But I suspect you already knew that.

....I don't make important decisions based on assumptions.

But Bernie has said on the record he will raise taxes on middle income folks as well to pay for M4A. That seems like a tough sell in a country full of people who struggle with nuanced concepts.

[link:https://www.washingtonpost.com/politics/2019/11/05/warrens-plan-pay-medicare-for-all-does-it-add-up|]

Only pasted the summary at end because there’s too much detail to excerpt.

Basically the numbers add up if it all goes according to plan and the wind is blowing at just the right speed and direction. In reality what would pass would have to be less ambitious. Prescription reform and reimbursement reform coupled with a public option is a good first step to me.

Your taxes aren’t going up and you can keep your more expensive insurance is a much better message to me. Once a government plan is running let employers push workers onto that plan because it’s cheaper and better.

By the way, the article mentions that bernie doesn’t have the same details.

...what might happen if anything changes.

But the OP is about Sanders' plan, not Warren's. Sanders hasn't given us much detail whatsoever.

There are other factors, too - how can the government dictate how much a doctor can charge for a visit or procedure? What happens to medical and drug research when the government limits how much revenue they can get?

Or maybe I should say the op could have been candidate neutral so I answered as if it were. I think i said bernie doesn’t have the same details.

If the government pays the bills they can set the price just like they do for Medicare. But today providers can refuse Medicare patients and hospitals say they are only reimbursed 90% of costs. Reimbursement costs are going to be difficult to rein in and it won’t happen in one election cycle in my opinion

I don’t have a philosophical problem with medical price controls even if the government isn’t the payer. It is not a free market. I have a pragmatic problem in that we can really screw up the availability of providers in some specialties and geographies if we get the rates wrong.

I’m more optimistic on pharmaceutical reform. A lot of basic research is government funded. Companies spend like 20% on research. A lot of the problem is in gouging on old medicines. Some of the most critical research is on new antibiotics and that’s probably going to have to be government funded anyway.

I see the risk/reward as simpler. The priority at this moment should be getting existing drugs affordable at the risk of some new wonder drug being delayed. We should be able to find a balance but for where we are I favor affordability.

It’s an extremely complicated problem akin to changing the engine in a car while it is still being driven. The current system causes deaths and ruins lives. If we screw up reforms the delayed treatments and closed hospitals will also kill people. People often talk as if reform should be easy because the system works better elsewhere. The complexity is really in how do we get there without too much disruption.

The political problem is even worse. We have to convince voters they won’t experience any pain ion the way to getting better healthcare.

Thanks for the thread Donkees.

We have to gradually pull people there over time. Bernie wouldn't get it through the House, let alone the Senate.


And his surrogates are already admitting as much (AOC).

It may not happen this year but that day is certainly coming. The younger voters powering Sanders’ campaign will make sure of that.