An Open Letter to the Wall Street Journal on Its Bernie Sanders Hit Piece

[MrMickeysMom]

Gerald Friedman Become a fan
Professor of Economics, University of Massachusetts at Amherst

Gerald Friedman's research was cited in a Wall Street Journal story about Bernie Sanders's proposals for government spending. Friedman responds to that story below.

It is said of economists that they know the cost of everything but the value of nothing. In the case of the article "Price Tag of Bernie Sanders's Proposals: $18 Trillion," this accusation is a better fit for the Wall Street Journal that published it.

The Journal correctly puts the additional federal spending for health care under HR 676 (a single payer health plan) at $15 trillion over ten years. It neglects to add, however, that by spending these vast sums, we would, as a country, save nearly $5 trillion over ten years in reduced administrative waste, lower pharmaceutical and device prices, and by lowering the rate of medical inflation.

These financial savings would be felt by businesses and by state and local governments who would no longer be paying for health insurance for their employees; and by retirees and working Americans who would no longer have to pay for their health insurance or for co-payments and deductibles. Beyond these financial savings, HR 676 would also save thousands of lives a year by expanding access to health care for the uninsured and the underinsured.

The economic benefits from Senator Sander's proposal would be even greater than these static estimates suggest because a single-payer plan would create dynamic gains by freeing American businesses to compete without the burden of an inefficient and wasteful health insurance system. As with Senator Sanders' other proposals, the economic boom created by HR 676, including the productivity boost coming from a more efficient health care system and a healthier population, would raise economic output and provide billions of dollars in additional tax revenues to over-set some of the additional federal spending.

more...
http://www.huffingtonpost.com/gerald-friedman/the-wall-street-journal-k_b_8143062.html

[840high]

1. ty kick

[Douglas Carpenter]

2. knr

[pacalo]

3. K&R.

[sleepyvoter]

4. K&R

[Docreed2003]

5. K&R

Excellent piece

[MrMickeysMom]

6. Agreed...

These findings are not surprising, given how the U.S. stacks up with other countries offering single payer systems when comparing the amount spent on current health care and its outcomes.

I know this as an insider working all these years within the number of 3rd party payer models (fee for service, which was replaced by prospective payment, which has been curtailed to the current ACA that is less accountable for pharmaceutical negotiations.

I knew that someone was capable of taking a comprehensive approach to HOW single payer systems reach further outside the boundaries in a medicare for all concept. The current inability to negotiate, or where health care is offered has a major impact in cost and outcomes. The cost of employer-based insurance to hires and sustainable employment is a conversation that has been missing in the debate.

[Docreed2003]

7. The current system is a joke...

When my patients come to my clinic, the average copay for the middle class/well to do patient is about 10-15 dollars. My poorest patients are charged a 30-60 dollar copay because that's what their shit insurance plans dictate. It's so infuriating to me as a provider. I whole heartedly believe in single payer for many reasons but here's a few: no copays which is a relief to those on the extremes of society, no more arguing with big insurance over the justification for tests that patients rightly deserve, and a unified reinbursment system that is fair to patients and providers. I'm not concerned about how much I make, I'm an employee of a hospital system so my pay is graded on how many patients I see. I will be well paid no matter what...but my patients shouldn't have to suffer because they are on the extremes of society and they have the barest insurance they can afford. That's bullshit and it needs to change.

[Ed Suspicious]

11. Thanks for this post. Let's just say that my copay's are in the 30-60 range and the way it's

working right now, there is NO relief on the horizon. We are paycheck to paycheck, so our only choice is the cheapest coverage my wife's company offers. The better coverage is in another world as far as we're concerned. Every year our plan covers less and less. I hate having to tell my doctor that I can't take diabetes injectables that he prescribes because the extra 600/year isn't in the cards for me. He said this coming new year he's going to try to hook me up with some sort of patient assist on the injectables. Otherwise it's metformin, glipizide, diet, exercise, and settling for 9 on my A1C. Something is going to give. I can't keep thinking that death is the best way out to relieve my wife of the burden. Something has got to give.

[Docreed2003]

13. I'm so sorry Ed...

Your situation is all too familiar and it breaks my heart. This isn't why I went into medicine. I'm so broken by the current system that my wife actually wants me to go back on active duty in the navy because there weren't these kinds of headaches, but that doesn't help your situation. I'm a surgeon, and there are rules that state I have to see a patient within 30 days of surgery. Now, I'm very busy and most patients I can get in for surgery in 2-3 weeks, buts some I can't. I refuse to charge those patients copays to see me, if nothing has changed. I've worked an alternative in my office to circumvent the "actual visit". Now, am I frauding the system?? Probably, and I take responsibility for that. But I'd rather that, than force my patient to fork over 60$ for a visit prior to surgery that is meaningless. That money could be better spent elsewhere. So there are those, like myself, who are fighting the system...but at the end of the day, the system has to change

[chervilant]

18. Indeed, the system has to change...

I have been working as a non-medical caregiver for the elderly and sight-impaired. This is meaningful and fulfilling work, and gives me another layer of advocacy skills that has become VERY ego-gratifying (my clients think I'm the greatest thing since sliced bread--isn't that lovely?).

Anyway, one of the companies for which I work had me lifting and shifting an elderly person who has limited use of her/his upper torso and right hand. After three months of this, and despite advising my scheduler that this lifting was hurting my back, I've ended up with severe sciatica in my left hip and leg, all the way to my calf. I have been bedridden for almost a month. I've tried to resume some activity, but the extreme pain returns almost immediately, no matter how careful I've been. Plus, I'm frightened about the possibility of irretrievably injuring my back.

I've been advised that I need an MRI, and I might need back surgery. I earn less than $9 an hour, work less than a 40 hour week (34, if I'm lucky), and I have no benefits. Because my initial back injury occurred when I was in my twenties, my company disavows any responsibility for this current injury, and I have had no income for the entire month.

I don't think ANYONE in this nation should ever be put in a position to need expensive tests, and serious surgery, without some way to obtain those services without incurring an obscene amount of debt. Furthermore, the specialists to whom I've been referred have advised me that they don't take medicaid, and they don't accept "self-pay" patients. Things are looking dicey...

I am determined to get the help I need so that I can continue to work as a caregiver, but I am scared. I find myself wishing I lived in England or Canada.

I appreciate your concern for your patients. We could use more physicians like you.

[MrMickeysMom]

25. That was excellent, chervilant...

Not your situation, of course... That is an all too common example of how "health care" is valued. The fact that you pay... YOU PAY for a failed system, so valued by those for whom you helped, shows the irony of this system.

[chervilant]

26. It does, indeed.

And, thank you.

I remain hopeful. The sun is shining today, after four days of a steady, dreary drizzle. Cold though it may be, I wish I could go for a hike and forget about this relentless pain.

[senz]

12. Yes, it's unfair to patients and a headache for office staff.

Single payer would streamline the process in a fair and equitable way. It's a no-brainer.

[Docreed2003]

14. Agreed 1000% n/t

[MrMickeysMom]

19. Got it.... I'm living in the middle of the proof as an RT...

Respiratory patients come to our comprehensive lung center to see specialists. Their co-pays are often $30-$40, even $50 range, for same reasons. I am pretty sure that if faced with a 6 month "follow-up" needed to continue pharmaceutical care of their COPD/asthma/fibrosis/sarcoid related lung disease, I'd being out a good $500/month in just keeping up until I reach the donut hole and decide HOW THE HELL I'm going to make due. Eat and turn the heat on, or continue the non-negotiable.

It's INFURIATING to see where we've gone over a 40 year span with these patients alone... I can't imagine the angst as a primary provider that you have.

Yeah... It's bullshit, alright.

[jwirr]

29. Thank you for speaking out. I wish more providers would.

[Ed Suspicious]

8. Who are the losers and how much influence do they have? I ask because this shit makes so much sense

that only corruption could stop it.

[MrMickeysMom]

20. We all stand to be the loser, Ed...

For as long as I've been in health care, anything that couldn't be harvested from a 3rd party (insurance based allowed reimbursement of costs to hospital, physician providers and out-patient/durable medical equipment, pharmaceutical services) has been cost shifted to the rest of us. This is why it becomes so much more expensive to wait until you present yourself in an emergency room, not be able to pay that cost (or ICU, which is the next expensive end of waiting too long). All that cost is shifted somewhere. Some of the "indigent" care can be written off by the health care system that owns much of what is described above. Ultimately, the people at the top of these organizations prosper (see what a hospital CEO makes at UPMC where I work, and you'll see how the trickle down effect limits some 20 or so millionaires, and the rest of us get some of the worst pay for this type of health care delivery system.

IMO, it doesn't work well. However, it works VERY well some of the time, but at a cost for EVERYONE. If that isn't due to the health care lobbyists at the state and national level, then I don't know what IS corrupt.

[senz]

9. Good comeback to righties (D & R) who say Bernie's HC plan costs too much

especially as the author is an economics professor.

He includes an interesting chart --

Projected 10 year impact of HR 676 in billions

[MrMickeysMom]

21. I tried to get that chart up, but didn't have your kung-foo...

That is an excellent chart to MAKE THE POINT.

[senz]

27. No kung-foo necessary, MMM

Just right click on the image, select "copy image location," then do a paste (ctrl V) into your post. It's easy, and you've done it many times with pictures. It's just a picture. Good OP writers like yourself should have thee things at their disposal.

And, as you probably know, we can test all this stuff via "Preview" whether or not we post a comment.

[MrMickeysMom]

28. :-)

As the tin man said... "I should of felt that in my Haaaart!"

[Spitfire of ATJ]

10. There was a grocery strike in California over ten years ago over keeping their health plan...

That would never happen under a single payer system.

[MrMickeysMom]

22. Perfect example...

In fact, you probably know how important some "suck" jobs are, mainly due to "I'll be eligible for health care" provisions!

[beam me up scottie]

15. Thank you, MMM!

K & R!

[MrMickeysMom]

23. Thank you, scottie!

I'm gonna put a few OPs up on the Board today. We need to hammer these issues!

[Duppers]

16. Excellent.

[Betty Karlson]

17. K&R. eom

[99Forever]

24. K.R

[Marty McGraw]

30. ain't that a K & R

in the Head.

Thank you again,


How is it that I have been
Missing out on all your
wonderful posts? Hard Effort
and follow-ups as well. I need to
do more than skim the headlines of DU and actually dig in to the groups more often

[MrMickeysMom]

32. That's cause my brilliance emits itself in bursts...

Kind of like a the after-affects of a big burrito!

[Marty McGraw]

34. ( ._.)

[MrMickeysMom]

35. That's so friggin cool!

And I'm gonna steal that gif for ralps M-F thread (for Mike Malloy's Truthseeksers thread). Big kitten fans, there.

[Marty McGraw]

36. Always a good thing

When Kids are gigglin' and cat's tails are waggin'!

Then again... kids can be mischievous and furballs can be on the hunt...

Have at it! And the link displayed on the gif has a bunch of others there as well

[Marty McGraw]

37. Some can Make

Really good use out of those 'After-Effects'!

[MrMickeysMom]

38. For the last 20 minutes I've been LMAO...

... So many gifs, only so much time to the end of this week-end... G'AUUHH!!!

[Live and Learn]

31. K&R nt

[reformist2]

33. For-profit health care is one of Wall Street's most prized golden gooses.

[Bradical79]

39. This is all very frustrating

It would be nice if more Democrats would take the lead in pushing/selling a plan that seems to be both ethically and financially superior. It doesn't inspire much confidence in the future from me. While I'm thankful that President Obama was able to push through Obamacare when we had majorities in Congress, the reality is that it's mostly been just a temporary band-aid for my parents and I. Unless I triple my pay in the next few years, things might not go too well for us. Even that might not be enough :-P I think I can do it, but it's pretty iffy.

[MrMickeysMom]

40. This provides a good example of how even the ACA is unsustainable...

No matter what you make hourly/yearly as an average employee, it can NEVER keep up with the cost of providing what should be a constitutional right, and if we had the 2nd Bill of Rights WOULD have been constitutionally guaranteed.

I make regressive pay every year with a 2 or 3% (this year, in spite of an excellent review, I got 2%). This doesn't begin to keep up with the cost of living, let alone the cost of health care. Why are we still doing this? Because the industry tell congress to keep doing this, and it doesn't affect them.

Single payer is financially superior because it eliminates the cost of employment benefits and the premiums to an insurance company that privately cannot administrate it efficiently, but sure can make a profit from not utilizing services.

THIS.MUST.STOP.