The eye-popping cost of Medicare for All

[Yo_Mama_Been_Loggin]

Sen. Elizabeth Warren’s refusal to answer repeated questions at Tuesday night’s debate about how she would fund Medicare for All underscores the challenge she faces finding a politically acceptable means to meet the idea’s huge price tag — a challenge that only intensified today with the release of an eye-popping new study.

The Urban Institute, a center-left think tank highly respected among Democrats, is projecting that a plan similar to what Warren and Sen. Bernie Sanders are pushing would require $34 trillion in additional federal spending over its first decade in operation. That’s more than the federal government’s total cost over the coming decade for Social Security, Medicare, and Medicaid combined, according to the most recent Congressional Budget Office projections.

In recent history, only during the height of World War II has the federal government tried to increase taxes, as a share of the economy, as fast as would be required to offset the cost of a single-payer plan, federal figures show. There are “no analogous peacetime tax increases,” says Leonard Burman, a public-administration professor at Syracuse University and a former top tax official in both the Bill Clinton administration and at the CBO. Raising that much more tax revenue “is plausible in the sense that it is theoretically possible,” Burman told me. “But the revolution that would come along with it would get in the way.”

At the debate, as throughout the campaign, Warren refused to provide any specifics about how she would fund a single-payer plan. Instead, whether questioned by moderators or challenged by other candidates, she recycled variants on the same talking points she has used in venues from campaign town halls to a recent appearance on The Late Show With Stephen Colbert. Rather than explaining what revenue she would raise to fund the plan, Warren insisted that under single payer, middle-income families would save more money with the elimination of health-care premiums, co-pays, and deductibles, regardless of any taxes imposed. “Costs will go up for the wealthy and for big corporations, and for hard-working middle-class families, costs will go down,” she said at the debate.

https://www.msn.com/en-us/money/healthcare/the-eye-popping-cost-of-medicare-for-all/ar-AAISFNC?li=BBnb7Kz

[Hekate]

1. How much is that counted in Trident Missiles?

Or in the aircraft carrier(s) the Pentagon didn't ask for but Trump promised them?

Asking for a retired nurse.

[lapfog_1]

23. 2,461 Ford class nuclear carriers (complete with electromagnetic launch systems)

so there is that

BTW, we would have to build 246 a year for the 10 years that the cost of M4A was estimated.

Currently the US Navy lists a total of 19 carriers... however out of those 19, only 10 are actual carriers the others are rather limited in size, air wings, etc.

https://thediplomat.com/2014/04/does-the-us-navy-have-10-or-19-aircraft-carriers/

[Thekaspervote]

2. No wonder EW doesn't want to talk about it. Really pleased this has come out. Voters need to know

[LonePirate]

8. Voters need to know that they will save $ when their new taxes are less than their current premiums.

It's funny how opponents of MFA almost never talk about how much the median taxpayer will save when their future taxes are much, much less than their current premiums.

[brooklynite]

11. It's funny how supporters never talk about how much the median taxpayer will save either...

All that say (if anything) is THAT they'll save, but they never make a solid financial argument.

[LonePirate]

17. Even if the savings are as low as 5%-10%, it's still a massive benefit for the country.

Chances are the savings will be considerably higher; but I guess it is easier to do the bidding of insurance companies and health companies by scaring people about MFA.

[qazplm135]

28. Well what are they then?

Five? Ten?

For whom?

Details are going to be necessary for such a large change.

[LonePirate]

33. For whom? Is that a serious question? Do you honestly think the average American will pay more?

Where in the world are these sorts of irrational fears and questions originating?

[qazplm135]

35. yes it's a serious question

and yes I think a LOT of people will ask whether or not they will pay more and simply saying Don't worry about it, only the rich will pay more, trust me...is not going to be a suitable answer.

You trust Warren. That's great. I trust Warren. That's nice. There are a lot of folks who are going to need a wee bit more info before they commit to voting for someone proposing perhaps the most massive social program in the history of the country, a massive change with a massive tax bill/cost.

Yet your position is to mock and say, she says only the rich will pay more...what more do you need idiot?

Good luck with that approach. I hope Warren doesn't take it.

[LonePirate]

41. Why would a Dem implement a system where the typical person pays more? How would that pass?

Please explain to me how a new system where the average user will pay more will ever pass Congress. Your fears are based on that premise so how in the world does that happen?

[qazplm135]

47. lol

so you think the nation is filled with Dems?

And that all Dems just think, well, it's a Dem doing it, so it MUST be great, I need no details at all for this massive systemic change.

And that there aren't going to be those who aren't so...trusting that might want to know more than just, a Dem said it so don't worry about it?

Like I said, I hope Warren takes a wee bit different approach to you if she wants to get elected.

Because you don't need no details just trust me is not going to be a winning message.

[LonePirate]

49. What's amusing is you thinking a Dem President can force Congress to pass such a bill.

How or why would Congress pass a bill which you think is so bad - a belief based on net increased costs to the average American? What makes you think there are 218 representatives and 50 senators who would support such a bill? Again, if this change is as bad as you think it is, how does it pass Congress? Democrats in Congress are not the mindless toadies like Republicans who will vote for whatever bill a same party president sends them. So, either you are wrong or a Democratic Congress has been replaced by hordes of mindless drones simply carrying out the will of a president pushing a bill that is bad for America. Now which of those two possibilities is more likely to be true? It sure isn't the latter one.

[qazplm135]

58. What's amusing is you think

Voters remotely think that way.

Please stay away from any campaigns.

[dsc]

160. have you lived in this country lately

Congress passes bad bills in a rather regular basis.

[eilen]

144. consider recent history-- the cost of insurance under the ACA

Between the monthly insurance payment of the average ACA policy-- gold or sliver or platinum... and the deductible... is that how much M4A will cost per taxpayer.. or only certain taxpayers above which bracket?

[wasupaloopa]

22. You have no proof of what you say.

[LonePirate]

32. Why do you believe an MFA system implemented by Dems will increase costs to the average American?

[lapfog_1]

27. for many of us, it isn't US that saves money on those premiums

it's our employers... and yes, that is a substantial cost savings for them... however, good luck getting those corporations to give that money to the M4A program in the form of higher corporate taxes (a huge tax increase on them).

[LonePirate]

60. if Congress has the wherewithal to pass an MFA bill, corporate taxes will definitely increase.

Of course, they need to increase even without an MFA bill, and they likely will under a Dem President and a Dem Congress.

[lapfog_1]

61. The "pound of Flesh" extracted by the repukes for

replacing the evil Obamacare with an even more "socialist" M4A will be passing a tax increase on the middle and lower class incomes.

Count on it.

[LonePirate]

62. I am all for a tax increase since I would no longer pay premiums, co-pays, deductibles, meds, etc.

[lapfog_1]

63. good - I'm guessing you don't have a decent employer provided ( or union provided ) plan -n/t

[LonePirate]

64. I have great insurance. I will still be better off under MFA as will you and every other American.

You would need to live in a fantasy land if you think you will be worse off under MFA, unless you already have so much money it won't matter.

[lapfog_1]

65. maybe the "insurance" will be fine...

but I'm CERTAIN my taxes are going up to pay for it... by a lot. Bernie says they will.

My salary will NOT increase enough to pay for the tax increase. And neither will yours.

and you (and EW) cannot offer any proof that this will not be the case. No proof that I would trust.

And I don't mind a small tax increase on me to pay for providing medical care for those less fortunate, but I pay MAX TAX for years now (I have almost no deductions)... and I bet my federal tax burden will go from 36% to around 50% to pay for M4A.

[LonePirate]

66. Now take your preposterous 14% increase and start deducting everything you no longer pay for.

Deduct your premiums, deductibles, co-pays, specialists, medications. Do you still think your net expenses will be that 14%? And if you're paying 36% now, you're already making far more income than the vast super majority of Americans. Your taxes need to go up even without an MFA bill.

[lapfog_1]

67. I have a decent insurance plan... medical, dental, vision

I pay very small co-pays... and I deduct $50 twice a month into an HSA which completely covers all of my co-pays and deductibles. I also have an $500,000 life insurance plan completely paid for by my company ( with double indemnity should I die at work or traveling for work). I also receive a $200 stipend every month to take mass transit to / from work (which completely pays for my train tickets since I go to work 3 days a week and work from home). My company also provides on site day care, free cafeteria with very decent food, etc. Yes, I'm fortunate to work in high tech in Silicon Valley. Everyone should have my perks.

That said, I also pay a lot more in cost of living for being here. and high taxes (11% to the state, 36% to the feds, 8.5% sales, etc).

so yeah, me, and millions like me, do NOT want M4A. Not unless my company takes the money that they spend on my medical / dental / vision plan and dump it into the government M4A program... and all the other companies do the same. And I don't trust them to do it.

[BBG]

92. Nice, it sounds like you got yours

And happy we are for you.

Now let’s talk about the whole population and not your slice of heaven.

[Act_of_Reparation]

183. Copays and deductibles?

What about actual coverage?

Emergency care. Hospitalization. Cancer treatment. You know, the kind of shit that bankrupts insured people every day.

If, forbid, you get seriously ill, how long do you think you'll remain a member of your awesome plan?

[MichMan]

68. Look at all the anger here earlier from wealthy people who had their SALT deductions limited to 10K

[emmaverybo]

128. Not every American. Some who pay very little for employer-provided good quality plans won't be

when taxes outstrip what they would save on premiums. Some pay zero for premiums. I don’t live in a fantasy land and my situation is not unusual. Many in relatively low-paying jobs have good plans at group rates which carry over in retirement so when Medicate kicks in they pay zero premiums on the supplemental and even Medicare Fee is paid for.

[LonePirate]

129. You can focus on selfish outliers. Real Democrats like me will focus on the good for all of society.

And when you eliminate co-pays, deductibles, prescriptions, etc., over the long run, even those with low premiums now will come out ahead in a system with guaranteed health care.

[emmaverybo]

134. Many have very low co-pays,no deductibles, prescriptions never more than $15 and usually about

Two dollars...Ignoring why millions do not want to lose their employer and retirement benefits-provided insurance or calling on them to be more altruistic really does not make the case for
M4All. Better to anticipate the counter-argument by getting realistic than to make exaggerated claims.

Single payer can exist with private insurance. So many ways to get to universal healthcare.

[eilen]

145. Medicare pays for 80% for hospitalization

and doctor visits.

So technically you are liable for 20% of all costs + monthly premiums.
So open heart $100,000-- you owe $20,000+ cost of meds+your monthly premium. I guess you will have to apply for that mortgage after all.

I pay less than that now with my current employer subsidized insurance that not only has a deductible, also has co-insurance.

[MichMan]

153. Corporate taxes are ultimately passed on to the consumer

Just like was widely discussed with the tariffs. Taxes are no different.

[elleng]

51. Yes

[Gothmog]

122. Societal Savings are not tax revenues and this plan will not work in the real world

Such a plan in theory may generate societal savings but such savings would not pay for a program. Governments can only spend tax revenues and/or borrowings. This study does not say how one would pay for such a program in the real world. I note that Prof. Krugman like the concepts of such a plan in theory but notes that taxes will have to be raised a great deal to pay for such a plan
Back in 2016, here is his position Prof. Krugman compares Sanders hoped for health care savings to the GOP tax cuts. http://krugman.blogs.nytimes.com/2016/01/19/weakened-at-bernies/?_r=0

On health care: leave on one side the virtual impossibility of achieving single-payer. Beyond the politics, the Sanders “plan” isn’t just lacking in detail; as Ezra Klein notes, it both promises more comprehensive coverage than Medicare or for that matter single-payer systems in other countries, and assumes huge cost savings that are at best unlikely given that kind of generosity. This lets Sanders claim that he could make it work with much lower middle-class taxes than would probably be needed in practice.

To be harsh but accurate: the Sanders health plan looks a little bit like a standard Republican tax-cut plan, which relies on fantasies about huge supply-side effects to make the numbers supposedly add up. Only a little bit: after all, this is a plan seeking to provide health care, not lavish windfalls on the rich — and single-payer really does save money, whereas there’s no evidence that tax cuts deliver growth. Still, it’s not the kind of brave truth-telling the Sanders campaign pitch might have led you to expect.

Today, Prof. Krugman says that such a plan is feasible if you are willing to pay a great deal more in taxes
https://www.alternet.org/news-amp-politics/paul-krugman-explains-why-single-payer-health-care-entirely-achievable-us-and-how

If we went to government provision of all insurance, we’d pay more in taxes but less in premiums, and the overall burden of health spending would probably fall, because single-payer systems tend to be cheaper than market-based."

The amount of higher taxes are not quantified in this article by Krugman. To pay for any such plan will require massive tax hikes

Again sanders has utterly failed in his attempts to get Vermont to adopt his magical single payer plan because the state of Vermont cannot use hypothetical societal saving to pay for this plan. Even Krugman admits that much higher taxes are needed

[LonePirate]

124. What do you think happens to the premiums deducted from paychecks under an MFA plan?

Do you prefer paying premiums or taxes? Do you think your taxes under MFA will be more or less than your taxes and premiums today?

[dpibel]

132. You keep saying this. Can you tell me what you mean?

It's an honest question.

I have seen you say this before in MFA discussions: "Societal savings."

What do you mean by that?

Because my baseline on this is pretty simple: The outlay for medical care in the U.S. is already right around the projected price of MFA. The scary MFA number is $34 billion in a decade. The current aggregate spending in the U.S. is $3.5 trillion a year or more.

So the only real question is who administers the money: The government or private insurers.

Somebody sometime may have projected some savings from MFA. I can't answer for why they did that, although it seems likely.

If nothing else, you have to admit, I hope, that eliminating profit and excess administrative costs would automatically save about $90 billion a year.

So it seems to me you are arguing that there will be some inexplicable vast increase in the cost of medical care in the U.S. under MFA which is not offset by "societal savings." But my question is: Why would we spend more than we are already spending? The projections say we won't.

Again, this is just my best guess. Because you state with great certainty that "societal savings" won't solve the problem.

I'm just not getting what the problem you see is.

[Gothmog]

167. Read the studies being used to support these single payer plans

sanders and the persons pushing these single payer plans cite a couple of studies that promise $5.1 trillion is savings that will pay for these plans. I read the studies and saw that these studies all talk about savings to society and not tax revenues. See these DU threads https://www.democraticunderground.com/100211497483 and https://www.democraticunderground.com/100211531815

I used to be a college debater and I know now studies such as the one cited above are prepared. It seems that there are some fairly aggressive assumptions used in this study and I doubt that these savings will be realized in the real world. There is a reason why sanders has totally and utterly failed to get his magical single payer plan adopted in the real world which is that policy makers cannot us magical or theoretical savings to pay for a program.

Prof. Krugman and I treat the so-called societal savings the same way that we both treat the magical economic growth that is supposed to be generated from GOP tax cuts. http://krugman.blogs.nytimes.com/2016/01/19/weakened-at-bernies/?_r=0

On health care: leave on one side the virtual impossibility of achieving single-payer. Beyond the politics, the Sanders “plan” isn’t just lacking in detail; as Ezra Klein notes, it both promises more comprehensive coverage than Medicare or for that matter single-payer systems in other countries, and assumes huge cost savings that are at best unlikely given that kind of generosity. This lets Sanders claim that he could make it work with much lower middle-class taxes than would probably be needed in practice.

To be harsh but accurate: the Sanders health plan looks a little bit like a standard Republican tax-cut plan, which relies on fantasies about huge supply-side effects to make the numbers supposedly add up. Only a little bit: after all, this is a plan seeking to provide health care, not lavish windfalls on the rich — and single-payer really does save money, whereas there’s no evidence that tax cuts deliver growth. Still, it’s not the kind of brave truth-telling the Sanders campaign pitch might have led you to expect.

GOP tax cuts are not magical and never pay for themselves.

If you want this study to be taken seriously in the real world, then identify how the plan will be paid for. A government cannot spend magical savings and can only use tax revenues. The study identify societal savings which are nice but which are not tax revenues

The real world is a nice place. Magical savings are nice but cannot be used in the real world. sanders has utterly and completely failed to get his magical plan adopted anywhere including Vermont. sanders is careful to never tell anyone how he would pay for his program and cite amusing but worthless studies like the one in the OP. No governmental entity have accepted sanders plan because it would need a large raise in taxes.

The real world is a nice place.

[dpibel]

169. Friend,

From your very own quote:

To be harsh but accurate: the Sanders health plan looks a little bit like a standard Republican tax-cut plan, which relies on fantasies about huge supply-side effects to make the numbers supposedly add up. Only a little bit: after all, this is a plan seeking to provide health care, not lavish windfalls on the rich — and single-payer really does save money, whereas there’s no evidence that tax cuts deliver growth. Still, it’s not the kind of brave truth-telling the Sanders campaign pitch might have led you to expect.

Krugman says "single-payer really does save money."

What part of this helps your argument?

[Gothmog]

171. Again, you have to pay for these programs with tax revenues and not societal savings

sanders failed in his attempts to get this program adopted in Vermont. There are good reasons for this failure.

[dpibel]

172. Again,

You have failed to identify the "societal savings" on which your argument depends.

You cite Krugman as supporting your point of view.

Krugman says, "single-payer systems tend to be cheaper than market-based."

So what is it that you find so compelling about the current system?

Krugman says single-payer systems are cheaper.

Yet you keep citing him as proof that MFA is a disaster.

How does that work in your real world?

[Gothmog]

174. I read and understood the material

Societal savings are not tax revenues in the real world. To me this is a very simple concept and explains why sanders failed completely when he tried to get a single payer plan adopted in Vermont. If sanders failed in friendly Vermont, how will such a plan work in the rest of the country

Again, you need tax revenues and not hypothetical societal savings to pay for such a plan

[dpibel]

175. And you still won't say what "societal savings" means

I'm singularly interested in this question: I read the link you provided, and I didn't see one single thing that said the Vermont proposition was in any way related to Sanders.

So why do you say "If Sanders failed in friendly Vermont"?

What is your evidence that the Vermont plan was Sanders' plan?

I have to admit: You outrank me on high school debate. I didn't do that.

I'm not sure that it matters in this forum.

It's a real simple question. You claim that "societal savings" are the basis of MFA.

You will not explain what you mean by "societal savings."

As a matter of fact, I have read every single one of your links that is not behind a paywall.

And I have still not discovered this magical "societal savings" that you claim (incorrectly, best I can tell) Krugman says are the fairy dust in MFA.

Seriously. If all you can do is continually say, "click this link" (and, whenever I am able, I click the link and it doesn't support your proposition), but you can't in plain language explain your point of view, I'm having a hard time giving you very much credit.

If you think you've got a killer point, do this: "Here is my killer point. A = B = C. If you don't believe me, check out this link." But "I win. Click link." actually doesn't get the job done.

I think you know this. You were in high school debate.

[dpibel]

181. Deepest apologies

I said, "high school debate."

But you did college debate.

I did not intend to demote your debate level.

[Gothmog]

190. A dose of reality for Medicare-for-all

Link to tweet

Now we have two more data points. The quite credible think tank, Committee for a Responsible Federal Budget, comes up with some options assuming a cost of $30 trillion over the next decade (a midway point in the range of estimates):

We estimate the cost could be covered with a 32 percent payroll tax, a 25 percent income surtax, a 42 percent value-added tax, or a public premium averaging $7,500 per capita or more than $12,000 per individual who wouldn’t otherwise be enrolled in Medicare, Medicaid, or CHIP. Medicare for All could also be paid for by more than doubling individual and corporate income tax rates, reducing federal spending by 80 percent, or increasing the national debt by 108 percent of GDP. Tax increases on high earners, corporations, and the financial sector by themselves could not cover much more than one-third of the cost of Medicare for All.

But you say, none of that is remotely feasible politically and would have all sorts of negative economic consequences.

Warren actually has an even harder task since CFRB does not exempt the middle class. Therefore, Warren cannot use “a 32 percent payroll tax, a 25 percent income surtax, a 42 percent value-added tax, or a public premium averaging $7,500 per capita” if they are going to hit the middle class to such an extent that it wipes out savings from removing insurance premiums, co-pays, deductibles, etc. This is the equivalent of trying to balance on elephant on the head of a pin.

[Gothmog]

184. Read the material

I am sorry if you do not understand the material linked to

[Gothmog]

185. Did you actuall read the material and that is what you got from it

Krugman is skeptical about cost savings and compared these cost savings to the same magical thinking used to justify GOP tax cuts that are supposed to pay for themselves. I read and understood the material

[George II]

186. Nobody has ever been able to specifically quantify the "savings" that would result, nor...

...address specifically (i.e., other than in vague terms) the personnel ramifications of "Medicare for All".

-Just how and where would those savings be seen?-
-How MUCH are the savings in real dollars?
-How many people would the government employ in the course of the implementation of such a plan?
-What would happen to the hundreds of thousands of people (even millions?) currently working for the private healthcare insurance companies that will either be "outlawed" (yes, that's the term being used) or dramatically downsized.

These are serious questions that have never been specifically addressed.

[InAbLuEsTaTe]

176. EXACTLY RIGHT!!

Bernie/Elizabeth or Elizabeth/Bernie 2020!!
Either way, they're stronger together!!
Welcome to the revolution!!!

[beachbumbob]

3. how many people know what DRG is? Medicare effectively sets a max cost and once any provider hits

that limit, they simply stop providing services as they will NOT do it for a loss.


everything has limits and some one has to pay for the services as it doesn;t apper out of thin air

[wasupaloopa]

4. 34 trillion vs 1.7 trillion over 10 years

I'm ready for the denials.

[Doodley]

5. This is just bullshit. Other developed nations are able to provide healthcare for all at a fraction

of what US is already paying. There is no need for massive increases in government spending. Stop repeating false right-wing propaganda.

[Yo_Mama_Been_Loggin]

7. Read the article and the links provided

It is not right wing propaganda. It's a left leaning group that did the study.

[Doodley]

82. A "Left leaning" study in America is far right by the standards of most

other developed nations. Sorry, but having lived in the UK most my life, I can recognize far right propaganda when I see it.

[Yo_Mama_Been_Loggin]

84. You're not in the UK

So don't play that shit

[Doodley]

87. What shit? What are you talking about? Listen to yourself.

[Yo_Mama_Been_Loggin]

88. Back at you

Follow your own advice.

As I said, you're not in the UK. We kicked those assholes out over 200 years ago.

[Doodley]

90. USA pays nearly 18% GDP for healthcare. UK less than 10%. Guess what? The Brits

live longer. healthcare outcomes are better, infant mortality is better, everybody is covered. You want to keep a corrupt system that puts business profits over the lives over people? Sorry, but I expect and I demand better, and I am not going to be fooled by any bullshit report that says Americans will have to pay 34 trillion dollars more to cover everybody.

[Yo_Mama_Been_Loggin]

99. Do they now?

Since you offer no respected backup I can't take you word for it.

Learn this if you're capable. Colonialists are never taken seriously.

[dpibel]

104. You didn't ask me, but here are some numbers

I'm thinking governmental agencies constitute respected backup. Could be wrong!

"Total current healthcare expenditure in the UK accounted for 9.6% of gross domestic product (GDP) in 2017, compared with 9.7% in 2016."

"Life expectancy at birth in the UK in 2016 to 2018 was 79.3 years for males and 82.9 years for females; slight improvements were observed from 2015 to 2017 of 3.7 weeks and 4.2 weeks for males and females respectively."

"In 2017, the overall expectation of life at birth [in the U.S.] was 78.6 years, decreasing from 78.7 in 2016. Between 2016 and 2017, life expectancy at birth decreased by 0.1 year for males (76.2 to 76.1) and did not change for females (81.1)."

"There were also fewer live births in England and Wales in 2017 and this meant the infant mortality rate increased to 3.9 deaths per 1,000 live births compared with 3.8 in 2016."

"In 2017, the infant mortality rate in the United States was 5.8 deaths per 1,000 live births."

Life expectancy? Check.
Infant mortality? Check.
I think "everybody is covered" is kind of a given.
As for "better healthcare outcomes," there's actually a lot out there to support that, as well. But I'm thinking, you being a reasonable person and all, you'll figure that life expectancy and infant mortality are two standard indicia of general well-being and figure that the better outcomes is probably true.

I have no idea, but am honestly interested, in what you meant by your ender there. Colonialists? Where did that come from?

[Doodley]

107. Thank you for providing facts that every American should be aware of.

I think the "colonialist" comment was a crass insult of the caliber expected by the likes of Donald Trump. It seems that for some people insults have replaced facts.

[Cha]

12. Yo is Not "spreading rw propaganda".. He

wouldn't do that.

[Zoonart]

31. Other nations do not have a population of

329,064,917. Other nations developed this
Infrastructure and bureaucracy many years ago when it cost far less to implement. We will have to destroy the current health care community in order to save it .It will be tremendously expensive and will take perhaps a decade to achieve.

[Doodley]

83. Thanks for the far right talking points.

[Blue_true]

79. Other nations have two characteristics that we don't have.

First, all are much smaller in terms of population.

Second, the vast majority implemented their systems when rebuilding from war damage.

To get an idea of our costs, it would make sense to add up the cost of a number of nations such that their total cumulative population equals ours.

I have always preferred an approach where we filled gaps, get people that work and can't afford insurance insured at costs that are affordable to them. Cover people in the 50-64.12 age range that are too young for Medicare but are unemployed, or underemployed, but who have assets that prevent them from getting Medicaid.

[Doodley]

85. I've heard the same talking points on Fox News. Ever heard of economies of scale?

A bigger population should mean more savings, not less. Americans are being scammed. We need to wake up to that fact. Get an MRI with insurance - it will be $3000. Now shop around with no insurance - $500. Repeat for hundreds of procedures and screens. It's a rip off.

[Blue_true]

96. Shop around for MRI?

LOL. Cheap where? Billy's Imaging?

I just had a routine medical procedure done. Believe me, I would rather have it done by properly compensated professionals than by someone offering a bargain basement price.

What you seem to gloss over is nations that have lower healthcare costs sunk money into infrastructure years ago, when building out that infrastructure was far less expensive than today. You mention economy of scale, have you ever heard of incremental expenditures? Both are vital to business and societal success. When money is put into structures and systems that are going to last decades, then the incremental costs of keeping those structures and systems up to date are vastly lower than it would be for building out those structures and systems from scratch. Also, "economy of scale" is really a poor example when talking about an issue such as Health statistics. Economy of scale assumes that output is equal, that is a wrong assumption when talking about people's health, where the range of people's health conditions is enormous.

Don't take me wrong. I absolutely love the concept of a universal system where costs can be averaged (i.e., take advantage of the system containing really healthy people who cost almost nothing to offset the costs of expenses for people that have bad health or are gravely ill). In our system today insurance companies have split up the herd and are overcharging each piece of it, an end needs to be put to that, the question is how.

[Doodley]

109. Why do you use the "LOL" when it comes to MRI? I don't find it funny that

my wife and I have to spend so many hours fighting insurance companies, insurance agents, and providers to receive the most inexpensive services, including my wife's MRI that she had last week.

[Blue_true]

115. I would rather pay someone who is not going to rush through something

because they need to get y patients through in an hour to have a chance of paying the bills.

I have had cheap medical care and medical care where the Doctor charges rates that allows him to have a professional staff and good in-office diagnostic equipment - there IS a massive difference in the outcomes.

[dpibel]

94. That's why we have the term "per capita"

The total population really doesn't matter that much in these calculations.

The issue is what do they spend per capita.

But I'd suggest you do the exercise you suggest. Pick a group of EU countries whose population equals that of the U.S.

Since all of them have lower per capita costs, you will discover that their total cost is lower than that of the U.S.

Guaranteed.

It's the magic of per capita.

[Blue_true]

98. I understand what per capital means.

A snapshot value of per capital depends upon what took place in the past. I pointed out that those countries made low cost investments at cheap prices. Those investments are paying dividends now, their new expenditures are just to keep their system modern. In the USA, investments are made by for profit companies, who made those investment to begin with to make a profit. So our per capital costs naturally are going to be higher. To reverse that, government would need to own hospitals and places like imaging, heart and lung and Gastroendo clinics - that requires an enormous PRESENT DAY expenditure of money, an enormous amount when we talk about MFA or similar programs that seek to insure everyone via the government. I believe that closing the ACA gaps is a far saner way to go longterm.

Also, there are some other features, those countries don't have the large number of obese people that we have, nor the net number of people that smoke and drink to excess. There are enormous costs associated with those health damaging conditions being present in this country in large numbers.

[dpibel]

100. I'm afraid you are confused

You are positing what it would cost to move to a national health care system, like the one in Britain.

That is not the same as a single-payer system.

Look at it this way: Currently, all that capital investment that concerns you, is being paid for, to the tune of $3.5 trillion a year. Some of those dollars come from insurance companies, who do not own the infrastructure. Some of those dollars come from the U.S. government which (with the exception of the VA system) does not own the infrastructure.

Moving the source of payments from insurance companies to the government would require no change at all in the ownership of the infrastructure.

What am I missing?

As for your last point: One of the benefits of having universal health care is the ability to offer interventions for people with health issues before they become catastrophic.

[Blue_true]

101. What are you missing? Lots.

First off on infrastructure. Insurance companies have an enormous amount of infrastructure in place to support private insured people. If those people went over to a government run payer, the government would need to either:

Vastly expand government infrastructure such as the VA or Medicare to absorb something like 200 plus million Americans.

Or

Buy the insurance company infrastructure at market prices, or take it by fiat. Either one spells big trouble.

The best option is to fill coverage gaps until we have moved everyone over to one payer. The gradual buildout allows people that are privately insured stay that way until it becomes obvious to them that joining a one payer plan is less expensive for them.

I don't dispute your last point. I do dispute the best way to accomplish that end. In my view, closing the gaps in the ACA gets to that end result faster and for less money sunk in.

[dpibel]

102. Last go round

Insurance companies do not have medical care infrastructure. That's what you were talking about when you talked about the cost of buying MRI equipment, etc.

Yes, insurance companies have office buildings, and cars, and stuff like that. So does the government.

In terms of absorbing the administrative costs of dealing with an additional 200 million Americans (accepting, arguendo, your number), that will actually not be a problem. Republican myths of governmental administrative waste notwithstanding, the administrative costs for Medicare, e.g., are far below those of any private insurer.

I think that we are talking past one another here. I cannot understand your point and you, clearly, cannot understand mine. So you're welcome to a last comment; I'll not respond.

I wish you the very best.

[Blue_true]

116. Insurance companies have extensive claims and payment infrastructure in place.

Plus they have infrastructure for collecting funds (premiums) and negotiating things like drug prices (yes, the largest insurance companies DO negotiate drug prices).

If the federal government took over all healthcare payment and funds collection and drug price negotiation, it would need to build infrastructure to support the non VA or Medicare people in the new system, that would require either setup of a new department, or vast expansion of the roles of existing departments. That stuff takes money.

[UniteFightBack]

6. Throw in free childcare for every baby, free college and eliminating student debt and I say we have

ourselves a winnah.

[bullimiami]

9. The Eye Popping costs of what we pay now are probably more.

Then add on all the schemes to get more money out of you.
- Deductibles
- CoPays
- Out of Network doctors and specialists
- Hidden hospital fees

[blm]

14. Yup. We are already paying WAY MORE, inc bloated corporate overheads

[wasupaloopa]

20. Overhead is an accounting term. It can be figured in many ways. That chart has no explanation.

Warren and Bernie folks have no idea what the true facts are. Just words and unexplained charts.

When you get a real study that supports what you say get back to me.

[blm]

42. Uh huh. No one at Physicians for National Health Program is smarter

than you. It is not a serious group that employs serious studies. I understand.

And the shuttle arrives in.......

[angstlessk]

59. We spent $3.5 trillion, or $10,739 per person in 2017.

That's 35 Trillion...and that does not include people not insured who didn't receive ANY health care.

SO Medicare for all is CHEAPER

https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/highlights.pdf

[blm]

10. "Premiums would disappear, and 95% of all households would save money."

Last edited Wed Oct 16, 2019, 08:55 PM - Edit history (1)

https://pnhp.org/

Single-payer national health insurance, also known as “Medicare for all,” is a system in which a single public or quasi-public agency organizes health care financing, but the delivery of care remains largely in private hands. Under a single-payer system, all residents of the U.S. would be covered for all medically necessary services, including doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs.

The program would be funded by combining our current, considerable sources of public funding (such as Medicare and Medicaid) with modest new taxes based on ability to pay. Over $500 billion in administrative savings would be realized by replacing today’s inefficient, profit-oriented, multiple insurance payers with a single streamlined, nonprofit, public payer.

Premiums would disappear, and 95 percent of all households would save money. Patients would no longer face financial barriers to care such as co-pays and deductibles, and would regain free choice of doctor and hospital. Doctors would regain autonomy over patient care.

The Medicare for All Act of 2019, H.R. 1384, based on PNHP’s AJPH-published Physicians’ Proposal, would establish an American single-payer health insurance system.

[Yo_Mama_Been_Loggin]

13. Are you familiar with Medicare?

It doesn't cover everything. People generally have to get supplemental insurance.

I'm 62 and will be on Medicare in a few years.

[blm]

15. Yes. It all needs an overhaul.

Get to a true single-payer....like other civilized nations.

[wasupaloopa]

18. Why becuase you think so? The American people do not think so. Supporting that is supporting trump

in my book

[blm]

25. Majority of American people DO support single-payer.

Newsflash: The majority of people support gun control.

[CurtEastPoint]

29. I'm 69 and have been on Medicare Advantage for 3 years and beg to disagree

Yes, there are copays and deductibles but not unreasonable.
And my plan has no premium above what Medicare takes from your SS payment.

[Hoyt]

80. But, so many Democrats believe Medicare Advantage is a scam.

If Kaiser were in my area, I’d go back tomorrow.

[CurtEastPoint]

112. I have Aetna and I kinda hate them for some admin and

profit driven details. We have Kaiser here and I hear good things. Have considered switching.

[Hoyt]

113. I liked it. But if I were one of those who had to see a certain doc, take any medicine I wanted,

etc., I would have been ticked.

There were no Marcus Welbys working there, and they were going to start you off with the cheapest drug that might help you. I was OK with that, but a lot of patients aren't.

[eilen]

147. But those are all private health insurance companies

that have contracts with the government. They have structured plans that differ from standard Medicare. Not everyone is suited for those plans. For example, a man living on Social Security will not do well with $10 copays if he has to see a Dr. every week (different specialists) and have homecare or wound care visits that cost $40 in addition to drug costs no matter how low particularly if he is diabetic.

[Hoyt]

148. That's why there is choice, and one can go back to Medicare if

Last edited Sat Oct 26, 2019, 08:55 PM - Edit history (1)

your condition changes. But someone who doesn’t see a doc every week can easily save $150 a month. And there is a maximum out of pocket cap that traditional Medicare doesn’t have.

[wasupaloopa]

16. All fairy tales! Where is the study that supports all that? It is just made up shit!

Anyone of us can write a wish list like that.

[blm]

21. Go to Physicians for a National Health Program site. There are

a number of studies linked there over the years.

Are you accusing them of making shit up, ferreal?

[Hoyt]

30. I've been hearing that since 1977 when I worked for a state Medicaid agency, even believed it.

Fact is, it's going to be tough wringing the profit out of the system. It needs to be done. While I can't get upset about the average doc taking a pay cut, I'm not sure their nurses are going to be happy working at the salaries paid in Canada, UK, Norway, etc.

While I still believe that long-term one government run system will be better -- although subject to political whims of the next trumpian Prez -- I think most people are skeptical and will need to try a Public Option before enthusiastically supporting mandatory MFA.

Warren need to publish what a family making $40K, $60K, $100K, etc., will pay in taxes for healthcare (and all the other programs she's proposing).

"Look, you'll be better off" ain't gonna cut it for most people.

[blm]

36. I don't disagree about a public option as first step.

Which is why I wanted it in ACA.

[Hoyt]

44. If only a Public Option had been enacted, 80% of population would be enrolled by now, close to MFA.

[blm]

46. Exactly.

[kcr]

111. Yeah. If only.

Same talking points being used right now in this very thread killed that.

[Midnightwalk]

19. Let's use some arithmetic

Last edited Wed Oct 16, 2019, 09:03 PM - Edit history (1)

Does 34 trillion in 10 years make sense?

The US spent 3.5 trillion (on healthcare) in 2017 and 3.5 * 10 is close to 34 trillion.

Some of that 3.5 trillion includes Medicare and medicaid so it wouldn’t be fair to count that

Medical costs are still rising faster than inflation aren’t they? But there will be some savings too. Part of the savings will be difficult to achieve quickly because immediately cutting a trillion dollars a year and those corresponding jobs might have some economic impacts

I know it’s way more complicated but 34 trillion is not an outlandish estimate. Depending on the medicare factor above it could be high.

Edit: ancientgeezer made me realize I didn't say 3.5 trillion on healthcare

[AncientGeezer]

40. "The US spent 3.5 trillion in 2017 and 3.5 * 10 is close to 34 trillion."

Actually in the '17 budget yr is was $3.982T expenditures with $3.3 revenue. While adding debt....nothing changed.
And budgets increase every yr automatically.
How do you double that cost without wrecking the economy?
There aren't enough dollars in the U.S. to double it even minus the FICA issues....not even close.

[Midnightwalk]

45. Doh l didn't say on healthcare

I’ll fix that.

Thanks for making me see l said it wrong and for giving the relative size of government spending

The two numbers together show the magnitude of the problem we have to solve.

I’m not defeatist about fixing healthcare but l think it’s going to take multiple steps.

[The Liberal Lion]

24. I think the nature of these discussion that center around the question of

"How can we afford that" are lacking in courage completely and remains the reason why we Americans can't enjoy a robust socialized healthcare system like countries like Canada, England and Germany. Are you telling me we Americans just aren't smart enough to do what other industrialized countries can do? It insults the intelligence to say we can't. The only reason we can't is because we lack the courage to say that indeed we can. I support Kamala Harris, but EW is certainly on the right track and I commend her.

[MichMan]

70. 15-20% VAT

That is how most all other countries pay for it. I don't see any of our candidates proposing that solution

[The Liberal Lion]

106. I agree with you on both counts

and therefore lack of courage. But here in America we think of healthcare of "sickcare". This is a problem. I'm not saying these other countries do it, but our largest obstacle to "healthcare" is getting people to actually be concerned about their health and not just only becoming worried about it when they become sick because they have neglected their health. Health care starts with a healthy lifestyle. Sure the argument of we can't afford it is true when we consider the average American's poor diet and even poorer exercise routine (and certainly I understand not all sickness is related to diet), but when healthcare is tied to wellness these unaffordable cost drop like a rock. So place a VAT on poor diet products and eliminate it for wellness diet products (and I'm not talking about Jenny Craig here). Give tax incentives for exercise programs. This can be done, but it takes the courage to do so.

[former9thward]

138. A VAT is a tax on the poor.

It suppresses consumer spending which costs jobs. What is the unemployment rate in countries with 15-20% VAT? Countries with a big VAT spend next to nothing on their military. That is not an option for the U.S.

[AncientGeezer]

72. The population of thoes 3 nations is approximatly 176million...combined.

The U.S. 327mil....N.Y. State alone has half the population of Canada and can't do "socialized healthcare".
Canada has a GDP of $1.6ish trillion... N.Y.S. a GDP of $1.5ish trillion....yet no socialized HC.
I live in N.Y....I know this.

The 3 countries you site also have alternative coverages.

[The Liberal Lion]

105. Respectfully

It's a matter of tax base

[AncientGeezer]

120. I respectfully disagree..it's a matter of comparing apples to a cactus.

As pointed out above...a 15-20% VAT....if you think the 2010-2014 mid term losses were bad for us......try that..a regressive VAT.
Actually...don't.

[CurtEastPoint]

26. Simple: put a tax on all Wall Street financial transactions

[blm]

39. ✔️

[GeorgeGist]

34. In 2018 the US spent ...

$3.5 Billion on healthcare. Over 10 years that would $35 billion.
https://www.pgpf.org/chart-archive/0006_health-care-oecd

So there's that.

[flotsam]

37. The real question should be "How much does it cost now?"

You know-Medicare, Medicaid, every citizens insurance premiums, every Company's benefits cost, plus 350 million peoples out of pocket costs. That is the number to compare the cost to. I'm betting when compared the number is not too scary.

[flotsam]

38. The real question should be "How much does it cost now?"

You know-Medicare, Medicaid, every citizens insurance premiums, every Company's benefits cost, plus 350 million peoples out of pocket costs. That is the number to compare the cost to. I'm betting when compared the number is not too scary.

[Boxerfan]

43. The eye popping costs of Insurance executives-AND

The toll of human sacrifices in search of profits because those insurance executives work real hard for the money.

This is reee-dick-tou-less. the current health system is bloated & layered in bureaucracy. A simple M4A would obviously cost less due to say 30% less overhead.

And as also mentioned-a simple transaction tax on trades would cover it easily.

Why does yo Momma get a pass on a obviously racist screen name?

Just asking.

[Hoyt]

81. There you go, cut execs' salary to zero, and everyone would save 5 cents a month.

Those same execs oversee administration of Medicare, BTW.

[dpibel]

114. A nickel's a bit low. It's also irrelevant.

I do understand that there's lots of talk about outrageous CEO pay in the health insurance industry. And that's unfortunate, because it allows people to say things like, "It's only a nickel a month."

But CEO pay is also a tiny fraction of what is extracted from the money stream by private insurers.

According to the National Association of Insurance Commissioners, in 2018, health insurance industry profit stood at $23.4 billion.

The same report says 2018 administrative costs were $92.4 billion. On $707 billion of earned premiums, that's 13% administrative costs, which is right in line with the standard representation of private admin costs vs. Medicare, which runs about 3%.

I'm believing (and please correct me if I'm wrong) the CEO compensation (I'm finding numbers ranging from $330 million a year to $1 billion a year) is included in the admin costs. If I'm correct about that (and I don't see another line in the NAIC report that would include it), then the variance doesn't matter much because, as you said, nickels.

But eliminating private insurance doesn't just eliminate piddly bits of CEO pay. It also eliminates profit and 77% of admin costs (the difference between 13% and 3%).

Which would be $23.4 billion + $71.1 billion = $94.5 billion.

Which for 330 million Americans is $286 a year, $23.86 a month, per child, woman, and man.

Not a vast pile of money. But, when you think about it, 477 times as big as a nickel.

And if we're frightened by the scariest of the Urban Institute's projections, the one that says true MFA, including undocumented residents, will cost an extra $720 billion a year, that $94.5 billion gets us 13% of the way to covering that cost.

Oh. And if the private industry CEOs are critical to the administration of Medicare, hire them part time. Because their Medicare admin duties are just a fraction of what they do. And, besides, nickels.

[wellst0nev0ter]

48. $4 Insulin costs $400 a month

And you people are using that fact to "discredit" M4A?

This is why we can't have nice things.

[Joe941]

50. The rich will pay most of it.

[Yo_Mama_Been_Loggin]

52. Are you sure?

Even Bernie said most people's taxes will go up.

[AncientGeezer]

121. No they won't.....they will move their money.

[Joe941]

125. They cant move money that hasnt been made yet.

[BlueMississippi]

53. It will bankrupt the country and people know it

MFA is political suicide.

[Turin_C3PO]

54. It can be done.

But first we need to implement a Medicare buy-in public option. Let people experience for themselves the good coverage a public option would provide. In any case, the transition needs to be done gradually as to not completely shock the current system.

[BlueMississippi]

55. That is not MFA - that is extension of ACA nt

[Turin_C3PO]

56. Yes.

But I’m saying we could eventually get to M4A but it needs careful planning and careful transitioning.

[BlueMississippi]

57. Yes -- but that will take years and I have no problem transitioning nt

[Hoyt]

78. Agree. That's fastest way to better healthcare system as long as so many are skeptical.

[dpibel]

74. How does that work

As mentioned elsewhere in this thread, in 2017 US spending on health care was $3.5 trillion.

$35 trillion over ten years (assuming, incorrectly, flat spending for a decade).

But spending $34 trillion on MFA will bankrupt the country.

Help me understand how that works.

[BlueMississippi]

75. Currently, the entire spending comes from older, at-risk people

When you fund it through taxes, the young, healthy people will bear the brunt of it.

[dpibel]

86. What?

I'm sorry. What do you mean?

That number--$3.5 trillion in 2017--is all spending on all health care in the U.S.

From the link (emphasis supplied):

"The National Health Expenditure Accounts (NHEA) are the official estimates of total health care spending in the United States. Dating back to 1960, the NHEA measures annual U.S. expenditures for health care goods and services, public health activities, government administration, the net cost of health insurance, and investment related to health care. The data are presented by type of service, sources of funding, and type of sponsor.

"U.S. health care spending grew 3.9 percent in 2017, reaching $3.5 trillion or $10,739 per person. As a share of the nation's Gross Domestic Product, health spending accounted for 17.9 percent."

That is what is spent in the U.S. on all health care: young, old, and everything in between.

So I honestly cannot even comprehend what you mean when you say, "Currently, the entire spending comes from older, at-risk people."

I guess you believe that the $3.5 trillion is the annual cost of Medicare. It's not. You can check it out.

Simple truth: We already spend $3.5 trillion a year on health care in the U.S. Some of it is via taxes (Medicare and Medicaid). Some of it is via insurance premiums. Some of it is out of pocket.

But the "young, healthy" people are already paying for their share of it, even if it's via the relatively invisible means of their employers paying health insurance premiums on their behalf.

[blm]

103. Thank you. Some of the arguments against single payer

Are head scratching. Especially for a Democratic site.

[Joe941]

133. We are already well on our way to bankruptcy...

Have you seen tRumps deficits?

[PhoenixDem]

69. Americans are not ready for a 65% income tax

to pay for MFA.

The premiums paid to insurance companies are cheaper.

[MichMan]

71. Haven't you heard? The rich will be paying for all of it

along with free college, free child care and student loan forgiveness.

[PhoenixDem]

73. lol

There aren't enough rich people to pay for it all.

[Turin_C3PO]

76. Where did you get that number, 65%?

Thanks.

[lapfog_1]

77. Over $10,000 a year for every man, woman and child in the US

seems hard to believe.

For a family of 4, $40,000 a year in health care.

[Doodley]

89. You are right. These are bullshit numbers. They are talking point numbers that are there to help

the status quo and the insurance companies.

[dpibel]

91. It is hard to believe

But it's also the official number.

"U.S. health care spending grew 3.9 percent in 2017, reaching $3.5 trillion or $10,739 per person. As a share of the nation's Gross Domestic Product, health spending accounted for 17.9 percent."

https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html

I mean, it's not something made up by some advocacy group. It's just what gets spent on health care in the U.S.

I guess you could postulate that, since 1960, the government has been making up numbers. But I'm inclined to think that maybe it's just a real number.

It doesn't take too many million dollar premature babies, half-million dollar end-of-life heroic interventions, and $70K a dose courses of chemo to get those averages up.

[Doodley]

93. Yes, it is real, but the idea that we have to almost double it to cover everybody is not real.

We are being scammed. If other nations can give everybody coverage, for less money and have better healthcare outcomes and life expectancy, then we should do the same. We don't need to increase costs to provide healthcare for everyone. It is scaremongering to claim otherwise.

[dpibel]

95. I'm sorry.

We're on the same side here, I believe.

See my other posts in this thread.

I cannot comprehend the argument that, although the U.S. currently spends $3.5 trillion a year on health care, there is something threatening and catastrophic about instead spending $34 trillion over a decade (by my math, less money), except having that money administered by the government instead of for-profit corporations.

Yes. We are being scammed. Both by the insurance companies and by the doomsayers who say that the U.S. can't do what every civilized country in the world has been doing for years.

[Doodley]

110. You are correct. I would say that all Democrats need to wake up to what you are saying:

"We are being scammed. Both by the insurance companies and by the doomsayers who say that the U.S. can't do what every civilized country in the world has been doing for years."

[dansolo]

150. Because your math is wrong

That $34 trillion is the increase in government spending, not the total amount of spending, so you need to add in all of the current government spending on top of it. It is also based on very generous assumptions. I expect that costs will very likely be even higher.

[dpibel]

155. Beg to differ

Ummm. If the government takes over all spending (kind of the basic idea of a single-payer system), then what the government spends is, de facto, the total amount of spending.

In point of fact, the Urban Institute report on which the Atlantic screed quoted extensively in the OP is based, projects that, under MFA, annual total spending in the US would increase by $720 billion a year.

So here's the math:

Current government spending: $1.3 trillion a year, $13 trillion per decade.
Private spending, which the government would assume under MFA: $2.2 trillion a year, $22 trillion per decade.

Projected total spending increase from the Urban Institute: $720 billion a year, $7.2 trillion per decade.

The numbers do not match precisely. That accounts for $29.2 trillion of the purported $34 trillion.

But it's in the ballpark.

And the simple fact is this: Under no scenario, would we spend the same amount we're spending now PLUS $34 trillion in government spending.

Question for you: What is your source for "It is also based on very generous assumptions."

[dansolo]

182. My source? The Urban Institute

https://www.urban.org/sites/default/files/publication/99151/estimating_the_cost_of_a_single-payer_plan_0.pdf

In June 2018,the Mercatus Center at George Mason University released a report in which they found that the Medicare for All Act of 2017,1 introduced by Senator Bernie Sanders, would increase federal spending by $32 trillion dollars over its first 10 years of implementation (Blahous 2018). The Medicare for All Act (MFA) would provide universal health insurance coverage with no premiums, no deductibles or other forms of cost sharing (with the possible exception of modest beneficiary contributions for
nongeneric prescription drugs and biologics), broad covered benefits, and tight constraints on provider payment rates. The new program would be fully tax financed. The Mercatus Center report received considerable press attention.2 Frequently, media reports on the Mercatus report mention that the results are similar to those found by the Urban Institute’s 2016 analysis of Sanders’s presidential health reform proposal (Holahan et al. 2016). In that study, we estimated that Sanders’s presidential proposal would increase federal health expenditures by $32.6 trillion dollars over 10 years.

[dpibel]

97. This is pretty wild

If you were to actually follow the first link in the quoted material--which goes to the abstract of the actual Urban Institute study, you would find these words:

"The analysis demonstrates that there is more than one effective approach to achieving universal health care coverage in the United States and highlights the trade-offs of different reform strategies."

IOW, the actual study on which this Atlantic screed purports to be base, seems not to find the same catastrophe that the Atlantic author does.

(Side note: Am I alone in thinking that the Atlantic is not my go-to source for progressive analysis?)

The Urban Institute abstract has this to say about the plan that results in that scary $34 trillion number:

"Coverage and costs:
"This reform option covers the entire US population. National spending on health care would grow by about $720 billion in 2020. Federal government spending would increase by $2.8 trillion in 2020, or $34.0 trillion over 10 years."

Here's the key thing: Yes, the federal government would spend a lot more, because it would be paying the entirety of the current $3.5 trillion a year, instead of something like half that. But national spending, i.e. the aggregate of what the government spends and private spending (be it insurance premiums, co-pays, out of pocket, or whatever) would increase by $720 billion a year.

Now that's not chump change, but it is in the range of what you could get with a wealth tax, with realistic military spending, eliminating insurance company profits, and, yes, the (often deemed chimerical) savings from having a healthier population.

No, I haven't read the whole Urban Institute report. I have no reason, however, to believe that their abstract significantly misrepresents the report.

And it does not appear to me to be a statement that MFA is unicorns and rainbows.

[garybeck]

108. excuse me but how much are we paying now????????????????????????

[iwannaknow]

141. K&R!!!!

[highplainsdem]

117. Ron Brownstein tweet:

Link to tweet

The @urbaninstitute analysis concludes the public option plans most like Biden/Buttigieg etc. would reach near universal coverage with a 10-year cost about 1/2 of one year (!) of the #Medicare4All option they call closest to Warren/Sanders. Revenue needs not remotely comparable

[dflprincess]

118. "Coverage" does equate to access to care

ask anyone with an annual deductible of several thousand dollars.

[myohmy2]

119. the eye-popping...

...cost of exophthalmos if you have no health coverage in our country...

NHS UK,

" Treatment for exophthalmos (bulging eyes) largely depends on what is causing the problem.

In some cases, an ophthalmologist (eye specialist) may feel immediate treatment isn't necessary. You may only be advised to have regular examinations to monitor your condition. "
…………….

" Surgery may also be carried out during the active phase of thyroid eye disease if there's an immediate threat to your vision due to compression of the optic nerve (which transmits signals from the eye to the brain).

Surgery may also be effective if the exophthalmos is caused by other problems, such as issues with the blood vessels behind the eyes. "

https://www.nhs.uk/conditions/bulging-eyes/treatment/
………………………………………

...with Medicare For All you'd be covered and you wouldn't have to go bankrupt or be exited from the emergency room with only an aspirin and a hearty handclasp...

...NHS UK is affordable and it works...

...we can do it...

[Gothmog]

123. Joe Biden's health plan looks like the winner

Link to tweet

The leading presidential contenders continue to debate Medicare for All, a sweeping new government program that would replace private insurance and require trillions of dollars in new federal spending. Senators Elizabeth Warren and Bernie Sanders are the biggest backers. Former Vice President Joe Biden favors more modest changes that would keep private insurance in place but offer more government help for people who can’t afford a private plan.

Voters seem to be siding with Biden. New polling by the Kaiser Family Foundation shows 51% of people favor Medicare for All, down from 59% last year. Other polling shows support for Medicare for All plummets when people realize it would mean abolishing private insurance and raising taxes.

The Kaiser survey, meanwhile, shows 73% of people favor a more limited public option that would keep private insurance in place. That’s up from 65% earlier this year. Among Democrats, 71% support Medicare for All while 85% support a more limited public program.

[gibraltar72]

126. We already pay it.

[iwannaknow]

142. Yes!!!!!!!

[in2herbs]

127. I thought Warren's M4A plan was (essentially) the same as Bernie M4A plan. If so, why only require

Warren to explain?

[Gothmog]

130. Warren Left $30 Trillion Short of Paying for Her Health Plan

I look forward to seeing Warren's plan https://www.bloomberg.com/news/articles/2019-10-17/warren-left-30-trillion-short-of-paying-for-her-health-plan

Elizabeth Warren took a lot of flak at this week’s Democratic presidential debate for being evasive about the taxes needed to pay for the $30 trillion Medicare for All plan she champions. There’s a reason for being vague: Her team hasn’t yet figured out how to pay for it.

“Her taxes as they currently exist are not enough yet to cover fully replacing health insurance,” University of California, Berkeley economics professor Emmanuel Saez, who advised the Warren campaign when developing the wealth tax, told Bloomberg News on Wednesday....

That’s true for the rest of her plans. In total, she’s proposed an agenda that she estimates would cost nearly $6 trillion, according to her campaign. She’s offset those costs with more than $7.3 trillion in tax increases, according to Warren’s estimates and projections from the non-partisan congressional Joint Committee on Taxation.

“She is offering a Medicare for All plan and not offering even close to enough to pay for it,” said Kyle Pomerleau, the chief economist at the conservative Tax Foundation. “One place she hasn’t gone yet is raising the existing individual income tax for top earners.”

However, he added, even that would only garner a fraction of what she’d need to fully fund a health care plan.

[dpibel]

135. 40% is a pretty big fraction

Taking as a given the article's $30 trillion cost, since Medicare and Medicaid already constitute $1.28 trillion a year, that's 43% of the amount needed.

So when the article says she's only looking at "a fraction of what she'd need to fully fund a health care plan," I suppose that's true.

But for many of us, 4/10 is a pretty sizeable fraction.

[Crazyleftie]

131. Let me simplify this

1. I have medicare. I pay premiums. Premiums should stay in place, and they would be LOWER than private insurance, because Medicare does a good job of limiting costs(they have national standard costs for procedures, ie, one hospital can't charge 5000 while another charges 10000. If you are still working you already have these deductions.
2. If the medicare premiums were progressive based on income that would help immensely.
3. The system is already in place and it is spectacularly good with regular statements. Scaling up should not be a problem.
4. Medicare allows you to choose your own doctor/hospital, without referrals.
5. A "tax" may not be necessary, we would just have medicare premiums in lieu of private insurance premiums.

All that being said a private option should be allowed (for conservatives....lol), as well as requiring people to have insurance, as long as the premiums are income based.

[iwannaknow]

139. Well stated!

Regardless of how M4A is funded, without all the overhead the overall cost of healthcare will almost certainly go down, not up. I like the concept of allowing private policies, the premiums of which must be based on AGI income level.

[Gothmog]

136. Support for a public option has been increasing, and for Medicare-for-All has been decreasing

Link to tweet

[Gothmog]

137. Why Elizabeth Warren won't talk about the cost of 'Medicare for All'

Link to tweet

The elephant in the waiting room remains the staggering cost of this new system. There's a reason why Warren avoids the conversation about how we're going to pay for Medicare for All. In fact, anyone with a pencil and paper and third-grade math skills would quickly figure out that this proposal simply cannot work.

Depending on whom you ask, cost estimates range from $2.5 trillion to $4.7 trillion per year. It's important to keep in mind that the entire federal budget for fiscal year 2020 is $4.7 trillion (including a $1.1 trillion-dollar deficit). Basically, we would have to double the size of the government through higher taxes on every American employee and fundamentally alter the structure of the American economy.....

Medicare for All fans propose to demolish our current health care system that certainly needs streamlining, more competition between insurance companies and plans and new and better technology. Other issues that must be addressed are drug manufacturing and distribution networks and hospital consolidation.

While we desperately need reform, any realistic policy proposal would recognize that 90 percent of Americans currently have health insurance. Instead, reasonable politicians should focus on how to cover those who are uninsured or underinsured in our current system.

[iwannaknow]

140. This is a bogus argument. Overall healthcare costs will go down with M4A.

Whether it's financed through premiums or taxes, people will be paying less on average for healthcare.

[Gothmog]

143. Societal savings are not tax revenues and cannot be used to pay for this program

Such a plan in theory may generate societal savings but such savings would not pay for a program. Governments can only spend tax revenues and/or borrowings. This study does not say how one would pay for such a program in the real world. I note that Prof. Krugman like the concepts of such a plan in theory but notes that taxes will have to be raised a great deal to pay for such a plan
Back in 2016, here is his position Prof. Krugman compares Sanders hoped for health care savings to the GOP tax cuts. http://krugman.blogs.nytimes.com/2016/01/19/weakened-at-bernies/?_r=0

On health care: leave on one side the virtual impossibility of achieving single-payer. Beyond the politics, the Sanders “plan” isn’t just lacking in detail; as Ezra Klein notes, it both promises more comprehensive coverage than Medicare or for that matter single-payer systems in other countries, and assumes huge cost savings that are at best unlikely given that kind of generosity. This lets Sanders claim that he could make it work with much lower middle-class taxes than would probably be needed in practice.

To be harsh but accurate: the Sanders health plan looks a little bit like a standard Republican tax-cut plan, which relies on fantasies about huge supply-side effects to make the numbers supposedly add up. Only a little bit: after all, this is a plan seeking to provide health care, not lavish windfalls on the rich — and single-payer really does save money, whereas there’s no evidence that tax cuts deliver growth. Still, it’s not the kind of brave truth-telling the Sanders campaign pitch might have led you to expect.

Today, Prof. Krugman says that such a plan is feasible if you are willing to pay a great deal more in taxes
https://www.alternet.org/news-amp-politics/paul-krugman-explains-why-single-payer-health-care-entirely-achievable-us-and-how

If we went to government provision of all insurance, we’d pay more in taxes but less in premiums, and the overall burden of health spending would probably fall, because single-payer systems tend to be cheaper than market-based."

The amount of higher taxes are not quantified in this article by Krugman. To pay for any such plan will require massive tax hikes

Again sanders has utterly failed in his attempts to get Vermont to adopt his magical single payer plan because the state of Vermont cannot use hypothetical societal saving to pay for this plan. Even Krugman admits that much higher taxes are needed

[dpibel]

156. I ask you again

Text of post #132, edited to correct a billion/trillion error.

It's an honest question.

I have seen you say this before in MFA discussions: "Societal savings."

What do you mean by that?

Because my baseline on this is pretty simple: The outlay for medical care in the U.S. is already right around the projected price of MFA. The scary MFA number is $34 trillion in a decade. The current aggregate spending in the U.S. is $3.5 trillion a year or more.

So the only real question is who administers the money: The government or private insurers.

Somebody sometime may have projected some savings from MFA. I can't answer for why they did that, although it seems likely.

If nothing else, you have to admit, I hope, that eliminating profit and excess administrative costs would automatically save about $90 billion a year.

So it seems to me you are arguing that there will be some inexplicable vast increase in the cost of medical care in the U.S. under MFA which is not offset by "societal savings." But my question is: Why would we spend more than we are already spending? The projections say we won't.

Again, this is just my best guess. Because you state with great certainty that "societal savings" won't solve the problem.

I'm just not getting what the problem you see is.

[Gothmog]

161. NYT-This Is the Strongest Argument Against Medicare for All-

A deep-blue state’s failure to enact a single-payer system shows why a national version is unlikely to succeed. www.nytimes.com/2019/10/09/opinion/bernie-sanders-single-payer.html

Link to tweet

The first problem for any single-payer push would be political support: Mr. Shumlin campaigned on a promise to build a single-payer system in Vermont, but the public never quite bought in. An April 2014 survey showed 40 percent support, 39 percent opposition and 21 percent undecided — a lukewarm result for such a major undertaking. That year, Mr. Shumlin barely won the popular vote against an anti-single-payer Republican. As John E. McDonough of Harvard wrote in a perceptive New England Journal of Medicine analysis of the plan’s collapse, “a clear public mandate” for Mr. Shumlin’s health care agenda “was nowhere in evidence.”

One reason the plan lacked strong support was lawmakers were cagey about how to pay for it. The 2011 proposal included no specific financing mechanism, because Mr. Shumlin’s team worried that might kill its chances.

Initial cost estimates were far too optimistic. A 2011 study led by William Hsiao of Harvard found that single-payer could reduce state health care spending by 8 percent to 12 percent immediately and more in later years, resulting in about $2 billion in savings over a decade. But by the time Mr. Shumlin ditched the plan, internal government estimates showed a five-year savings of just 1.6 percent.....

The Vermont plan was done in by high taxes, distrust of government and lack of political support. Any effort by a Sanders administration to enact a single-payer system at a national level would probably be doomed by similar problems.....

But if it couldn’t work in Vermont, with a determined governor, an accommodating legislature and progressive voters, Mr. Sanders will have a tough time explaining why it will somehow succeed on a vastly larger scale. Vermont represents a practical failure on friendly turf, and that is what makes it such a powerful counter to Mr. Sanders’s proposal.

“If Vermont can pass a strong single-payer system and show it works well, it will not only be enormously important to this state, it will be a model,” Mr. Sanders said in 2013.

As it turns out, it was a model. But instead of showing us how it would work, it showed us why it would fail.

[dpibel]

162. Seriously?

I'm looking very hard in what you've supplied for a definition of "societal savings." Please help me find it.

But even more. You're quoting from an op-ed by "Peter Suderman, features editor at Reason"?

I. Mean. Seriously.

You would like to base democratic policy on the maunderings of a person who writes for a libertarian rag?

No. This is not some sort of ad hominem.

Reason Magazine is a libertarian propaganda rag.

Why are you putting that stuff on Democratic Underground? NYT published it? Don't care. Still libertarian crap.

Always give your music posts a look. But maybe will not so much your posts on substantive matters.

[Gothmog]

163. Read the Krugman article

[dpibel]

164. This part? Or a different one?

"If we went to government provision of all insurance, we’d pay more in taxes but less in premiums, and the overall burden of health spending would probably fall, because single-payer systems tend to be cheaper than market-based."

That's just what you quoted. TBH, I don't have an NYT sub and can't read what lies behind your NYT links.

But those right there are Prof. Krugman's words.

If we pay more in taxes but less in premiums and the overall burden of health spending will likely fall, what is your beef?

[dpibel]

165. Still waiting, btw

for your explanation of the "societal savings" that won't pay for anything.

It's a key part of your argument. Or at least one you keep repeating.

But if you won't say what it means, it's kinda lacking in probative value.

[Gothmog]

168. See post 167

[Gothmog]

166. Again, read the material

The NYT article is on how and why sanders totally failed to get a single payer plan adopted in Vermont. From the NYT article cited above

And so, at the end of 2014, Mr. Shumlin admitted defeat. “I have learned that the limitations of state-based financing, the limitations of federal law, the limitations of our tax capacity and the sensitivity of our economy” make single-payer “unwise and untenable at this time,” he said. “The risk of economic shock is too high.”

The Vermont plan was done in by high taxes, distrust of government and lack of political support. Any effort by a Sanders administration to enact a single-payer system at a national level would probably be doomed by similar problems.....

But if it couldn’t work in Vermont, with a determined governor, an accommodating legislature and progressive voters, Mr. Sanders will have a tough time explaining why it will somehow succeed on a vastly larger scale. Vermont represents a practical failure on friendly turf, and that is what makes it such a powerful counter to Mr. Sanders’s proposal.

“If Vermont can pass a strong single-payer system and show it works well, it will not only be enormously important to this state, it will be a model,” Mr. Sanders said in 2013.

As it turns out, it was a model. But instead of showing us how it would work, it showed us why it would fail.

How will sanders succeed after this failure?

[Gothmog]

191. Choices for Financing Medicare for All: A Preliminary Analysis

This is from a non-partisan think group that is well respected http://www.crfb.org/papers/choices-financing-medicare-all-preliminary-analysis

Proposals to adopt single-payer health care in the United States have grown in popularity in recent years, as numerous lawmakers and presidential candidates have embraced Medicare for All. However, few have grappled with how to finance the new costs imposed on the federal government. By most estimates, Medicare for All would cost the federal government about $30 trillion over the next decade. How this cost is financed would have considerable distributional, economic, and policy implications.

In the coming months, the Committee for a Responsible Federal Budget will publish a detailed analysis describing numerous ways to finance Medicare for All and the consequences and trade-offs associated with each choice. This paper provides our preliminary estimates of the magnitude of each potential change and a brief discussion of the types of trade-offs policymakers will need to consider.

We find that Medicare for All could be financed with:

A 32 percent payroll tax
A 25 percent income surtax
A 42 percent value-added tax (VAT)
A mandatory public premium averaging $7,500 per capita – the equivalent of $12,000 per individual not otherwise on public insurance
More than doubling all individual and corporate income tax rates
An 80 percent reduction in non-health federal spending
A 108 percent of Gross Domestic Product (GDP) increase in the national debt
Impossibly high taxes on high earners, corporations, and the financial sector
A combination of approaches

Each of these choices would have consequences for the distribution of income, growth in the economy, and ability to raise new revenue. Some of these consequences could be balanced against each other by adopting a combination approach that includes smaller versions of several of the options as well as additional policies.

[manintheback]

146. Thanks to none other than the the Koch brother we now know

Not going with single payer will cost us a hell of a lot more than M4A. Thanks Koch brothers.

[link:https://theintercept.com/2018/07/30/medicare-for-all-cost-health-care-wages/|

[ehrnst]

149. Actually, that Intercept claim is a little off, factually speaking

https://www.washingtonpost.com/news/fact-checker/wp/2018/08/07/democrats-seize-on-cherry-picked-claim-that-medicare-for-all-will-save-2-trillion/

https://www.factcheck.org/2018/08/the-cost-of-medicare-for-all/

[George II]

154. We still have NO concrete idea of how much "M4A" will cost overall.

[dpibel]

158. About 11% more than we currently spend

Baseline: Current total US spending on health care is $3.5 trillion a year. That's $35 trillion per decade.

Uninsured American human beings under age 65 in 2018 = 11%.

So if you cover everyone, instead of just 89%, your cost should go up right around 11%.

Why would it be substantially different?

You could, I suppose, argue that those 11% uninsured are far more sickly, so they'll bump the price up. Even if that were true, you're still looking at small change (in the great big scheme of things).

But, more likely, those 11% are poor. Or, maybe, young, healthy, and stupid--that is, after all, the demographic that most hated the ACA mandate.

In any case, there's not some deep mystery here. The US spends $3.5 trillion a year on health care. Paying for 100% of people instead of 89%? There's a pretty small range on how catastrophic that will be. (Spoiler alert: Not very.)

[Kurt V.]

151. my eyes popped. hope i can afford to get them fixed. haha.

Seriously tho, there is not worthy argument against m4a.

[rainy]

152. The discussion ends when you consider we are all human and should be better than this, meaning, yes

we can take care of the sick and wounded without bankrupting the nation. We are better than this bs that we can't afford to take care of our fellow humans. Can we evolve to be this good and compassionate being that values people over war, hate, mine, yours, insane consumerism etc...?

[mn9driver]

157. In 2017 total health care spending in the US was $3.5 trillion.

It is more now. Multiply that out 10 years and you get $35 trillion.

This isn’t rocket science. Medicare for all gives more coverage and better outcomes for the same or less money. Apparently Americans are too stupid to do simple math.

[questionseverything]

159. controling costs is the first step

medical care is just too important for capitalism

[Yo_Mama_Been_Loggin]

173. Word of advice

You don't convince anyone by calling them stupid.

[Skid Rogue]

170. Honest question

Last edited Sun Oct 27, 2019, 11:04 PM - Edit history (4)

My partner and I pay about 450 dollars a month as a payroll deduction for our insurance. If that amount was not paid to BCBS, but paid instead as a tax to cover our part of a national healthcare system, what would the difference be? I mean, insurance is not free for anyone. What is the total we, as Americans, pay nationwide for our collective insurance, isn't it kind of an eye popping price to begin with? This is not a rhetorical question. I really want to know the answer... the difference. Will we pay $200, $550, $850, $1550... isn't that the question many of us will ask?

[at140]

177. I can prove MFA will save money for middle class

> No longer medical bills will be the leading cause of middle class bankruptcies

> Every dollar of profit (and the total is tens of Billions) by the private health insurers goes into MFA pot.

> Every dollar of obscene CEO & Executive compensation is kicked back in the MFA pot

> Every paycheck paid to the vast army of staff employed by private insurers goes in to the MFA pot.

> The vast army of employees in doctor's offices will be reduced, which can reduce doctor's bills significantly.

> The vast army of employees in Hospitals haggling with private insurers will be reduced significantly,
reducing hospital bills significantly

> You will not be paying higher premiums due to pre-conditions

> You can change jobs more easily since you never have to worry about losing health insurance or paying Cobra payments

> MFA gives the gov't enormous clout in negotiating prescription drug prices...another saving for everybody

[boomer_wv]

178. More

You can bet projections are low, since we can never do anything for less than we expect.

I'd be surprised if the number was under 50 trillion by the time all is said and done.

[Tiggeroshii]

179. Vs the eye poping cost of the current insurance system?

Vs the eye poping cost of the military indistrial comlplex? Charter schools? Not all costs are measured in dollars.

[Turbineguy]

180. It might be hard to quantify.

Less people will die prematurely. Many, many fewer people will go bankrupt. Obviously costs will go up with people going to doctors when they are sick. But costs will go down without for-profit insurance companies.

In my case, counting before I was 65, if my income taxes had doubled, I would have been ahead on my health related costs.

[Gothmog]

187. A dose of reality for Medicare-for-all

Link to tweet

Now we have two more data points. The quite credible think tank, Committee for a Responsible Federal Budget, comes up with some options assuming a cost of $30 trillion over the next decade (a midway point in the range of estimates):

We estimate the cost could be covered with a 32 percent payroll tax, a 25 percent income surtax, a 42 percent value-added tax, or a public premium averaging $7,500 per capita or more than $12,000 per individual who wouldn’t otherwise be enrolled in Medicare, Medicaid, or CHIP. Medicare for All could also be paid for by more than doubling individual and corporate income tax rates, reducing federal spending by 80 percent, or increasing the national debt by 108 percent of GDP. Tax increases on high earners, corporations, and the financial sector by themselves could not cover much more than one-third of the cost of Medicare for All.

But you say, none of that is remotely feasible politically and would have all sorts of negative economic consequences.

Warren actually has an even harder task since CFRB does not exempt the middle class. Therefore, Warren cannot use “a 32 percent payroll tax, a 25 percent income surtax, a 42 percent value-added tax, or a public premium averaging $7,500 per capita” if they are going to hit the middle class to such an extent that it wipes out savings from removing insurance premiums, co-pays, deductibles, etc. This is the equivalent of trying to balance on elephant on the head of a pin.

[melman]

188. Jennifer Rubin

lol

[Gothmog]

189. Choices for Financing Medicare for All: A Preliminary Analysis

This is from a non-partisan think group that is well respected http://www.crfb.org/papers/choices-financing-medicare-all-preliminary-analysis

Proposals to adopt single-payer health care in the United States have grown in popularity in recent years, as numerous lawmakers and presidential candidates have embraced Medicare for All. However, few have grappled with how to finance the new costs imposed on the federal government. By most estimates, Medicare for All would cost the federal government about $30 trillion over the next decade. How this cost is financed would have considerable distributional, economic, and policy implications.

In the coming months, the Committee for a Responsible Federal Budget will publish a detailed analysis describing numerous ways to finance Medicare for All and the consequences and trade-offs associated with each choice. This paper provides our preliminary estimates of the magnitude of each potential change and a brief discussion of the types of trade-offs policymakers will need to consider.

We find that Medicare for All could be financed with:

A 32 percent payroll tax
A 25 percent income surtax
A 42 percent value-added tax (VAT)
A mandatory public premium averaging $7,500 per capita – the equivalent of $12,000 per individual not otherwise on public insurance
More than doubling all individual and corporate income tax rates
An 80 percent reduction in non-health federal spending
A 108 percent of Gross Domestic Product (GDP) increase in the national debt
Impossibly high taxes on high earners, corporations, and the financial sector
A combination of approaches

Each of these choices would have consequences for the distribution of income, growth in the economy, and ability to raise new revenue. Some of these consequences could be balanced against each other by adopting a combination approach that includes smaller versions of several of the options as well as additional policies.

[melman]

192. lol

"In the 1990s, CRFB formed a "Cost Containment Coalition" that objected to the Clinton Health Care reform proposals and any new taxes to pay for health care. CRFB's opposition was portrayed as a tough, principled stand, but years later, documents were revealed that showed the Tobacco Institute, a now defunct industry lobbying group, funding the coalition[4] while Philip Morris funded CRFB President Carol Cox Wait.[5] Internal Philip Morris memos found in the Tobacco Library describe how the firm worked with CRFB to set up the coalition to help the company achieve its "overriding objective" of avoiding tobacco excise taxes as part of any health care reform package.[6]

Cox Wait, who is reportedly married to Philip Morris vice president Bob Wait,[7] was doing double duty as a federal budget consultant to the tobacco giant. An internal Philip Morris document explains why this is helpful to them: "Because of her bipartisan Board, 'Committee for a Responsible Federal Budget,' and given her 'neutral' status, Carol is able to access many people who would be inaccessible to us given our issues."[5]


---

"CRFB is listed as a partner organization in the Fix the Debt Campaign, but is better described as a "parent organization."[8] The Campaign to Fix the Debt is the latest incarnation of a decades-long effort by former Nixon man turned Wall Street billionaire Pete Peterson to slash earned benefit programs such as Social Security and Medicare under the guise of fixing the nation's "debt problem." Fix the Debt is listed as a "project of" the Committee for a Responsible Federal Budget (CRFB) on the organization's website as of February 2013, which is itself a project of the New America Foundation (NAF).[9] The Peter G. Peterson Foundation gave NAF $2,050,000 from 2009 to 2011.[10] CRFB used to be an independent organization, but became associated with NAF in 2003.[11]"

https://www.sourcewatch.org/index.php/Committee_for_a_Responsible_Federal_Budget

[Gothmog]

193. Medicare for All's jobs problem

Link to tweet

Initial research from University of Massachusetts economists who have consulted with multiple 2020 campaigns has estimated that 1.8 million health care jobs nationwide would no longer be needed if Medicare for All became law, upending health insurance companies and thousands of middle class workers whose jobs largely deal with them, including insurance brokers, medical billing workers and other administrative employees. One widely cited study published in the New England Journal of Medicine estimated that administration accounted for nearly a third of the U.S.’ health care expenses.

Even if a bigger government expansion into health care left doctors, nurses, and other medical professionals’ jobs intact, it would still cause a restructuring of a sprawling system that employs millions of middle-class Americans.

University of Massachusetts researchers who analyzed the 2017 version of Sanders’ Medicare for All bill estimated that nationwide more than 800,000 people who work for private health insurance companies and a further 1 million who handle administrative work for health care providers would see their jobs evaporate.

The workers generally earn middle-class wages, according to the November 2018 study forecasting the economic ramifications of Sanders’ plan. The median annual income of a worker employed in the health insurance industry is nearly $55,000; for office and administrative jobs at health care service sites, it’s about $35,000, researchers said.

“The savings don’t come out of the sky,” said Pollin. “The main way we save money is through administrative simplicity. That means layoffs. There’s just no way around it.”

[Gothmog]

194. Nancy Pelosi is "not for doing away with Obamacare" and prefers to give people choices.

Link to tweet