Medicare for All
Medicare for All is not single payer, so media or politicos using the term single-payer are wrong.
The insurance companies should be jumping at the bit for Medicare for all, a windfall bonanza of new Medigap plans that are profitable; in fact, competition in the Medigap market is fierce and healthy. Imagine 300 million paying the monthly premiums in such a program.
And the ruse that giving states more freedom in controlling health care is a farce. Medicare has a very small overhead operating cost because it's administered as one federal program.
Indeed, Medicaid's 50 different state programs causes a quagmire and eats up it's funds in 50 administrations instead of one.
I sincerely believe that we could take all the federal expenditures of Medicare and Medicaid plus the tremendous billions we now supplement the insurance companies in Obamacare with and the new monthly premiums Medicare patients pay (billions from adding the entire population) and make Medicare for All work.
Additional benefits would do away with "can't find a doctor talking points" in the present Medicaid program and pay Medicare rates to doctors and hospitals instead of the present sixty-some cents Medicaid pays on the dollar compared to Medicare, strengthening the hospitals with revenue closer to actual costs of services and allowing freedom of choice for health care services.
These thoughts are predicated on everyone using traditional Medicare and not managed plans which are, imo, another boondoggle.
I share these thoughts, written quickly, without citing references and please correct me if my assumptions are wrong.
I advise congress critters to embrace this concept knowing that a phase-in may be required.
Thanks for reading my vetting, I'm so tired of hearing misstatements from everywhere.
Comments
Actually, if you look at worldwide single payer systems
60¢ on the dollar is high for "actual cost". At the latest report (chart can be found either here or at JPR) the most expensive system is Switzerland's, at 70¢. (and forgive me for being a little simplistic, but the Swiss plan looks more like "Obamacare with real price controls" than single payer) The only single payer system at 60¢ is Norway's.
The cost differential is mostly a myth. Reductions in paperwork and collections expenses would make up for most of our higher "costs".
On to Biden since 1973
Good points about US costs to other
countries. I've edited my statement-"Medicaid program and pay Medicare rates to doctors and hospitals instead of the present sixty-some cents Medicaid pays on the dollar compared to Medicare, strengthening the hospitals with revenue closer to actual costs of services and allowing freedom of choice for health care services--"to better reflect what I meant by the 60 cent statement. Presently, Medicaid pays around 60 cents of what Medicare pays for the same services, doctors included.
And I totally agree, tremendous cost savings can be had in cutting the bureaucracies of medicaid and redundant insurers' billings and claim adjustments.
I wish the CBO would do a cost analysis as I think that over time, the private insurance companies would live on as Medigap plans and my thinking is that with everyone paying in, almost everyone, anyway, as you suggest, the Medigap premiums could be reduced in time.
Thank you for your good thoughts.
Many countries with single payer still have private insurance
Although not needed, the private insurance companies add a bunch of extra cadillac perks for a modest premium. These companies don't have nearly the business that they do here where they control the entire health care market and can extort money from people in exchange for their lives.
Beware the bullshit factories.
Why hasn't Conyer's HR 676 bill which gathered more
cosponsers this session than any previously, been considered? Don't understand what Bernie is doing here. He could have co signed the bill which has been re-introduced many times.
You may choose to look the other way, but you can never say again you did not know. ~ William Wiberforce
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Anyone remember when we made phone calls
signed petitions and contacted our senators to ask them to get behind single payer or a public option when congress was debating health care reform? I remember the enthusiasm we had for getting involved with this process and then being so disappointed when this didn't happen and we got the ACA insurance reform instead.
Boy how times have changed since then. Now anyone that wants to get behind a single payer or public options has to come up with ten different ways on how to pay for it.
This just boggles my mind. Hey! Maybe if it had been Hillary working for this instead of Bernie, those DKBOTS would think differently.
Yep, there are Senators, especially, i would enjoy
having a few private words with for shooting down even a simple public option in 2009.
@snoopydawg Except I'd argue none of
Except I'd argue none of them is behind single payer, and most of them probably aren't behind a public option either. They're in favor of starting a conversation about such things.
"More for Gore or the son of a drug lord--None of the above, fuck it, cut the cord."
--Zack de la Rocha
"I tell you I'll have nothing to do with the place...The roof of that hall is made of bones."
-- Fiver
Bernie is redefining incramentalism
Medicare is fundamentally flawed in that it has a 20% co-pay. Once MFA is passed that flaw will become universally obvious and people will demand that it be ended. Over time the co-pay will be lowered. That's real incrementalism.
On to Biden since 1973
@doh1304 See my comment on
See my comment on redefining terms without announcing the fact (and why).
"More for Gore or the son of a drug lord--None of the above, fuck it, cut the cord."
--Zack de la Rocha
"I tell you I'll have nothing to do with the place...The roof of that hall is made of bones."
-- Fiver
I heard maybe the speech he gave introducing the bill and I
distinctly heard, "no copays" so I am confused. Maybe I need to read the bill. I read the early versions and HR 676 by Conyers, several years ago.
So maybe time to do my homework.
You may choose to look the other way, but you can never say again you did not know. ~ William Wiberforce
If you can donate, please! POP Money is available for bank-to-bank transfers. Email JtC to make a monthly donation.
my comment came without reading the bill
I should have known that bernie would anticiate.
On to Biden since 1973
Medicare medigap premiums are already
age-based; increasing as we age, so one would think that a phase-in could make the appropriate
premiums to scale for eventually adding young people at lower costs per month.
Just another thought; so many positives to MfA and the push back today is how we going to pay for it, raise taxes?
Sincerely, just shifting the resources we already spend should do the trick without new taxation. Someone's going to have to prove me wrong on this, because this is an economies of scale observation that appears more than rational to me.
Hi, Smiley! Thanks for posting
this essay.
Actually, I think it's fair to ask 'how will it be paid for?' Especially, since many retired folks live on a fixed income, and health care expenses (often) eat up a big chuck of their monthly expenditures.
(Mr M and I like knowing exactly what we have to pay for our health care. That way, there are no surprises. Of course, Part D is the one exception. Needs to be revamped!)
BTW, if you haven't already looked, Joe posted a couple of pieces about Bernie's bill. As I stated over there, I'm inclined to favor a system that is built upon our current Traditional Medicare program.
If I'm not mistaken, Chris Murphy, who's a so-called 'rising star' in the Dem Party according to the MSM (and, possibly a Presidential candidate in 2020) is going to sponsor a Medicare For All 'buy-in' for folks of all ages, and for businesses. He's made the announcement, but hasn't put forth a bill (yet). I'll let you know when he does. It would probably come closer to passing, and yes, it might even bring down those sky high Medigap premiums.
BTW, the Part D Plan Deductible for 2018 is only going up $5. It will be $405 in 2018, instead of $400.
Mollie
“I believe in the redemptive powers of a dog’s love. It is in recognition of each dog’s potential to lift the human spirit, and therefore, to change society for the better, that I fight to make sure every street dog has its day.”
--Stasha Wong, Secretary, Save Our Street Dogs (SOSD)
SOSD - A volunteer-run organisation dedicated to the welfare of Singapore’s street dogs. We rescue, rehabilitate, and rehome strays to give them a second chance.
On Twitter - SOSD Singapore@SOSDsg
Everyone thinks they have the best dog, and none of them are wrong.
another way to answer the question
" how we going to pay for it . . ."
Answer: we are already paying for it, and then some. It is just that we aren't getting much for our money.
Yep, paying for it and adding profit...
Bernie's plan includes vision and dental, as well, beyond the best of Medicare which is Medicare and plan F Medigap.
Damn, if all other arguments fail, "the US can afford to bomb seven countries at once, why not Medicare for All?"
"Medicare for All" used to be synonymous with single-payer
It was a phrase used by left-wing healthcare advocates because the term "single-payer" doesn't mean anything to the average American.
What they meant back then was that everybody in America would be on Medicare automatically.
Now it has been redefined to mean "a public option." In other words, it has been redefined to mean: an American citizen can get on Medicare instead of private insurance, if they so choose.
I'm not against a strong public option--if I could believe that the government would ever provide serious competition to a group of rich financiers, which I can't.
But I'm always against redefining words and phrases without making it very clear one is doing so, and why.
Thank you for being honorable and using language responsibly, which is more than I can say for people in DC, who have moved the goalposts and hope we won't notice.
"More for Gore or the son of a drug lord--None of the above, fuck it, cut the cord."
--Zack de la Rocha
"I tell you I'll have nothing to do with the place...The roof of that hall is made of bones."
-- Fiver
I'm unaware of this redefinition of Medicare for All.
There will be abundant confusion over this, since the phrase now means several different things.
The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.
@UntimelyRippd I believe the intent is
I believe the intent is to make it so that there is no common language to describe what we want, except the clunky and overly-wonky "single-payer."
But I can fix that.
"More for Gore or the son of a drug lord--None of the above, fuck it, cut the cord."
--Zack de la Rocha
"I tell you I'll have nothing to do with the place...The roof of that hall is made of bones."
-- Fiver
Glad that CStMS and UR brought up the 'definition'
of Medicare For All.
It's worse than what they've described, though. (IMO)
How activists define MFA is one thing. But, more importantly, 'how' do lawmakers define it?
Later, I'll post what Bernie had to say about his plan after we grab some grub. (Don't know the area, so, it may quick--maybe not!)
I hope that folks read what Joe posted at EB last evening. Apparently, what was put forth was pretty much what he included in his brochure from the campaign. (Which I've already posted, and don't have time to dig up right now.)
And, there's not a 'new' piece of legislation. IOW, the mechanics of his proposal are based on the 2013 legislation which I've posted numerous times in the past.
The outline/summary is rather fuzzy, because it's skimpy, but, it does say that the system will allow the VA and the IHS to continue to exist [as they are today].
So, you could argue that it's not a true single-payer system, but more like a public option.
More importantly, I'm trying to convey to folks that his proposal is not 'Medicare' as we know it. That it's not simply 'opening up' the 60's era program that many of us are currently enrolled in.
IMO, this is a difference, with a distinction.
Personally, I don't agree with using the term MFA as a 'marketing tool.' The term 'Medicare' has a definite meaning to most folks enrolled in the program, and, arguably, even to those folks who haven't aged into it yet. After all, we all have/had parents and grandparents.
Anyhoo, it's my belief that if someone proposes to radically upend, or, in this case, flat-out replace a 50-plus year old program, they have the responsibility to be forthright about their intention to do so.
True, most of us follow the political machinations in D.C. closely enough to realize that lawmakers and/or activists may (and often do) use this term differently.
But, I'd bet that more than 90% of Americans, wouldn't have a clue that it doesn't mean--literally--just opening up our current Medicare program to allow Americans of all ages to enroll.
I'm gonna strive to make sure that the '4' Dem health care bills that have been introduced in the past month, are totally transparent. It's only fair that people have the facts before they throw their support behind a piece of legislation.
Unlike, during the march to the ACA!
Mollie
“I believe in the redemptive powers of a dog’s love. It is in recognition of each dog’s potential to lift the human spirit, and therefore, to change society for the better, that I fight to make sure every street dog has its day.”
--Stasha Wong, Secretary, Save Our Street Dogs (SOSD)
SOSD - A volunteer-run organisation dedicated to the welfare of Singapore’s street dogs. We rescue, rehabilitate, and rehome strays to give them a second chance.
On Twitter - SOSD Singapore@SOSDsg
Everyone thinks they have the best dog, and none of them are wrong.
@Unabashed Liberal Wait...they're actually
Wait...they're actually using this to remake Medicare?
Maybe I should be glad it's not going to pass.
"More for Gore or the son of a drug lord--None of the above, fuck it, cut the cord."
--Zack de la Rocha
"I tell you I'll have nothing to do with the place...The roof of that hall is made of bones."
-- Fiver
Yes, it's a 'reinvention' of Medicare,
not a literal expansion and improvement of the existing Medicare program/structure.
My question is:
Why not just add an amendment to Title XVIII (Medicare) of the Social Security Act if the intention is to 'improve and expand it?'
A simple amendment stating that there will be no OOP costs, and that enrollment begins at birth, should be sufficient.
Mollie
Postscript: Here's the paragraph from Bernie's Bill Summary that explains that the 'new' system would be put in place of the current Medicare program.
Sorry--can't copy the PDF text. Here's a link to the Summary.
Title IX - Relationship To existing Federal Health Programs.
Says in black and white--
Guess when we refer to Bernie's bill, the proper lingo is 'Universal Medicare Program.'
Whew!
Everyone thinks they have the best dog, and none of them are wrong.
Thanks Mollie for bringing
to light that we are being led astray.
As I wrote in my diary above
We are in agreement, traditional Medicare is what we need!
No problem, Smiley. Thanks for posting the essay! ;-D EOM
Mollie
Everyone thinks they have the best dog, and none of them are wrong.
We found out the hard way when my mom needed
Glaucoma surgery, she and dad were enrolled not in the traditional type Medicare. They were in the pick-a-network type, and the doctor we really liked was not in her "network". Terrible thing. The guys she could go to wanted a +85 y/o woman to undergo surgery, then lie still for two weeks minimum. They were the worst kind of old fashioned.
That's when the whole family learned there are two types of Medicare. Traditional is the way to go.
You may choose to look the other way, but you can never say again you did not know. ~ William Wiberforce
If you can donate, please! POP Money is available for bank-to-bank transfers. Email JtC to make a monthly donation.
yep, traditional medicare for everyone, eventually...
I think the insurance companies make out like bandits on Medicare Advantage programs and insurance agents push them, my agent did, for instance, but i said no and all this is so complicated for us seniors, plus the monthly premiums for advantage plans are far lower.
We must cut the profit motive from healthcare, period, in the end.
Thank you for your good thoughts, appreciated.