Medicare for All is a Money Saver
https://jacobinmag.com/2018/08/medical-for-all-health-care-spending-mercatus
https://jacobinmag.com/2018/08/medical-for-all-health-care-spending-mercatus
Medicare for All is a Money Saver
https://jacobinmag.com/2018/08/medical-for-all-health-care-spending-mercatus
Tilt, as I posted earlier, we won't need a "tax" of that volume if we can set a level of employee participation and use the money they currently pay to private insurers and redirect it to M4A funding. The tricky part is to get the 15-20% who aren't in employer groups into the program. We also have to include in the law that no matter how many hours you work that you are to be covered to avoid companies cutting work weeks to opt out.
Business is already participating, but they will bitch about not being able to dance around including all employees.
The 40% savings may be bit high but 30-35% should be doable. The 5-10% difference is a huge amount when you are talking about trillions of dollars.
This is better. I like Bruenig, but I think there are a couple of major problems with this analysis.
2. But even if we were to ignore the problems with the bill itself and it's assumptions, there is another big challenge, one that he does not address at all -- how to feasibly create the required M4A tax to pay for the project. His overall point is that if you were to capture all of the money Americans (and state governments) spend currently on health care, and give that money to the government in taxes instead, we could give everyone a very generous health care package (much more generous that many of the European models that those of us that typically support universal health care wish we could better emulate), and then have $2 trillion left over (over 10 years) for other pieces of the DSA agenda. But no one in the DSA or Bernie's group has put forward a proposal for how such a tax would work, which should illustrate just how difficult it is to design any sort of tax that would generate ~$30 trillion. What is clear is that it would require huge tax increases on everyone, not just the wealthy.
I don't really understand this. The point of med4all is to uncouple health coverage from your employer.
I'd like to get better at understanding the variables that are different under the proposed med4all plan and the status quo. Isn't the idea that the tax wouldn't have to generate $30 trillion, but rather the delta between national health spending now and national health spending under a single-payer plan?
and if only you were as clever as you think you are
Yes and no. The theoretically argument Bruenig and others are making is that all that matters is the total health care spend. And looking through that lens, M4A looks great! Again assuming all the cost cuts/projected savings in the M4A plan, the total spend is actually less than the status quo by about $2 trillion over the next 10 years, and covers far more people. But, as we all know, the status quo relies on personal health expenditures (co-pays, premiums, etc). The argument goes that that money that people spend on personal health care expenditures would need to instead be collected as taxes. But what needs to be collected is not just the delta (which is actually positive), but the entire cost of the program. It sounds great in the abstract because collectively people would actually be saving money (that is, paying more in taxes, but saving even more in reduced health care expenditures and higher wages), until you try to come up with a way to collect the $3+ trillion per year you would need. You'd have to more than double federal corporate and individual tax receipts. Changes of that magnitude are really, really hard, likely create big winners and lots of (net) losers, and no one has come up with a proposed way to do it yet.
to my knowledge, i've never expressed or even feigned support for the DNC's leadership.
speaking of fantasy:
‘Medicare for All’ Is a Fantasy
But the surge in support for the idea gives Republicans the chance to offer a coherent alternative.
Yes and no. The theoretically argument Bruenig and others are making is that all that matters is the total health care spend. And looking through that lens, M4A looks great! Again assuming all the cost cuts/projected savings in the M4A plan, the total spend is actually less than the status quo by about $2 trillion over the next 10 years, and covers far more people. But, as we all know, the status quo relies on personal health expenditures (co-pays, premiums, etc). The argument goes that that money that people spend on personal health care expenditures would need to instead be collected as taxes. But what needs to be collected is not just the delta (which is actually positive), but the entire cost of the program. It sounds great in the abstract because collectively people would actually be saving money (that is, paying more in taxes, but saving even more in reduced health care expenditures and higher wages), until you try to come up with a way to collect the $3+ trillion per year you would need. You'd have to more than double federal corporate and individual tax receipts. Changes of that magnitude are really, really hard, likely create big winners and lots of (net) losers, and no one has come up with a proposed way to do it yet.
I agree. Capital is risk adverse, so big money political campaigns have become equally risk adverse - basically if something has never been done it will poll poorly, and if it polls poorly, no one will give it any money or support. Fortunately for Gillum, he received just enough big money support to run a successful field based campaign.Yeah. It’s similar to the FL Democrats loudly wondering during the primary if Gillum can win in Nov because he’s black.
This is better. I like Bruenig, but I think there are a couple of major problems with this analysis.
1. He states that the Mercatus Center report shows that Bernie's M4A plan could "realistically" save $2 trillion over 10 years. That is not what the Mercatus report shows. The Mercatus report (which is actually quite similar to a previous analysis by the Urban Institute), showed that if all of the assumptions and projections within the plan actually came to pass exactly as written in the bill, the result would be approximately $2 trillion in savings overall. It doesn't say anything at all about whether those assumptions are realistic. Just one example, it calls for physicians to be reimbursed at current Medicare rates for all patients, which is, on average ~40% less than private insurance, and below costs. Some reductions in physician pay is likely warranted, especially highly compensated specialists. And certain physicians would see far less of a cut, especially if they already treat a large number of medicare and (especially) medicaid patients. But an across the board cut of that magnitude is unlikely to be feasible. And the savings quoted in the report are highly dependent on this an other sources of cost savings that, imo, are not realistic as currently described.
2. But even if we were to ignore the problems with the bill itself and it's assumptions, there is another big challenge, one that he does not address at all -- how to feasibly create the required M4A tax to pay for the project. His overall point is that if you were to capture all of the money Americans (and state governments) spend currently on health care, and give that money to the government in taxes instead, we could give everyone a very generous health care package (much more generous that many of the European models that those of us that typically support universal health care wish we could better emulate), and then have $2 trillion left over (over 10 years) for other pieces of the DSA agenda. But no one in the DSA or Bernie's group has put forward a proposal for how such a tax would work, which should illustrate just how difficult it is to design any sort of tax that would generate ~$30 trillion. What is clear is that it would require huge tax increases on everyone, not just the wealthy.