Current Healthcare System Vs. Single-Payer "Medicare-for-All"

[Danny Bateman]

T

 

I agree our system appears to be unfair to the poor and has inflated healthcare costs, but would a transition to a single-payer system be as seamless as Sanders tries to make it seem?

 

I'm actually in favor of the concept he is proposing. Logistically, there's not a whole lot solid out there as to how it would be funded, and nothing current. He continues to say he will be releasing data on this "shortly," but hasn't yet put anything out. From the articles I've read regarding his 2013 single-payer proposal, Bernie's plan COULD work, but the figures he estimates don't add up. He has said the only taxes needed to pay for his system are a 6.7% payroll tax and a 2.2% income tax.

Most all of that would roll downhill to the EMPLOYEE as opposed to the employer (in terms of payroll), and 9% of my income seems like quite a bit to pay for healthcare. But if you examine the system proposed for us in Vermont, it calls for an payroll tax of 11.5% and a sliding income tax of 0 to 9.5%. 21% of income going coverage is absurd.

 

Then you think about the negative effects that Medicare-for-all could have on health care rationing and quality of care, and it just gives me a lot of pause. Not to mention the fact that our already implemented public single-payer program, Medicare, whose "whose cost has grown substantially faster than the economy for most of the last 50 years," shows no sign of improving efficiency.

I'm actually a proponent of what Sanders is striving for. Of course healthcare should be afforded to people. As a medical professional, I put the patient first and people should be able to afford medical coverage. But I'm worried about the sketchy details Bernie has offered regarding actual implementation of his plan, and I'm starting to think it will be a lot more expensive than he's making it out to be.

 

Here's some reading for some of the stuff I cited:

 

http://www.bloombergview.com/articles/2014-04-11/vermont-s-single-payer-dream-is-taxpayer-nightmare

 

http://www.bloombergview.com/articles/2014-04-30/single-payer-would-make-health-care-worse

 

http://www.politifact.com/truth-o-meter/article/2016/jan/13/how-much-would-bernie-sanders-health-care-plan-cos/

 

The last is probably the best place to start and the other two play devil's advocate as to whether single-payer only could function at a national level.

[JJ Husker]

I would absolutely love to get my Healthcare premiums cut back to only 9% or 10% of my gross income. I am currently paying about $1450/mo or $17,400 annual for my Obamacare plan. It has better coverage than the plan I had prior to Obamacare but the premiums are still increasing about 20% per year. If somebody can come up with a plan, single payer or otherwise, that only costs 9% to 15% of my gross income, and prevents the yearly 20% increase, count me in.....way in.

[TGHusker]

Watched some of the Dem Debate last night. It is pretty evident that Bernie wants a "single payer' health care system. My question to those who are more knowledgeable on this topic - what are the pros and cons of a single payer system over a truly free market system. I've always thought one of the problems wt the pre-ACA system was that health insurance wasn't portable (from job to job and state to state) thus giving too much power to the insurance company - less competition. If we make that one change it seems that would drive down prices as insurance companies would have to be more competitive on price and offer better plans. As it stands now, your lose your job or move on to a new job and you are out of insurance coverage but if you could take the insurance with you like you can your auto or life insurance, it would drive down pricing. While single payer would put the govt in control of health care insurance (basically being the insurance company) - this too me risks too many possible negatives. You cannot walk away from a bad govt insurance plan to select another if it is the only game in town.

In some ways it seems the single payer route also goes against what I think people like Bernie complain about the most - wall street and govt scratching each other's back. The big corporations would probably love nothing more than being released from their responsibility of providing health insurance for their employees. A all powerful govt wouldn't mind taking control to make sure everyone is treated equitably. So, here we have wall street getting a 'bailout' from the govt - not that much different than the 2008 bailouts in some ways. To me it seems that the better way is to drive real completion in the market - competition typically lowers prices while improve quality unless a particular insurance company positions themselves as the Walmart of health insurance - low cost, limited benefits insurance.

So, If I'm missing something here, please enlighten my perspective. I appreciate your input.


Speaking of Bernie. He kind of grows on you. It has been said that he and Trump both bring 'anger' into their respective races. You know, I think I can take Bernie's anger better. Trump cuts people down and attacks them personally, Bernie attacks the issue. They both have forced the discussion in both races and that is a good thing. Regarding Bernie, I might like his college tuition plan. It seems to me that higher education in many respects is not that much different than big wall street corporations. They are an end to themselves and the student or employee be dammed in the end. A student should have to be in 'debtor's prison' so to speak due to his school debt. It is hard to grow an economy when students graduate with such large debts. There has got to be a better way to finance vo-tech and a college education. Colleges and Universities are by and large liberal entities but they have no shame in taking govt research and grant money while charging students an arm and a leg for the 'right' to study within their hallowed halls. So Bernie might be on to something there. However, when you take all of Bernie's proposals - he'll break all of our backs (and banks) wt the tax burden. In some ways I see were he and Rand Paul could be in agreement on some issues or at least have the same concerns but maybe solve them differently. It would be nice to have a candidate who was a composite of the best of each but that is impossible in a 2 party system.

[Landlord]

Speaking of Bernie. He kind of grows on you. It has been said that he and Trump both bring 'anger' into their respective races. You know, I think I can take Bernie's anger better. Trump cuts people down and attacks them personally, Bernie attacks the issue. They both have forced the discussion in both races and that is a good thing.

 

 

Bernie's got a lifetime of remarkably consistent actions to back up his words. Dude marched with MLK in his 20's for goodness' sake. He's definitely the closest thing to an honest politician we've ever seen, at least in my generation, and is actually for the people and understands you can't maintain that belief while being complicit in accepting money from those with other agendas.

 

Most all reasonable people I know, in the democratic and republican parties, really like Bernie. I've got a lot of Republican friends hoping Bernie wins the whole thing - they think he might completely fail, but he'd do it with the absolute best intentions and the best effort anyone possibly could.

[Redux]

The fact of the matter is that regardless of who is in office, we will always be on our own for health care. We will continue to pay taxes AND pay out of pocket for anything concerning medical needs. Our government employs far too many people at high paying wages to make any sort of transition to a different model anything but a nightmare for those who already struggle paying for it.

[TGHusker]

 

Speaking of Bernie. He kind of grows on you. It has been said that he and Trump both bring 'anger' into their respective races. You know, I think I can take Bernie's anger better. Trump cuts people down and attacks them personally, Bernie attacks the issue. They both have forced the discussion in both races and that is a good thing.

 

 

Bernie's got a lifetime of remarkably consistent actions to back up his words. Dude marched with MLK in his 20's for goodness' sake. He's definitely the closest thing to an honest politician we've ever seen, at least in my generation, and is actually for the people and understands you can't maintain that belief while being complicit in accepting money from those with other agendas.

 

Most all reasonable people I know, in the democratic and republican parties, really like Bernie. I've got a lot of Republican friends hoping Bernie wins the whole thing - they think he might completely fail, but he'd do it with the absolute best intentions and the best effort anyone possibly could.

 

I would agree. The contrast between him and Hillary is pretty apparent. You know I voted for George McGovern for US Senate - my 1st vote when I reached voting age in 1974. A guy like Bernie could almost persuade me but I'm probably too conservative to take that leap. But I do appreciate the sincerity, honesty and his intentions - that is refreshing especially as the repub debate wallows in charge/counter charge.

[B.B. Hemingway]

.

[zoogs]

I thought this was solid coverage of Bernie's recently-released response to criticism that he had no plan:

 

http://www.vox.com/2016/1/17/10784528/bernie-sanders-single-payer-health-care

 

The easy rejoinder to this is that this is just a campaign proposal, and these are details that can be worked out in the legislative process. I disagree. Sanders is proposing a huge, disruptive reform here — he owes the public answers to the most central, obvious questions about how that reform would work. Perhaps more importantly, he also needs to show that he's at least aware of the difficulties of a single-payer system, and has realistic ideas for managing the transition.

It's great the talks such a good, appealing talk. Where I'm a lot more skeptical is the merits of his actual proposed approach to his presidency. Specific to healthcare, I feel we have achieved landmark legislation that was tumultuous a process enough. The next step to build on it, and not to rock the boat again under the delusion that the process won't be just as compromise-filled.

[Creighton Duke]

 

Speaking of Bernie. He kind of grows on you. It has been said that he and Trump both bring 'anger' into their respective races. You know, I think I can take Bernie's anger better. Trump cuts people down and attacks them personally, Bernie attacks the issue. They both have forced the discussion in both races and that is a good thing.

 

 

Bernie's got a lifetime of remarkably consistent actions to back up his words. Dude marched with MLK in his 20's for goodness' sake. He's definitely the closest thing to an honest politician we've ever seen, at least in my generation, and is actually for the people and understands you can't maintain that belief while being complicit in accepting money from those with other agendas.

 

Most all reasonable people I know, in the democratic and republican parties, really like Bernie. I've got a lot of Republican friends hoping Bernie wins the whole thing - they think he might completely fail, but he'd do it with the absolute best intentions and the best effort anyone possibly could.

 

What is the correlation with marching with Dr. King and being honest? Jesse Jackson was close with Dr. King and...do I need to get into that?

 

Also, did you look at the article (and the links) in the "Strange Election" thread that point to improper use of funds by Sanders' family?

 

I'm incredibly reasonable and I DON'T like Senator Sanders at all, yet alone a lot. I do think that he would be better than former Secretary Clinton, but I'd rather not have to make that choice (thankfully, I never will!)

 

I do agree with TGHusker, though. It is refreshing to see these guys crashing the party. The American 2-party system needs to be trashed.

[zoogs]

I read some of that "improper funds" stuff. It was ridiculous. Back when he was a smaller operation and presumably didn't have access to hire the most experienced staffers, he hired some family members and paid them ... honestly, pretty low sums for consulting and salaried work over 3-5 years.

 

It's scandal-chasing, and nothing more. But I do agree, Bernie's still a politician. He's capitalizing on the appeal of his image but I don't think the gulf between him and other politicians is *that* wide, and that these qualities in him boost his appeal more than his qualifications to the office.

[Landlord]

 

Bernie's got a lifetime of remarkably consistent actions to back up his words. Dude marched with MLK in his 20's for goodness' sake. He's definitely the closest thing to an honest politician we've ever seen, at least in my generation, and is actually for the people and understands you can't maintain that belief while being complicit in accepting money from those with other agendas.

 

Most all reasonable people I know, in the democratic and republican parties, really like Bernie. I've got a lot of Republican friends hoping Bernie wins the whole thing - they think he might completely fail, but he'd do it with the absolute best intentions and the best effort anyone possibly could.

 

What is the correlation with marching with Dr. King and being honest? Jesse Jackson was close with Dr. King and...do I need to get into that?

 

Also, did you look at the article (and the links) in the "Strange Election" thread that point to improper use of funds by Sanders' family?

 

I'm incredibly reasonable and I DON'T like Senator Sanders at all, yet alone a lot. I do think that he would be better than former Secretary Clinton, but I'd rather not have to make that choice (thankfully, I never will!)

 

I do agree with TGHusker, though. It is refreshing to see these guys crashing the party. The American 2-party system needs to be trashed.

 

 

 

 

Per your bolded, I would disagree that you're reasonable. Moving on.

 

There's no correlation between marching with MLK Jr and being honest, but when he preaches a message in support of the oppressed and the disadvantaged, there is evidence that he actually believes it by his actions when they weren't popular or scoring any political points.

[Danny Bateman]

I thought this was solid coverage of Bernie's recently-released response to criticism that he had no plan:

 

http://www.vox.com/2016/1/17/10784528/bernie-sanders-single-payer-health-care

 

The easy rejoinder to this is that this is just a campaign proposal, and these are details that can be worked out in the legislative process. I disagree. Sanders is proposing a huge, disruptive reform here — he owes the public answers to the most central, obvious questions about how that reform would work. Perhaps more importantly, he also needs to show that he's at least aware of the difficulties of a single-payer system, and has realistic ideas for managing the transition.

It's great the talks such a good, appealing talk. Where I'm a lot more skeptical is the merits of his actual proposed approach to his presidency. Specific to healthcare, I feel we have achieved landmark legislation that was tumultuous a process enough. The next step to build on it, and not to rock the boat again under the delusion that the process won't be just as compromise-filled.

 

 

I think you and I see eye-to-eye on this one, Zoogs.

 

I try to play devil's advocate with my roommate. He's a big Bernie guy, and I'm actually in favor of any of the Dems, but I think I am in favor of Hillary before Bernie at this point.

 

This is the first time in my life I have actively researched and tried to understand the nuances of something as complex as the healthcare system in our country. I think, after some work, I understand the benefits of a single-payer system. But it does seem a bit pie-in-the-sky to think we can up and switch from our current system to single-payer. If it was so beneficial (and relatively straightforward to implement), why have all the other historical single-payer plans from politicians failed?

 

Furthermore, you raise a good point that Obama had an extremely difficult time getting the ACA through, with a supermajority in Congress. I have a very hard time believing the current Congress is going to want to play ball with ANY of Bernie's ideas, including healthcare.

 

If you want more reading, check out the second BloombergView story I linked in the OP. It was written by Megan McArdle, a finance writer, and goes in depth on why single-payer isn't the magic bullet to fixing our heathcare system overnight. Basically, she says that the US already spends much, much more (percentage of GDP) than any other country touted for using single-payer. Single-payer is a model that is great at curbing GROWTH RATE in spending, and that it won't necessarily help if you start off at an already highly-inflated amount. She showed that no other single-payer system has ever actually cut spending any appreciable amount (i.e., negative growth rate) and sustained it, which is what Bernie is proposing.

 

Ultimately, on Bernie, I definitely like the guy, and I definitely think out of all the candidates, he has people's interests at heart the most in what he does. But I'm the type of guy who wants to hear specifics. I like the anger he has at the millionaires and billionaires and Wall Street. But I want specifics on how he's going to achieve what he wants to do.

[Danny Bateman]

 

 

Bernie's got a lifetime of remarkably consistent actions to back up his words. Dude marched with MLK in his 20's for goodness' sake. He's definitely the closest thing to an honest politician we've ever seen, at least in my generation, and is actually for the people and understands you can't maintain that belief while being complicit in accepting money from those with other agendas.

 

Most all reasonable people I know, in the democratic and republican parties, really like Bernie. I've got a lot of Republican friends hoping Bernie wins the whole thing - they think he might completely fail, but he'd do it with the absolute best intentions and the best effort anyone possibly could.

 

What is the correlation with marching with Dr. King and being honest? Jesse Jackson was close with Dr. King and...do I need to get into that?

 

Also, did you look at the article (and the links) in the "Strange Election" thread that point to improper use of funds by Sanders' family?

 

I'm incredibly reasonable and I DON'T like Senator Sanders at all, yet alone a lot. I do think that he would be better than former Secretary Clinton, but I'd rather not have to make that choice (thankfully, I never will!)

 

I do agree with TGHusker, though. It is refreshing to see these guys crashing the party. The American 2-party system needs to be trashed.

 

 

 

 

Per your bolded, I would disagree that you're reasonable. Moving on.

 

There's no correlation between marching with MLK Jr and being honest, but when he preaches a message in support of the oppressed and the disadvantaged, there is evidence that he actually believes it by his actions when they weren't popular or scoring any political points.

 

 

I think the word we're looking for is genuine. Most all politicians do things a lot of the time not because of their principles, but for the benefits it may have for their career. It's all about getting votes, pandering, etc. Not a hint of this from Sanders. The closest thing you could toss out would be his pro-gun voting history, but I'm assuming he had to do it to maintain his seat in Vermont.

 

I think most people like Bernie so much because he seems to be up there doing not with some hidden agenda, but because he honestly thinks it's what's best for the country and its people.

[BigRedBuster]

Back to the main original topic.

 

I'm not against a single payer system. I used to be...but not anymore.

 

I also believe there is a middle of the road system that could easily be implemented now that ACA has been enacted.

 

Here is the problem with the healthcare debate as I see it.

 

A) You have liberals looking stink eye at companies with their pitch forks raised FORCING them to provide health care to their employees....or else....

 

B) You have conservatives spitten chewing tobacco the boots of government claiming they just want to take over another major industry and if you do.......we will REVOLT.....

 

Both sides are so full of BS. Their making their arguments based on emotions promoted by their respective media's and aren't thinking this through.

 

Hey....right now we have market system set up. It was originally proposed by the Republicans in the 90s and was implemented by the Dems recently. So.....Now let's use that to make real changes. Ones that the ACA drastically failed to do.

 

Let's have EVERYONE go through the exchanges to get health insurance. No...you'r health care is not tied to your job. It is mobile like your car insurance...etc. Even the CEOs of major companies and congress have to go through the exchange.

 

Also, remove any restrictions on what health insurance companies can participate ( not sure if there is any. Just want to make sure they freely can participate).

 

Now, if something needs to be done to fund this, put in a payroll tax. Make a portion of that "healthcare payroll tax" paid by the employee and the rest by the employer. We already have some payroll taxes that are like that.

 

BOOM....done. A lot of the health care problem goes away. The big mean ol corporations are still paying a major part of it. The insured has all the options available and is free to take that insurance wherever they may go. Everyone has access to it.

 

Now....here is the problem. You still have insurance companies in charge. THAT is the biggest problem as I see it. They are making a lot of money. Taj Mahals are being built in the name of "Hospitals" so they aren't hurting. Pharmaceutical companies aren't going broke any time soon.

 

So......don't see costs coming under control anytime soon.

 

As a business owner, I am absolutely so sick of dealing with health insurance. No, that's not because I'm some evil person that want's to leave everyone out in the cold. I'm just sick of trying to play the game of finding an affordable plan for everyone involved. It's tiring. Let the employee go buy it and through payroll, I'll help pay for the program through payroll taxes.

[TGHusker]

Good post - see my resent post on the Democratic Primary thread and the costs to implement Bernie's plans.