myDeaconmyhand
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He didn't endorse Ben jealous for governor of Maryland either. Who the fuck knows
Bullshit Ocasio-Cortez says
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ImTheCaptain
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avalon
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Oh no, Obama also didn't endorse Beto or Finkenauer or Axne or Houlihan or Fletcher or McBath or Valdez or Ortiz Jones or Rose or McGrath or Sherrill or Luria or Spanberger or Wexton or Golden or Ojeda or Hegar or O'Connor or Holguin or Scholten or Grechen or Wallace or Eastman or
If you can get where? What math are you doing? We can most certainly pay for single payer healthcare. I think of medicare for all as a moral issue as much as an economic issue. Solves both an economic justice issue but also a health justice issue.
Highland Deac
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I don't know if Ocasio-Cortez will turn out to be a dud or a smashing success (she's not even been elected to her first public office yet), but based on early reviews it looks as if Fox News and conservatives are well on their way to finding their new boogeyman (or woman) to hate and despise and fear. And they have been joined, apparently, by some Democrats, who fear that her outspoken progressive views (and a few early verbal blunders) will damage the party. Maybe she'll work out, maybe not, but it's certainly been interesting to watch the usual suspects already hard at work turning her into the new symbol of everything they hate, or fear, or disdain.
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dartsndeacs
THE quintessential dwarf
How much does single payer cost? I was using the cost numbers quoted in the OP.
ConnorEl
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I hear she’s actually the daughter of the devil.
JuiceCrewAllStar
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point taken, but let's not pretend Obama is part of or a fan of the party's move leftward
he's as establishment as they come
JuiceCrewAllStar
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Plan would save $2 trillion in expenditures over 10 years, per study in OP: https://jacobinmag.com/2018/07/medicare-for-all-mercatus-center-report
myDeaconmyhand
First man to get a team of horses up Bear Mountain
The German health insurance industry is not at all comparably similar to the American one.
"Though mostly public, the German health insurance system is not a state-run system like the National Health Service in the United Kingdom. In fact, more than 100 different health insurers, known as sickness funds, compete for members in Germany’s comparatively decentralized system. These sickness funds are non-profit, non-governmental organizations that operate autonomously.
The government does play a key role in setting standards. For example, all sickness funds are required by law to offer the same comprehensive benefits package, which covers virtually all health care needs. But it is a non-governmental body, the Federal Joint Commission, which decides what benefits are covered. The commission has 13 voting members, including 5 from the sickness funds, 5 from doctors and hospitals and 3 neutral members. The German system is thus not state-run. Nor, however, is it a private, for-profit system like America’s. The sickness funds are non-profit organizations, and generally speaking, no money is exchanged at the point of service when Germans go to the doctor.
Most Germans’ health insurance contributions are deducted from their paychecks by their employers. The amount, however, is capped at 14.6 percent of a person’s salary, split fifty-fifty between the employer and the employee, so 7.3 percent each way. But coverage is not dependent on the employer, so when Germans change or lose their jobs, nothing changes in their health insurance. Premium contributions, moreover, cover the full range of benefits. Co-payments do exist in Germany, but they are limited. For example, Germans have to pay €10 per quarter for outpatient care, between €5 and €10 for prescription drugs and €10 a day for hospital stays.
The sickness funds do not limit which doctors their beneficiaries can see, as is often the case with private health insurance in the United States. Germans choose their primary-care physicians, specialists and the hospitals they visit. In the German system, therefore, there is no conflict between personal freedom and solidarity.
Because the contributions are higher, patients with private insurance are a more lucrative business for doctors. As a consequence, they often receive service faster.
Though Germans are overwhelmingly satisfied, Bismarck’s system does face challenges in the 21st century. As in other rich economies, health care costs are rising in Germany as the population ages. In 2015, Germany spent €4,213 per person on health care, which adds up to 11 percent of gross domestic product. To deal with rising costs, the government has started subsidizing the sickness funds with tax money to the tune of €14.5 billion this year.
Private insurance exists but is controversial. Anyone who makes more than €57,600 a year can opt out of the public system and purchase a private policy. Nearly 9 million people have done this. Because the contributions are higher, patients with private insurance are more lucrative for doctors. As a consequence, they often receive service faster. An 2013 investigation by the news group Welt N24 found patients with public insurance often had to wait weeks longer to see a doctor...."
https://global-handelsblatt-com.cdn...errer=https://www.google.com&_tf=From %1$s
Their health insurance industry is a product of 130 years of UHC.
"Though mostly public, the German health insurance system is not a state-run system like the National Health Service in the United Kingdom. In fact, more than 100 different health insurers, known as sickness funds, compete for members in Germany’s comparatively decentralized system. These sickness funds are non-profit, non-governmental organizations that operate autonomously.
The government does play a key role in setting standards. For example, all sickness funds are required by law to offer the same comprehensive benefits package, which covers virtually all health care needs. But it is a non-governmental body, the Federal Joint Commission, which decides what benefits are covered. The commission has 13 voting members, including 5 from the sickness funds, 5 from doctors and hospitals and 3 neutral members. The German system is thus not state-run. Nor, however, is it a private, for-profit system like America’s. The sickness funds are non-profit organizations, and generally speaking, no money is exchanged at the point of service when Germans go to the doctor.
Most Germans’ health insurance contributions are deducted from their paychecks by their employers. The amount, however, is capped at 14.6 percent of a person’s salary, split fifty-fifty between the employer and the employee, so 7.3 percent each way. But coverage is not dependent on the employer, so when Germans change or lose their jobs, nothing changes in their health insurance. Premium contributions, moreover, cover the full range of benefits. Co-payments do exist in Germany, but they are limited. For example, Germans have to pay €10 per quarter for outpatient care, between €5 and €10 for prescription drugs and €10 a day for hospital stays.
The sickness funds do not limit which doctors their beneficiaries can see, as is often the case with private health insurance in the United States. Germans choose their primary-care physicians, specialists and the hospitals they visit. In the German system, therefore, there is no conflict between personal freedom and solidarity.
Because the contributions are higher, patients with private insurance are a more lucrative business for doctors. As a consequence, they often receive service faster.
Though Germans are overwhelmingly satisfied, Bismarck’s system does face challenges in the 21st century. As in other rich economies, health care costs are rising in Germany as the population ages. In 2015, Germany spent €4,213 per person on health care, which adds up to 11 percent of gross domestic product. To deal with rising costs, the government has started subsidizing the sickness funds with tax money to the tune of €14.5 billion this year.
Private insurance exists but is controversial. Anyone who makes more than €57,600 a year can opt out of the public system and purchase a private policy. Nearly 9 million people have done this. Because the contributions are higher, patients with private insurance are more lucrative for doctors. As a consequence, they often receive service faster. An 2013 investigation by the news group Welt N24 found patients with public insurance often had to wait weeks longer to see a doctor...."
https://global-handelsblatt-com.cdn...errer=https://www.google.com&_tf=From %1$s
Their health insurance industry is a product of 130 years of UHC.
JuiceCrewAllStar
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That’s what he’s getting at: he predicts we’ll end up with a system like that when the healthcare dust settles, not one like the UK or what we have now.
The projected savings comes in large part to reductions in payments to doctors, hospitals and other providers. Those reductions will never take place (at least to the extent projected). From the Mercatis model:
"The M4A Act as introduced specifies that provider payment amounts are to be consistent with those paid under current Medicare law.21The adoption of Medicare payment rates would represent asubstantial reduction in provider reimbursements for care provided to everyone now covered by private insurance (though it would also be a temporary increase in physician payments for those now covered by Medicaid, which currently pays physicians at lower rates 11than does Medicare). For example, in 2014,hospitals were reimbursed just 89 percent of their costs of treating Medicare patients and 90 percent of their costs of treating Medicaid patients—losses that were offset by hospitals collecting private insurance reimbursement rates equaling 144 percent of their costs...
Furthermore, it is not precisely predictable how hospitals, physicians,and other healthcare providers would respond to a dramatic reduction in their reimbursements under M4A, well below their costs of care for all categories of patients combined. The Centers for Medicare and Medicaid Services (CMS)Office of the Actuary has projected that even upholding current-law reimbursement rates for treating Medicare beneficiaries alone would cause nearly half of all hospitals to have negative total facility margins by 2040. The same study found that by 2019, over 80percentof hospitals will lose money treating Medicare patients—a situation M4A would extend, to a first approximation, to all US patients."
https://www.mercatus.org/.../blahous-costs-medicare-mercatus-working-paper-v1_1.pdf
Let me try this again. The $2T savings is generated by a projected $5.3T reduction in payments to providers. There's no way payments will be reduced anywhere close to that amount.
I'm not arguing against Medicare for all; just want us to go into this with our eyes open.
myDeaconmyhand
First man to get a team of horses up Bear Mountain
When the dust settles from what? How exactly are we going to reorient a trillion dollar private health insurance industry and keep it private? 85% of Germans receive their healthcare from public organizations. Suddenly we prevent BCBS from serving everyone but the very wealthy top 10%? Every moderate who makes this argument against M4A, that the German mixed public/private health insurance model is more "realistic" is just demonstrating that they don't know anything about the German model, besides that some people in Germany still have private insurance.
myDeaconmyhand
First man to get a team of horses up Bear Mountain
Any UHC model that involves the federal government subsidizing private health insurance is absolutely doomed to fail, because that keeps a layer of obscurity and detail inbetween government and the voters.
When the federal and state governments are directly providing the healthcare, there is no debate over responsibilty for problems. Whereas now, Republicans can rip the shit out of the ACA by secretly and obscurely fucking over private providers and then campaign on how fucked up the ACA is.
When the federal and state governments are directly providing the healthcare, there is no debate over responsibilty for problems. Whereas now, Republicans can rip the shit out of the ACA by secretly and obscurely fucking over private providers and then campaign on how fucked up the ACA is.
JuiceCrewAllStar
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At the risk of mis-speaking on behalf of ChrisL, I don't believe he's arguing that the path to UHC is having the government absorb private insurers and we carry on our way, but that UHC will involve a model that has an insurance-style structure because that understanding of healthcare is so deeply imbedded. Not that BCBS is going to become a quasi-government agency administering a new healthcare system.
I don't even think he's advocating for it based on that post, just predicting how, if UHC comes to pass, it will look.
I don't even think he's advocating for it based on that post, just predicting how, if UHC comes to pass, it will look.