... to taxes. Corporations would reap the loss of a big expense, while taxpayers would see a big increase.

If the law could get that money from corporations, diverting from health insurance cost to a tax for single-payer, that would make sense. But it's a big "if". Corporations would probably see it as a cash-flow bonanza, allowing them to buy more of their stock back from the market. They would not voluntarily use it to pay for universal health care, or to bump employee pay to cover increases in taxes.

So, it total, universal health care would be a bargain. The devil is in the details, as usual.

would also be far less than the current employer contributions, they would still have $$ left over for the greed things

As a general rule, corporations pick up 2/3 of premiums and employees pay 1/3. Some union companies pay 100% and there may be some that only pay 50%

With that lowering of costs, smaller businesses could do better for their employees than previously.

....and the expense spoken about doesn't take into account the "losses" - hundreds of thousands, if not millions, of people would lose their jobs or be uprooted, forced to relocate. That's just a simple example, there are many other factors that haven't been considered, either.

Both Warren and Sanders have been telling us that it would cost $3.5 Trillion per year because that's what we supposedly spend per year on overall healthcare costs.

However, when forced to do a more thorough analysis in November 2019, her cost estimate went to $5.2 Trillion per year ($52 Trillion over 10 years). Other credible organizations -- like the Urban Institute -- put it at $59 Trillion.

Point is, they don't know what it will cost, and apparently really don't care. It's just a promise that they think will bring them votes.



https://www.cnbc.com/2019/11/01/elizabeth-warren-releases-plan-to-pay-for-medicare-for-all.html

https://www.npr.org/2019/11/01/775339519/heres-how-warren-finds-20-5-trillion-to-pay-for-medicare-for-all

https://www.politico.com/news/2019/11/01/elizabeth-warren-medicare-for-all-plan-063775

https://khn.org/morning-breakout/warrens-52t-plan-to-pay-for-medicare-for-all-leans-heavily-on-employer-taxes-avoids-increase-for-middle-class/

What will be the cost to society if we do not find the means of funding Medicare for All?


Yes, there will have to be a transition period. Yes, there will be screw ups. Yes, it will not be perfect.

But, how many people have to die, live with chronic conditions, suffer bankruptcy or have their entire world turned upside down because we fail to act?

What will be the cost?

single payer and covers everyone?

Or perhaps an economic one.

But when it is you that needs treatment that you cannot afford because you're not insured, you have crummy high-deductible insurance or you simply cannot afford the financially crippling copay, then you sing a different tune. But no one hears because hey, we can't afford it.

We CAN afford a giant tax cut for billionaire parasites. We CAN afford nearly $733 billion for 'defense.'

But we cannot afford a single payer system for Americans.

There is NO way you can tell me that. Because it has to do with how the tax code is structured.

It also has to do with morality and common decency. We are the ONLY, ONLY, ONLY country in the industrialized world that does not have a universal health care system.

Britain has one. How do they afford it? What percent of their GDP does healthcare take up? Denmark? Holland? France? Germany? Canada?

No, this is a moral issue. The only reason we are even having this argument is that big pharma and health insurance lobbies are SO powerful, corporations are considered people, and under Citizens United, a dollar is considered free speech, so they can spend unlimited amounts of money fighting this one thing. That's why. All about GREED as opposed to doing the right thing and taking care of our people.

As to the numbers, there are currently 411,670 people employed with direct health insurance carriers. This industry has a 12.72 job multiplier, which means that 5,236,440 jobs could potentially be affected. HOWEVER, if this was spaced over a period if five years with expanding coverage each year, this would be partly mitigated. In addition we have a workforce development system that presently retrains people who have lost their jobs as a result of NAFTA by giving them two years worth of monthly unemployment insurance payments, AND tuition assistance for up to two years to get training to make them marketable.

Again, a matter of national priorities. Sadly, the healthcare of the American people is NOT a priority in this country, except to a couple of Democratic candidates who are being called 'socialists'.

and not the just the two who are being called 'socialists'.

The question isn't if it a priority, its how to get from here to there.
And losing the election is not going to improve the chances or timeline to get from here to there.

The people who wanted a revolution instead of gradual change, got us the orange menace. And so we have been going backward for 3 years on healthcare. With the possibility that all the gains from the Obama administration being lost entirely.

And, yes, I'm quite aware the argument is how to get there. But I am equally aware that some of the potential solutions are being walled off from us by big corporate lobbies. And that is sickening.

As to your third paragraph, that's a bit strong. Yes, some of the people Bernie brought in who were not Democrats, but followed him, caucused for him, voted in the primary for him did not vote for Clinton. That was pretty bad, I agree. And I also agree that if these people had not voted Stein or the libertarian in three swing states, Clinton would have won.

But I think you are deliberately putting meaning into Bernie's 'political revolution' that is not there. This political revolution, Fresh, is not a revolution at all, if you read what Bernie is saying. Sadly, it is basic civics.

That's right. Basic civics. To take our responsibility as citizens of a republic seriously enough to actually dig into issues and make informed decisions about how to vote. Be active in the Democratic party at the precinct, county and state level. Caucus. Vote in the primaries. Vote in the elections.

And, when the people you have (or haven't) voted in actually go and take office, keep track of what they are doing, and be in regular contact with their offices via telephone, email and snail mail.

Read what Bernie has said about the 'political revolution.' THAT is what he's saying. We need, as a people, to embrace basic civics. The kind they no longer teach in schools. I mean, think about people you know who can spout statistics, trends and can make sophisticated analyses of SPORTS teams, or reality TV, but don't know Congress has two houses, or how many justices on the Supreme Court. That's what Bernie is saying on 'revolution.'

Because most Americans are really, really ignorant, and the corporate-funded media, AM talk radio and a variety of other propaganda organs set forth in Lewis Powell's 1971 manifesto like to keep it that way. As George Carlin is famous for saying: They don't want citizens who think critically, "they want obedient workers." And again, "It's a big club, and YOU (we) ain't in it!"

Just remember, Fresh, that the powers that be are afraid of us because we are many and they are few. If we engage in basic civics, become informed, vote accordingly and stay engaged, that IS the revolution he's been talking about. But, hey, people LOVE to purposely misunderstand that one.

Oh, and leave off the 'bullshit.' Not necessary.

Warren's plan would annually cost 5 times the entire defense budget plus the yearly "lost tax revenue" of the latest tax cut. In other words, not spending a penny on defense and repealing trump's cut, doesn't come near covering the cost.

I absolutely agree with the immediate goal of getting everyone covered by a viable insurance plan be it subsidies, expanding Medicaid, offering some type of Medicare program, MFA that doesn't cover dental (yeah, I know dental can contribute to overall health), retaining some cost sharing, telling some drug companies that we just aren't going to pay for that much for any drug no matter how loudly patients scream, etc.

But, we need to go into this acknowledging everyone is going to have to make some sacrifices -- providers, employees like nurses, health care corporations, patients, etc., to come up with something truly affordable.

Undoubtedly, we can tax the hell out of million/billionaires. Unfortunately, we need that tax money for other things too -- climate change, education, income redistribution, childcare, jobs training, infrastructure, bolstering social security, deficit and debt reduction, etc.

Every country has made concessions that America would gripe to hell about, even for a system that is much better than what we have now.

Canada doesn't cover prescription drugs (you have to buy a private policy for that), other countries pay doctors, nurses, etc., less than we do; Britain has copays on prescription drugs; Britain will take your assets to pay for long-term care; there is some rationing in other countries and some services are actually denied to older or others to sick to benefit; and there's a lot more.

Point is, why do we keep talking about 100% coverage, when other countries don't do it. It is not financially viable in the short-term and any candidate -- like Warren or Sanders who simply says no one in middle class will have to pay a penny because we can pay for it by cutting defense and reversing tax cuts, is flat out lying to us. And, in 2020, those candidates won't win the general election.

_____________________

Here is an article on how Britain essentially rations drugs.

"National Institute for Health and Clinical Excellence (NICE) NICE's rationing decisions start with a basic premise: The government should spend its limited resources on treatments that do the most good for the money. NICE calculates cost-effectiveness with a widely used measure called a quality-adjusted life year (QALY)."

https://www.pri.org/stories/2010-12-17/how-uk-rations-health-care


Christ, if someone suggested that as one way of being able to afford a viable system much better than what we have now that would keep people from going bankrupt, CommonDreams, populist candidates, etc., would throw a fit.

Another article --

"Since the 2008 financial crisis, the U.K., like many countries, has been taking in less tax revenue — so it's had to cut spending. Its expenditure on the National Health Service has still grown, but at a slower pace than before. That means drugs are now being rationed. Tens of thousands of operations have been postponed this winter. Wait times at the emergency room are up, says Richard Murray, policy director at the King's Fund, a health care think tank.

https://www.npr.org/sections/parallels/2018/03/07/591128836/u-k-hospitals-are-overburdened-but-the-british-love-their-universal-health-care
________________

Gone on long enough, sorry.

We have to get across to people here that they aren't going to get a perfect system that won't cost them anything, might require some rationing -- but rationing that is better than self-imposed rationing because we can't pay for it or might go bankrupt -- and the like. I don't see anyone doing that.

with pretty much any of the candidates provided we also flip the senate and keep the big house majority.

Guess I'm a Utopian. In fact, I'm sure I am. Because I'd like to reorganize pretty much everything around human need. Yeah, I know...ain't gonna happen. But a nice, warm, fuzzy thought!

I think for me - and you know how I feel about health care, because we've talked before - as long as there's REAL progress in reversing the Republican sabotage that has happened over the last decade, and making general improvements in cost, I will be OK. I suspect that's how most people feel.

My strategy has always been to ask for the moon, in the hope that when you get less it will still be enough.

But, Hoyt, a rhetorical question: Why do we have all this money for tax cuts and for defense, wars, bombs and so on, but we don't make it a priority to take care of our people, including you and me?

No need to answer that, but the question must stand during each election year, each primary season. Because we're out here, watching, waiting, hoping that we'll elect people who actually DO care about us enough to do more than just pay lip service to things like head start, subsidies for childcare, healthcare, and so on. And, frankly, after most elections I'm still hoping.

With the exception of Obama. He and the Dems did pass the ACA. That was a big deal. But most of the time, the word is BOHICA. I suspect you know what that means

was because it was adopted shortly after WWII during which English went without -- or strictly rationed -- just about everything.

I wish we had adopted universal care then. We'd probably have a great system today without the hard work of convincing people it will be good for society. And a lot of misery would have been avoided too.

I just want something done, even if it is only a 40% improvement over ACA for the next few elections. Maybe some significant subsidies to buy coverage and elimination of most copays/deductibles for people with limited income. If we don't win in 2020, I fear we'll move backwards.

Had to look up the acronym -- BOHICA -- but I know exactly what it is. I have remained flexible from bending over.

someone will have to process those MFA claims. They ain't gonna process themselves

Even with the most sophisticated auto pay programs stuff kicks out for one reason or another and has to be broken down and reviewed by someone.

A claim denies for one reason or another, and either the provider or the patient questions that decision. Somebody has to review that claim and make a decision. One of my best jobs ever was doing exactly that for the Medicare Part B carrier in my state.

A good solution would be to subcontract the paperwork to the claims departments of various carriers and make them bid on it, which is what was done in the early days of Medicare. An existing claims shop could set up a dedicated department using current employees, get them trained on the plan and that would be that.

Regardless, whoever is handling this stuff is going to want experienced claims analysts. Providers are going to want payment you know.

The bidding process is quite tough too. Contractors get changed often.

The claims process really is much more automated than one would think. Claims kickout -- sex doesn't match the procedure, the patient already had a cataract operation on the left eye, procedure not covered, service not covered for diagnosis, provider's office screwed up, etc. -- and an automated explanation is sent to the provider telling them to correct it. It's seldom that you ever get to a real person, and that's an experience in itself.

But, you are correct that some will be needed for claims processing if more beneficiaries are enrolled in Medicare, answering patient questions, provider certification, quality and utilization review, etc. But, there will be a lot of private insurance employees who are no longer needed too. I'm not much for featherbedding in any industry, but it is one of the factors that have to be considered to some degree.

I did not know Medicare did that in its early days.

They take a loss on Medicare and Medicaid patients (particularly Medicaid).

As you pointed out yourself, going to MFA would mean spending $3 trillion as opposed to $3.5 trillion. That's $500 billion that providers are currently getting that they won't get under MFA, which means a lot of hospitals and doctors' practices will have to close.

The money for MFA works out very well, unless you're in the business of providing medical care, in which case it is a dramatic cut.

I was planning to look more at the details and form some responses throughout my day off yesterday as posts came in, but the Kobe Bryant news just left me shook all day. Still feels sureal.

It's all something I'll be looking at for some time, though.