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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsThe answer to the "How will you pay for Single Payer healthcare?" question
Dear Democrat,
When the media asks you this question, this should be your response:
"Well, how are we paying for our healthcare now? Mostly through a hodge-podge of private insurance offered as benefits from employers, or people buying it on their own, or people going without healthcare insurance at all, which then lead to high rates of personal bankruptcies when people cannot pay for the care that they need. With the current system, we're seeing is ever higher premiums, higher deductibles, and astronomical costs for pharmaceuticals. In sum, we're paying for healthcare now in the most expensive way possible. Yes, the ACA regulated the health insurance market somewhat, but it has not gone far enough simply because it did not do away with the need private health insurance whose business model is to maximize premiums and minimizes paying for the healthcare services that people need. No amount of regulation can get around that basic model.
Single payer alleviates that burden by removing the need for profit health insurance carriers from the market. We will pay for it with slightly higher taxes which will be more than offset by eliminating ever escalating premiums, deductibles, and prices for drugs. In essence, we will treat healthcare as a public utility just like our schools and our fire and police departments. It will be something that we all pay for together which lower the costs that we all have to pay individually. "
Please feel free to improve upon my response.
Trust Buster
(7,299 posts)Where would the votes come from to even get such a bill to the floor of either house ?
lagomorph777
(30,613 posts)Push the Russiapublicans out and get some work done!
Trust Buster
(7,299 posts)The Executive Branch are good long term goals but this midterm will not produce that kind of result. Let us be honest about that.
lagomorph777
(30,613 posts)No point crying about it - I've done enough of that.
JCanete
(5,272 posts)That question you ask is of a different nature to why those questions are being proffered in the first place. They are there to put Democrats who want Medicare-for-All on the defensive and paint them as impractical for the viewer, who then at some point, presumably votes. We should win these arguments handily.
Hortensis
(58,785 posts)two years from now?
Maybe look around and see if you might be missing something? This is like deciding to rearrange your closet while the house is on fire.
Kavanaugh is being appointed to form a SCOTUS majority that will reinterpret the constitution to make this and most or all other big government programs illegal. NO single payer of any type at any cost. After all the necessary cases are decided, no ACA either, no VA, no Medicare, no Medicaid, no CHIPS. And that's just healthcare.
BigmanPigman
(51,651 posts)that I have been calling in opposition to Kavavaugh's nomination. The other issues are abortion and women's health, the fact that he lied to the senate in the 2000s and there is proof, his stand on thinking that the fake prez can't be impeached and is above the law, his gambling debts and his vagueness with questions in general. This was BEFORE the rape accusation. We must stop any and all SCOTUS picks while there is an investigation of the sitting fake prez.
Call them non STOP! This is a 30 year seat that will effect future generations negatively.
We have to keep calling to pressure the GOP senators both on the Judiciary Comm and the rest of them. Here is contact info...RESISTANCE WORKS!
DC Senate Directory (202)224-3121
Judiciary Comm members' contact info
https://www.judiciary.senate.gov/about/members
4 "iffy" Dem and 4 "iffy" GOP contact info
https://www.democraticunderground.com/?com=view_post&forum=1011&pid=2543
Hortensis
(58,785 posts)BigmanPigman
(51,651 posts)even those who are working for the GOP senators, are nice to me. I have the feeling they have heard this from others besides me. Or perhaps it is because I talk really fast so I can get it all in before they hang up on me and it is sort of amusing that I am so passionate. The 4 Dem "iffy" Dem senators I called on my list are all now on record for wanting investigations into the rape accusations and a delay in the hearings before a vote is taken on Kavanaugh...that is a good thing (all the Dems are on board with this issue anyway!).
Hortensis
(58,785 posts)recorders are permanently full. My husband's does emailing.
I've been doing some texting to GOTV for elections. That's relatively new, and I'm hoping people are more receptive than to phone calls. Poor things.
But there's no excuse for not voting to stop what's happening on the right.
DonCoquixote
(13,616 posts)"how do we expect to gain any victories when all we do is say "they won they won." The onyl way to avoid bring killed, which is their goal, is to make the whole effort so finanacilaly exhusting for the gop that their masters say "oh back off, we will try again next decade."
Hortensis
(58,785 posts)they do NOT win.
Your chance, Coquix, of passing ANY kind of healthcare program if we do not get control of congress is exactly zero. You WILL watch them use the power voters gave them to finish destroying the ACA.
Turbineguy
(37,412 posts)What will we do with the people who are honestly employed by keeping the current system so inefficient? Unemployment would rise by perhaps several percentage points.
Hortensis
(58,785 posts)The right-wing billionaires trying to stack the court have no intention of paying into unemployment insurance or the kind of universal basic income fund we Democrats are currently planning to meet this enormous change. Yes, they're extremists and they're very real and very powerful.
They got that way because not enough people were paying attention. But as they near success they're forced out of hiding.
It's way past time time to pay attention. If chatting about unemployment insurance is a way of avoiding scary realities now, just imagine how it'd feel to wake up to it after unemployment insurance was declared unconstitutional?
GulfCoast66
(11,949 posts)The largest barrier remains the 1/3 of Americans that still have decent health through their employer.
They will pay significantly higher taxes for something they are already getting and their is no way their employers will give them the money now being spent as employers share.
These people vote and while I would be for it even though it would cost me more, perhaps significantly more, most people would not.
The French already solved this problem. Their system is as an insurance plan for all but employers are not off the hook. If we could come up with something like this we could sell it.
And the main thing the French have done is remove profit from the healthcare industry. There are several insurance exchanges that can be used, and all are non profit like Blue Cross used to be.
Use the existing ACA as the foundation for an expanded system seem way more doable especially since it is now more popular.
I have said just enough to make me look stupid. Hopefully a DU member with more knowledge of the French system can correct/expand on my explanation. I only researched their system due to having taken several extended vacations there and wanting to be prepared in case of illness.
My main concern is that many are selling the impossible by understating the disruption going to single payer would cause.
Demsrule86
(68,788 posts)Yavin4
(35,454 posts)That means those corporations that offer the benefit will have to pay more and more which then incentivizes them purchase plans with higher and higher deductibles or not offer the benefit at all.
GulfCoast66
(11,949 posts)But that is irrelevant to the points I made.
You have a huge number of voting Americans who still get health care from their employers. They Can do math and will not agree to pay higher taxes for something they have.
It is not a matter of convincing me! I want universal care. But do not wear rose colored glasses and remember how hard the ACA was. I think there are more doable, and quite frankly, better ways to insure all Americans have affordable health care than single payer. Especially Medicare for all. A majority of the DU members seem for it but I have never heard a buyable explanation of how it will be paid for. Or win support from the majority of Americans.
These are answers we must have before actually trying to achieve our goals.
Of course, first we have to win congress and the presidency. I think we have time to work it out.
Hortensis
(58,785 posts)They will, of course, be paying regressive sales taxes on all purchases they are still able to make.
GulfCoast66
(11,949 posts)But lots of people will, and many of them for a benefit they already have.
Do not confuse my points with being satisfied with the embarrassment we have now. But I just cant see how we can take employers out of the solution and have a prayer of winning support.
I will bet dollars to donuts that having health care thru an employer correlates strongly with being a regular voter. Until we figure out a way to allow those people to keep health care without significantly higher taxes I cant see us winning.
And I get it, these people may well lose their care in the future. But until that happens they will not support single payer.
The ACA keeps the employers in the mix and it would way easier to expand it over time that to start all over.
Our goal is universal health care. Lots of ways to accomplish that.
lame54
(35,345 posts)Ridiculously rich guys
TreasonousBastard
(43,049 posts)municipal and state hospitals and programs
VA
Indian Health Service
SCHIP
Medicare
Medicaid
public employee health insurance
public retirement health insurance
public emergency rooms.
and more.
This is perhaps half of all medical expenditures, but I'm not sure of the exact percentages. Within the limitations they all have, they work as well as can be expected, and sometimes better. At least as well as for-profit insurance.
What's left are the insurance industry and various mutual insurance schemes, along with corporate health schemes that are not traditionally insured. And those outside the systems, such as the very rich and the uninsured.
The numbers are difficult to work up, but the advantages of single payer are eventually limiting many of the duplications in the many systems out there now. It could also reduce the variation in payments, and maybe raise payments such as the low Medicaid payments without raising total costs. Needless to say, the duplicative expenses in those various insurance companies would be reduced or eliminated, and their profits would disappear.
The usual argument you hear is the trillions in additional government expense. The answer to that is simply that the trillions already paid in the private sector will simply be transferred to the government, and the premiums will become taxes. Possibly a net gain for all of us.
roamer65
(36,748 posts)It isnt that difficult. Especially when its all rolled up into one big budget.
Hortensis
(58,785 posts)behind the Republican congress's seemingly inexplicable "craziness" get their way. They're not crazy. They're in the later stages of restructuring our democracy to serve them. If we let them.
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MichMan
(12,002 posts)It is 13% in Ontario
Uncle Joe
(58,524 posts)Why access to health care is a national security issue
(snip)
Over the course of about four months, the Canadian health system worked hard to contain the virus, treating 400 people who became ill and quarantining 25,000 Toronto residents who may have been exposed. Ultimately, 44 people died from the disease in Canada, but the result would have been much worse without a quick and well-organized response.
The Canadian governments response had its glitchesprimarily in the form of poor political leadership. Mel Lastman, the mayor of Toronto and a former furniture salesman, became angry when the World Health Organization (WHO) issued a travel advisory against his city. He railed against the WHOs decision on television, revealing his complete lack of knowledge about either the organization or public health in general. As a result of Lastmans poor leadership, he was ultimately relegated to a secondary role as the deputy mayor took his place. Lastmans credibility and legitimacy never recovered from the SARS outbreak. Likewise, US leaders will be judged by how they handle a bioterrorist attack or pandemic.
Unlike Canada, Americas piecemeal healthcare and public health systems are inherently less able to handle such crises. The Affordable Care Act helped fill in the gaps, but really, the only way to prepare for the eventuality of pandemics or bioterrorist attacks is with a single-payer government-run system that covers everyone. The United States might consider modeling its health care system after the one in Israel, a country that, given longstanding threats, takes every terrorist risk very seriously. In 1994, it established universal health coverage for all citizens. The countrys Ministry of Health monitors and promotes public health, oversees the operations of the nations hospitals, and sets healthcare priorities. As a result, Israels public health, emergency response, and hospital systems are state-of-the-art, highly efficient, and coordinateda necessity when responding to terrorist attacks.
The preamble to the US Constitution states the goals to provide for the common defense and promote the general Welfare. The US government wont fulfill either of these duties if it fails to protect its citizens against pandemics and bioterrorism. The mandate requires a robust public health infrastructure and a universal healthcare system that covers all Americans. The Trump Administration and Congressional Republicans threaten to undermine this essential function of government, unnecessarily jeopardizing American lives.
https://thebulletin.org/2017/06/why-access-to-health-care-is-a-national-security-issue/
Thanks for the thread Yavin.
Demsrule86
(68,788 posts)won't pay the high taxes needed for Medicare for all...Clintoncare failed for this reason. But if we save the ACA, we can work towards universal care...along the lines of Germany or France's care. I would also add you need 60 votes for Medicare for all...but not for fixing the ACA and adopting a public option that can be done in reconciliation.
Hortensis
(58,785 posts)It has already been happening, it is happening, and it WILL happen.
What will they do if universal healthcare programs are declared unconstitutional?
Maybe google "healthcare" and "unconstitutional." All that discussion that comes up is mostly mainstream and hackneyed. The archconservatives trying to stack the court with Gorsuch and Kavanaugh to join the other conservatives already there made up their minds long ago to MAKE it unconstitutional.
And now we're here. Healthcare super hurricane forming and heading for us.
Where will you "evacuate" to? Don't think Mexico or Canada. They both have national healthcare programs, but their borders are already slamming shut.
Demsrule86
(68,788 posts)healthcare to those who need it is to fix the ACA and to offer a public option. It can be done in reconciliation...we will change or methods based on circumstances when the time come.
Hortensis
(58,785 posts)advances already achieved, because of the danger to all healthcare programs, and build on those.
But next year the ACA, in key parts or effectively its entirety, may be declared unconstitutional, with no replacement possible.
There's been speculation that a single payer system might be more constitutional -- under current interpretations, but the right wing billionaire extremists packing the court have no intention of packing it with people who'd allow ANY national healthcare program. They also intend to make state programs unconstitutional.
Demsrule86
(68,788 posts)alive we increase support for this .
Hortensis
(58,785 posts)Sorry to shout at a friend along with the others, Demsrule, but don't you understand that if an archconservative-dominated court declares it unconstitutional it cannot be?
Game, set, match for those determined to make progressive government ILLEGAL.
As I said before, healthcare is only one part of what they intend to dismantle. America as we know it is to be changed into a state where the people are allowed to subsist as long as they don't cause trouble. Government of, by and for the people is on the line.
Not if we don't allow it. There are 330,000,000 of us after all. We can stop it if we choose.
Demsrule86
(68,788 posts)It could be done.
MichMan
(12,002 posts)going to pay enough taxes to pay for them and the 70% who are no longer employed?
0rganism
(23,989 posts)otherwise, it gets "explainy" if you know what i mean. we should not be explaining things with our precious media airtime.
something like "taxes to our elected government, not excessive protection money to private insurance" but a pro could probably squash it down even more.
i'm just hoping our candidates will be able to hire talented wordsmiths who understand the immense value of brevity.
regnaD kciN
(26,045 posts)Your response is thorough, but most people asking that question will stop listening after your first sentence, figuring this persons just throwing words out there to disguise the fact that well be taxed to death. And, after that, youll have no chance of getting through.
joshcryer
(62,287 posts)Easy.
GulfCoast66
(11,949 posts)You expect them to support paying 5 or 9k for something they already have. Not happening.
Expanding the ACA gets us where we need to be and is way more likely to happen.
ProfessorPlum
(11,280 posts)or is it just a way for them to be shackled to a shitty job, because they are afraid to leave it because of the insurance?
GulfCoast66
(11,949 posts)They are proud of their jobs and do them well. And they have good health care. They are not trading that for 9k additional taxes and an uncertain healthcare future. Even those that vote democratic will not go for that deal.
Fortunately we have the ACA we can expand and they will not be faced with that delimia.
ProfessorPlum
(11,280 posts)nor your employees who may lose or change their jobs, or get denied coverage by your company's healthcare, as good as it might be.
And . . . your employees have parents, children, cousins, nieces, nephews, friends, who may not be covered by your great healthcare. What a bargain it will be to provide them all with healthcare as well, and at a huge bargain for your and your company, and them.
GulfCoast66
(11,949 posts)Does not mean I do not actively support the type of health care my employees have for everyone.
I get tired at the insinuation that it does. Most companies could afford to provide health care. They did not stop providing it to stay in business but increase their profits and stock prices. No reason we can do as FDR suggested and make companies provide a life for their employees rather than just their owners.
For those unable to work for such a company expand the ACA including fully subsidized plans which cover 100% for those who do not have the ability to pay. If we did that then it would be a much less heavy life for taxpayers.
Oh, yeah, and take the profits out of healthcare by going back to non-profit insurance prividers and making for profit health plans unlawful.
The health care in France is always rated in the top 5 in the world. This is what they have done. It allows a mechanism to cover everyone.
And please stop with the attempt at shaming just because I disagree with the way we get to what is all of our goal. Universal Healthcare for all Americans.
ProfessorPlum
(11,280 posts)it's ok to disagree. there will always be private health insurance in this country that will provide coverage beyond a single payer government plan, you can bet on that. However, slowly turning back the age when medicare kicks in is not "starting over". It's taking the most efficient and beloved part of our current system and spreading it to everyone, where it will continue to be even more efficient (because of lots of younger and healthier people in the system) and more beloved (because it will actually be there when needed).
I'm glad your company has good health insurance. So does mine, thank goodness. I'm also glad you want to cover everyone, so do I.
GulfCoast66
(11,949 posts)Dial back the age for Medicare to, say 60. See how it works. I would require higher paycheck deductions, by not enough to cause most people to choke. Especially if we collect on a progressive scale. Allow folks to keep their private plans.
But I still think a key is forcing employers to provide a decent life to their workers thru medical care and benefits. Otherwise, universal healthcare becomes corporate welfare like food stamps are now. No reason we cant mandate 2-3 weeks paid vacation, paid sick leave etc. Every other developed nation can make it work.
ProfessorPlum
(11,280 posts)but it is mental to tie health insurance to employment. In this world, where employment is hard to come by and we pass around unemployment like a hot potato (but the fed keeps it officially pegged at around 5%) you are dooming some people to never have it.
Then there are the self-employed, those that work for non-profits or volunteer outfits, etc.
Your way is inferior. Health _care_ for everyone, not "coverage", is the way to go, and the day when someone with a broken arm or a fever can just go and be treated without proving anything first will be a great day indeed.
GulfCoast66
(11,949 posts)So long as we both have the goal of affordable universal healthcare we are just disagreeing on methods. Not goals.
ProfessorPlum
(11,280 posts)hunter
(38,349 posts)...because most of them have never tested it, and never will.
Fighting with insurance companies is the last thing you want to be doing when you suffer a serious injury or illness; the kind of illness or injury that's not going to fixed in a few months.
People think they have good insurance until they discover they don't.
The U.S.A. in general doesn't have "First World" quality health care. Even wealthy U.S. Americans, the kind of people who can write checks for $10,000 a few times a month without blinking, frequently suffer crappy, inappropriate, and absurdly expensive medical care.
GulfCoast66
(11,949 posts)Many of my employees have had serious medical situations. The average of my 30 some odd employees is over 45 and most have over 20 years with the company. I personally had a scare with cancer and had treatment and regular test every 3 months.
I havent heard too many complaints nor do I have any about the healthcare I receive. Just because some people have crappy plans does not mean everyone does.
There is no reason we have to jettison everything we have now and start over. The ACA provides a platform to build on until everyone has affordable health care.
hunter
(38,349 posts)... in the middle of chemo.
She was accepted to the state insurance at the last possible day, didn't suffer any dangerous discontinuity of care, and is thankfully healthy now, but it was scary as hell.
Savings don't carry far when random shit falls out of the sky, when monthly "out of pocket" pharmacy costs alone are greater than your mortgage.
It took us years to recover from that financial hit, we almost lost our house, and it wouldn't have happened in a nation with universal health care. Medical bankruptcy in the U.S.A. is real. My wife and I would have been much better off living in a nation with universal health care.
Health insurance is a grotesque way to hold onto employees who may only be working for you because they fear losing their health insurance, insurance which probably isn't as good as they think it is anyways. Or worse, they find their very lives or the lives of their loved ones dependent upon their employee health plan.
I agree with you about the positive aspects of the ACA, and see it as something transitional to universal health care. I'm currently on my wife's plan, through her current employer, but was uninsurable before the ACA. One of my brothers, who has health issues similar to mine, has been self-employed for many years. He wouldn't have health insurance at all without Obamacare.
joshcryer
(62,287 posts)America's health care system costs twice that of developed nations for no good damn reason.
GulfCoast66
(11,949 posts)Their health care cost are negotiated in a collective bargaining agreement. Now the companies cost is over 10k per employee but no way that shows up in the workers check if suddenly the company does not have to carry the costs.
I fully get and agree with your point about healthcare being crazy expensive in this country but there are still workers with decent plans.
There are things we can do. Follow the lead of Europeans nations and take profits out of healthcare but insisting insurance be provided by non profits. Keep the employer role, make it stronger and tax enough to provide care who cannot afford it. In other words, strengthen and expand the ACA.
joshcryer
(62,287 posts)But it's still insane and unworkable.
People with good 20 year jobs with a nice 401k and a cushy pension on their way are not going to give two craps about single payer.
But they might be convinced if you point out just how much more than other developed countries are paying for their health care.
GulfCoast66
(11,949 posts)And no 401k to speak of. Which is one reason they will fight to hold onto what they do have. They will have to work till 65.
I am sure many of them would be for mandating that all companies provide health care for their employees. It is what many countries do that have universal healthcare but not single payer.
Then expand the ACA to cover everyone including full subsidies for those that cant or dont work for a company. By taxing people who have the resources to pay. Make the top marginal rate around 70% like it was in the 50s, 60s and 70s. This seems so much more feasible than ditching what we have and starting over. It is what other nations have done.
FDR thought that a business that cannot provide a decent like for their employees is not an asset for the country. I agree.
guillaumeb
(42,641 posts)When any country allows capitalists to essentially monetize the health of its people, health will be second to profits.
Your post is excellently written.
Recursion
(56,582 posts)Lowering total cost would mean having doctors do 25% more work, for less money than they make now.
still_one
(92,502 posts)and 47% didn't even bother to vote, we will be lucky if we are able preserve Social Security and Medicare before 2020, since now Larry Kudlow from the trump administration is now talking about cutting entitlements
Patterson
(1,534 posts)Will you still be there when you retire? Will they still be there? What if you need or want to move?
GulfCoast66
(11,949 posts)If we strengthen employer mandates any job will offer benefits.
No one on DU is against providing universal health care. Or it so I have not read their posts. But there are lots of ways to do so. Medicare for all has lots of fans here. However there has been no actual plan shown that will get us there.
The ACA is the best vehicle to use. If for no other reason than it is attainable.
area51
(11,940 posts)ProfessorPlum
(11,280 posts)and it means FREEDOM!
Freedom to pursue different jobs without having to worry about health insurance. Freedom to change jobs without being shackled to a shitty one because of the insurance. Freedom even to be un- or under-employed for short periods time without worrying about it.
Freedom from the fear of bankruptcy from illness, even if you _do_ think you have good insurance now. Because just as in Michael Moore's Sicko, there are plenty of people with insurance who go broke from illness.
Freedom to not have to track every co pay or medical expense. Freedom to have more time not arguing with your insurance. Freedom not poring over bills. Freedom to make a doctor's appointment when you thionk something is wrong, rather than just hoping it gets better on its own.
JPK
(656 posts)...it would eliminate the need for the VA hospital system and their medical staffs and it would do away with the mountain of paperwork required now by all the different insurance companies. And by the way, the insurance companies aren't insurance, they are banks. They invest in the stock market, the money they get from premiums to line the upper management crooks that run the companies.
Ron Green
(9,823 posts)an investment scheme. We have enough investment schemes in this country, and we need a health care system.
A public option will simply drive the higher-cost patients into that system, and allow the private insurers to continue to cherry-pick the others.
One pool: Everybody in, nobody out.
Stellar
(5,644 posts)that Trump gave the 1%. Never heard an answer or anyone question how to pay for that.
Perhaps that would be the way to pay for Medicare for all. Trump is considering giving them another tax cut.
Hoyt
(54,770 posts)the relatively large tax increase will offset premiums and other costs someone is paying now, convince them that single payer wont dramatically increase cost above projections as just about every federal and state healthcare program has, that there will be costs savings soon enough to prevent cost increases, that your loss of choice is worth it, that improved health is good for society, etc. Legislators in those states ran from major healthcare legislation because they knew they couldnt convince stupid people, who dont trust government, that it would be an improvement.
Ive supported single payer, basically Medicare/Medicaid for all since early 1980s, but its hard convincing the majority of people that already have decent insurance that a significant increase in taxes is worth it.
I know polls show the majority want something like single payer, a Medicare buy in, public option, etc. But when you ask them if theyll accept a large tax increase (offsetting premiums, etc.) for a government socialist program, 40% or more go berserk. Thats exactly what is happening in the gubernatorial race in several states. Some flat say if they dont want to pay for health insurance theirs or some lazy people they shouldnt be forced to.
For these reasons, I think a Public Option is the best way forward. If buying into Medicare is as good as we think, people will gravitate to it quickly.
dansolo
(5,376 posts)Because they won't be.