General Discussion
In reply to the discussion: Bernie Sanders talks universal Medicare, and 1.1 million people click to watch him [View all]ehrnst
(32,640 posts)Canada didn't go federal single payer until all the provinces had done so independently, so when a very liberal government was elected, all they needed to do was add a federal layer. Judging from the lack of success in Colorado, Vermont and California to do this, that's likely not going to happen here, at least not in our lifetime.
Canada also doesn't have what's being promised in "Medicare for All" - no general oral health care, no RX, no eyeglasses or hearing aids, so a comparison needs to include that.
Keeping costs down is much easier than slashing them. Cutting services for people who have them and are happy with them is much harder than offering medical care to people back when they had no access to physicians, let alone wanted to keep their doctor. In England the national system started in the 30's, when health care wasn't as expansive or had as many expensive technologies and procedures, and people weren't expecting a particular access to them. There wasn't a system in place, so going to any system was easier to get people on board with. We are way past that point here in the US, with a system that is a substantial part of the GDP, and a major change in the funding mechanism will disrupt health care delivery if done too quickly. And that's not a good kind of "disruption." The Sanders plan doesn't take into account those factors, and has been shown to cost more than it claims, and will disrupt health care delivery far more than it claims to do in eight years:
"When Sen. Bernie Sanders (I-Vt.) proposed a Medicare for all health plan in his presidential campaign, the nonpartisan Urban Institute figured that it would raise government spending by $32?trillion over 10 years, requiring a tax increase so huge that even the democratic socialist Mr. Sanders did not propose anything close to it."
https://www.washingtonpost.com/opinions/single-payer-health-care-would-have-an-astonishingly-high-price-tag/2017/06/18/9c70dae6-52d2-11e7-be25-3a519335381c_story.html?utm_term=.b74a17534317
https://www.urban.org/research/publication/sanders-single-payer-health-care-plan-effect-national-health-expenditures-and-federal-and-private-spending
And there was not a virulent anti-government movement in the few countries that do have single payer. Even Bernie's not going to change that part of the rust belt.
Switzerland voted down single payer in 2014, opting to keep the ACA style universal health care system they have.
Non-political health care policy think tanks say that the most feasible, affordable and least disruptive to the health care delivery system way to get to universal health care in the U.S. is gradual incremental expansion of the ACA, allowing people to buy into Mediare earlier, expanding CHIP to all kids, etc. That's what Hillary was proposing.
If we could just focus on what actual health care policy people say instead of what a politician promises, we could get to Universal Health Care more quickly.
You would think that we would have learned that lesson watching the GOP promise to eliminate abortion by getting rid of Planned Parenthood. Politicians who contradict medical and public health professionals, and go on the attack when the professionals weigh in aren't doing "progressives" any good. And neither is attacking anyone who fact checks a politican as simply "hating" that politician.
Yes, I had single payer when I lived and worked in the UK, and loved it. I wish we had it here. I lived in the west end of London, in the pub where I worked, and the local clinic was a humble, almost shabby building, more like what we are used to in DMVs. I had never had insurance, so I was fine with that - much like a New Yorker is happier with a tiny space to live than a midwesterner used to larger spaces. Those expectations of the majority of Americans who have insurance and are used to the private system will need to be managed. Hillary said during the 2008 campaign that one of the things that she learned from 1993 was that they kept saying, "We're going to cover the uninsured" without addressing the concerns of those who had insurance that theirs would be compromised- and they are still the majority. And yes, if we were to expand actual Medicare, their benefits would be cut, and the hurdles you have to jump in getting procedures approved like chemotherapy would apply to them.
**Those** are the people that have to be convinced - not the people going bankrupt. That's why a gradual expansion of Medicare for those who *want* it is a more realistic way to go.