2016 Postmortem
Related: About this forumAvg health care spend is $6,125 (working age) and $3,628 (child) but Bernie claims you only pay $466
For a 2 parent 2 child family that's $20k on average.
https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html
But according to Bernie, you only pay $466 per family in taxes for $20k of estimated costs.
Last year, the average working family paid $4,955 in premiums and $1,318 in deductibles to private health insurance companies. Under this plan, a family of four earning $50,000 would pay just $466 per year to the single-payer program, amounting to a savings of over $5,800 for that family each year.
https://berniesanders.com/issues/medicare-for-all/
Where do the costs magically disappear to?
If a used car salesman was offering me this deal, I would walk away...
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HassleCat
(6,409 posts)Why would you pay $500 for a used car when you could pay $5000? That would be stupid!
hill2016
(1,772 posts)offered you a car for $500 and claims it's worth $20k I would be very suspicious.
HassleCat
(6,409 posts)Just the same as if they showed you a $500 car and claimed it was worth $20k. More to the point, they would show you a $500 car, claim it was worth $10k, and tell you why you had to pay $20k for it.
I would understand that the actual cost of the car is maybe $10k but you have to add in overhead like paying for the dealership and so on hence the cost adds up to $20k. And oh I would understand that if the government gets into the car business I would only be able to buy one black model and additional options would take a DMV like bureaucracy to get approved.
HassleCat
(6,409 posts)Of course. Silly me. I should have spotted it sooner.
hill2016
(1,772 posts)
kristopher
(29,798 posts)You played self-serving games with a couple of non-representative numbers; that isn't proving a proposition using 'maths'.
hill2016
(1,772 posts)vs what Bernie claims that household pays in taxes.
kristopher
(29,798 posts)If you did the required "maths" then share with us what, exactly, do the numbers you used represent?
For instance, please show how you integrated the numbers you offered, together with this data (from just above it at the NHE page), and then compared the result to Bernie's plan?
Remember, SHOW ALL YOUR WORK.
Bill USA
(6,436 posts)kristopher
(29,798 posts)What Bernie's plan actually says:
MAJOR SAVINGS FOR FAMILIES AND BUSINESSES
Bernie’s plan will cost over $6 trillion less than the current health care system over the next ten years.
The United States currently spends $3 trillion on health care each year—nearly $10,000 per person. Reforming our health care system, simplifying our payment structure and incentivizing new ways to make sure patients are actually getting better health care will generate massive savings. This plan has been estimated to save the American people and businesses over $6 trillion over the next decade.
The typical middle class family would save over $5,000 under this plan.
Last year, the average working family paid $4,955 in premiums and $1,318 in deductibles to private health insurance companies. Under this plan, a family of four earning $50,000 would pay just $466 per year to the single-payer program, amounting to a savings of over $5,800 for that family each year.
Businesses would save over $9,400 a year in health care costs for the average employee.
The average annual cost to the employer for a worker with a family who makes $50,000 a year would go from $12,591 to just $3,100.
HOW MUCH WILL IT COST?
This plan has been estimated to cost $1.38 trillion per year.
THE PLAN WOULD BE FULLY PAID FOR BY:
A 6.2 percent income-based health care premium paid by employers.
Revenue raised: $630 billion per year.
A 2.2 percent income-based premium paid by households.
Revenue raised: $210 billion per year.
This year, a family of four taking the standard deduction can have income up to $28,800 and not pay this tax under this plan.
A family of four making $50,000 a year taking the standard deduction would only pay $466 this year.
Progressive income tax rates.
Revenue raised: $110 billion a year.Under this plan the marginal income tax rate would be:
37 percent on income between $250,000 and $500,000.
43 percent on income between $500,000 and $2 million.
48 percent on income between $2 million and $10 million. (In 2013, only 113,000 households, the top 0.08 percent of taxpayers, had income between $2 million and $10 million.)
52 percent on income above $10 million. (In 2013, only 13,000 households, just 0.01 percent of taxpayers, had income exceeding $10 million.)
Taxing capital gains and dividends the same as income from work.
Revenue raised: $92 billion per year.
Warren Buffett, the second wealthiest American in the country, has said that he pays a lower effective tax rate than his secretary. The reason is that he receives most of his income from capital gains and dividends, which are taxed at a much lower rate than income from work. This plan will end the special tax break for capital gains and dividends on household income above $250,000.
Limit tax deductions for rich.
Revenue raised: $15 billion per year
Under Bernie’s plan, households making over $250,000 would no longer be able to save more than 28 cents in taxes from every dollar in tax deductions. This limit would replace more complicated and less effective limits on tax breaks for the rich including the AMT, the personal exemption phase-out and the limit on itemized deductions.
The Responsible Estate Tax.
Revenue raised: $21 billion per year.
This provision would tax the estates of the wealthiest 0.3 percent (three-tenths of 1 percent) of Americans who inherit over $3.5 million at progressive rates and close loopholes in the estate tax.
Savings from health tax expenditures.
Revenue raised: $310 billion per year.
Several tax breaks that subsidize health care (health-related “tax expenditures”) would become obsolete and disappear under a single-payer health care system, saving $310 billion per year.
Most importantly, health care provided by employers is compensation that is not subject to payroll taxes or income taxes under current law. This is a significant tax break that would effectively disappear under this plan because all Americans would receive health care through the new single-payer program instead of employer-based health care.
B$ 630 + 210 + 110 + 92 + 15 + 21 + 310
The revenue stream described accounts for B$1358
Bill USA
(6,436 posts)kristopher
(29,798 posts)From DKOS at http://www.dailykos.com/stories/2016/1/22/1473620/--Some-Experts-Like-Krugman-Supported-Single-Payer-Until-Bernie-Sanders-Put-It-in-His-Platform
Posted on January 22, 2016 by Yves Smith Naked Capitalism
Then-WaPo-blogger Ezra Klein at Netroots Nation 2008.
I would like to sign the insurance companies out of existence with my pen. It would be sweet. But it’s never going to happen in this country where we have sent a multi-billion dollar industry employing tens of thousands of people in every district in America out in one shot…They have a sneaky strategy, the point of which is to put in place something that over time, the natural incentive in its own market [is] to move it to single payer.
James Surowiecki, 2010
http://www.newyorker.com/magazine/2010/01/04/fifth-wheel
The truth is that we could do just fine without them: an insurance system with community rating and universal access has no need of private insurers. In fact, the U.S. already has such a system: it’s known as Medicare. In most areas, it’s true, private companies do a better job of managing costs and providing services than the government does. But not when it comes to health care: over the past decade, Medicare’s spending has risen more slowly than that of private insurers. A single-payer system also has the advantage of spreading risk across the biggest patient pool possible. So if you want to make health insurance available to everyone, regardless of risk, the most sensible solution would be to expand Medicare to everyone. That’s not going to happen. The fear of government-run health care, the power of vested interests, and the difficulty of completely overhauling the system have made the single-payer solution a bridge too far for Washington, and for much of the public as well. (Support for a single-payer system hovers around fifty per cent.) That’s why the current reform plans rely instead on a mishmash of regulations, national exchanges, and subsidies. Instead of replacing private insurance companies, the proposed reforms would, in theory, turn them into something like public utilities. That’s how it works in the Netherlands and Switzerland, with reasonably good results. One could recoil in disgust at the inefficiency and incoherence of the process—at the fact that private insurers will continue to make billions a year providing services the government has shown, via Medicare, that it can provide on its own. But, messy as the reform plans are, they can still dramatically transform the system for the good. Reform would guarantee that tens of millions of people who don’t have insurance will get it, and that people who have insurance now won’t have to worry about losing it. And, by writing community rating and universal access into law, Congress will effectively be committing itself to the idea that health care, regardless of risk, is a right. If a little incoherence is the price of that deal, it’s worth paying.
Jonathan Chait, 2011
http://nymag.com/news/politics/liberals-jonathan-chait-2011-11/
I understand disaffected liberals....
More at: http://www.dailykos.com/stories/2016/1/22/1473620/--Some-Experts-Like-Krugman-Supported-Single-Payer-Until-Bernie-Sanders-Put-It-in-His-Platform
Bill USA
(6,436 posts)Both those bodies being in Democratic Party control SP will never happen (remember the CLinton administration healthcare reform war?). The GOP isn't going to lie down and let the Dems do that to their Health Insurance company benefactors.
You are preaching to the choir.
... But I think the only way we can get there is very incrementally (some would say sneakily).
kristopher
(29,798 posts)Or don't you understand the electoral consequences of his extraordinarily broad appeal?
Human101948
(3,457 posts)This entire argument about paying for healthcare 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 needing more money, it's about capitalists sucking the blood out of the populace like the slimey leeches they are.
rurallib
(64,621 posts)
Human101948
(3,457 posts)and sadly so.
PoliticAverse
(26,366 posts)arcane1
(38,613 posts)Seriously, it's not that hard to figure out, if you honestly want to. How much of that $4,955 was profit for the insurer?
an insurance company can spend up to 20% on non medical claims like marketing, claims processing, underwriting and of course profits.
elias49
(4,259 posts)about profits. Any idea?
arcane1
(38,613 posts)And to frame the Sanders plan as a magical fantasy.
No, that can't be it.
hill2016
(1,772 posts)it's included in the 20% along with a whole host of other actual costs.
Goblinmonger
(22,340 posts)Anything to back that up?
Bill USA
(6,436 posts)The 80/20 rule is sometimes known as Medical Loss Ratio, or MLR. If an insurance company uses 80 cents out of every premium dollar to pay for your medical claims and activities that improve the quality of care, the company has a Medical Loss Ratio of 80%.
Insurance companies selling to large groups (usually more than 50 employees) must spend at least 85% of premiums on care and quality improvement.
If your insurance company doesn’t meet these requirements, you’ll get a rebate from your premiums.
Many insurance companies spend a substantial portion of consumers’ premium dollars on administrative costs [font size="+1"]and profits[/font], including executive salaries, overhead, and marketing.
The Affordable Care Act requires health insurance issuers to submit data on the proportion of premium revenues spent on clinical services and quality improvement.
ObamaCare Rebates
If your insurance company spends more than 20% (15% in large markets) of premium dollars on expenses other than health care costs they will have to send out rebates for the difference. You may see the rebate in a number of ways:
(more)
hill2016
(1,772 posts)
Recursion
(56,582 posts)Take the amount taken in in premiums, subtract the amount paid out to providers. The difference cannot be more than 20% of the amount taken in in premiums.
Just as a side note, in fact it's well under that, about 12%.
arcane1
(38,613 posts)But you already knew that.
hill2016
(1,772 posts)you saved me 20%. But there are people who previously did not have adequate access to health care whom the system will have to pay for. It will probably offset any cost savings from cutting out the insurance companies.
Let's start with the 30m uninsured people and people who are under-insured.
arcane1
(38,613 posts)hill2016
(1,772 posts)arcane1
(38,613 posts)You "save" because the expense of funding health care is LESS than the cost of enriching your insurer.
I don't know why you are intentionally playing dumb here, but it's clear that you don't actually mean the questions you are asking. Why play this game? That's for republicans to do: pretend they don't know the answers to stupid questions.
hill2016
(1,772 posts)into the system. Doesn't this drive up aggregate costs?
arcane1
(38,613 posts)
Fearless
(18,458 posts)hill2016
(1,772 posts)Hoyt
(54,770 posts)also be necessary in Medicare for all. You'll end up with a profit of less than 10‰, significantly less. I think single payer is good for us, but Sanders isn't being honest about the cost.
Recursion
(56,582 posts)
jeff47
(26,549 posts)For example, my primary care doctor's staff is 3 people who do appointments and similar things. And 6 people who deal with insurance companies. Single-payer would mean only 1 or 2 people dealing with claims.
2) Progressive taxation. There's a reason that $50k is in there.
You could actually try reading the plan before attempting to criticize it. Might look a bit less foolish though.
so basically Sander's health care plan is to shift the cost to someone else to pay?
jeff47
(26,549 posts)Let's say you have insurance with BC/BS and get cancer. You only pay a tiny fraction of the cost of your treatment. The vast majority of the costs are shifted to other BC/BS customers who didn't get cancer.
Now, let's say we've entered the horrible dystopia of Medicare-for-all. You only pay a tiny fraction of the cost of your treatment. The vast majority of the costs are shifted to other people who didn't get cancer.
Wow....such a stunning difference. 
All insurance (medical, fire, homeowners, life, etc), whether public or private, is cost shifting. That's the point of insurance.
hill2016
(1,772 posts)you pay your actuarial cost (before ACA added subsidies and community rating).
When you say the single payer is funded by progressive taxation, doesn't mean that someone else is paying for your actuarial costs?
Like I said, if the average family spends $20k in medical costs and only pays $500, isn't someone else picking up most of the expected costs?
jeff47
(26,549 posts)Your question implies they've scored you and figured out a cost for you. That's no longer possible in ACA plans, except for a small number of risk factors (ex. smoking).
Instead, you are paying the actuarial cost for a typical person who is within the same decade as you in age.
If you're relatively healthy, you are already paying other people's actuarial costs.
If you're relatively sickly, others are already paying your actuarial costs.
Yes. In our current system, it's picked up by the below-average spenders. In a single-payer system, it's picked up by other taxpayers. Whether that is done via something flat-tax-ish or progressive comes down to political ideology.
hill2016
(1,772 posts)that under the proposed single payer system, the costs of paying for health care are shifted massively to other people. There's barely a link between actuarial cost and tax/premium.
Do you agree?
Autumn
(48,871 posts)The tax payer.
jeff47
(26,549 posts)The costs are already shifted. That's what insurance is. Whether that insurance is provided by private companies or the government, the costs are already shifted.
hedda_foil
(16,957 posts)That's about 180 degrees away from traditional Democratic philosophy as it's possible to get. Tell me, have you ever heard of Keynesian economics? How about John Kenneth Galbraith? For that matter, how about FDR?
To my mind, you're arguing in favor of a culture of selfishness and greed. This goes way beyond any argument Hillary would dare to make outside of a private speaking engagement with the banksters and company.
Hoyt
(54,770 posts)jeff47
(26,549 posts)Except for very, very rare holdouts.
Hoyt
(54,770 posts)with Medicare for All, maybe more. Ever filed a Medicare claim?
jeff47
(26,549 posts)The reason the doctor needs all those people is each insurance company they deal with uses slightly different systems with slightly different quirks that you need to figure out to efficiently use the system. Especially since for-profit insurance has a much larger incentive to deny claims based on the flimsiest of pretexts.
One system, with one set of rules, that doesn't have a big financial incentive to screw over patients would require far less work to navigate. As demonstrated by Canada.
Hoyt
(54,770 posts)Medicare and private insurers pretty much do things the same. Heck, for Medicare, you are filing your claim with a private insurance company that the government contracts with to process claims. In fact, most private insurers nowadays have pretty much adopted Medicare billing rules.
Now, if your primary care docs and all the others are willing to go on salary paid by the government, there might actually be some savings. Most aren't willing to do that. If they were, they'd be working for the VA or community health centers.
jeff47
(26,549 posts)Navigating those quirks adds a lot of complexity. And each one has their own dispute pathway, again adding complexity.
If you're going to claim it doesn't help, why do Canadian doctors manage to do with far fewer people in claims and billing?
Hoyt
(54,770 posts)records. That takes care of most disputes. With Medicare, the appeals process after that is much tougher.
Do you have an stats on the difference in billing/coding staff in Canada vs. USA? There is a difference between the two countries in the complexity of the coding system, ours being much more complex. But that is a difference between countries.
In the USA, both private insurers and Medicare pretty much use the same codes, claim forms, clearing houses to file electronic claims, etc. There are some minor differences, that a coder/biller learns quickly and can usually be programmed into the computer system. Now, if you wanted to change the coding system, that might produce a savings in the long-run.
jeff47
(26,549 posts)
Yes.
Don't you? You've been claiming to be such an expert on medical claims.....
Hoyt
(54,770 posts)while the requirements among different insurers here and Medicare aren't nearly as different as you think.
hack89
(39,181 posts)how many tens of thousands will have to lose their jobs?
jeff47
(26,549 posts)How many will lose jobs versus how many jobs will be created by effectively giving lots of money to people who are currently struggling.
So....just how many people should we employ in jobs that actually do not actually produce anything?
hack89
(39,181 posts)certainly not enough to create jobs. Those people that were struggling will now pay off debt and hopefully save some for a rainy day. Plus the things they will buy undoubtedly will be made overseas.
jeff47
(26,549 posts)Now, I'm not struggling so that money will not be transformational. But it is about 30x what the "Bush rebate" was for me. Remember how that was supposed to create so many jobs?
Awww....you think banks will extend credit to poor people. Cute!
Most likely, the sustained increased spending will be in the service industry. You don't need a new TV every month.
hack89
(39,181 posts)you have absolutely no way to know how things will actually work out once it gets into the political machinery. And lets not forget the inevitable unexpected consequences that will pop up. The only certainty with most campaign promises is that they never really come true as advertised.
So you really think that debt is not a reason that people are struggling? Wow.
jeff47
(26,549 posts)If you're going to criticize the proposal, shouldn't you use its math?
Depends on who you're talking about. The poor aren't, because no one will extend them credit. The young are, because they're drowning in college debt. And so on.
hack89
(39,181 posts)just because Bernie says it will work does not mean it will.
jeff47
(26,549 posts)Clearly, they don't exist. Because they were unrealistic.
hack89
(39,181 posts)but we only determined they were realistic after the fact. And that was after lots of work, detailed legislation and changes and refinements along the way. One thing for certain - the final implementation of those programs looked nothing like the first proposals issued in a campaign press release. And that is all Bernie has right now - a campaign press release that is missing critical details and based on some questionable assumptions.
jeff47
(26,549 posts)Why do you assume everyone else is a complete and utter moron?
We know it won't be exactly the same. We know there will be horsetrading. We have been fighting this battle for 80 fucking years. Stop pretending we're new to it.
hack89
(39,181 posts)how can you if you know that things will change significantly? The only thing I am questioning is your certainty as to how much money this will save.
R.A. Ganoush
(97 posts)regarding your post. You posture that if SP is enacted, that medical facilities would be able to reduce office headcount by up to 2/3 because of the lack of claims processing through insurance companies.
Have you ever asked a physician who accepts Medicaid or Medicare if claims processing is easier with CMS vs. processing through insurance companies?
From my experience (my wife is a doctor who operates a cash-only practice and no longer accepts Medicare patients, so I've heard the complaints more times than I can count), CMS is a much larger challenge to get claims approved than the carriers, and involves multiple submissions in order to get approval (e.g. if printed data in fields isn't properly aligned, and extends outside of the designated box by even a hair, the claim is rejected and must be resubmitted). Granted, it is not the case in every instance, but I don't think its as seamless as you make it out to be if we cut out the insurance carriers. (I'm truly curious if there is any data available that shows the average amount or number of submissions prior to getting a claim approved through each).
The reason that many practitioners will not accept Medicare and Medicaid patients isn't necessarily the lower reimbursement rates than carriers, but the extra red tape from CMS that requires repeat efforts to get approval and negates any increase in office efficiency.
If we want to make a move to SP or Medicare for all, those logistical problems are going to have to be improved in order to get the medical practitioners on board. Otherwise, I think you will see larger amounts of physicians who will move to cash only, in addition to a doctor shortage.
jeff47
(26,549 posts)They'd be able to cut office staff. Techs, nurses, etc would still be around.
A single, complex system is still simpler than multiple, complex systems.
If every other first-world nation can figure it out, I'm pretty sure we can too.
R.A. Ganoush
(97 posts)I was referring to your original post about having 6 employees dedicated to billing, sorry if I wasn't clear on that. I still think they would need as many people to process claims through CMS because it doesn't seem to be any more efficiency to their claims processing than private insurance.
Using the examples of other first-world nations, do you know what type of transition to a SP, universal or similar model they've had to go through from their previous systems? Although a worthwhile goal to strive for, I think that for the US to change tack in a similar manner would be a much longer process than most people think.
Certain elements of the ACA implementation have had to be delayed just because the scope was much larger than the legislation anticipated - something of this magnitude (a universal system) will require a much longer strategic implementation and the continued support of the populace beyond the range of election seasons.
Please don't get me wrong, I'm not arguing against the idea of putting a better system in place, in fact, I'm all for it - it would make my job a lot easier. I just think most people underestimate the sea change required to accomplish it. We need serious forward-thinking people in charge of this, and like it or not, they're most likely going to have to come with experience from the private sector.
unc70
(6,495 posts)You post way too much to be acting clueless. Disingenuous as best.
For the record the money comes from several places, including a significant payroll tax (replacing private insurance premiums), higher taxes on upper income brackets, and consolidation of all the many existing government-finder health care (Medicare, Medicaid, CHIPS, VA, etc.).
arcane1
(38,613 posts)Autumn
(48,871 posts)use and catch heck for it some posters have to become "Deliberately obtuse" to avoid getting caught doing it again. .
matt819
(10,749 posts)your taxes may be offset by a credit based on premiums pad. Doesn't apply to everyone, but it can be substantial. So he may not be wrong. Sometimes the credit is applied in advance, lowering your premium. Sometimes it is applied when the tax return is filed.
DanTex
(20,709 posts)Number crunching is forbidden on the unicorn ranch.
cherokeeprogressive
(24,853 posts)room temperature people in boxes, cover them with dirt and place stones with inscriptions over their heads?
whatthehey
(3,660 posts)It's not like this is a shot in the dark.
cherokeeprogressive
(24,853 posts)Ferd Berfel
(3,687 posts)Insurance cost is largely based on the size of the POOL membership. Everybody in = what.. 350,000,000 people?
Then there is actually negotiating prices which Hillary doesn't talk about only Bernie will do it. There's more but it will land on deaf ears with people that are willing to ignore so much that they would support the Oligarchy.
'Single-payer is the only health reform that pays for itself'
non-partisan Physicians for a National Health Program (PNHP) http://www.democraticunderground.com/12511052189
and THIS
Elizabeth Warren: Anyone Who Says ‘Change Is Just Too Hard’ Is in ‘Bed With the Billionaires’
http://www.democraticunderground.com/?com=view_post&forum=1251&pid=1064813
Great answers to the OP. Thanks.
Ferd Berfel
(3,687 posts)
Vinca
(53,587 posts)
Marrah_G
(28,581 posts)Motown_Johnny
(22,308 posts)Please try again.
questionseverything
(11,684 posts)the one thing that bothers me about bernie's plan is, for self employed people that pay both parts for themselves, it is a high tax raise...altho NOT as costly as the aca is now
i think the real growth in gdp still begins with the self employed so i want it easier for small businesses to get started not harder
this is something that could be worked out with some kind of credit for low income self employed people and i trust bernie to do that because he actually listens to us
pinstikfartherin
(500 posts)I'll gladly take the tax instead of the ACA because in the end it is cheaper for me instead of paying my high premium plus deductibles, copays, etc. I did not get insurance this year because it will be cheaper for me to pay the penalty. I can even go to the local doc in a box for $175 with no insurance, covering all xrays and tests. When I had BCBS and got sick last year, I still paid $125 out of pocket that my insurance didn't pay plus a $30 copay. It's crazy.
In the end, I imagine it will probably be similar to payroll taxes for self-employed people now where you can deduct the employer portion of your self-employment tax from your adjusted gross income. I wouldn't complain if there was some other credit as well, but just having the security of having health insurance makes it well worth it to me.
questionseverything
(11,684 posts)little off topic but another thing that stinks about the aca is the sign up period, being self employed in construction ,from about 2 weeks before Christmas to February not much money is moving,not much work and that is the time they picked to have sign ups
not a good time to take on an expense bigger than most house payments,ya know
Warren Stupidity
(48,181 posts)They will still be high under the payroll tax plan - but note that they will at least be proportional to income. As things are now if you are self employed health insurance costs are only partially based on income - you might get an ACA subsidy if you qualify, otherwise you are paying full price regardless of income.
workinclasszero
(28,270 posts)This is where the rainbow pooping unicorns step in I'm pretty sure.
But no worries because Bernie Sanders will bring all the jobs back from China and we will all be making 20 plus bucks a hour and a months paid vacation a year too.
Why dollar bills will just rain from the heavens, dont you know?
With a major assist from the teabag house of reps of course.
Goblinmonger
(22,340 posts)Is everything she is saying she will get done just fueled by rainbow pooping unicorns? Because I don't see the "teabag house of reps" that held the Benghazi hearings and voted to get rid of the ACA a billion times being all that supportive of Clinton, either.
Or is it just Sanders that will have a hard time with them?
workinclasszero
(28,270 posts)dealing with the teahaddists in the house because he would lose the GE in a landslide to Herr Trump and this country will totally go to hell soon after.
Goblinmonger
(22,340 posts)Or are we just believing polls when they say Clinton is ahead? Most polls have Sanders beating Trump by a bigger margin than Clinton does.
workinclasszero
(28,270 posts)The republican attack machine has treated Bernie with kid gloves because they hope he can knock off Hillary for them.
If that happens the full weight of the reich wing will desend on poor Bernie and they will destroy him easily.
Goblinmonger
(22,340 posts)They have plenty of ammo on her and aren't afraid to use it.
But, hey, keep stocking up on tin foil.
frylock
(34,825 posts)which one is it?
Sancho
(9,192 posts)
Vinca
(53,587 posts)and they don't have to hire extra personnel to fill out 50 different insurance forms. In some cases they don't have to have anything to do with maintaining an office. Add to that the college debt U.S. doctors have and it's probably more profitable to be a physician in some of the countries you've cited. From your chart, it's hard not to wonder why the country with the highest paid doctors doesn't have the healthiest population. Last time I checked we were #38. Apparently money doesn't buy good care.
Sancho
(9,192 posts)Bernie (or no one else) is going to get the US to wave a magic wand and tell doctors and nurses that they are going to make less. In fact, US doctors make more (and we won't even get into all the many differences from number of doctors per capita, hours, conditions, etc.).
The bottom line is that Bernie's single payer plan would have the effect of reducing health care workers salaries - not just administrative costs.
Vinca
(53,587 posts)I am so sick of the current "no we can't" mantra. It's disgusting. We must accept the status quo, according to some, and remain in the clutches of big insurance and big pharma forever and ever and ever. I assume when the ACA was created you were opposed to the public option because if that had been included we wouldn't be having this discussion. People might have voted with their $$$ whether they wanted to buy a private insurance policy or a government-sponsored plan such as Medicare. Hillary is quickly becoming the "no we can't" candidate and it's not terribly inspirational.
Sancho
(9,192 posts)The ACA will likely lead to some state introducing a public option at some point, but you don't even have any idea what's important besides $$$$s.
In Florida, 25% (or more) were born outside of the US. Employers take advantage of everyone who is undocumented. The ACA is one more way to hold employers accountable. If you have more than a limited number of employees, then the employer has to insure them. When employees go to the ER or whatever - the ACA will ask, "where's your insurance?" and "who do you work for?".
Eventually, there will be a real path to citizenship - and it will come sooner if Hillary is President.
Bernie's plan is DOA, but Obama's ACA is a start - and just like 94-142 (the start of special education), the ADA, and Title IX - I've seen real change that evolves as long as it survives the GOP attacks long enough to become a third rail.
It's social justice that I'm interested in - and Bernie's proposals usually miss the boat for millions of Americans. Reducing salaries and increasing taxes on regular folks is a dumb idea - even the salaries of heath professions should not go down.
I don't think single payer will work or pass Congress in the US. I believe that a public option, expansion of medicaid, and improving medicare are possible.
Vinca
(53,587 posts)Don't you? I'm still trying to decide if you're a Republican in disguise or not.
Sancho
(9,192 posts)You couldn't even hold a candle to me as a Democrat!
That's goes back many years too.
Your inability to understand is not my issue.
Vinca
(53,587 posts)Sancho
(9,192 posts)and MONEY is pretty far down on my list of things that are the key to social justice. There is no purely economic policy, law, or plan that will ever be enough to satisfy my Democratic heart because I know for a fact that it's a dead end to chase dollars without real equality and respect.
I was against the Korean War (40,000 Americans died), the Vietnam War (68,000 Americans died), and the Cold War. I actually protested and didn't just stand around complaining about how people voted. The Iraq War was just one drop in the bucket of recent American Wars - so don't complain about Iraq unless you are in the streets today. Some of us remember the lessons of the Democratic Convention of 1968 (look it up if you don't know what I'm talking about).
I worked for change (18 year old vote and ERA), likely before many DUers were born. I introduced Jimmy Carter when he was campaigning once, and I have actively worked for all sorts of Democratic politicians over the last 50 years.
Even today on DU I see and hear lots of "loud claims", but see little action. I was recently at a college campus where there was an effort to get students to register to vote - the majority were not registered, and a small subset actually vote.
That's a lot different than when I was A1 in the draft and people were scrambling for deferments. We were seriously interested in politics. I've been a union member for about 50 years too.
So I posted some factual information that is only ONE small reason that Bernie's single payer plan is simplistic and doomed. That's the fact that the US pays higher salaries to doctors and nurses than other countries (while we sometimes pay teachers less!). In spite of his years in Congress, Bernie is selling something that won't happen and also is misguided.
Bernie can't say with one breath that everyone will get a raise to $15 an hour and with the next breath say that doctors and nurses salaries will go down a third. Think about it.
http://nymag.com/daily/intelligencer/2016/01/what-sanders-doesnt-understand-about-politics.html
Vinca
(53,587 posts)Remember when we weren't? I'm paying 1/5th or less of what I was before being eligible for Medicare. Shouldn't everyone have that opportunity? Your bio isn't so different from my own which makes your stance all the more puzzling.
Sancho
(9,192 posts)Most doctors are paid less by Medicare than they "usually" get. If you have Medicare for all, you're going to have to figure out how to pay for it (and Bernie has not).
1.) You can double or triple the number of doctors; including sending doctors and nurses to school for free so that they will accept lower salaries.
2.) You can spend half on the military and fund a single payer system.
3.) You can tax the hell out of everyone.
At any rate, a public option is likely in the future of health care; with a parallel public/private system (like education is today). Practically, there's no way to have a single payer system in the US in the next generation.
What you cannot do is pass a law that all the doctors and nursers will now work for 30% less money.
Sancho
(9,192 posts)Now, a veteran health economist has produced a more serious assessment of Sanders' proposal and concluded that the critics were right...
Covering more people and providing most of them with more generous benefits obviously requires a lot of money. But single-payer systems abroad manage to provide generous, universal coverage for much less than the U.S. spends -- because those foreign systems fritter away less money on administrative waste and profit, and because they give governments the power to set medical prices and salaries at much lower levels than the U.S. currently pays.
Sancho
(9,192 posts)Vinca
(53,587 posts)Autumn
(48,871 posts)and certain posters cough * here *cough like to twist and complain about.
Agnosticsherbet
(11,619 posts)So how do we manage to pay $466.00 per year. (662.69 CAD)
Why would Canadian Health Care taxes be so much more expensive?
http://www.huffingtonpost.ca/nadeem-esmail/canada-free-health-care_b_3733080.html
In 2008 in Britain it was about $2,500.00 per person.
http://content.time.com/time/health/article/0,8599,1916570,00.html
Why are these foreign government with national health care forcing their citizens to pay more than the $466.00 that Sanders says we will pay?
I simply don't believe his numbers.
Sancho
(9,192 posts)Also, in Europe they have VATs plus spend less on the military.
Bernie's plan is not paid for with the numbers in his plan.
Agnosticsherbet
(11,619 posts)The money quoted in this article does not match any other country, it doesn't even come close.
Vermonters were sold a bill of goods, that they would be able to create a single payer system, but the cost proved impossible and it was never implemented. Articles I've read show that just the increased Medicaid costs, even with Federal government assistance, is putting a strain on state finances.
I do not think that the cost of Sanders plan is honest.
Warren Stupidity
(48,181 posts)Other taxes are also included in the funding stream. Over 500b year comes from revenue other than the payroll tax.
But you don't care about the actual cost and funding, do you?
uponit7771
(93,505 posts)... a year.
The 6.4% is supposed to come from the employer but we all know they'll be passing that down to the employee in a myriad of ways
Nanjeanne
(6,541 posts)Can anyone show me even 1 number from the Clinton campaign on what she is doing to make the ACA better and how she is paying for it. I've researched her website, I've clicked on all her issues - I've downloaded every pdf that's available and I've clicked on every link in her statements. I find nothing.
. . . and while we are getting that - would someone please also give me her detailed tax bracket information - exactly what she is raising - on who and how much?
Thanks a million!
Matariki
(18,775 posts)Armstead
(47,803 posts)Excuse the all caps but this bears repeating.
Healthcare involves life and death and disease and accidents. It costs money. It makes no economic sense because lifer is random and unpredictable. And it is expensive to fix people.
Given that reality, there are two choices. Do you make it an economic priority for the nation to bite the bullet and do everything possible to provide healthcare to everyone, and try to devise a system that is as financially manageble as possible, while realizing it is will not follow nice little economic yardsticks?
Or do we just leave it to "the markets" that are only oriented to soaking the system to make as much priofit as possible off the pain and suffering of people? Do we continue to perpetuate a for-profit system whose only goal is to rake in premiums while denying as much health care as it can get away with?
That is the only basic choice. The GOP obviooiusly prefers the latter market based approach.
The Democrats should be better than that.
Ron Green
(9,867 posts)One risk pool, no "cherry picking" (this is an expensive bit of malfeasance from the big insurers.)
People getting rich in the system will take a hit: Million-dollar docs, Big Pharma execs, medical equipment CEO's with big Medicare billings, and so on.
Poor people have to learn how to go to the doctor and be engaged in a good system. They've not had this opportunity before.
Healthy communities include housing, transportation, food supply and education that's on the Scandinavian model rather than the Somalian model. That'll help a bunch.
We're all gonna die. Let's not spend 90% of our health care dollars doing it.
hill2016
(1,772 posts)how come that's not part of the equation at all?
Ron Green
(9,867 posts)You're joking, right?
hill2016
(1,772 posts)Recursion
(56,582 posts)I'm not seeing that; I see the Federal government guaranteeing their overpriced revenue stream, and a history of Congress being unwilling to ever lower reimbursements for fear of being attacked for "cutting Medicare"
Ron Green
(9,867 posts)isn't it? Electing Bernie Sanders is Step One of many difficult steps, and taking dollar-chasing out of what must become a health- and life-sustaining system of care is another. It may not happen, but people all over the country are working together to bring it; it's just the right thing to do.
Or we can keep what we've got.
Recursion
(56,582 posts)Seriously. I'm not saying he couldn't, I just mean he's never mentioned anything about that.
Ron Green
(9,867 posts)an important part of the transformation that has to occur if we're going to continue on the earth. Although Sanders hasn't specifically addressed the income hit that will be taken by those milking health care, the move away from a rent-seeking economy to a fair and steady one, which will include such income hits, cannot happen with the election of any of the other candidates. And may not happen with him, but we ought to try.