Democrats seize on cherry-picked claim that ‘Medicare-for-all’ would save $2 trillion
S E E D E D C O N T E N T
As our colleague David Weigel reported, Democrats have latched onto the catchy idea of “Medicare-for-all” (also known as M4A) as a way of expressing their support for universal health care.
On July 30, the Mercatus Center at George Mason University released a working paper on the 10-year fiscal impact of the Medicare-for-all plan sponsored by Sen. Bernie Sanders (I-Vt.). The report was written by Charles Blahous, a former economic adviser to George W. Bush and a public trustee for Social Security and Medicare from 2010 through 2015.
Gillum, the mayor of Tallahassee, was quoted in Weigel’s article as having touted, during a debate, a $2 trillion cost-savings figure that is in the report. Sanders, too, has tweeted about this $2 trillion number, sarcastically thanking the conservative Koch brothers, whose foundation has contributed to Mercatus.
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In doing his research, Blahous decided to follow the text of the Sanders plan and assume that providers — doctors, hospitals, drug companies and the like — would face an immediate cut of 40 percent in their payments. That in theory would reduce the country’s overall level of health expenditures by $2 trillion from 2022 to 2031. But he makes clear that it’s a pretty unrealistic assumption.
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We don’t intend to pick on Gillum, who appears to have picked up a talking point that is circulating among Democrats. But we do want to lay down a marker because this goes too far.
All too often, politicians mischaracterize conclusions that are contained in academic or think tank studies. At the Fact Checker, we rely heavily on how a study’s author says the data should be presented. In this case, it’s clear that Blahous bent over backward to accept Sanders’s assumptions, only to find they did not add up. Democrats cannot seize on one cherry-picked fact without acknowledging the broader implications of Blahous’s research.
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Democrats, Socialists, Liberals, and the Far Left ALWAYS cherry pick things to make THEIR point LOOK GOOD.
BULLSHIT AGAIN !
"In this case, it’s clear that Blahous bent over backward to accept Sanders’s assumptions, only to find they did not add up."
It's just fucked up, but what-the-heck. Put it out their anyway.
If we are going to get real, All politicians cherry pick what makes them look good. It is not only one stripe that does this.
Agree….but this article is only about (1) one of them. I used a bunch of labels as I really don't know what Bernie is. He has soooo many faces.
And had 40+ years to grow them.
We could waste less time arguing about how to pay for it if we could lower costs.
Why an MRI costs $1,080 in America and $280 in France
Well....ALL Americans want to be whom they hate......Richers, although they will claim otherwise !
Without the work required that is.
A grand for an MRI, the last ones I had in May were 2 grand a piece .. it takes 3 to scan my spine...
Why not meet in the middle Medicaid for all when younger, pay reasonable premiums and co-pay - then when one is elderly Medicare for all with no premiums or co-pays ...
I do not know what other states are doing, but my good friend is insured through the Montana Medicaid Help program .. she pays a monthly premium of 37 dollars (based on her income) and pays 10 percent of the doctor cost up to I think she said 750 out of pocket for herself and around 200 for her child...
Definitely not a cure all .. but it is a start - Medical insurance does not have to be free, it has to be reasonably priced.. not everything in ACA was bad .. but there is no reason to purchase through an exchange / middleman ...
Just a thought
Someone has to pay for that. It doesn't grow on tree's.
Ooo please, IF money did grow on trees the US government could/would fuck even that up... prob let the trees die from neglect and leave them as fuel for wild fires ….
Most elderly have worked their lives and paid their dues in the form of FICA tax (not their fault the system has been abused) not everyone has a large nest egg to fall back on .. they have a fixed income .. they should not be making a choice over going to a doctor, paying for meds or eating that month!
Like I have said before.....SOMEONE has to pay for that shortfall of OTHERS !
I do believe you are correct.
Yep okay .. I can see the discussion ends there..
Either that or vast corruption would stop "We the People" from having any..
Government makes money off "OTHERS" backs.....right ?
There really "IS" no more needed....unless you have a new definition of what "IS".....is !
But why do we all have to pay for the 30% profits of others when it's such an essential life and death benefit? Why are we still using capitalism to determine the price of health care? Medicare costs just 1.5% overhead to run versus private health insurance companies that run 17% to 30% overhead. Why are we forcing the elderly who are often on fixed incomes to choose between going to the doctor, buying their medications or buying enough food to eat that month just so some corporate paper pushing manager can get a bigger bonus?
If you want to address healthcare costs you have to take the capitalism out of it. As long as it's supply and demand, where the supply can never keep up with the demand since we ALL need it eventually thus prices continue to jump. It's not like someone can just decide not to get their chemotherapy like they decide not to buy the more expensive loaf of bread that week. In a Medicare for all system all the doctors, hospitals and physicians will still be private companies competing to do the work on a fixed price schedule with regulated price increases based on what Medicare would pay. The only difference between now and a single payer option for all would be more people in the Medicare pool thus making it less likely for individual doctors to refuse to take Medicare patients. Just like with Medicare, the work isn't being done by government doctors as some falsely imagine, only the management system and repayment system would be government managed with no CEO's getting huge bonuses, instead that money is going to provide better care for patients.
It could be done and could be done well.
Government is there to work for the people. They are supposed to work for us, not the other way around.
For some reason people tend to think that taxes are the bane of their existence. They are not. Some act as if 5 dollars a week will make or break them and they would rather see government services swirl down the drain. Some maintain the I have mine screw you attitude.
I know people right now that pay about 1,500 a month just for insurance that will cover them. That is a large chunk of their monthly expenses.
I guess I don't understand why some would rather pay insurance companies all of this money when it could just be spend directly into the system.
If that were truly true....they wouldn't come out of government as Millionaires !
"I guess I don't understand why some would rather pay insurance companies all of this money when it could just be spend directly into the system."
And what would that "System" actually cost ? Bet it would run a deficit.
Maybe, let working folks contribute into their own "System" to take care of themselves ? If they mess up, they mess up. Government does it all the time.
Advocating for Socialism ?
ALL companies make a profit. It's ALWAYS been the American way.
I always ask questions to thinking like yours.
"If it's so bad here, why are you insisting here is where you want to still be ?"
There are other countries that seem to support your ideal, that MIGHT take you in...… MIGHT !
It's like the folks that come here from other countries, and then want this country to change to what they left.
The word "Sense" needs to be eliminated from the Dictionary.
True. I have seen candidates that try and try again just to get in there. There has to be a reason they seem so desperate to get their foot in the door.
It would probably cost the average person a lot less than 1,500 a month. That is the whole idea of everyone has skin in the game. I would rather not have to put money into a system that can mess up, as far as my health is concerned. We should not have to (in this day and age) live in a society when only the wealthy can afford good healthcare.
We are all already paying for healthcare one way or another. It would make more sense to pool all of that money centrally and for the same purpose, for the same goals, than having that money widely dispersed, doing less good.
Not arguing with you It Is Me .. yes everything costs money .. the government makes money off of other people backs and spends it as they see fit .. a Billion dollars here, a Billion dollars there .. don't worry about where it came from there can always be more printed to hang on the backs of future Americans ….. while government devours everything in its path and our elected civil servants get rich - but someone needs to pay for those other individuals shortfalls...
I am a conservative individual .. yet I also care what is happening to the elderly with the shortfalls … of which I will be one - I have to be poor in order to get disability - I prob have another 10 years left of my nest egg, which I worked damned hard for and invested wisely... I will be 62 when I run out of cash and SS will not be enough .. so I guess I will be a shortfall'r
Take care of you It Is Me - one never knows when an injury can/may stop your future from happening the way you desire it to...
Why "Me" or You" ?
"Take care of you It Is Me - one never knows when an injury can/may stop your future from happening the way you desire it to..."
For sure. That's why I have "Insurance" for everything.
Yes, we always have ...… with no complaints.
Funny.....somehow it got worse when a "Certain Someone" made it an issue 8 years ago.
That "Certain Someone" should have left it alone. NO ONE was bitching !
Cool..
but I do not think you understand that insurance on everything does not stop a loss of income due to a debilitating injury - not even worker comp can keep the wolf off the door step
Yes people were and still are. That has not changed. It has been an issue for a long time.
Still, people pay insurance, some cannot afford it and end up in the emergency room, usually after the damage is done, which costs even more. Preventative medicine and doctor visits have been proven to make a healthier society.
The health of the people should be a major concern as the less healthy the people are the less productive and happy the people will be.
Pooling the money together instead of it being dispersed would be the most cost effective way to go.
Soft voices apparently.
I know my loud bitching started when Obamacare kicked in and I saw my new billing.
In case you haven't figured.....IT WASN'T A GOOD THING. But what the heck. The "Few" deserveded
MORE huh !
I understand. Nothing can stop the boogie man "If" it hits !
Funny word "Insurance".
in·sur·ance
[inˈSHo͝orəns]
NOUN
a practice or arrangement by which a company or government agency provides a guarantee of compensation for specified loss, damage, illness, or death in return for payment of a premium.
It does seem to have "Limits", no matter how it's defined and no matter how much you PAY into it.
IMO that is the whole problem. The insurance industry. We should not have to go to them for our healthcare needs. They should be nothing but an after thought. A rider that one can have as Medicare does not pay 100 percent.
You don't have to.
Doctors accept cash. Hospitals accept cash.
This is like being upset that your house costs so much and thinking the problem is the bank who loaned you the money.
Yeah I thought that, too. I was like, "where are they getting an MRI for only a thousand dollars?"
Who makes 30% profits?
Because we don't want the doctors' office to run like the DMV.
You've listed three numbers, and all of them are incorrect. I can see how you feel the way you do if your information is this poor.
You do realize the elderly are all on this supposed single payer utopian system, yes?
Do you intend to sieze all the private hospitals and clinics, or attempt to buy them?
Who do you think makes all the profits in healthcare??
Almost all doctors take Medicare. What they don't take is Medicaid, which is what this nonsense will degenerate into very quickly.
You do realize that Medicare claims are all processed by private contractors whose CEO's get huge bonuses, yes? I guess not.
So how about learning a little bit before committing to an idea that you don't understand to solve a problem that you don't understand?
Correct. Probably between $1000 and $1200/mo. Per person. So $4k-$5k/mo for a family of 4.
Nonsense. The whole idea is to get somebody else to pay. That's really all "single payer" is about.
Government is not designed to be a Business ! To many CEO's running around not paying attention to anything.
"The trustees’ summary listed total Medicare expenditures of $678.7 billion for 2016, of which $9.2 billion was characterized as "administrative expenses." That works out to 1.4 percent"
"America’s Health Insurance Plans found that 17.8 cents of every premium dollar goes to operating costs."
"But those are averages looking across health care markets. When the Congressional Budget Office broke those costs down, they put administrative costs in the nongroup market at 20 percent"
As we have established, we all already pay anyway. Even with insurance, the bigger the risk pool, the lower the cost.
I would rather all of us be in the same pool.
Even with insurance you are paying for someone else, so I fail to see why some would have condemnation for the same thing being used on a wider central scale.
In your insurance pool you are still paying for little Timmy to have his broken arm set. So I don't buy this, paying for others crap. We do anyway. What would change is taking it out of the insurance companies hands.
I don't care if someones Grandmother needs to see a doctor. I don't care if someone needs a flu shot or their appendix removed. It is all for the greater good and the well being of society.
Also, as far as government run, the best hospital in our town is the one on base.
I disagree with your first paragraph.
if having more people in the pool reduced costs, why haven't healthcare insurance costs gone down under Obamacare?
I would actually attribute that to some of the new regulations that were put into place. Such as people cannot be denied, which some companies would do so they could pay out less. Trying for no caps on treatment expenditures etc. The insurance companies are in it to make a buck, otherwise they wouldn't do it.
If one person was in a pool, they would pay all the expenses. Two people would be splitting the cost, which might not work out well if one uses more than the other. The more people in the pool, the more the expenses get spread.
Two things, the target number of insured was never reached due to the anti-ACA campaign that has been waged by Republicans since the ACA was first signed into law, and it did in fact slow the rate of premium increases rather dramatically from before the ACA was implemented.
"Under Bush, the average family premiums (including both what employers and employees pay) went up $4,677 in his last six years in office, from 2002 to 2008, an increase of 58 percent. That $4,154 growth under Obama is a 33 percent increase. If we look at Bush’s first six years, the discrepancy gets even bigger: From 2000, the year before Bush was first inaugurated, to 2006, the average family premium went up $5,042, or an increase of 78 percent."
So even though the Republicans fought it tooth and nail, didn't implement their own State exchanges which seriously damaged enrollment, tried to sabotage it at every turn, voted nearly 80 times unsuccessfully to try and repeal it, it still cut the average annual premium increase in half. I happen to remember my health insurance before the ACA was implemented and I was seeing the increases. After the ACA the increases slowed dramatically. No, it didn't actual reverse those increases, but stopping them from growing so fast is still a huge win.
That isn't exactly what you claimed earlier, and if what you claimed--that more people reduce costs, why haven't our costs gone down despite so many more people being insured?
The claim is that more people will result in lower costs.
A "fact" unproven even with Obamacare.
Millions and millions more added to insurance, no cost reduction.
Reduction!?!?!? Rates have skyrocketed under ACA along with deductibles!
Please. There is NOTHING affordable or sustainable about a program in which 85% of those enrolled need government assistance.
I know.
With Obamacare, we have verifiable proof that more insured doesn't result in lower costs.
But the left wing will still clamor for single payer, which will end up costing us all (well, us TAXpayers, anyways) millions more per year.
So we saw increase of up to 78% before the ACA with fewer people in the insurance pool. Then after adding 22 million those increases were cut to 33%. That would indicate that the more people in the pool the lower the cost for everyone overall. So the claim is not only valid, it was proven.
Um, NO.
If I am insured along with 10 million others and our rates have gone up 10-30 % every year, and then we add 10 million to the pool and our costs only go up 5%, that is STILL NOT A REDUCTION IN COSTS. More money our of ALL of our pockets.
You sound like some politicians who like to claim reductions even though the spending has increased. It is freaking ridiculous.
You're right, and that wasn't the intent of the ACA. If everyone had gotten insured so we had close to 100% of Americans insured that number would have been much much lower, but as it is, the ones who got in the pool first were the ones who needed the care most but couldn't afford it so it was front loaded with costs. Then the healthy people didn't get in the pool as expected which threw the whole thing into a mess. Without the deliberate sabotaging of the program it likely would have worked as billed.
Deliberately sabotaging?
You mean people opting to pay a tax instead of enrolling, as the law as written and then passed by Democrats, allows?
From your own source:
Woolhandler and Himmelstein are leftists, BTW.
So do tell us again where that 30% comes from?
Costs are never going to go down unless there are caps on what will be paid to medical providers.
Larger companies (with more people) have more wiggle room and can better negotiate with providers.
It is also true that when people can see a doctor, have preventative care and catch problems early on, they are easier and cheaper to treat.
The growth rate for medical spending has slowed.
Is it possible they don't know what happened with Medicare when implemented?
Medicare blew through its 10-year projected spending in about 6 years and then doubled about every 4 years for the next 12 years.
good question - i suppose it has to do with Make America Great Again ? apparently a lot of people felt America wasn't great, they actually felt it was bad but they insisted on staying here - ever ask those conservative minded people why they insisted on staying if they felt America was bad and had to be made "Great" again ?
very true, but they stayed just like everyone else, isn't that odd ?
So it is not accurate that more insured lowers costs, which is exactly what I have been trying to tell you.
Now you seem to be changing the tune from more insured lowers costs to the growth rate has declined.
Two VASTLY different arguments.
But we wouldn't all pay under Bernicare. That's the attraction.
That's not true at all. Large pools make expenses more predictable. A knee operation costs the same whether you're insured on an individual plan or work for a Fortune 500 company.
Most of us do not want to give up our choice for your "rather".
You're talking about a program that would take over $1 trillion/yr currently paid by corporations and stick it on the backs of individual taxpayers. A very few individual taxpayers.
Somebody is paying little Timmy's premiums....either his parents or their employer. You want to make that premium a tax. If current trends follow, 87% of that tax burden will fall on 1/5th of our population.
Make no mistake. "Medicare for all" has nothing to do with who processes claims. It has to do with who pays premiums. It's a very poorly disguised attempt by its supporters to get somebody else to pay their bills.
You can do that without taking away everybody's insurance. Just freeze Medicare reimbursement rates.
No, they don't. They use pre-made networks just like small employers do.
Yes it is. Which is why you're seeing many insurers eliminate primary care copays. You can't make people go for preventative care. But if you can get them care when they start to feel bad, you have a better chance of lowering the cost of that care.
Risk pools and premiums are set by people in the pool. The more healthy people in the pool, the less premiums need to be. The more services needed, the more premiums are.
Having more people in the pool that were healthy instead of only people that need it would reduce what needs to be paid out.
The whole idea of pools is to spread out cost. If it didn't work the companies would go out of business.
Once again, SPREADING costs is far different than LOWERING costs, which has been the claim.
And I know of no pool OTHER than self-insured in which the people in the pool set premiums. That falls to the insurance companies, who will have to pay the claims.
The people are still paying for this. The insurance companies are not paying out of the goodness of heart. They still make a profit.
We all still pay for the poor with them going to hospital. I would rather pay for them to see a doctor before it got to that point.
It's a lot less expensive to give a guy some pain killers and a crutch in the emergency room and send him on his way than to stick the taxpayer with a knee replacement operation. On top of that Obamacare did not reduce emergency room visits.
You won't get a response on that. They always ignore it when someone points out that there is nothing affordable or sustainable about medical care in which 85% of those enrolled need government assistance with too.
To my knowledge there is no policy ..
A load of steel tubing was dropped on me by a careless forklift operator on a jobsite in 2007 - I now have a lil business doing my artwork.. but the nerve damage is now taking my hands away from me. I claim every cent I make in order to keep my SS current - do not even get me started on the taxation of money that has already been taxed...
Work comp only goes so far .. my settlement was invested into a special needs trust .. and my life savings / investments / my retirement ..I am living off - to young for SS and have too many assets for disability .. there is NO insurance I ever heard of that keeps paying ones salary til one is retirement age..
Enough of the sob story - I am blessed, and therefore I cannot bitch - but I become frustrated with the smack talk about shortfalls and not my job to help … I am heading for an uncertain future when I did everything right to insure my future and retirement... rather certain there are many more of us...
Have a sweet night MUVA
Because not all states embraced the Medicaid expansion .. sorta knocked ACA on its ear...
No. They're not.
US employers currently pay over $1trillion/yr toward healthcare for their employees and dependents. They do this because they need to provide those benefits in order to attract and retain decent employees.
They didn't join as expected? That is really funny. Healthy people didn't join exactly as expected , and exactly as all the annalists predicted.
Did you mean to say it failed exactly as all the proponents said it would? Or are you taking the common path of shirking all responsibility from the disastrous policies imposed by the Democratic party?
You are the "YOU" I was speaking with now ?
it's odd that you are unable to straightforward answer the questions posed to you on a public forum. it definitely speaks volumes.
It's "Odd" YOU actually became "another".
An X Files episode ?
i wish this made sense outside of your head ... i'm still the same person .. you brought up a concept and i asked if you brought up that concept earlier when it still applied to a specific group ( and still does considering who we have in office ), instead of answering a very simple question - you talk about X-Files ?
You're "Dismayed Patriot" ?
who is "Ender" ? who are you talking about ? are you even reading the comments ? where did you pull "Ender" or the "X-Files" from in any of my comments to you ? i never mentioned any of those things. If you can't have a conversation or can't answer the question - then just say so and move on, your attempts at being "mysterious" and "cryptic" are an epic fail. I'm not "Dismayed Patriot" or "Ender" or anyone else - if you could read you would see that I'm Phoenyx13 and have never been anyone else, this is my only account.
'your attempts at being "mysterious" and "cryptic" are an epic fail.'
But that's all he's got.
Too quick on the trigger again ?
that definitely seems to be the case, it's pathetic at best.
sorry i didn't wait for you to try a bunch of different names and just replied to your original comment - looks like i showed everyone your mistakes
States were not required to expand Medicaid, and many states with an eye to the future realized that one day federal funding would be greatly reduced, leaving the states to fill the gap in funding.
It failed exactly as it's opponents wanted it to based on their actions, not because the plan was bad. It had the opportunity to reduce healthcare costs and get all Americans covered. Due to Republican partisanship they chose to refuse the Medicare expansion in their States, refused to set up State exchanges, dragged their feet with implementation and tried to repeal it nearly 80 times. It still cut the health insurance premium increases in half, helped 22 million Americans afford health insurance and got rid of the odorous pre-existing conditions that many health care companies were using to deny patients coverage. It did most of what it was supposed to do and when Trump and the Republicans who control the white house, congress and the Senate tried to take it away the people rose up to prevent it, even in red States the Republicans were getting overwhelmed by the public, many of whom literally can't live without it, banging down their doors and surrounding them at town halls. That proves it was not nearly as "disastrous" as many of it's opponents claim.
Accepted.
If Democrats wanted every state to expand Medicaid, then they should have funded it in the bill--and not just for a short period of time. They also chose not to make it compulsory.
great - now you can answer the previous questions posed to you before you tried to derail by talking about the X-Files and various NT members
Question ?
No...the plan was bad.
No, it never did. That's why it was a bad plan. You see, actuarial science is a real thing. An oddly enough, it doesn't care about feelings or political dogma.
If you don't know the difference between Medicare and Medicaid, you should stop attempting to defend this thing you clearly don't understand.
Let's use this as one small but perfect example of why the ACA is such a cluster. Do you know the difference between a state exchange and the federal marketplace? Software. That's it. Who writes the software and whose servers are used. The same subsidy rules apply whether you buy on a state exchange or the federal marketplace. So do explain to all of us how having 50 different software vendors is better than having one. Then explain why we needed to provide that software in the first place, instead of just requiring insurance agents to provide it.
No it didn't.
Also no. And it drove millions of people off of their previous, more affordable plans.
Heyyyyy. You got one right. Woo Hoo. Although I'm not sure we can verify they had a smell.
It did NONE of what it was supposed to do.
If we said at the outset "we want to get everybody covered and we want to lower costs", then brainstormed a list of ways to make sure neither of those things happened, and then wrote that into law, we would have the ACA.
see 2.2.11 ... here's one of them:
you are welcome.
Where do conservatives say America was Bad again ?
Seems to me it's a different type of person than you propose, that find the "American Flag"....." OFFENSIVE and OPRESSIVE " !
nope - would you like to try again ? if the conservative minded didn't find America "bad" then why would they vote to "Make America Great Again" if they thought it was already great ? They had more than 2 choices to pick from, didn't they ? yet.. the winner picked by the conservative minded (mostly, not completely) was (or is) supposed to "Make America Great Again" as if it wasn't great already... care to explain ?
"No...the plan was bad."
That's your opinion.
"No, it never did. That's why it was a bad plan. You see, actuarial science is a real thing. An oddly enough, it doesn't care about feelings or political dogma."
Yes, it did have the opportunity and did a lot for millions of Americans whether you want to admit it or not.
"If you don't know the difference between Medicare and Medicaid, you should stop attempting to defend this thing you clearly don't understand."
I apologize, I did mean Medicaid and I do know the difference, it was hasty fingers typing faster than I can get my thought out.
"Let's use this as one small but perfect example of why the ACA is such a cluster. Do you know the difference between a state exchange and the federal marketplace? Software. That's it. Who writes the software and whose servers are used. The same subsidy rules apply whether you buy on a state exchange or the federal marketplace. So do explain to all of us how having 50 different software vendors is better than having one. Then explain why we needed to provide that software in the first place, instead of just requiring insurance agents to provide it."
The difference is that each State determines which companies can do business in their States and not all the carriers on the Federal exchange were available in all States. I live in California and we had CA.Gov up and running right away and it's been quite successful in getting customers linked up with providers.
"No it didn't. "
Yes, it did. You link the fact that premiums continued to rise, which is true, but I said it cut insurance premium INCREASES in half, which it did. The increase between 2000 to 2006 was 78%. The increase between 2009 and 2015 was 33%, less than half of the pre-ACA health insurance premium increase average.
"Also no. And it drove millions of people off of their previous, more affordable plans."
Total bullshit. There were 47 million Americans (18%) without health coverage in 2008. It had dropped to just 25 million uninsured in 2016. Since then the uninsured rate has risen by about 3 million so were close to 28 million uninsured now. That's still 19 million people who weren't covered in 2008 and are covered now. It has nothing to do with people being "driven off their previous, more affordable plans" which is a joke. I remember well my previous health plan and we were seeing 20-30% annual rate increases before the ACA and I was paying more then for less policy than I have now.
No...it's pretty much fact at this point. The best case scenario is that we'll still have 27 million uninsured, costs are rising steadily, and about 40% of the country now has only one option for health insurance. If you consider this a success, you have a very strange definition of the word.
We had a chance....and we blew it.
The CBO disagrees with you, and always has. BTW, do you see how you've changed from "all Americans" to "some Americans"?
The federal marketplace simply shows participants the insurers available in their zip code. It's just software. Health insurance agencies have been using similar programs for years. We could easily have made them bear the cost.
Actually, it's not even close. The law violates too many actuarial principles.
By which you mean "fact".
The ACA defined policies issued before the passage of the law in March 2010 as "grandfathered". Anything purchased after that was "non-grandfathered" and could not continue to exist past January 1, 2014. But plans purchased prior to 2014 were still medically underwritten. High risk applicants were rejected, so those people who qualified were able to pay much, much less for their coverage. All of those non-grandfathered policyholders got letters from their insurers in 2013 stating that their policies would be canceled Jan 1, 2014 and they would need to apply for a new, ACA compliant "metallic" plan. Metallic plans were/are issued without regard to medical history, so the premiums are naturally MUCH higher.
The majority of those people went on employer based plans as the economy improved and people went back to work. Or do you suggest the ACA was impacting the number of uninsured in 2009? Check this out.
Some of which are even due to the ACA.
What do you imagine happened to those people who actually had private purchase insurance prior to 2014? There were millions of them, BTW.
Without knowing your situation, it is important to point out and remember that just because somebody else is paying for something does not mean it's actually cheaper. It's also important to remember that huge numbers of people don't qualify for a subsidy on the federal or state exchanges, and those people are stuck paying these MUCH higher premiums, or going without coverage at all.
Yep !
nope - would you like to try again ? if the conservative minded didn't find America "bad" then why would they vote to "Make America Great Again" if they thought it was already great ? They had more than 2 choices to pick from, didn't they ? yet.. the winner picked by the conservative minded (mostly, not completely) was (or is) supposed to "Make America Great Again" as if it wasn't great already... care to explain ? (apparently you agreed that America was "bad")
It would cost tens of trillions of dollars and cause health care rationing.
A number of other prosperous countries do it and do it well. The main thing to remember with these people is that they sure as hell want their health care paid for by someone else but damn if everyone should get that.
They don't like to talk about the government they worship and it's regulations that way.
Yeah, uh how could we do that? Maybe if we just ask nicely doctors and hospitals will lower their charges. Of course, a big reason those charges are high are all the unpaid care that hospitals (not so much doctors) give to people who don't have insurance and don't have the money to pay for that care. Or, hospitals could insist on cash up front before any care is rendered. We could ask private insurance companies to stop siphoning off profits from the health care dollar. I'm sure they'd want to cooperate.
I wish I could give you a quick and simple answer that guaranteed success. I suspect there are multiple things we can and should try. It may take a combination of free market solutions, tort reform, regulation reform, and maybe even some government restrictions on pricing or business practices. It's would likely take a lot of work, imagination, and patience. Unfortunately, all the Left ever wants to do is jack up taxes, promise healthcare for everyone even though they can't pay for it and to hell with the problem of super high costs.
You pretty much described the ACA right there. It was the alternative to a single payer Medicare for all option. In fact, Republicans are the ones who invented the ACA model.
"Republican Sen. John Chafee of Rhode Island was the point man. The bill he introduced, Health Equity and Access Reform Today, (yes, that spells HEART) had a list of 20 co-sponsors that was a who’s who of Republican leadership. There was Minority Leader Bob Dole, R- Kan., Sens. Orrin Hatch, R-Utah, Charles Grassley, R-Iowa, Richard Lugar, R-Ind., and many others. There also were two Democratic co-sponsors."
Among other features, the Chafee bill included:
An individual mandate;
Creation of purchasing pools;
Standardized benefits;
Vouchers for the poor to buy insurance;
A ban on denying coverage based on a pre-existing condition.
"You would find a great deal of similarity to provisions in the Affordable Care Act," Sheila Burke, Dole’s chief of staff in 1993, told PunditFact via email. "The guys were way ahead of the times!! Different crowd, different time, suffice it to say."
It's likely why Obama was surprised it didn't get any Republican support. There were over 100 changes made to it, requested by Republicans, in order to get some Republican support and make it a bi-partisan bill. But Obama wasn't counting on the pact Republicans made the day he was inaugurated.
As then Republican Senator George Voinovich said of the meeting, “If (Obama) was for it, we had to be against it, (McConnell) wanted everyone to hold the fort. All he cared about was making sure Obama could never have a clean victory.”
A number of Republican Senators privately confided to Joe Biden that Mitch McConnell had given them the directive that there was to be no cooperation with the new administration — because he had decided that “we can’t let you succeed.”
So it's pretty clear to me who really damaged our nation during Obama's two terms, and it wasn't President Obama or the ACA. It was the refusal by Republicans to work together with Democrats to benefit our nation. It was the "our way or the highway" demand from the GOP that has cut our nation to the quick. Democrats continue to be willing to compromise, but to Republicans compromise is a dirty word. They are responsible for the huge division we find ourselves with, closer to another civil war than we've been in 160 years. It's rather sad that their hearts are so hard that they refuse to accept other Americans who happen to be gay, liberal, progressive, immigrants or not of their faith as fellow Americans and would rather side with white nationalists from an enemy foreign government just to get their way. It's a very sad time in which we live.
The Republican bill (which I opposed) was for catastrophic coverage, not comprehensive healthcare. A fact the left always leaves out
Easy. Freeze Medicare reimbursement rates. Most private insurers reimburse based on "Medicare plus X%", so you stop the escalation on a per service basis. You still have to deal with the fact that we have an aging population of Baby Boomers driving utilization, but you can still slow the tide.
No, they're gonna squawk like you can't imagine. But they're not going broke on current rates now, and they won't go broke if they have to live on them for several years at a time.
Or...we could let those hospitals turn any delinquent accounts more than 180 days old over to the US Treasury for reimbursement. The Treasury could then take those obligations out of that person's tax refunds until the debt is paid. MUCH more effective than an individual "mandate" with almost no penalty.
How much....in actual hard US dollars, do you think that is?
One answer is for republicans to stop taking away the little bit of progress that was made over the last few years. Or, maybe hold Scumbag to his promise to give everyone in the country cheaper and better health insurance.
At which point every other Republican and 50% of Democrats said..."mandate?????....You mean REQUIRE American citizens under penalty of law to purchase a product whether they want it or not???....Have you lost your fucking mind????"
And everybody agreed this was a terrible idea that should not be enacted and it died.
Do you pay State taxes that go to building, repairing and improving our roads and highways? Some people don't drive, why should they have to pay for road maintenance, right? It's because we decided collectively we like roads that enables us to get to and from work, take vacations and travel around far faster than the old cross country horse and buggies or wagon trains. It's a collective expense that we all benefit from even though I've likely never driven down your street but likely pitched in for its construction and maintenance.
That's all the individual mandate is, it required everyone to either buy into our health care system or pitch in through penalties. You can say "I will never get sick or ever go to the hospital so why do I need to pitch in?". But the fact is that's not a choice you get to make. If you're badly injured in an auto accident, they take you to the hospital and treat you regardless of ability to pay. Before the ACA we averaged nearly $150 billion annual in hospitals treating those with no insurance who were unable to pay the bills they accrued. The ACA was intended to reduce that which it did, though not as much as expected because we still have millions refusing to purchase coverage. So we can either mandate that all of us pitch in through the ACA or just take it out of our tax dollars like we used to and cause huge increases in health care costs for everyone paying their premiums to cover those who refuse to pay into the system.
Road maintenence is paid by a tax paid when purchasing fuel for your vehicle .If you don't drive chances are you don't have a vehicle and don't have to put fuel in one and do not pay those taxes.
well that statement doesn't seem to be true :
" Today, general taxes paid by all taxpayers cover nearly as much of the cost of building and maintaining highways as the gas tax and other fees paid by drivers."
So not only was your attempt at deflection by not answering the actual point I made ineffectual, it was also totally bogus and untrue.
You're surely not going to attempt to suggest that paying taxes and being forced to buy a product are similar.
We don't make them buy cars, now do we?
You really don't understand how this works, do you? Hint...I don't live on a federal road.
Not even remotely close. You are attempting a gargantuan rationalization, and it's not working for you.
How about if I'm a multi-millionaire and can self insure? How about if I don't need maternity coverage? How about if I don't need pediatric dental coverage? How about if I'm just a regular millionaire and can easily handle a $20,000 deductible? Buying insurance appropriate to any of those situations would now put me in violation of this idiotic law.
Do I also need to buy motorcycle insurance because my neighbor needs it? Does the guy in the apartments down the street need to buy homeowners insurance because "most" people live in houses?
Largely because we had 34% of those eligible for Medicaid failing to actually enroll. But we didn't bother to fix that. You also had tens of millions of non-citizens using care and not being able to pay for it. We didn't fix that, either.
Why would you assume we only have two options? Why would you assume there is no plan that might actually solve some of these problems?
For example...why not simply let people be responsible for their medical bills. Allow any provider what has been stiffed to turn the claim into the US Treasury. The govt could pay the claim and then add it to the person's tax liability. I promise it would be better incentive than the ACA mandate.
I was on Obamacare. They took away my doctor and my rates kept going up. It sure didn't feel like progress.
The tax is buying a product, roadways that not everyone use but everyone pays for. The mandate penalty is going to buy a product, health care that not everyone may use but everyone pays for. Yes, they are very similar.
"We don't make them buy cars, now do we?"
No, and we don't make anyone use their health coverage either, but it's there if they need it just like the roads are.
"You really don't understand how this works, do you? Hint...I don't live on a federal road."
No, but you like use State and Federally funded roads and highways everyday.
"Not even remotely close. You are attempting a gargantuan rationalization, and it's not working for you."
My rationale is sound, just because you have an ideological repulsion to it is your problem, not mine.
"How about if I'm a multi-millionaire and can self insure?"
That's great for you and you won't really even notice the $2085 maximum annual penalty for not buying health insurance.
"How about if I don't need maternity coverage?"
It's true, as a guy you can't get pregnant. But you were born right? You can get women pregnant right? You're not completely free of any responsibility when it comes to maternity coverage and it's something we shouldn't just burden women with, unless you insist on being a total dick.
"How about if I don't need pediatric dental coverage?"
Again, are you really going to begrudge children dental care? Really?
"How about if I'm just a regular millionaire and can easily handle a $20,000 deductible?
Then you can easily handle the $2,085 penalty for not buying insurance.
"Buying insurance appropriate to any of those situations would now put me in violation of this idiotic law."
And piece meal health insurance so you don't have to pitch in for women and children shouts to the world loud and clear "I'm a huge heartless dick!"
"Do I also need to buy motorcycle insurance because my neighbor needs it?"
No, but you did pay for the road that he's using his motorcycle on. The $173 a month penalty for not having health insurance isn't buying anyone else a bunch of coverage, it's barely covering the potential cost for you when you get in an accident and get taken to a hospital and treated regardless of your insurance status.
"Does the guy in the apartments down the street need to buy homeowners insurance because "most" people live in houses?"
No, but he collectively pitches in to the fire department who will come to save either residence if they're on fire.
You are trying to pretend that government expenditure and individual expenditure are the same thing...which is utter nonsense.
This is what identity politics does to people. You are attempting any and every rationalization you can in an attempt to defend the indefensible simply because your political tribe passed the law. It's a law, BTW, that is the antithesis of decades of Democratic Party ideology. Pelosi & co were duped by the insurance lobby, and now every liberal everywhere feels the urgent need to pretend this was a good idea.
You've still created a law that requires them to purchase something they will never need. Will I have to buy tampons, as well?
The ridiculous rationalizations just keep coming.
Not unless I cheat on my wife, which isn't ever going to happen. So tell me again why I need to insure for something that cannot happen. Oh...because it makes Democrats "feel better", I forgot.
*sigh* This isn't about feelings or ideology. This is about math. It's about assessing premium to risk, the way insurance is supposed to work.
Simply because your party screwed up healthcare reform beyond all recognition? So really....you don't care at ALL about anybody who isn't a complete, lock-step Democrat.
Again...you're just talking about your feelings. So really the only defense you have for this mandate is that it makes you "feel better", and you really don't give a shit about anybody who doesn't agree. OK then.
That kind of logical, cogent and well-accepted concept of how a society works is completely wasted on the "sovereign citizen's 'mind.'" You'd have better luck trying to explain quantum mechanics to your cat or dog (probably more with your cat, though).
I'm hoping you'll tell us that you have refused to take Medicare benefits on "principle" since you seem to want to keep anyone else from having the same kind of health care coverage.
Interesting. It seems you and Bernie Sanders have very much the same ideas on this subject.
Glad you asked. It has been estimated by a couple of recent studies to be between $383B¹ (2010) to $500B² (2017) annually . These two studies were based on administrative cost differences between a single payer system (Canada) and the U.S. private insurance system.
¹ Medical Spending Differences in the United States and Canada: The Role of Prices, Procedures, and Administrative Expenses
² Single-Payer Reform: The Only Way to Fulfill the President's Pledge of More Coverage, Better Benefits, and Lower Costs
Yeah, but that's not "Obamacare" which was "soshulissss." (/s)
From your first source:
It never mentions a $383B figure, BTW.
Your second source is Steffie Woolhandler, who is a founding member of Physicians for a National Health Plan, and who is famous for saying absolutely anything in order to advance her cause.
I guess if we're just going to quote bullshit biased studies, I could go find something from the Heritage Foundation. But that just seems tedious.
Still, even if we were going to save $383b....which is yet to be established...we're just trading admin costs for fraud losses.
The GAO says we lose 10% of Medicare's budget to fraud. Other estimates put that number as high as 25%.
So why do we want to trade one problem we can control for a problem we clearly can't?
Naaah. I'm interested in ideas that might work.
He's interested in telling crazed leftists whatever they want to hear.
That doesn't respond to the question that was asked. Do you or don't you pay those taxes (federal and state)?
It's mentioned in the second source and in a Politifact article.* You could also do the math by using all the information in that first source. But that figure was based on a 2007 study so I'm happy to go with the $500B that the more recent (2017) study came up with.
*
Of which you have none, of course. But I'm fascinated by your arithmetic in how you arrive at a zero sum with a $60B total estimate of Medicare fraud and a $383B(low estimate) annual administrative savings. No wonder this is all too confusing to you if that's how you calculate.
Well, of course, you'd sling unfounded slurs against someone who know what she's talking about and brings facts to the table rather than ad hominem attacks. To get something published in the Annals of Internal Medicine, which is the official journal of the American College of Physicians, requires a level of scholarship to be met (I realize I've lost you there if not before). But I knew your request for actual data was a sham. You don't want data. If god itself handed down evidence on a golden tablet you'd claim that god was just a socialist plant.
Woolhanlder is famous for the "60% of all bankruptcies are medical bankruptcies" lie.
It makes a great headline, and she realizes that M4A supporters are terrible at math so they're certainly never going to question hers.
But when one is possessed of traditional Gen X skepticism and happens to have a degree in mathematics and endeavors to read her methodology, it becomes obvious that she's astonishingly dishonest.
Her definition of "medical bankruptcy" is any bankruptcy where any medical debt of any size was included in the items discharged. So if you owed $300k on your credit cards, $2million in back taxes, another $800k on your business loan, and $40 for an outstanding prescription co-pay...you have a "medical bankruptcy".
It's very convenient for making a wildly unbelievable leftist point. It's also utterly dishonest.
Now... you can choose to defend her based on her degrees, and she is certainly well educated. But degrees do not certify a person's honesty. Trump is a Wharton graduate. Bill Clinton was a Rhodes Scholar. Well educated people lie and misrepresent. Steffie is one of them.
Out of curiosity, are you familiar with the concept of "percent"? Here, maybe this will help.
Medicare loses 10% of it's $600b budget to fraud. If we were to actually enact this atomically stupid plan, that total budget would go past $4 trillion. 10% of $4 trillion is $400 billion, so all your supposed (and still unverified) savings are already overtaken.
Or did you imagine you could expand an already weak program by over 600% and fraud would just stay the same? Wow. This BernieCare thing really does require massive levels of naivete.
Come on! The more government spends the less fraud there’s going to be....Right? Well actually, NOT!
Since when is cherrypicking narrow time slots ect in order to prove a point a surprise? Just happened to me on one of my seeds by another member who was cheered and got multiple thumbs up for the effort.
They still cling to debunked global warming models too. The same tactics were used for the Paris climate agreement and the best possible scenario of projected impact over 30 years was STILL a joke. If there is any truth at all to ANY of what they are pushing then by their own "best scenario" numbers, we all may as well just kiss our asses goodbye and make the best out of how long we have before the earth implodes. The numbers they give show there is no reversal. We can only hope to slow it down with things like carbon taxes, so you best get on board there's not much time left Nevermind that no one can agree on or measure how much impact human activity has on any of this.
Ten years is the upper limit for making estimates like this. Jeziss, who doesn't know this?
Trying to equate a budgetary process to the science of global warming represents a new low in the level of understanding of, well, it seems every goddam thing. I love how this comment also ignores what's going on with the planet right now. Massive new records, not by just a few degrees but by double digits, all over the place. It's a smear on ostriches about them burying their heads in the ground. The top species for that is homo rightwingus.
Totally unfreakingbelievable. It's happening here and now.
Rain fall totals have been record breaking. Yesterday in Middle River (Maryland) they had several inches of rain in several hours. A month's worth of rain.
Towards the end of July in Maryland - we had a month's worth of rain in less than two weeks.
There were two '1,000' year floods in less than two years in Maryland. In Elllicott City specifically. This is just in Maryland where I live (Columbia).
Record breaking temperatures in the midwest.
Record breaking temperatures in Scotland.
But no, global warming isn't happening, not at all.
This is no different from the warmingand cooling cycles we’ve had for billions of years. Mankind has nothing to do with it
That is so fucking hilariously wrong and not just because up to about one billion years ago the planet was a dry hot rock with no life whatsoever on it. I'm going to put a bit of scientific knowledge, so prepare yourself livefree. I don't want you to have a stroke or anything:
Best healthcare plan I had was my first job out of college, seems they just keep getting worse and worse
So, let's not change anything, okay?
I should have added that was 39 years ago
So, again--why change anything now?
So, now bringing up facts that destroy the rightwing lies is called "cherry picking." These are some damn big, delicious, juicy and above all relevant cherries.
ummmm…..The article "Destroys" that moment of "Health Care for all for Free" CRAP ..... put forth by the Socialist Left Wing !
CRAP is right. The only people who make that idiotic claim (that anyone says health care will be free*) are rightwingers hoping to prevent any change in a horribly expensive and wasteful (i.e., inefficient) system that you, yourself, the seeder of this article even admitted.
*Well, there's one idiot who ran for president in 2016 and promised BETTER health insurance for EVERYONE and it would COST LESS. And that Scumbag actually got the job and never has said another word about that promise.
Bernie …. and (a)Cost(you) outlines it !
How did you actually miss that again ?
The article notes Free, as put forth by "THE PROCLAIMED SOCIALIST"...…. is Crap" !
'Who knew health care would be so hard?'
"horribly expensive and wasteful"
You mean Obamacare didn't cure everything?
It was one of Trump’s liberal promises that I hated. Hopefully we can get a Congress who will eliminate all federal involvement in healthcare.
get rid of Obamacare, Medicare, and Medicaid
Just keep repeating the BS but be sure to rinse in between.
Deny, Deny, Deny.
Do you mean literally end Medicare and Medicaid? If so, what happens to those who depend upon these services? Take an elderly retired person who has paid into Medicare during his/her life with the (natural) expectation that it would be around at retirement - this individual now relies upon this service. Worse, what about individuals who need nursing home care and cannot afford the ~$50,000 per year (varies considerably)? Without Medicaid what are these people supposed to do?
I am all for people paying their own way, but I also recognize the need in any civilized society to provide a basic safety net. Seems to me you want to kick grandma out of the nursing home, eliminate her meds and other care and have her get to work serving french fries from her wheelchair.
Medicare should be phased out so that it doesn’t unfairly affect current enrollees and those over 50.
Any government healthcare involvement including for the poor should be determined by state, local governments and the people (like nonprofits)
regious based hospitals used to provide free care to the needy before government stepped in
The value of what you might have in mind depends upon the specifics but it is good to see that you are not advocating abolishing social safety nets.
It does not so there's your CRAP.
"what difference does it make?"