organized as for-profit corporations.

I don't see why you're having such trouble understanding that.

[Matariki]

6. You are confusing Medicaid with Medicare

And trying to use the numbers from a state run program (numbers which would be dependent on the state you sister works in) to criticize a completely different program.

https://www.medicaremadeclear.com/about/medicare-vs-medicaid

State differences / proportions of Medicaid vs Medicare payments to care providers:
http://kff.org/medicaid/state-indicator/medicaid-to-medicare-fee-index/

[leftofcool]

11. No, the poster is not. The difference was clearly shown.

[Matariki]

19. Anecdotal evidence from a relative

not supported by reality.

[MadDAsHell]

32. I'm not confusing anything...Medicaid pays their costs (albeit behind), Medicare pays less than half

[rhett o rick]

8. You may have done your homework but you failed the test anyway.

Do you see the problem you are selling in other countries that have single payer? No.

[Matariki]

9. No s/he didn't do any homework except talk to a relative.

S/he is comparing apples to airplanes. Using Medicaid reimbursement (as per relative's complaint) to try and prove something about a completely different program.

FAIL for sure.

[rhett o rick]

18. S/He must not have a problem affording health insurance. Mine went up 33% this year.

Thanks Obamacare. The ACA still allows insurance companies to make a profit off our misery. And HRC doesn't want to end that.

[MadDAsHell]

34. So you're saying a brain injury rehab facility can survive on $350 a day per patient...

when their costs are $850/day plus?

It's simple math. If Medicare pays $350 a day per patient, but costs are $850 a day per patient, and all the patients are reimbursed via Medicare, they go bankrupt.

Are you suggesting that somehow with "Medicare for All" the government is all of the sudden going to up their reimbursement for these services by 250%??

My guess is you're not suggesting anything because the math isn't important to you.

[rhett o rick]

41. Your figures are for a current system that includes jacked up "costs" due to having

insurance industry involvement. I believe when people say Medicare for All they mean universal health insurance.

[Recursion]

47. Insurance profit is 4% of our total healthcare spending. It's a unicorn.

It's an annoyance at worst.

The problem is how much providers charge at every single stage of the delivery process.

The brain injury clinic's costs are not 250% of Medicare reimbursement rates because of "the insurance industry".

[anigbrowl]

85. It won't work

Like many political discussions, fallacies of composition abound.

[whatthehey]

10. Other countries aggressively negotiate rates

with providers and still manage to have care provided.

Maybe every single hospital doesn't need conference rooms better than the UN's and a town of 40,000 can get by with fewer than 10 MRI companies after all?

[Recursion]

22. Ding ding ding

Now: convince me Medicare For All wouldn't make that problem in the US worse...

[whatthehey]

36. Worse than what?

What's worse about providing care without obscene profits and excess?

[Recursion]

46. How would Medicare For All stop obscene profits and excess?

Providers are very, very good at getting obscene profits and excess from Medicare.

[whatthehey]

48. By negotiating pricing

Which becomes much easier when

a) You represent the vast majority of customers instead of a subset
b) You repeal industry-giveaway laws that expressly forbid you to negotiate.

There is a reason the same drugs cost ten times as much here than in Canada. I've worked for a couple of pharm. companies and their Canadian sales were profitable. Profit is fine. Gouging isn't.

Why do you think State Farm pays far less for bodywork than you or I do uninsured?

[leftofcool]

13. Medicare for all is a joke. Doctors are dropping medicare patients like flies.

We have 14 doctors in our county. Only one will take medicare patients. Five of them won't take any insurance at all.

[Human101948]

27. That's capitalism for you!

Those who have the bucks get to live.

[rhett o rick]

44. Funny how it works in other countries. What would you suggest? nm

[whatthehey]

50. And they could continue this if everyone were on Medicare how?

Not really profitable being a Doctor with no patients.

[leftofcool]

52. Easily. Medicare is just another insurance. Doctors don't have to take it to make money.

[whatthehey]

59. But we can change what "is" quite easily

There is nothing preventing us adopting laws common in other nations.

Even without legislation Medicare for all would quickly cause most employers to drop healthcare benefits, vastly reducing the pool of otherwise insured, and the insurance companies would find it almost impossible to compete for customers against the much lower overhead and provider rates of Medicare. We would quickly end up, as other countries have, with everybody but a tiny few of the ultra-rich willing to pay for boutique care covered by either Medicare or corporate clones of it forced to match its overhead and provider rates to get customers.

[anigbrowl]

87. Oh my

Essentially you're saying we'll save the system by blowing it up. It's interesting that you think insurers would find it impossible to compete against the much lower rates of Medicare, but you seem to be overlooking the possibility that they'll compete on getting you treatment in a timely manner in return for more money. You can't make doctors take medicare.

I'm for universal healthcare, I grew up with it in an EU country and know a good deal about how it works. BUt I'm not very impressed with Bernie on this issue because he doesn't seem to have a plan for how he is going to implement this big change so far. When he produces one I'll certainly pay it close attention, but right now it's about as persuasive as plans to bring about world peace at a beauty contest.

[Fawke Em]

90. He does have a plan and has introduced legislation.

https://www.congress.gov/bill/113th-congress/senate-bill/1782/text

Sigh.

[ljm2002]

62. With Medicare for all, it will NOT be "just another insurance"...

...it will be the baseline insurance that EVERYONE has.

Sure, some will buy supplementary policies. But remember, what most people now pay as private insurance premiums will become taxes that they pay instead -- and most will not be buying supplemental insurance.

And in any case, supplemental insurance will be just that: supplemental. So if I buy supplemental insurance that covers the 20% that Medicare does not (hypothetically), and I need an operation -- well no doctor is going to see me if that is all I will pay them with, are they? No, they will want that 80% from my Medicare as the baseline.

Now sure they will prefer those who have supplemental insurance. Just like today, we have boutique doctors who will see you anytime for any reason, if you pay them $100,000 per year for the privilege (again, amounts are hypothetical). But that will never be the majority of patients.

Right now, of course, the majority of people do not have Medicare, and the only ones who do have it are older and therefore, need more care. The math changes quite a bit when the pool is expanded to include everyone, including the young and healthy.

Of course getting the last 30 million of us insured also has costs. So yes, there will be issues. OTOH, wasn't that the goal of the ACA: to get everyone insured? But it has not succeeded in that goal, although there were certainly some advances.

Me, I'll stick to advocating for a Medicare-for-all system. We already know how to run such a system, the infrastructure is in place and can be expanded to meet the larger numbers.

[leftofcool]

75. Good, then maybe you can ask those 14 doctors here to start taking medicare

What is it about doctors don't have to take any insurance don't you people get?

[anigbrowl]

88. The thinking is that once the revolution is underway everyone will just go along with it

Considering the way the last 7 years have gone I find this happy-go-lucky optimism bizarre. Obama's failure to deliver all the things people hoped is not because he's a soulless corporate robot or a money-hungry sellout, it's because he's faced massive political opposition from the get-go, and Republicans have simultaneously politicked and gerrymandered their way to a strong position over that time. I'm baffled by how Bernie's fans expect this opposition to just evaporate.

[Trajan]

14. Just so Hillary supporters know ..

I also ignore Bernie supporters passing falsehoods ...

Gone ...

[Matariki]

16. I work for a hospital. My anecdotal evidence is that most healthcare providers want Medicare for All

And not just my anecdotal evidence:

Doctors group hails reintroduction of Medicare-for-all bill

http://www.nationalnursesunited.org/press/entry/nurses-blast-clinton-attack-on-health-care-for-all/

http://www.commondreams.org/views/2015/09/24/future-doctors-rising-medicare-all

http://www.charlotteobserver.com/living/health-family/karen-garloch/article28011271.html

more

[kenfrequed]

25. I work at a clinic

And the largest source of waste is the insurance industry. They are what has made healthcare more and more impossible to afford.

[Human101948]

30. You nailed it!

They are not needed.

[Matariki]

31. Not to mention the extreme time suck of paperwork for multiple insurers.

[kenfrequed]

37. Oh gods yes

I so hate having to spend 45 minutes on a phone while the patient calls are backing up just so I can get a list of alternate medications rather than the useful medication that the doctor prescribed in the first place. It is the worst kind of profiteering and Humana is about the worst private insurance out there.

People need to come to grips with the idea that your business model is not a right. Laws are for the public good and public safety and if your business (insurance) violates that then laws can be made to knock your ass out.

Single payer universal or medicare for all is probably the best route.

[Matariki]

49. +1

"People need to come to grips with the idea that your business model is not a right"

What you said.

[TexasBushwhacker]

93. Some larger healthcare providers have employees

whose sole responsibility is haggling with insurers, trying to get them to pay.

I had a friend who had this kind of job. One of their patients had bladder surgery. The patient had a heath insurance policy that excluded pregnancy or anything related to the female reproductive system. Since the bladder is "down there", the insurance company refused to pay. Of course that makes no sense at all. So after multiple attempts at getting the insurance company to pay for the bladder surgery that should be covered, the insurance company's final answer to my friend was "If you don't like it, sue us".

[beam me up scottie]

29. GREAT research!

Thank you for putting that talking point to bed.

[Recursion]

35. Of course they do. Wouldn't you like the government to guarantee your revenue stream?

Physicians and hospitals have always liked single payer because it locks in their overcharges. Hell, look at the 20 year history of the "doctor fix".

[Matariki]

38. It's because THEY ACTUALLY CARE ABOUT PEOPLE

What drove most of them to become healers. And it really, really sucks when people have to neglect their health because they can't afford care, or have the stress of financial ruin because they need care. Every health care provider I know gives a damn about that. I work for a not-for-profit hospital and most of my coworkers donate from their paychecks regularly to the hospital's foundation that provides care for those who can't afford it.

Your post is WAY off the mark.

[kenfrequed]

40. The horse and cart are confused by you.

The reason hospitals charge so much is to recoup losses from ER visits that are not paid for and to recoup losses from deadbeat insurance companies that refuse to pay.

These costs are often moved to affiliated clinics who also have to sometimes struggle to force insurance companies to find their goddamned checkbooks.

Also, all this paperwork, authorizations, and coding of visits leads to the need for larger and larger pools of people to process claims and crowbar out proper compensation.

The insurance industry has actually driven the increase of costs of healthcare more than any other force save possibly the pharmaceutical industry.

Blaming the doctors reeks of blaming teachers.

[Rainforestgoddess]

56. In Canada, we don't have for profit hospitals

I believe the doctors are paid less, and I know that the number of appointments they are allowed to bill for is limited to a reasonable number per hour so they don't give short shrift to the patients.

[Matariki]

58. I bet medical school doesn't cost them $600,000 either.

[Rainforestgoddess]

94. It's still expensive, but I don't know exactly what it costs. N/t

[Recursion]

79. Yep, both true. You also have fewer doctors but more hospitals per capita

Always wondered what to make of that last part.

[Rainforestgoddess]

95. We do have a doctor shortage

It's a retiring baby boomer issue.

[arcane1]

39. Your "homework" is talking to a like-minded relative?

The status quo has really gone downhill

[MadDAsHell]

43. My homework comes from years working in a FQHC friend.

Not in it anymore but for 10+ years I saw the struggle of other providers to stay open.

Does us zero good to celebrate "Medicare for All" when the choice of providers (especially for scarce specialties like brain injury rehabilitation) is cut down to almost nothing as they all close their doors.


I'm simply saying we ought to care about how/ something is actually implemented, not just that it is/ implemented. But again, I get the impression the vast majority of folks clamoring for "Medicare for All", at least here on DU, 1) don't work in healthcare, and 2) don't care what the ultimate outcome of the war is, as long as they win this political battle.

[notadmblnd]

92. If you truley had been doing you homework

you would know that the migration to single payer would not occur overnight. You would also know that money would be put aside for retraining of those displaced. So go back and hit the books again. This time take notes.

[seaglass]

42. I think Medicare sucks. My mom had to buy private insurance to make up for all the Medicare

shortfalls. It wouldn't be something I would get behind. I also don't trust any politician who promises a decrease in health care costs. 10 years later in MA we are still waiting for it. It's bullshit.

[MadDAsHell]

45. Agreed 100%. How many of DU's "Medicare for All" cheerleaders are actually ON Medicare?

We can figure out universal healthcare without "Medicare for All."

[ljm2002]

63. I am on Medicare. n/t

[leftofcool]

53. It does indeed suck. And so would medicare for all.

[ljm2002]

64. And what we have now is so great...

...right?

You can't seem to grasp the basic fact that this country spends more on health care with worse outcomes than other industrialized countries. Gosh, maybe there's a reason for that.

Decrying "Medicare for all" because Medicare is imperfect... what's that old saw... oh yeah: Don't let the perfect be the enemy of the good.

[MadDAsHell]

65. You may think Medicare is good as a beneficiary, but that doesn't mean your providers do...

And it ceases to be good when that provider closes its doors or refuses to treat you because your payer is Medicare.

Medicare, as is and at current rates, would be terrible for providers if it was the only payer.

[ljm2002]

66. "Medicare, as is and at current rates"...

...well that's the key right there. Once it is expanded to include the whole population as its insured pool, there is a much larger number of younger, healthier people covered. Therefore the program will be better financed.

At the same time, the government will then have great negotiating power with the drug companies -- one of the factors that continues to drive health care prices through the roof.

Finally, once again I will point out, that if EVERYONE has Medicare as the baseline, then no, the great majority of
doctors will not be refusing to see Medicare patients. Just ain't gonna happen.

Yes any change of this magnitude will be disruptive. Lots of changes are so. Doesn't mean we should not do it.

[anigbrowl]

89. 'Just ain't gonna happen.'

And you know this how? When Nye Bevan set up the NHS in the UK he faced huge opposition from doctors, whose participation is after all not something that can be dispensed with. He famously said that he 'stuffed their mouths with gold' in order to get them onboard, ie he offered them enough money to shut up. The doctors are not simply going to roll over and be price takers, because they don't have to.

I am perfectly willing to countenance Bernie's plan, but I want to see a lot more detail on how he intends to implement it. People keep telling me that it's just a simple rule change, and the more I hear the more convinced I am that these folks don't know the first thing about public administration.

[Vinca]

51. If everyone is on Medicare either the provider will see you or they won't have many customers

(formerly known as "patients). If everyone is on Medicare it will be better funded and will not consist of only the sickest people (elderly) in the country so reimbursements could be increased to providers.

[MadDAsHell]

54. That is my hope. That Medicare for All would make such a dramatic difference that...

it would be able to raise reimbursements to providers like my sister's employer.

But I'm skeptical, as in their case reimbursement would have to jump by 250%; is that likely?

[Vinca]

68. It would probably increase to the same level private insurance now reimburses.

The only people who pay the full bill are the uninsured.

[Armstead]

73. My guess is that having a larger healthier patient population paying in....

would also bolster Medicare (or its replacement) financially. If money that currently goes into private insurance, including profits, were available to a public program Medicare could offer mnore to providers.

[Vattel]

55. My doctor moved his practice out of Baltimore beause he couldn't afford all the medicare patients.

But he is totally in favor of single payer. He thinks the private insurance system is a disaster.

[Matariki]

57. What would the difference be between Medicare or 'single payer'?

presuming that single payer would be run by the federal government, how would it be different than Medicare for all?

[Vattel]

69. I will ask him what he thinks. He belongs to a single payer advocacy group.

Maybe he thinks a single payer system would have to pay more than medicare does, or could be coupled with measures to control the costs of providing medical care. I don't know much about the issue, I am afraid.

[Matariki]

70. Thanks.

I'd be interested in hearing that opinion. In some ways it sounds like a 'name only' thing - or rather Medicare for all with reforms made to it.

[Z_California]

60. "Medicare for all" is merely a communication tool

Most people don't understand the terms "Universal Health Care" or "Single Payer". But many of these same people perfectly understand "Medicare" and the vast majority see it as a very very good thing. So the term "Medicare for all" is an excellent way of communicating the concept to lower information voters. Medicare works for the beneficiaries of Medicare and is extremely popular.

Your point is well taken - the details of a single payer system need to work for everyone in the healthcare chain, as they do in most of the civilized world.

[Motown_Johnny]

61. The same argument was used against the ACA.

Maybe if we had single payer, they would have a great many more patients and be able to stay open.



I am not saying that the change over will not have some short term negative effects, I just think that a policy of "eternal private for profit insurance" is insane.


The system needs to change and Politifact's fact check on Bernie's 2013 Bill (and the math behind them) show that we have a viable bill already written. We should try to adopt it asap.

[MineralMan]

67. You're mistaken, actually.

I'm on Medicare. My parents are on Medicare. My mother-in-law is on Medicare. I and my mother-in-law live in major metropolitan area. My parents live in a rural community near a major metropolitan area. None of us have any problem whatever getting appointments for any sort of services. If I contact the multi-specialty clinic for an appointment, I am asked if I want to see the doctor that day.

My mother-in-law just spent 3 weeks in a specialty hospital being evaluated for issues related to dementia. She will pay nothing for that hospitalization. She just moved into a memory-care unit based on that evaluation. Now, that isn't covered. Fortunately, she can self-pay for her care there. Had she been unable to, she'd have been going to to a nursing home, with her costs covered by Medicaid. If she lives more than seven years, which is unlikely, she'll have to do that.

I'm 70 years old. I have an appointment next week for my annual extended Medicare health exam, which will include a full CBC blood count and a colonoscopy, if I agree to it, which I won't.

My father had a brain bleed a couple of years ago, which involved weeks in the hospital and more weeks in a transitional health care center. We thought it was beads for him, but he survived. He's also had a triple bypass and a hip replacement since going on Medicare. My mother has had two knee replacements since going on Medicare. Cost to them for all of that: $0.00. They're both 91 years old.

None of the people mentioned got a bill for anything. We all have supplemental insurance that costs between $100-180 per month, and that covers the remainder of the costs.

No waits for appointments, even for specialists. No second-rate care for extremely serious and costly treatments. The hospitals and physicians groups seek us out. They want us as patients. Individual doctors? I have no idea. I've used a multi-specialty clinic for years that's part of a healthcare system that includes hospitals as well.

If everyone is on a similar healthcare system, the system will accommodate them. They will have no choice. The private insurance companies will beat down the doors competing for the supplemental policies that pay the 20% Medicare doesn't cover. That's what they do now. They love Medicare patients. Medicaid? Not so much, due to the slow payment. But Medicare? Without it, none of the hospitals or multi-specialty clinics could survive.

I'm guessing that you aren't on Medicare, or you live in some rural area far from urban medical systems. Where I live, everyone loves Medicare patients.

You're simply wrong or misinformed. Sorry.

[madfloridian]

86. I agree with you on this.

It's a good program.

[Armstead]

72. So what do you suggest as an alternative?

Just wondering

[Warren Stupidity]

74. Apparently the flawed wasteful non universal

For profit current system is all we deserve.

[Tommy2Tone]

76. My thought is not that it is a bad idea.

My thought is it will never happen. It becomes easy to campaign on something that will never happens. Bernie is full of ideas that will never happen. Show me something he can accomplish and I will get excited. But rehashing ideas that have been tried over and over to no avail is planning what your are going to do with the money when you win the lottery.

[INdemo]

77. How many billions nation wide do you think

Is written off by hospitals and medical facilities because of treating uninsured patients
Even deductables from patients that have Obamacare are absorbed by the providers.
If Medicaid had been extended by the stubborn Red states than Obamacare would
Be/had been much more successful

[notadmblnd]

78. You sound so familiar. Isn't that one of the arguments used against the ACA?

[MadDAsHell]

81. What, math?

You're either saying math is irrelevant, or that you don't care what happens to small but much needed healthcare providers.

Which is it?

[notadmblnd]

82. Don't tell me what I'm saying. I know what I'm saying

you are using the same scary argument that the right used in reference to the ACA. So far that argument has been a big fail for them. I don't think trotting the meme back out now is gonna work either.

[MadDAsHell]

84. We're talking about Insurance Giveaway 2010 correct?

Which did you work for? United? Cigna? No let me guess: Humana.

[notadmblnd]

91. never been in the health care field. IT was my game

whats the matter, you worried you might have to help your extended family financially in the future? No faith in the small business your relative works for? I can understand the republicans have you scared. Money means everything to them too.