Seems like some of our Representatives in DC are AWOL on Medicare for all. I’m sorely disappointed by my rep, Kennedy – doesn’t seem to be “Some people see things as they are and say why? I dream things that never were and say, why not?” material. I called Kennedy’s office yesterday and got a verbal shrug. “Idunno?”
I politely suggest that these Reps get called by their constituents.
At least health fare is a true example of American Exceptionalism: almost every other industrialized nation ensures that all citizens (at least) get quality health care at reasonable costs. In the US… not so much on any of those.
Please share widely!
Catchy name, but what does it really do?
below.
Based on my quick skim … it seems a little slapdash. Health insurers may not sell benefits covered by the bill?
Its a terrible bill, written in an amateurish manner. Parts of it are clearly unconstitutional. Bills written this way are not meant to be taken seriously.
Thanks in advance.
The bill requires that all providers convert to non-profit status, and also states that the owners shall not be compensated for lost value of their business. This is unconstitutional.
for profits can exist, but they will not be part of the plan. Other countries dealt with this, and made the conversion. There is also compensation for losses incurred in the change over.
Further the present insurers have abandoned the original intent of their creation by the 1973 Management Care Act. The present law, ACA, already has put limits on their “profitability”. It is weakly monitored, but cites that insurers have to keep overhead to 20% of their revenue.
Government has also intervened in the public interest by suspending rules. Harvard Health was allowed to call loans assets, and going back further was a player of folding Bay State Health Care, and Pilgrim into BC/BS and Harvard Community respectively. There are also rules for reserves and what they have to cover.
Further the Supreme Court on hearing complaints about the ACA, decided that what was called a penalty to the non-insured was really a tax.
Lastly, the legal bumps will be figured out as long as voters understand that this is the only substantial way of keeping costs in check, and providing comprehensive care. Complaining about the bill’s legal structure at this stage is not going to get where this nation has to go to bring affordable care to all.
The bill also provides significant funds to transition present insurance employees to other jobs. Employers will be in the mood to hire, since what they pay for insurance will be substantially less.
But it is draconian. We’re going to tell a large industry they can no longer exist?
they have long outlived their stay, and the goal is not to save a industry, but to do what’s right for the American people’s survival. What is draconian is the suffering for-profit insurers have wreaked on the public. What’s your stake with for=profit insurance anyway? Look up Wendell Potter who was an executive at Cigna, and left because of their practices.
Unless you count being a heavy user of it? Because at the moment, my family is.
Healthcare is one-sixth (I read one-fifth the other day) of the American economy. People first, but economic effects are not nothing.
you have the most to benefit from Single Payer. There will be no deductibles or co-payments. Your pay in will be my household income, not by community rating, age or illness. By cutting out unnecessary bureaucracy, this amounts to $500 billon saved across the country to use for care.
Germany uses a system of over 200 insurers that is non profit, but they sell other policies other than voucher covered health insurance.
Canada e.g. does not cover drugs or physical therapy, but insurance for that is low along with national negotiation for drug prices.
There just are better mousetraps.
Somehow, though, I feel there is a disconnect with how I am answering you because you counter with a new concern. Do you have any issues with social insurance like Medicare or Social Security? You are exactly the person that deserves reliable information so that persuasion comes from informed sources and working models throughout the first world.
At present 62% of our tax dollars go to pay for health insurance, a large chunk of which is inefficiently run. It includes Medicare, Medicaid, the VA, government workers on all levels, and taxes not paid on premiums from insurance paid through employers. Private insurance outside of this covers 30% of the expense, and the rest is out of pocket or some other contribution(charity for example).
I don’t think anyone here is arguing that single payer isn’t preferable to the status quo. Those of us skeptical of other plans (VT, this bill) are worried about implementation and the political reality of getting to ‘yes’ votes in the patchwork system we have.
I think baby steps like Midlife Medicare and Medicaid for Kids would be incredibly popular, easier to pass, and will ease the burden on the exchanges and private systems. Eventually a public option would be the way to ease everyone not covered already by the government into a government plan. Add price controls like MD in an all rate payer system and you have the next three-four likely steps to achieve universal coverage. It will not look like Canada or the NHS-but it will look a lot closer to Germany and Holland.
Last time I checked, they spent less than 5% on administrative costs. Private insurers are 15%-20% or more.
I haven’t checked into it, I’d guess that the VA’s costs per QALYS is world class (QALYS = Quality-Adjusted Life-Year Saved, a good way to determine true cost-efficacy of care.)
In VT the model was to just buy out the insurance companies as part of the switch to public healthcare. Jacobin outlines how this is technically feasible on the national level (legally and politically feasible is another story). But its an industry valued at $287 billion. The government could write a check, buy it, and then employ everyone in it to help run the new government system and help ease patients into it during the transition period.
A public option would have the affect of gradually eroding market share and causing this industry to decline anyway. ACA was probably the only reform that could help the industry increase market share-which is why HMOs and the AMA supported it. Jacobin forgets the lesson of the Clinton plan that you need special interest allies to actually pass laws in our system.
failed because it was not single payer. Several insurers and self insured companies were left in place. However the tax rate proposed would have still saved the state money on health care expense.
The problem with incrementalism is what we have seen today. It can be attacked by conservative or reactionary elements. What the GOP is proposing at the moment predates even the 1973 law.
The public option will just be another plan in the mix. By taking the highest risk patients, it would please the insurers no end. You do not get real savings unless the wasteful bureaucracy is removed. Also multiple insurers with their own risk pools dilutes out benefits of a single larger one. We are talking about keeping people healthy, not a get rich scheme. This industry was created by the 1973 law. It time to say it didn’t work out, and move to SP. Medicare stands as a model to enroll people. In its first year of operation 90% of seniors enrolled. The business community was thrilled that they did not have to pay for the 12% of the population that made up 20 to 25% of the cost. Medicaid also intervened by taking care of over 60% of nursing home care.
I haven’t seen a proposal that recognizes there are other players in the system who will never agree to it. Like I said, I favor sponsoring these kinds of bills to move debate and put the issue back on the front burner. I disagree with those who think symbolic bills don’t serve a purpose. I also disagree with the progressives who think we can go from status quo to single payer in one bill.
Governments make decisions all the time, including outright bans on previously legal activities or products, that aren’t takings, which I’m pretty sure was intended to mean real property as opposed to business value or potential to turn a profit.
This is about base service and moving the Overton window. When we have a majority and the White House again, then we can worry about serious plans. This is bill could be our repeal and replace-only we will have a real plan when we are in charge again.
That said-I think there is a strong case to be made for pushing Midlife Medicare and Universal Child Medicaid while we’re in the minority. Both can be accomplished by expanding eligibility for existing programs and both are things Trump, his voters, and the Tuesday Group could support as ACA fixes that also accomplish progressive incrementalism on healthcare.
I would have taken the last 3 weeks to be an object lesson in:
Don’t Pretend Healthcare Policy is Simple, Just for Base Service, When in the Minority, Because It Will Make You Look Inept And Incompetent and Will Also Cause Huge Party Divisions When You Are Not in the Minority
I take this sort of “base service” to be a sort of sop to the left wing types who are likely to use the word “neoliberal” and try to hiss anytime someone tries to explain that a particular policy problem “isn’t as simple as that.” If a big portion of your “energized” base is untethered from reality, and have grossly unrealistic expectations, you’re not going anywhere, even with a majority.
It would be better to start to work out the hard problems now, rather than later.
Without repeating myself, my second point was in fact to steer the conversation to realistic alternatives. And even find a way to work with moderates and Trump on health care ‘fixes’ that actually expand coverage. There are two workable models for this. Midlife Medicare and Medicaid for Kids. That doesn’t mean we vote against symbolic bills pushing Medicare for All ‘because they won’t work in the real world’.
Absolutely get people on record for single payer as a negotiating tactic to show that we are serious. It makes no sense to compromise with yourself before you get to the negotiating table. Something Obama did with ACA and nearly did with the Grand Bargain-needlessly moving policies further to the right pre-emptively. But if Trump and Republicans in Congress see Democrats united and serious about single payer-they may be more likely to meet us halfway at the table on Midlife Medicare and Medicaid for Kids. Two policies that are a lot simpler to implement, easier to explain to voters, and popular even among Republicans.
Let’s view voting for Medicare for All as voting for repeal. Entirely symbolic but it lets our base know we have their back. But when it comes to ‘replace’ we actually have viable patches that will work, unlike AHCA.
If liberals can’t argue about policy details without people, then they might as well just give up and binge watch the Bachelor.
I don’t care if it appeals to Trump voters who will never vote for your candidate anyway. I would prefer to leave “pretending that there are magic fixes to complicated problems” to the other political party.
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Long live it! 🙂
Midlife Medicare and Medicare for Kids are serious proposals from Brookings. All rate payer worked in MD. You don’t start a serious conversation with those bills. We bring attention and excitement to the cause with the symbolic vote, and bring Republicans to the table with the real proposals. This is a two pronged approach not th underpants gnoming the GOP does or preemptively watering down or own proposal as Obama did.
Who provide better care, for all residents, for half the price. Maybe not so bad? There’s probably a good and non-obvious reason behind it.
Sadly, Joe and others in Congress support health care as a basic human right of the working class….that’s available for purchase from the wealthy class.
n/t
I’m going to call her office everyday until she signs on! Really disappointed in her. 🙁
…I read the list above as those who have not signed on as co-sponsors, rather than active opponents.
Pressure is needed.
If the goal is really to expand debate and open Overton’s proverbial window, I have two thoughts.
1) Walk there a bit more slowly.
2) Not use this as a stick against Democratic officeholders. (Primary them if you like — let them make the argument.)
I disagree with JConway’s point above. A “repeal and replace” effort would not have the same effect with us. Our base expects better of us.
So for example let’s say our goal was drug legalization: medical use is one window. On healthcare, I don’t know … maybe preventive care? That saves everybody money later. So push for universal prevention as a lever, maybe even make covering prevention a cost of entry for insurers.
1) Symbolic Bills are Important and Don’t Have to Be Perfecf
Like Christopher, I like the Dingell/Conyers bill and would push to cosponsor that instead. Doesn’t have to be this bill. This is what liberals always do-argue amongst themselves before committing to a unifying action. Pelosi told a group of activists the other day that single payer is a pipe dream-its not.
There is a *yuge* constituency for this policy. And bills like the linked one above or the Dingell one are a signal that we want to do this. That’s all-this policy doesn’t have to be enacted this way-but saying we support it in theory as a party helps us achieve it in practice. It’s a goal like repeal was for the GOP. We should also learn from their fuck up and achieve it incrementally. Leading to pt 2:
2) Midlife Medicare and Medicaid for Kids
These are two policies that can be baked into the existing architecture of public healthcare and do a lot to drive costs down. A lot of folks (my own dad if he weren’t disabled) fall into the “too old to work/too young for Medicare” bucket. I bet this kinda plan would benefit our own John T May or folks like
my Uncle Jon whose employers may not offer competitive benefits.
Kids are the most expensive. One mixed couple I know (biracial as well as Clinton/Trump) are the kind of fiscal con/social lib moderates we expect to oppose single payer. And they both do-they both feel people should work for their healthcare and be responsible. But they both feel kids are really expensive to cover and it’s impacting their life and career choices. Delaying them from starting a small business they’ve been planning and ixnaying a possible third child entirely. This would be a huge middle class benefit. Trump voters would support both and our minority is wise to propose it and dare him to veto or play real ball.
the big impact that health insurance has on the budget, I can say Midlife Medicare would be a boon to cities and towns.
You move the highest risk patients into the public pool and voila-premiums go down for everybody else. Similarly moving kids onto the public pool would substantially reduce costs in the private sector and on the exchanges. This should totally be sold as a fix to ACA to bring Republicans on board.
I could live with a framework that says from 26-50 you’re either on your own to buy coverage (with scaling subsidies for income/public option) or get coverage through an employer. These baby steps are something Democrats, the Tuesday Group, and maybe even the White House could get behind.
Medicare rolls would save serious money for municipalities. For teachers alone, this would be a boon.
The savings wouldn’t necessarily be passed on to us.
Every time I hear Medicare for All, I wonder how many pause to consider that Medicare covers about 80% of medical expenses – hence, the supplement plans. Would the town not offer them, telling retirees/employees they’re in their own for the 20%? If you do choose to offer the supplement, what guarantee would you have that they would cost less in the long run?
be in the details. There would be a lot of negotiations involved. It’s my understanding that, as it is now, Medicare lowers the cost of insurance for the town. I’m thinking that benefit would be extended with the lowering of the age, but that’s hardly a done deal.