patrick.net

Wait, Koch brothers are not the source of all evil anymore?

Hugolas_Madurez says

Wait, Koch brothers are not the source of all evil anymore?

Another 180 swing!

It can't be because those nasty cheap asses want to externalize costs, eh?

Apparently CATO is going to have some major funding problems soon now that the Brothers Koch want Medicare-for-all.

tovarichpeter says

Former Clinton administration adviser Kenneth Thorpe... told the Associated Press on Monday. “Even though people don’t pay premiums, the tax increases are going to be enormous. There are going to be a lot of people who’ll pay more in taxes than they save on premiums.”/

Duh. It's a re-destribution scheme, pure and simple.

It would save billions for employers, who can stop paying medical group premiums and just deduct medicare from paychecks.

Yay, capitalism!

i've always wondered why Corporations weren't for medicare for all. I assumed it must be that all the corporate decision makers didn't want to lose their Cadilac health insurance. plans.

Perhaos they finally figured out that there is be a compromise way to do both.

Why not make continuing premium plans some sort of supplement to medicare much as senior now buy supplemental plans. THe insurance industry would be left those supplemental plans as a product to sell. Ths giving the added benefit of not totally destroying the insurance industry.

What if this is a great idea that will work ? Is a great idea something that our broken political system can embrace ? Which side gets credit ?

I've always thought that if Trump was what the Cucks say he is, he would do it. But I don't think he has the balls. What an interesting election that would make 2020, with Trump backing medicare for all.

marcus says

THe insurance industry would be left those supplemental plans as a product to sell. Ths giving the added benefit of not totally destroying the insurance industry.

This is why change NEVER happens. Even in your scenario the insurance industry would absolutely be destroyed actually. Whoever's name gets attached to this would be screwed because it would literally cause unemployment to skyrocket. The big insurers would have to cut their workforce overnight by 80% probably to stay profitable. Share prices would crash on these companies as valuations in the future would be completely out of synch with reality. Then a bunch of people with money tied up in what they thought were blue chip type stocks have lost 10-20% of their retirement fund 5 years before retirement (and some of them lost their jobs because of the decision). It would be a massive chain reaction disaster of epic proportions.

We'd then be stuck with a government system, that like most, doesn't really hold the employees accountable. And don't get me wrong, I'm not necessarily in support of the current insurance model by any means, but dramatic change needs to be REALLY well thought out and probably phased in over a very long period of time not to cause massive shock and disruption.

I know big corps aren't my friends either, but there are at least real consequences if they fuck up. Not really the case with government. Be careful for what you wish for.

WookieMan says

dramatic change needs to be REALLY well thought out

WookieMan says

Be careful for what you wish for.

EVeryone 65 and over already has medicare or medicare plus supplemental. So we already know how it works. And that's the period of life when people actually use their health care.

It's how we already get most of our health care.

It's funny really, Thinking of the thread about how liberals lack critical thinking skills. THis is such a fucking no-brainer.

marcus says

EVeryone 65 and over already has medicare or medicare plus supplemental. So we already know how it works. And that's the period of life when people actually use their health care.

Point noted, but you're talking about only 15% of the population "potentially" using medicare now. It's probably lower. https://www.cnsnews.com/news/article/terence-p-jeffrey/first-time-human-history-global-population-over-65-poised-pass

If it's healthcare for all, run by the government, that's a daunting task no matter if you're doing it for X amount of people right now. Arbitrary numbers, but if Apple sells a million iPhones right now per month and has a clean supply chain, WTF you think is going to happen if they're asked to make/sell 9 million a month? You're asking for close to 10X the output of services/product. Suppliers now need 10x the capacity to produce (real estate, machines, employees, etc). And no, not everyone will buy an iPhone (use healthcare), but you can't do it poorly if the 9 million phones were asked for.

Now put in place government employees, with little accountability and you think it's going to work out well? It would easily take a decade to implement and if there is any hiccup along they way it'll get tossed. Again, not saying it won't work, but it's not as simple as medicare for all and BOOM, it worked. So I'd say it's not a no-brainer really. It's why change in this realm is so difficult.

WookieMan says

Point noted, but you're talking about only 15% of the population "potentially" using medicare now

At the time interval of their life (if they've made it to 65), when they get sick and die. IT might be 15% of the population, but what percentage of health care expenditures do you think it is ?

Seems to me it must be at least 70%, but I will admit that's a guess. It must be more than half.

marcus says

why Corporations weren't for medicare for all.

marcus says

Perhaos they finally figured out that there is be a compromise way to do both.

Corporations have figured out that Medicare for All is a wonderful opportunity to fleece taxpayers some more. Apparently fleecing by Obamacare has reached its limits.

I've always wondered why Corporations weren't for medicare for all. I assumed it must be that all the corporate decision makers didn't want to lose their Cadilac health insurance. plans.

I can help you here, Marcus. Not for big corps, but I can tell you from a small-mid size corp point of view. Before ObamaCare, our personnel department had obtained a great medical plan for employees. It either paid the premiums on low deductible group coverage, or paid the premiums (to a certain level, depending on position) of insurance you bought yourself. The company group plan even had optical and dental coverage.

The benefit to the company was that the medical plan helped attract and retain better employees. Because of group purchase and at the time tax benefits, we could provide something less costly than increased wages, but more beneficial to the employee than increased wages would have been. Our group plan expired soon after ObamaCare kicked in, and we could not renew or find a plan without high deductibles. Also, "Cadillac" plans had a new tax added, and the company could no longer write off employee premium reimbursements.

tovarichpeter says

The ... report ... found that even doubling all federal individual and corporate income taxes would not cover the costs of Sanders’ Medicare for All plan.

Beautiful, fucking beautiful.

Everyone 65 and over already has medicare or medicare plus supplemental. So we already know how it works. And that's the period of life when people actually use their health care.

A better example, in my opinion, is Tricare Prime. This is medical coverage for military retirees that makes use of military medical facilities (not Veteran's Administration).

However, if we want a single payer or medicare for all type system, we had better decide to pay for it. We would need more doctors and related professions. If we did do medicare for all, I would like to see 2 things:

1. Medical Academies and Medical ROTC type scholarships that pay for medical education, but with a commitment to serve in a Medical Corp for a certain number of years after graduation. You are assigned where you are needed.

2. The ability for people to pay for and use private medical if desired. Nobody should be forced into the national health system out of "fairness."

HeadSet says

Nobody should be forced into the national health system out of "fairness."

I do not think it can work without everyone being forced into the system. Healthier people will choose to either forego insurance at all or they will buy cheap private insurance. Result, state system will be stuck with sick fat people who do not pay enough.

d6rB says

HeadSet says

Nobody should be forced into the national health system out of "fairness."

I do not think it can work without everyone being forced into the system. Healthier people will choose to either forego insurance at all or they will buy cheap private insurance. Result, state system will be stuck with sick fat people who do not pay enough.

Good point, but that could be solved by having everyone pay the medical payroll tax. You just would not be forced to use the system if you preferred a private option. Just like you can put your kid in private school, but you still pay local taxes for the public schools.

marcus says

Seems to me it must be at least 70%, but I will admit that's a guess. It must be more than half.

At least.

Look, the real problem with Medicare for all is that it would 1)eliminate the employer write off for providing health insurance, 2) Get employers off the hook for paying for any health insurance for employees, 3)disproportionately put the cost of insuring people back on the workers, since corporations don’t pay that much tax anyway.
Add to this the fact that the quality of health insurance would drop dramatically, rationing of health care and medicine would follow swiftly, and fewer health care workers would be interested in participating, right when the largest demographic is going into their twilight (expensive) years, it would be a fucking disaster.

The only good thing that could come of a Medicare for all scenario right now would be healthcare rationing that was severe enough to kill off a good chunk of Boomers a bit early so they’d stop draining the system before it’s entirely broken.

healthcare rationing

Without increasing the supply of doctors and medical facilities, rationing is inevitable. If not politically connected, the first to be denied will be smokers and the obese. Yep, fat boys will lose coverage if they do not follow a diet/exercise plan.

marcus says

Seems to me it must be at least 70%, but I will admit that's a guess. It must be more than half.

I don't know man. If you're talking age 65, then I don't think it is half the medical costs overall (regardless of medicare) strictly based on age. I get where you're coming from that older people need more medical care, but there's a ton of issues under the age of 65.

I just had a neighbor pass away about 6 months ago who was 80. Completely healthy until diagnosed with cancer and no other prior issues. While healthy, his body was too aged to handle treatments and he passed away about 2 months later. On the other hand my own father just turn 65 and has had treatments in some form or another over the past decade for cancer. He was getting injections that cost I think about $50k/mo and because of my mom's insurance as a teacher it was covered. He wasn't using medicare. And if he was, I'm pretty certain that he wouldn't have gotten the same treatment.

Listen, on paper it makes absolute sense. In practice though and the numbers involved it could and I think will be a massive disaster if it gets to that. There are more fucked up people (involuntarily) than you think under the age of 65.

https://en.wikipedia.org/wiki/Health_care_system_in_Japan

Hospitals can only be run and lead by doctors, cannot turn away patients, and cannot be for-profit. Government sets rates:

While some countries like the U.S. allowed costs to rise, Japan tightly regulated the health industry to rein in costs.[6] Fees for all health care services are set every two years by negotiations between the health ministry and physicians. The negotiations determine the fee for every medical procedure and medication, and fees are identical across the country. If physicians attempt to game the system by ordering more procedures to generate income, the government may lower the fees for those procedures at the next round of fee setting.[7] This was the case when the fee for an MRI was lowered by 35% in 2002 by the government.[7] Thus, as of 2009, in the U.S. an MRI of the neck region could cost $1,500, but in Japan it cost US$98.[8] Japan has had "catastrophic coverage" since 1973. Once a patient's monthly copayment reaches a cap, no further copayment is required.[9] The threshold for the monthly copayment amount is tiered into three levels according to income and age.[5][10]

Insurance companies and hospitalis in the US Collude to platinum-plate health care because more expensive costs mean higher premium justifications for insurers.

The problem with the US Healthcare system is basically the same as Cost-Plus Contracting. There's no incentive to keep the cost down when you get a guaranteed profit percentage of the cost. Better to make 10% of $100M than 10% of $20M.

A balance between being free of purchasing employee insurance plans versus corporate tax increases to pay for single payer.

If it is Medicare for all, then do we get to get rid of Medicaid?