If Bernie attacks the democrats in any way this evening

[ehrnst]

158. Well, since you don't seem to understand much about what happened

as your insistence that "rich people wanted to kill it" indicates, here is an overview.

Two factors explain most of the decline in the plan's financial prospects. First, the anticipated federal revenues from Medicaid and the ACA declined dramatically. Second, Shumlin's policy choices significantly increased the total projected cost of Green Mountain Care: raising the actuarial value of coverage — the expected portion of medical costs covered by a plan rather than by out-of-pocket spending — from 87% to 94%, providing coverage to nonresidents working in Vermont, and eliminating current state taxes on medical providers.

Public disagreement over single payer was clear in an April 2014 survey showing 40% public support, 39% opposition, and 21% undecided.1 Though Shumlin's team had worked hard on policy development between 2011 and 2014, they had neglected to launch a serious and sustained effort to educate the public — a crucial missed opportunity. Indecision was evident in the Vermont legislature, where strong support for single payer was hard to find. Also, the administration's disastrous launch of its ACA health insurance exchange website, Vermont Health Connect, created doubts about the state's capacity to assume management and administrative responsibilities for the entire health care system.

Asking the legislature to approve a new 11.5% payroll tax on employers and income taxes on households as high as 9.5% to finance Green Mountain Care would have increased the size of Vermont's 2015 state budget, set at $5.6 billion, by 45%. Even though the taxes would have replaced private insurance premiums that employers and individuals currently pay, and even though the Internal Revenue Service had agreed that the taxes would be federally deductible, in political terms it would have been a mammoth increase that would have been glaringly evident on every Vermonter's tax bill, unlike employer-based health insurance premiums, which most workers fail to notice. According to research in behavioral economics, people pay more attention to hypothetical losses than to hypothetical gains. The political furor that would certainly have erupted over Shumlin's tax plan — as foreshadowed by the political uproar over the ACA — would have left most Vermonters believing they would be losers. Shumlin's decision to withdraw the plan represented a failure of political will — but sometimes making decisions because of likely political consequences is the necessary, albeit regrettable, thing to do.

http://www.nejm.org/doi/full/10.1056/NEJMp1501050

"You do know that the taxes offset the out of pocket costs of insurance by a large degree right? "

You also keep repeating this as a mantra. But you have to show numbers, and you have to bring down costs in order to bring down out of pocket costs... It's much easier to keep costs low than to bring them down. So, you can't just point to other countries and say "See? That's what will happen when we do it!!!" when it won't.

You seem to think that moving the amount of money needed from one portion of the economy to another can simply be done via legislation. That's not how it works.

But you have made it clear that you will not accept any evidence to that effect - you will accuse the source as being "corporate!!" or otherwise wrong if they don't walk lockstep with Sanders. But, with hope that you might get a glimmer of what is actually involved..

But while a single-payer system would undoubtedly produce efficiencies, it would also bring huge disruptions. Said Starr, single-payer supporters “haven’t worked through the consequences.”

One of the biggest is exactly how to redistribute literally trillions of dollars. The problem, said Harold Pollack, a professor at the University of Chicago, is that the change will create losers as well as winners.

“Precisely the thing that is a feature for single-payer proponents is a bug for everyone who provides goods and services for the medical economy,” he said, since their profits — and possibly their incomes — could be cut.

And it’s not just the private insurance industry (which would effectively be put out of business) that could feel the impact to the bottom line. Parts of the health care industry that lawmakers want to help, like rural hospitals, could inadvertently get hurt, too. Many rural hospitals get paid so little by Medicare that they only survive on higher private insurance payments. Yet under single-payer, those payments would go away and some could not make it financially. “You would not want to wipe out a third of the hospitals in Minnesota by accident,” Pollack said. “And you could,” if payments to hospitals end up too low.

There are also questions about how feasible it would be to have the federal government run the entire health care system. “It’s hard to be nimble” when a system gets that big, said Ezekiel Emanuel, a former health adviser in the Obama administration now at the University of Pennsylvania. “No organization in the world does anything for 300 million people and does it efficiently.”

The politics of Medicare — which serves roughly 50 million Americans — already make some things difficult or impossible, he said, pointing to a current fight in which doctors and patient advocacy groups blasted a proposal to move to a more cost-effective way to pay for cancer drugs. “You already can’t do certain things in Medicare because of the politicization,” he said. ”When you cover the whole country, it would be a lot of gridlock.”

Pollack agreed, and pointed out it’s not just the health care industry that could revolt. When the Affordable Care Act was rolled out in 2013, he said, “the people who couldn’t keep their old plans — a very tiny number as a percent of Americans” were furious. “We saw how difficult that was and how angry the public was when that promise wasn’t kept. Now imagine the major shift we’d have to do to move to a single payer system.”

http://khn.org/news/democrats-unite-but-what-happened-to-medicare-for-all/