Real numbers from Sander's Health Care Plan

[kristopher]

Looking at the garbage being spewed by apparently innumerate anti-Sander's posters here has left me with the feeling that the goal is to undermine support by spreading fear, uncertainty and doubt (FUD).

Here are the numbers

What Bernie's plan actually says:

MAJOR SAVINGS FOR FAMILIES AND BUSINESSES
Bernie’s plan will cost over $6 trillion less than the current health care system over the next ten years.

The United States currently spends $3 trillion on health care each year—nearly $10,000 per person.

Reforming our health care system, simplifying our payment structure and incentivizing new ways to make sure patients are actually getting better health care will generate massive savings. This plan has been estimated to save the American people and businesses over $6 trillion over the next decade.

The typical middle class family would save over $5,000 under this plan.

Last year, the average working family paid $4,955 in premiums and $1,318 in deductibles to private health insurance companies. Under this plan, a family of four earning $50,000 would pay just $466 per year to the single-payer program, amounting to a savings of over $5,800 for that family each year.

Businesses would save over $9,400 a year in health care costs for the average employee.
The average annual cost to the employer for a worker with a family who makes $50,000 a year would go from $12,591 to just $3,100.

HOW MUCH WILL IT COST AND HOW DO WE PAY FOR IT?
HOW MUCH WILL IT COST?
This plan has been estimated to cost $1.38 trillion per year.

THE PLAN WOULD BE FULLY PAID FOR BY:
A 6.2 percent income-based health care premium paid by employers.
Revenue raised: $630 billion per year.

A 2.2 percent income-based premium paid by households.
Revenue raised: $210 billion per year.
This year, a family of four taking the standard deduction can have income up to $28,800 and not pay this tax under this plan.
A family of four making $50,000 a year taking the standard deduction would only pay $466 this year.

Progressive income tax rates.
Revenue raised: $110 billion a year.Under this plan the marginal income tax rate would be:
37 percent on income between $250,000 and $500,000.
43 percent on income between $500,000 and $2 million.
48 percent on income between $2 million and $10 million. (In 2013, only 113,000 households, the top 0.08 percent of taxpayers, had income between $2 million and $10 million.)
52 percent on income above $10 million. (In 2013, only 13,000 households, just 0.01 percent of taxpayers, had income exceeding $10 million.)

Taxing capital gains and dividends the same as income from work.
Revenue raised: $92 billion per year.
Warren Buffett, the second wealthiest American in the country, has said that he pays a lower effective tax rate than his secretary. The reason is that he receives most of his income from capital gains and dividends, which are taxed at a much lower rate than income from work. This plan will end the special tax break for capital gains and dividends on household income above $250,000.

Limit tax deductions for rich.
Revenue raised: $15 billion per year
Under Bernie’s plan, households making over $250,000 would no longer be able to save more than 28 cents in taxes from every dollar in tax deductions. This limit would replace more complicated and less effective limits on tax breaks for the rich including the AMT, the personal exemption phase-out and the limit on itemized deductions.

The Responsible Estate Tax.
Revenue raised: $21 billion per year.
This provision would tax the estates of the wealthiest 0.3 percent (three-tenths of 1 percent) of Americans who inherit over $3.5 million at progressive rates and close loopholes in the estate tax.

Savings from health tax expenditures.
Revenue raised: $310 billion per year.
Several tax breaks that subsidize health care (health-related “tax expenditures”) would become obsolete and disappear under a single-payer health care system, saving $310 billion per year.
Most importantly, health care provided by employers is compensation that is not subject to payroll taxes or income taxes under current law. This is a significant tax break that would effectively disappear under this plan because all Americans would receive health care through the new single-payer program instead of employer-based health care.

https://berniesanders.com/issues/medicare-for-all/

To summarize:
Average working family now pays $4,955 + $1,318 in premiums and deductibles.
Same single payer family of four (earning $50,000) to pay $466 per year.
Saving over $5,800 each year.

Note that is an AVERAGE and those making more will pay more while those making less will pay less.

What about the employers?
The average annual cost to the employer for a worker with a family who makes $50,000 a year would go from $12,591 to $3,100.
Savings: $9,400/year/average insured employee.


Paying for the program is accomplished with several revenue streams as listed above:
Billion $ 630 + 210 + 110 + 92 + 15 + 21 + 310
This accounts for $1388 billion of the $1388 billion the program is projected to cost.

What is the drawback?

The "savings" can also be described as "profits" for insurance, pharmaceutical and medical industries. So while the population, writ large, is going to benefit substantially, the losers are going to scream bloody murder.
Whose side are you on?

[HerbChestnut]

1. Thanks for this thread.

And you're correct about their goals. There's no other explanation. Anybody with 5th grade math skills can figure out that Bernie's single payer plan is cheaper than our current healthcare system.

[99th_Monkey]

2. Thanks for such a detailed break-down. BTW you seem to know about this stuff, so do you know

if this graph is accurate or not? I appears to claim to reflect whether and how much people's
taxes would go up (or not) under Bernie's single-payer healthcare plan. According to this
graph, NO ONE's taxes would go up one nickel except people making $250,000 or more.

If this is true, why isn't Bernie pointing this out clearly and emphatically, that "NO, your tax
won't go up, unless you make $250,000 or more" .. period. That would mean that something
like 85% of the electorate's taxes would not go up. Actually I'm not certain of that number
but it would be a vast majority of voters who wouldn't experience a tax-hike, so why isn't
Bernie saying that. Or, alternately is this graph just not accurate?

[kristopher]

3. From the OP info it looks right

Progressive income tax rates.
Revenue raised: $110 billion a year.

Under this plan the marginal income tax rate would be:
37 percent on income between $250,000 and $500,000.
43 percent on income between $500,000 and $2 million.
48 percent on income between $2 million and $10 million. (In 2013, only 113,000 households, the top 0.08 percent of taxpayers, had income between $2 million and $10 million.)
52 percent on income above $10 million. (In 2013, only 13,000 households, just 0.01 percent of taxpayers, had income exceeding $10 million.)

I think he is pointing it out, but he can't control the Mother FUDders that are trying to grab a soundbite and misinform.

[99th_Monkey]

7. I wish he'd said that last night to the gotcha "raising taxes for more big government" bullshit

from Mr. Cuomo.

But he did great never the less. Thanks for confirming that this is the case:
that there's "no tax hike unless one makes $250,000 or more.

peace to you kristopher.

[kristopher]

122. Yes, the entire event was a search for a sound bite.

He handled it as well as it could have been done.

Peace be with you also.

[Hoyt]

4. Exactly how do we go from $3 Trillion per year on healthcare to $1.38 Trillion?

Sorry, but there isn't that much profit in health insurance. And, I've been hearing about the savings in healthcare from improving preventive care for decades. Haven't seen it yet.

Anyone can say, "under my plan we will go form $3 Trillion to $1.38 Trillion in outlays, and that will only cost us 8.4% tax increase on employers and individuals, plus some capital gains increase, estate taxes, etc."

I'm fine with the concept of single payer for everyone. Sanders just needs to be honest about the cost (dollars and controls on utilization) of doing that, the cost of all the other stuff he's promising, and how he gets it through a Republican Congress.

[kristopher]

6. Cost control when there is a buyer's monopoly

Right now we are at the mercy of any and all corporations involved in health care provision who have effectively no limits on what they can charge. There is no market-wide bargaining agent protecting the buyer (you and me).

The present situation envisions "empowering" the consumer and effecting savings by sending you and me out to look for the best deal in health care.

That is a horribly flawed model that enables the medical industry cartels to decouple pricing from the costs associated with providing needed health care goods and services.

The only alternative is a single payer system that changes the cartels from price setters to price takers.

That is why everyone goes to single payer, and why they pay so much less than we do.

[Hoyt]

10. Medicare and Private Insurers currently pretty much ignore what physicians, hospitals charge.

They don't pay anywhere near what the charge. Under Medicare right now, Physicians, hospitals, etc., are pretty much price takers and they don't like what they are taking. Now, some work needs to be done with drug companies, but total drug expenditures are only 10% of our national spending. And, lots of new drugs, save a bunch of hospital and physician care.

Truth is, if there are some real savings -- we are going to have to be told the single payer isn't going to pay for all the tests docs have been ordering, the costly drugs that don't work a whole lot better than the old generics, and that we need to get of our fat asses and take better care of ourselves. Again, I'm for all that. But it ain't gonna happen overnight.

And who is going to put pressure on everyone to cut costs. Even Elizabeth Warren was encouraged to come out against the small medical device tax that helped pay for ACA. Why did she do that, the medical device industry is big in her state.

Like I said, I'm for single payer, have been since the very early 1980s after working for a state Medicaid agency. Getting there requires the truth about the cost and what else will need to be done. Not some BS that we will go from $3 Trillion to $1.38 Trillion.

[kristopher]

15. IT ISN'T BULLSHIT

Wish I could say the same thing about your obviously contrived and strained 'objections'.

It works everywhere else, but Exceptional Americans like you work hard to preserve the Exceptional American Medical Establishment because the Exceptional American Medical System is, well, ... Exceptional.

[Hoyt]

19. I'm saying how do you go from $3 trillion to $1.38 Trillion. Besides, countries like Germany and

France don't have single payer. So, you are wrong about that.

I do not believe our system is Exceptional, far from it. I'm saying, Sanders needs to be honest about what it is going to take to get to his $1.38 Trillion.

[kristopher]

24. Why not start with being honest about the profits in the present system?

Why don't you hammer on that at least half as much as you want to hammer on imagined shortcomings in the degree of savings?
Or are you denying that moving to single payer is going to improve everyone's lives?

Are you denying that Germany and France have a buyer's monopoly - which is the aspect of single payer that serves cost control?

Do you see a way that the ACA turns into a buyer's monopoly in a smoother fashion than just expanding the very popular Medicare program?

You are coming across as a concern troll, not as a person who is actually interested in making a change.

[mythology]

33. Because the math matters

It matters when Republicans use unrealistic economic growth estimates to justify tax cuts. It matters when Sanders uses unrealistic numbers to justify his health care plan.

[kristopher]

34. Yes math matters - especially the amount of profit being extorted by medical cartels.

[Hoyt]

36. OK, Insurers are making 6 - 8% profit on premiums (part of which gets plowed into systems, etc.).

Physicians, not-for-profit Hospitals, suppliers, etc. have been hammered in recent years by Medicare and private payers, but I'm sure we can get them to fire some nurses, cut services, etc. We can make the system more efficient, as I've heard people say for 40 years. We can tell more patients Nope, like every other country in the world does. There are lots of ways to cut costs in long-run, although not sure if we are ready to bite the bullet.

There is some room to tackle drug costs, but that's only 10% of expenditures and saves a lot in hospitalizations and medical treatment, so you gotta make sure not to negatively impact innovation. But, there has to be a better way to set up a system that adequately rewards investment.

There's more.

[kristopher]

40. They've been "hammered"?

Really? What mechanisms have been used to "hammer" them and what anvil were they "hammered" against?

"We can tell more patients Nope, like every other country in the world does."

If the other nations are telling their patients "Nope" then why are health care outcomes so much better everywhere else?

How many lives are saved by investing in boner pills, price-gouging on generics, and gaming the insurance systems (to name but a small fraction of the issues out there)?

[retrowire]

45. Nice. Excellent work. nt

[Hoyt]

49. Ask your doctor is he likes what he gets paid from Medicare or Medicaid. In the good ole days, docs

docs got paid a lot more than they do now for surgeries, office visits, etc. Medicare, Medicaid and private insurers have been ratcheting down fees for 20+ years.

How will you feel if you doctor says, nope you can't get a "boner" pill. People want the darn things, that's why they are made. Again, drugs are 10% of total health care expenses. If you cut out a good bit, still won't make a lot of difference.

Sanders still has a lot of splaining to do on how he goes from $3 Trillion to 1.38 Trillion, while taking on a bunch of people who have not gotten health care because they are uninsured. And, no, I'm not saying we shouldn't cover them -- just lay out a plan that will work. Even Democrats in Congress will laugh at this plan.

[kristopher]

64. (You know that shark that people jump?) Why do doctors want single payer?

Most doctors just want to practice medicine, but their industry has been captured by corporate interests that squeeze EVERYONE for more money to go to investors.

Who is PNHP
Physicians for a National Health Program is a non-profit research and education organization of 20,000 physicians, medical students and health professionals who support single-payer national health insurance.

Click here to learn more!

http://www.pnhp.org

Posted on: Friday, January 22, 2016
Doctors group welcomes national debate on ‘Medicare for All’
Nonpartisan physicians group calls single-payer reform ‘the only effective remedy’ for nation’s continuing health care woes and urges focus on facts, not rhetoric

FOR IMMEDIATE RELEASE, January 22, 2016
Contact: Mark Almberg, PNHP communications director, [phone], [email protected]

Physicians for a National Health Program, a nonprofit, nonpartisan organization of 20,000 doctors who support single-payer national health insurance, released the following statement today by its president, Dr. Robert Zarr, a Washington, D.C., pediatrician.

The national debate on single-payer health reform, or "Medicare for All," that has emerged in the course of the presidential primaries is a welcome development. But unfortunately a number of misrepresentations about single-payer national health insurance – and the prospects for its attainment – have crept into the dialogue and are potentially misleading the public.

Most of these misrepresentations, or myths, have been decisively refuted by peer-reviewed research. They include the following:

Myth: A single-payer system would impose an unacceptable financial burden on U.S. households. Reality: Single payer is the only health reform that pays for itself. By replacing hundreds of insurers and thousands of different private health plans, each with their own marketing, enrollment, billing, utilization review, actuary and other departments, with a single, streamlined, tax-financed nonprofit program, more than $400 billion in health spending would be freed up to guarantee coverage to all of the 30 million people who are currently uninsured and to upgrade the coverage of everyone else, including the tens of millions who are underinsured. Co-pays and deductibles, which have been rapidly rising under the Affordable Care Act, would be eliminated. Further, the single-payer system’s bargaining clout would rein in rising costs for drugs and medical supplies. Lump-sum budgets for hospitals and capital planning would control costs even more.

A recent study shows 95 percent of U.S. households would come out financially ahead under an improved version of Medicare for all. The graduated, progressively structured tax burden would be based on ability to pay, and the heavy cost to average U.S. households of private insurance premiums, co-pays, deductibles, and many currently uncovered services would be eliminated. Patients could go to the doctor or hospital of their choice, and would no longer be restricted to proprietary networks. Multiple studies over a period of several decades, including by the General Accountability Office and the Congressional Budget Office, show that a single-payer system would provide universal coverage at a much lower cost, per capita, than we are spending now. International experience confirms it. Even our traditional Medicare program, which falls short of a true single-payer system, has much lower overhead than private insurance, and shows that publicly financed programs can deliver affordable, reliable care.

A single-payer system would also greatly diminish the administrative burden on our nation’s physicians and hospitals, freeing up physicians, in particular, to concentrate on doing what they know best: caring for patients.

Covering everyone for all medically necessary care is affordable; keeping the current private-insurance-based system intact is not.

Myth: The U.S. has a privately financed health care system. Reality: About 64 percent of U.S. health spending is currently financed by taxpayers. (Estimates that are lower than this exclude two large sources of taxpayer-funded care: health insurance for government employees and tax subsidies to employers and individuals for purchasing private health plans.) On a per capita basis, the amount of government-funded health care in the U.S. exceeds the health spending of nations with universal health systems, e.g. Canada. We are paying for a national health program, but not getting it.

Myth: A single-payer system would overturn the gains won under the Affordable Care Act and provide inferior coverage to what people have today. Reality: A single-payer system would go far beyond the modest improvements that the ACA made around the edges of our current private-insurance-based system and ensure truly universal care, affordability and health security. For example, H.R. 676, the Expanded and Improved Medicare for All Act, would guarantee coverage for all necessary medical care, including prescription drugs, hospital, surgical, outpatient services, primary and preventive care, emergency services, dental, mental health, home health, physical therapy, rehabilitation (including for substance abuse), vision care and correction, hearing services including hearing aids, chiropractic, durable medical equipment, palliative care, podiatric care, and long-term care. It would eliminate financial barriers to care like co-pays and deductibles and eliminate restrictive networks. It would end the steady erosion of job-based coverage under our current arrangements and disconnect insurance coverage from employment. H.R. 676 currently has 61 sponsors.

Myth: The American people don’t support single payer. Reality: Surveys have repeatedly shown that an improved Medicare for All is the remedy preferred by about two-thirds of the population. A recent Kaiser Family Foundation survey yielded similar results, showing 58 percent of Americans support Medicare for All. A solid majority of the medical profession favors such an approach, as well, as do more than 600 labor organizations, and many civic and faith-based groups.

Myth: The goal of establishing a single-payer system in the U.S. is unrealistic, or “politically infeasible.” Reality: It’s true that single-payer health reform faces formidable opposition, especially from the private insurance industry, Big Pharma, and other for-profit interests in health care, along with their allies in government. This prompts some people to conclude that single payer is out of reach and therefore not worth fighting for. While such moneyed opposition should not be underestimated, there is no reason why a well-informed and organized public, including the medical profession, cannot prevail over these vested interests. We should not sell the American people short. At earlier points in U.S. history, the abolition of slavery and the attainment of women’s suffrage were considered unrealistic, and yet the movements to achieve these goals were ultimately victorious and we now wonder how those injustices were allowed to stand for so long.

What is truly “unrealistic” is believing that we can provide universal and affordable health care, and control costs, in a system dominated by private insurers and Big Pharma.

We call upon our nation’s lawmakers and the political leaders of all political parties to heed public opinion and to do the right thing by acting swiftly to bring about the only equitable, financially responsible and humane cure for our health care ills: single-payer national health insurance, an expanded and improved Medicare for all.

Physicians for a National Health Program (www.pnhp.org) has been advocating for single-payer national health insurance for three decades. It neither supports nor opposes any candidates for public office.

[Hoyt]

66. There are 1,000,000 doctors in the USA. The PNHP represented 16,000 last time I looked.

But again, you are not proving that doctors and other providers will accept a big cut in pay. So some support Medicare for All, I support that. My bet is they don't expect fees to be cut in half which is pretty much what Sanders' math would require.

I support everyone driving electric cars -- but how do we get there?

[kristopher]

68. Your assertions of support for single payer are not at all credible.

You say the group represents 16,000 doctors out of 1M. and dismiss them with no comment on their extensive library of answers (based on solid research) that would address your so-called 'concerns'. For example:

What will happen to physician incomes?

On the basis of the Canadian experience under national health insurance, we expect that average physician incomes should change little. However, the income disparity between specialties is likely to shrink.

The increase in patient visits when financial barriers fall under a single-payer system will be offset by resources freed up by a drastic reduction in administrative overhead and physicians’ paperwork. Billing would involve imprinting the patient’s national health program card on a charge slip, checking a box to indicate the complexity of the procedure or service, and sending the slip (or a computer record) to the physician-payment board.
http://www.pnhp.org/facts/single-payer-faq

Why are you so baselessly adamant in opposition? Do you know of any other group of practicing doctors that openly rejects single payer?

[Hoyt]

73. I am opposed to giving up on what was accomplished in the ACA, and not improving the ACA.

I think we get to single payer, or universal health care like Germany and France, by enacting a public option, and making other improvements without running the risk of losing everything to the GOPers.

Sanders has not offered anything that will get us there quicker.

[kristopher]

106. The only thing we risk losing is the private insurance industry and high prices.

There is no valid reason to preserve that industry in health care. Scaremongering with the non-existent threat that such a people-movement wrought policy change would be backwards is sheer unadulterated nonsense.

We're done here. Your objections are specious and unfounded and IMO amount to a voice that is dedicated to preserving the interests of those who are negatively distorting the debate for their own gain. We move away from policies all the time in ways that harm people with vested interests in the status quo. When the investor class profited by gutting industry in this country the middle class was expected to suck it up and take it on the chin for 'the rising tide'. The upshot was a strong part of the upward wealth transfer that everyone has had enough of.

Now it's time for those invested in the free-for-all that is our for-profit health care industry to suck it up and get out of the way.

[Hoyt]

118. And your arguments for immediately going to Medicare-for-all are naive. Won't pass, and would

be a monumental mess at first worse than the exchange rollout. If Sanders were elected, it would be at least a 20 year phase-in. I think we get there faster by adding a public option to the ACA that just about everyone will take if it is as good as people think.

[libdem4life]

43. There is a big difference between the medical system and the insurance system.

Insurance execs make 7, 8 and one I saw yesterday just went into the 9 figure range. That's just for starters...for pushing paper and denying coverage and such. The greed in that system needs to go. It's more top heavy than most, maybe except the pharmaceuticals.

The real medical workers, including doctors, have been taking reductions for a long time. So many have been leaving the system because the big bucks aren't there any more. It's started a promising trend of minor medical issues taken care of by Physician's Assistants, Telemedicine is becoming a huge, affordable industry. Lots of changes for the better.

Now we need to do the same for the first paragraph folks who haven't felt much....yet. They are a powerful lobby because they have so much money. Kind of a catch 22 until some stick like Bernie Sanders gets stuck in their spokes.

It's time.

[lumberjack_jeff]

79. Insurers are currently allowed up to 20% profit.

[Hoyt]

82. Large plans are limited to 15%. Out of that 15% comes most claims adjudication, member support,

sales, computer systems, paper, staples, rent, telecommunications, utilities, support staff to answer insured questions, interest on borrowed money for investment, risk, etc. 6 to 8% is probably high.

20% is for single coverage and very small group plans where the cost is much higher. Most people are covered by large plans -- hence 15%.

[Elmer S. E. Dump]

60. Yeah, like $1 for a tissue.

[Hoyt]

95. But, insurers don't pay anywhere near that.

[nc4bo]

70. AUTOMATED MESSAGE: Results of your Jury Service

On Tue Jan 26, 2016, 07:39 PM an alert was sent on the following post:

Why not start with being honest about the profits in the present system?
http://www.democraticunderground.com/?com=view_post&forum=1251&pid=1071979

REASON FOR ALERT

This post is disruptive, hurtful, rude, insensitive, over-the-top, or otherwise inappropriate.

ALERTER'S COMMENTS

This poster is calling another DUer a "concern troll" and calling another DUer a "troll" is a personal attack and out of line. This type of stuff even in GDP needs to end.

You served on a randomly-selected Jury of DU members which reviewed this post. The review was completed at Tue Jan 26, 2016, 07:46 PM, and the Jury voted 1-6 to LEAVE IT.

Juror #1 voted to LEAVE IT ALONE
Explanation: Calling Hoyt a concern troll over his criticism of Bernie's health care plan is perfectly accurate.

Juror #2 voted to LEAVE IT ALONE
Explanation: No explanation given
Juror #3 voted to LEAVE IT ALONE
Explanation: No explanation given
Juror #4 voted to HIDE IT
Explanation: The post is fine until the accusation at the end that a long-time DUer bringing up reasonable questions is a "concern troll." That is unnecessary but unfortunately typical of what discourse on DU among Bernie supporters has become. You guys don't reflect well on your candidate. Just saying.
Juror #5 voted to LEAVE IT ALONE
Explanation: STOP it. Puleeeeeeze Geez Louwheeeeze!
Juror #6 voted to LEAVE IT ALONE
Explanation: STOP. WITH. THESE. ASSININE. ALERTS. For the love of all that's Holy!
Juror #7 voted to LEAVE IT ALONE
Explanation: kristopher did not call a DUer a concern troll. He said the DUer was coming across (to kristopher, obviously) as a concern troll. kristopher s entitled to say how someone comes across to kristopher.

[senz]

88. Juror #6 is most entertaining, #7 most logical.

[OrwellwasRight]

100. Why the eff

would anyone alert on that post? I've seen harsher posts in the Lounge...

[merrily]

71. Jury results

On Tue Jan 26, 2016, 07:39 PM an alert was sent on the following post:

Why not start with being honest about the profits in the present system?
http://www.democraticunderground.com/?com=view_post&forum=1251&pid=1071979

REASON FOR ALERT

This post is disruptive, hurtful, rude, insensitive, over-the-top, or otherwise inappropriate.

ALERTER'S COMMENTS

This poster is calling another DUer a "concern troll" and calling another DUer a "troll" is a personal attack and out of line. This type of stuff even in GDP needs to end.

You served on a randomly-selected Jury of DU members which reviewed this post. The review was completed at Tue Jan 26, 2016, 07:46 PM, and the Jury voted 1-6 to LEAVE IT.

Juror #1 voted to LEAVE IT ALONE
Explanation: Calling Hoyt a concern troll over his criticism of Bernie's health care plan is perfectly accurate.

Juror #2 voted to LEAVE IT ALONE
Explanation: No explanation given
Juror #3 voted to LEAVE IT ALONE
Explanation: No explanation given
Juror #4 voted to HIDE IT
Explanation: The post is fine until the accusation at the end that a long-time DUer bringing up reasonable questions is a "concern troll." That is unnecessary but unfortunately typical of what discourse on DU among Bernie supporters has become. You guys don't reflect well on your candidate. Just saying.
Juror #5 voted to LEAVE IT ALONE
Explanation: STOP it. Puleeeeeeze Geez Louwheeeeze!
Juror #6 voted to LEAVE IT ALONE
Explanation: STOP. WITH. THESE. ASSININE. ALERTS. For the love of all that's Holy!
Juror #7 voted to LEAVE IT ALONE
Explanation: kristopher did not call a DUer a concern troll. He said the DUer was coming across (to kristopher, obviously) as a concern troll. kristopher s entitled to say how someone comes across to kristopher.

Thank you very much for participating in our Jury system, and we hope you will be able to participate again in the future.

Juror 4, using jury comments on one poster's posts to broadbrush smear Bernie Supporters. Stay classy!

[nc4bo]

74. Howdy merrily

[OrwellwasRight]

94. Not exactly.

Where there is only one hospital or one medical group, it is true that private insurance is a price taker as all insurance companies have to make contracts with the one hospital or med group or else no one wil sign up for their plan. But where there is competition (e.g., larger cities), the opposite is true: the hospitals have to compete to be covered by as many insurance plans as possible.

Medicare is never a price taker. It sets its own rates, and these are the rates all others are judged by. And close to all hospitals take Medicare. However, it doesn't set prices in a vacuum. It studies the market and there is plenty of lobbying and legislative interference that prevents efficient and independent rate setting. Medicare gives payment boosts for teaching hospitals, "critical access hospitals" and the like to promote policy goals, but there are also inefficiencies here as each special program then creates its own lobbying group to prevent its program from being reformed and losing financial advantages.

There are YUUGE gains to be had in many places, like changing the rules to prevent repetitive unneeded tests, requiring doctors to perform the least complex process that will do the job (e.g., no MRIs for suspected broken ankles, use x-rays instead), taking out the profits made by the insurance companies and PBMs, making sure diabetes patients get maintenance care so that they don't go blind or have feet amputated (which is more expensive in the end), negotiating drug prices, promoting midwifery & home births, increasing the use of nurse practitioners, decreasing the premia paid to specialists to equalize the salaries between PCPs and specialists, paying based on outcome or use of the most effective protocols instead of paying FFS regardless of outcome, charging penalties to doctors and hospitals who send sick people home too soon or infect their patients with staph or leave sponges in surgical patients, better policing conflict of interests created by pharma's bribes to doctors and doctor's self-interested investments that can undermine their therapeutic choices, etc. There are literally dozens of ways to reduce costs while improving care.

Insurance profits are high: http://www.publicintegrity.org/2015/01/26/16658/health-insurers-watch-profits-soar-they-dump-small-business-customers

[Hoyt]

98. There are inefficiencies in darn near everything that will never be removed. Most of the things abo

are already widespread --PAs,insurance companies negotiate drug prices, referring diabetics has been used for decades, etc. Sure there are efficiencies we MIGHT achieve, but not to degree Sanders has suggested.

Finally, who is going to tell a small community, we aren't going to help them keep their little, inefficient hospital open, or grandma can't have the latest drug. Soory, even a lot of patients aren't ready for what Sanders is selling. Now, if you want to get into forcing people into a healthy life styles, shipping patients to large efficient hospitals and treatment centers, denying expensive drugs to people not likely to benefit longterm, etc., then it might work.

[OrwellwasRight]

99. Oh so it is just happenstance that the US pays more for healthcare

than any other country on the planet? Just totally random and can't be fixed. Now I understand. Thanks for the explanation.

[Hoyt]

101. No, we pay more for most things. And, without question our system is inefficient

and we won't say no -- to patients, providers, suppliers, etc.

When we are ready to say no to older people who won't benefit long like England does, tell communities the 30 bed hospital is too inefficient, lay off 1 million unneeded people, nope we are not spending that much on your drugs, make people live healthy, doctors we are going to overrule your costly decisions, etc., we will get there. I don't think we have the guts to do that. So Sanders projections are unreachable.

[OrwellwasRight]

102. That is total hogwash.

People in rural communities in every other developed country in the world get healthcare just fine. And older people in other developed countries get healthcare just fine -- they just aren't subjected to excessive end of life care like old people are here. In fact people in other developed countries are far happier with their health care systems than we are. You've must be reading too many screeds on the evils of universal care or something. There are lots of inefficiencies in our system, and they can get fixed.

And it is also false that "we pay more for most things". What does that even mean? Have you ever left this country?

We pay less for gasoline, electricity, food, taxes, clothing. I could go on, but your defeatist, uninformed attitude against the efficiencies of single payer -- an idea that has been proved by evidence -- is boring me.

[Hoyt]

104. They get hospitalization in efficient regional hospitals. Best way to go. But people here are

too stupid to get or accept it. You can't get to Sanders' projections just cutting big Pharma and provider fees.

[jeff47]

9. So how does Clinton get her "strengthen the ACA" plan through Congress?

The alternative is just as impossible to pass.

[Ferd Berfel]

11. COngress won't work with her

They will work with Bernie.

[Hoyt]

16. We got through the hard part of getting a plan that puts the government in charge. Now, you add on

a public option, cut coinsurance/deductibles, ratchet down the Medical Loss Ratio, add coverage to those who still aren't covered particularly in red states that wouldn't expand Medicaid, etc.

The key is to get a public option, basically a relatively few paragraphs added to the law that allows people to purchase Medicare for say those between 55 - 65 (not interested into getting into all the details). If the public option is as good and cheap as everyone seems to think, people will give up their private insurance and gravitate toward the public option -- hence single payer without all the turmoil. Even if not, the public option will force private insurers to be competitive on the exchanges.

[jeff47]

21. Once again, how does she get that through Congress?

The party that scheduled 60 repeal votes is not going to add a public option.

[Hoyt]

38. Because a few critical changes year, a few next, etc., is a lot easier at this point.

[retrowire]

47. But how would those few changes get made? nt

[Hoyt]

50. Clinton knows where the skeletons are. She'll get it done. Sanders' bill died without getting

anywhere.

[retrowire]

52. That's an incredibly vague answer. nt

[Fawke Em]

67. It's not even an answer.

On top of being a corporate owned war monger, that poster thinks Hillary is a mob boss, apparently.

[Rose Siding]

51. Same way Social Security was changed and improved.

It wasn't birthed fully formed either. It was done incrementally. You know, progressively.

[retrowire]

53. Go on....? nt

[Hoyt]

58. Exactly. The initial SS system was quite shabby -- even excluding most women and minorities.

[jeff47]

110. And once again, how do you get that passed through Congress?

The party that has scheduled over 60 repeal votes will not be passing any incremental strengthening bill.

[Armstead]

75. That's fine except for changes that go in the opposite dorection

Like legally requiring people to pay for overpriced, low performing private insurance from corporate monopolies. And setting up a needlessly complex set of formulas and requirements - socialism without the social benefits.

It's also politically counterproductive, because it combines the worst aspects of socialism with the worst aspects of capitalism. That will add to the distortions of the right wing and poisons the well for generating public support for even modest things like a public option.

[Nanjeanne]

23. The Public Option

You mean that thing that Hillary has never mentioned wanting - never suggested in her many discussions and print outs about how she is going to make the ACA better - you mean THAT public option?

Yeah - let's vote for Hillary because her plan shows us how we get to universal coverage - if I could only find that damn plan!

[kristopher]

32. +1

[Hoyt]

37. Clinton definitely proposed a public option in 2008. Are you purposely misrepresenting her, or have

you been listening the Sanders supporters.

Clintons speech September 2007:

"You will also have as one of those choices a public plan, just like Medicare is a public plan. You will have access to a public plan that will provide a stable, competitive alternative to private insurance if that is your choice. My plan does not create a single new government department, agency, or bureaucracy. It is not a government takeover of health care. It is a public-private partnership that provides more choices. . . . . . ."

http://www.cnn.com/2007/POLITICS/12/21/clinton.trans.healthcare/


Although it has made him persona non grata to BS supporters, Krugman says Clinton is right too --

http://www.politicususa.com/2016/01/18/paul-krugman-hillary-bernie-wrong-healthcare.html

[Nanjeanne]

42. I'm sorry I thought this was 2016

We didn't have the ACA in 2008 Even Obama supported a public option then. But we don't have that now. It seems she's talked a lot about she is going to expand on the ACA. Surely she would have said the words "public option" somewhere in all those rallies, and all her policy papers on her website.

I can't believe you actually brought up what she said more than 8 years ago.

Krugman brought up public option as a way to make the ACA better. Which I find odd that he says Hillary is the way to go and yet I'm still waiting for Hill to say it.

Oh and Robert Reich says Sanders is right about his single payer system.

[retrowire]

48. Applauds* Brilliant. nt

[Hoyt]

56. Do you have a link to where she has said no to a public option now. I get she is not yelling about

it and waving her arms around like Sanders, but that is mostly so it won't be used against Democrats during the election by GOPers.

Funny how Robert NAFTA Reich has been pulled out from under the bus because he's supporting Sanders.

[Nanjeanne]

59. A link to where she didn't say something?

That's a joke right?

[Hoyt]

63. No a link to where she says she's opposed to public option. Try not reading pointing at each word.

[Nanjeanne]

69. I don't have a link

To where she said she is opposed to something no one has mentioned.

I can't believe I'm actually responding to this. seriously? She s supposed to say what she stands for. There are plenty of links where she gives generalities about her plan. So I ask again. What specifically will she do to make the ACA BETTER?

[Hoyt]

72. So, then, that may be what she means when she talks of improving the ACA.

She has one problem that Sanders doesn't have -- if Clinton says she's going to push for a public option as the way to get to single payer, GOPers will use that in the GE. Sanders doesn't have that problem, because the odds are still stacked against him getting there. In fact, his only chance of getting there is to promise enough people enough stuff to vote for him.

Just like I said, she makes it better with a public option, reduction in MLRation, reduction in out-of-pocket costs, increasing physician networks, etc.

[Nanjeanne]

77. Of course it is

Edited because - it's just not worth it.

[questionseverything]

93. it never is with that one

just keep working for bernie

[kristopher]

46. That's right. Krugman was for Bernies plan before he was against it

Do you dispute the fact that he is a Hillary partisan?

[jeff47]

111. Even if we pretend her 2008 plan still applies, how does she get Congress to pass it? (nt)

[Hoyt]

119. If you can't get a public option, you darn sure can't get single payer.

[jeff47]

125. You're the one claiming she can get it passed. How does she get it passed? (nt)

[Elmer S. E. Dump]

61. I haven't heard her plan. Could you give a synopsis?

[JDPriestly]

84. Reducing administrative costs at all levels including the doctors' offices.

Reducing the cost of high salaries for the CEOs and other management of for-profit health care. Reducing the cost of bill collection at all levels for unpaid medical bills since all bills that are allowed (and doctors will know from the get-go what is allowed because what is allowed will be universal and apply to all patients). Reducing the cost of collecting monthly premium payments. Reducing the profits which apparently are large enough to cause insurance companies to fight single payer with all their might. Reducing the share of our premiums for health insurance that go into advertising. Reducing the share of our premiums that go into political activities including lobbying and donating to candidates and other political groups.

Lots of money will be saved with single payer.

These profits aren't bad:

UnitedHealth Group beat the predictions of Wall Street analysts in the fourth quarter in what turned out to be a better-than-expected year for the health insurer.

UnitedHealth's profit in the last three-month period rose 5.8% compared with the same quarter in 2013 to more than $1.5 billion. That equated to $1.55 in earnings per share, ahead of the analyst consensus of $1.50.

Full-year profit dropped 1% but still hovered around $5.6 billion. Earnings per share were $5.70, above what CEO Stephen Hemsley predicted at the company's investor day in December.

http://www.modernhealthcare.com/article/20150121/NEWS/150129988

Chapel Hill, N.C. — Blue Cross Blue Shield of North Carolina on Friday reported $92.6 million in net income in 2013, a 60 percent jump from the previous year.

The state's largest insurer also reported in filings with the Department of Insurance that six executives made $1 million or more in compensation last year, led by President and Chief Executive Brad Wilson at $2.96 million.

. . . .

Blue Cross' annual revenue rose 10 percent, from $5.8 billion in 2012 to $6.4 billion, and it added about 90,000 customers to its rolls in advance of the Affordable Care Act's requirement that most Americans have health coverage, starting in 2014. It's profit margin rose from 1 percent in 2012 to 1.4 percent.

Customers in group insurance plans saw their premiums go up by an average of 8 to 9 percent, officials said.

http://www.wral.com/blue-cross-profits-executive-pay-up-in-2013/13438661/

Lots of profits. Lots to save by doing away with those profits. Of course, some of the money paid to the CEOs would go to the staff on either government organizations or non-profit health insurers.

[Hoyt]

90. United Healthcare made less than $250 per insured last year. More for some plans, less for others.

Not a staggering amount really.

[JDPriestly]

108. That does not include the money they paid their CEO way above and beyond what would be

paid under single payer. That does not include the monstrous administrative costs that United Healthcare pays.

[Hoyt]

117. If you took every dollar and gave it to insured, it would be less than 30 cents per. Who cares what

someone else makes as long as they run a decent insurance company, as far as insurance companies go. Millions of people have benefited from their Medicare supplements and Advantage plans. We may wish they didn't exist and complain, but unfortunately our Congress hasn't and won't pass 100% coverage for Medicare. So it's darn near a necessity. I bet you have a supplement or Advantage Plan.

[kristopher]

131. Without insurance Co. lobbying they wouldn't Need those supplemental plans.

The need is there by design.

[Hoyt]

132. Medicare was enacted with big gaps, and there were no companies to lobby.

Unless you buy a supplement one hospitalization will bankruptcy most seniors. Congress has never done a thing about it. 1/3 of Medicare beneficiaries voluntarily choose Medicare Advantage Plans because traditional Medicare is a ticket to bankruptcy.

[draa]

5. K+R!!!

Great breakdown Kristopher. Thanks.

[jeff47]

8. Sanders health plan calculator

http://valadian.github.io/SandersHealthcareCalculator/

Find out how much it costs you. (Or much more likely, saves you)

[Ferd Berfel]

12. 'Single-payer is the only health reform that pays for itself'

'Single-payer is the only health reform that pays for itself'

non-partisan Physicians for a National Health Program (PNHP) http://www.democraticunderground.com/12511052189

[kristopher]

17. +1

[beam me up scottie]

13. Excellent breakdown, thanks for posting.

K & R!

[Andy823]

14. So the big question is

How long will it take once Bernie takes office before anyone actually sees any of this happen?

[kristopher]

18. That depends on how long his coat-tails are, doesn't it?

The harder we work to make everyone understand the way the working class is getting the shaft, the better chance we have of passing expeditiously this and other programs. Wouldn't you agree?

[Ferd Berfel]

20. Once Bernie really gets going (next couple of months) he will have tremendous coat tails

Hillary, not so much.

[Andy823]

39. Well we might take back the Senate

But we won't take back the house, wouldn't you agree? If we get lucky, maybe in four years we could take the house, but what happens until then? Also how many who will be hanging onto his coat tails will feel the same way as he does about changing things?

Honestly I don't really see his health care plan coming to be, even if he were to stay in for 8 years. If he can not get anything done in his first four years, it will also not be easy for him to win a second term, don't you agree?

[pangaia]

54. Well then why don't you just give up.

[kristopher]

57. No, I don't agree about the House. Here's why.

Led by corporate interests, for more than 50 years politics have trended increasingly toward a "divide and conquer" strategy build around emotion-laden social issues that have no possibility of resolution.
For motive and structural planning see ( Where to find "The Establishment" and some history on how we got here ) http://www.democraticunderground.com/12511054337

While emphasizing these unsolvable social issues the corporatists have concurrently taken control of both parties economic planning apparatus. Jimmy Carter was the last president that had a sincere focus on the economic plight of the middle class.

The gerrymandering that the Rs are relying on and the Ds are so terrified of is based on the division that results from social issues.

When we look at an electorate that organizes itself around economic issues, a completely different map emerges where the gerrymandered districts disappear as the working class becomes a monolithic entity comprising perhaps 70% of voters.

So my question to you is this:
If you want progressive economic policies, does it make sense to continue to encourage a focus on the things that divide us, or should we be working towards raising awareness of the possibilities inherent in uniting the working class to elect representation at all levels that will enact programs that we know will work to improve the lives of nearly everyone in the country?

ETA: Here is an example of what I'm seeing that makes me think this is a realistic goal.

An Evangelical pastoral counselor and Liberty University graduate posted a short sermon about Bernie Sanders' speech at Liberty University to reddit yesterday:

Bernie is the voice of Justice crying out in the desert. Evangelicals like me are convicted by his message. (audio, a little under 17 minutes)
https://clyp.it/eusxalwe

https://www.reddit.com/r/SandersForPresident/comments/3kx57b/im_an_alumni_of_liberty_u_bernie_is_the_voice_of/

He was convicting the Christian leaders and the religious leaders in that university, and calling us out for being complicit in the abandonment of those who suffer, the least of these, and siding with the powerful and rich, the masters of this world. And he was convicting us and calling us out, and we scorned him, and we stared him down; and, with sour faces, we thought, "Who is this wacko, and why do all these people seem to follow him, seem to like him – this wild-haired Jew, crying out from the wilderness of the political left, in his hoarse voice?"

When I heard Bernie speaking in that way, when I saw that guy on stage at Liberty University, I saw John the Baptist...crying out to the religious leaders, the Pharisees of his day, calling them corrupt and complicit with those who have all the power and all the money and all the wealth, and abandoning the people that God loves, that God cares about...

As I heard Bernie Sanders crying out to the religious leaders at Liberty University, in his hoarse voice, with his wild hair – this Jew – and he proclaimed justice over us, he called us to account, for being complicit with those who are wealthy and those who are powerful, and for abandoning the poor, the least of these, who Jesus said he had come to bring good news to. And in that moment something occurred to me. As I saw Bernie Sanders up there, as I watched him, I realized Bernie Sanders for president is good news for the poor. Bernie Sanders for president is Good News for the poor. Bernie Sanders is gospel for the poor. And Jesus said "I have come to bring gospel" – good news – "to the poor."

And lightning hit my heart at that moment. And I realized that we are evangelical Christians. We believe the Bible. We believe in Jesus. We absolutely shun those who would attempt to find nuance and twisted and tortured interpretations of scripture that they would use to master all other broader interpretations, to find some kind of big message that they want to flout. We absolutely scorn such things, and yet somehow we commit to the mental gymnastics necessary that allows us to abandon the least of these, to abandon the poor, to abandon the immigrants, to abandon those who are in prison.

I listened to Bernie Sanders as he said he wanted to welcome the immigrants and give them dignity...

http://m.dailykos.com/story/2015/9/16/1421659/-An-Evangelical-responds-to-Sanders-speech-at-Liberty-U

[questionseverything]

97. i also think we can retake the house

50% of the eligible electorate does not vote....if dems give these people a reason to vote they will come

i live in downstate illinois....the only time in my life i have had a democratic representative was in '08 when obama turned mclean county blue for the first time in my memory

it can happen

ty for the great op

[uponit7771]

22. The 6.2% and 2.2% aren't "cost"?!!? Yes, they are they're payroll taxes that are paid...

... into Sanders plan by the employee seeing no one in their right mind believes the employer wont be passing the cost to the employer like they have for the last 10 years.

People wont just be paying 466 a year at 50k... that's crazy...

So 8.4% paid is mostly a shift of who's being paid and not the amount being lower.

I don't care if Daffy Duck gets paid just as long as it's not 8.4% of of 50,000.... that's still too much.

Were am I wrong here? tia

[kristopher]

25. I'd say you are wrong just about everywhere.

If you want a real response, make real comments.

[uponit7771]

27. ad homs is about 2/3rds of the responses I get these days from the supporters of these measures

... and not cogent retort.

There is a real comment, 2.2 and 6.4 is in the OP... as part of payroll taxes... the employee employer (aka the employee) will be pay the full amount... that's not a true cost saving but a shift of who's being paid from the private HCIs to government.

No employer pays 6.4% of 50k into HCI currently that's a falicy

[kristopher]

28. Write a cogent post and you'll get a cogent reply

For example, this is not a cogent remark, it is nonsense. It is so poorly put together that t's little more than meaningless gibberish. The numbers are in the OP, and if you have a point, you'll need to make it using those numbers.

There is a real comment, 2.2 and 6.4 is in the OP... as part of payroll taxes... the employee employer (aka the employee) will be pay the full amount... that's not a true cost saving but a shift of who's being paid from the private HCIs to government.

No employer pays 6.4% of 50k into HCI currently that's a falicy

[uponit7771]

29. The point was made well enough, this is another cut and run ... 2.2 and 6.4 are PAYROLL TAXES...

... that are NOT being paid today for HCI.... period.. that's simple enough.

So

instead of paying the private HCIs 9% of my income I pay the government 8.4%...

That's not half or a third and that's if I believe the rest of the tax increases can be made...

That's simple enough... get someone to help if there's no comprehension after this

[kristopher]

31. It is nothing more than a baseless claim.

Give specific income and premium numbers for you and your employer so that we can confirm your claim and compare it against Bernie's plan. Otherwise you are just making noise.

[RichVRichV]

81. Do you currently have deductables and co-pays under your current insurance plan?

The flaw in your logic is your trying to compare the floor of the current private insurance system against the ceiling of the single payer system.


You're comparing apples and oranges.


You're costs might be pretty comparable under both systems if you don't ever use your current insurance. The moment you do your costs can sky rocket. Under single payer your costs are relatively consistent regardless of whether you use it.

[uponit7771]

85. I'm using the median for 50,000 a year salary and it employers aren't paying 6.4% in HCI payments

... right now.

That's a net increase that they'll no doubt pass down to employee.

Currently I do not pay 8.4% + of my salary in HCI payments... it would be an increase for me... but that's not such a big deal its that my understanding the bill was supposed to be less than half.

There's no need to continue an expensive HCI program but giving the money to the government vs the private industry

People can't afford the CURRENT payments for a family of five... its expensive...

I'm thinking 150.00 a month for a family of 5 with the median of 50,000 a year with no deductible or copays would turn the system up on head.

Not just shift who's supposed to be payed these expensive premiums per month

[RichVRichV]

92. You have claimed that employers pay very low premiums because they pass huge deductibles

and co-pays on to employees, then you dismiss any talk of the costs of deductibles and co-pays on people.


I see why people don't bother discussing this subject with you, it's pointless. You keep repeating the same inane and inaccurate numbers while ignoring any other data that disproves what you're saying, no matter how accurate or pointed the reasoning is.


You ignore the costs of deductibles, the costs of co-pays, the costs of providing healthcare to the uninsured on the system. You keep claiming this will be some new huge burden on employers that will be passed on to the employees, but even that isn't true. According to the Department of Labor, the cost to employers of providing health benefits to employees ranges from 7.7% for private sector up to 11.6% for state and local government employees. That's with more and more of the burden being passed to the employee in the means of high deductibles and co-pays.


Employer Costs for Employee Compensation - DoL

[uponit7771]

126. No, employers for that median income hardly pay any premiums and most of the cost is shifted to

... the employer either throw suppressed wages or higher deductibles.

My issue is we'll still be paying a higher premiums just to the government vs private industry

Also, the 7.7% is not for the MEDIAN income... its an average which includes people who make 12341234 a year in salary.

For that MEDIAN income no employer is paying an extra 5% in HCI cost... I don't know where they get that from

[RichVRichV]

127. Prove it.

I sourced my claims. Least you can do is the same.

If the average cost to employers is 7.7% and employers of people around median pay are spending virtually nothing then employers of people not on median pay are spending substantially more than 7.7%. I don't buy what your selling. So back up your claims.


Besides you just pointed out how wages are already supressed because of health care costs. The exact thing you argue would happen under single payer.

[mythology]

35. Petulant foot stomping doesn't make you any less wrong

Sanders plan is very underfunded and relies on immediately saving better than 40%. It doesn't add up

[RichVRichV]

89. It's not that crazy when looked at other single payer countries.

When you look at what countries such as Canada, Australia, United Kingdom, and Spain spend on health care with single payer type systems, the savings are very achievable.

Those countries spend between 33% and 72% less than we do per capita on health care, and between 36% and 52% less as percent of total GDP.



Health expenditure per capita - WHO
Health expenditure per GDP - WHO

[questionseverything]

96. the premium for the aca is 8%

to use it we have to fulfill 2- 6 grand out of pockets....that is close to 30%

that makes 8.4% look like a bargain to me

for employers that already pay for their employees health ins this will be a savings.....for those that don't already offer hc it will be an increase

the current plan that leaves 29 million people with nothing but a penalty and another 40 million with insurance they can not use causes a lot of needless deaths....does that mean nothing to you?

[Warren Stupidity]

124. As the entire cost is lower than current costs

under your theory businesses will be passing this negative additional cost into their workers as a raise.

[Gothmog]

26. Krugman-Sanders health plan looks a little bit like a standard Republican tax-cut plan

I trust Prof. Krugman on this http://krugman.blogs.nytimes.com/2016/01/19/weakened-at-bernies/?_r=0

On health care: leave on one side the virtual impossibility of achieving single-payer. Beyond the politics, the Sanders “plan” isn’t just lacking in detail; as Ezra Klein notes, it both promises more comprehensive coverage than Medicare or for that matter single-payer systems in other countries, and assumes huge cost savings that are at best unlikely given that kind of generosity. This lets Sanders claim that he could make it work with much lower middle-class taxes than would probably be needed in practice.

To be harsh but accurate: the Sanders health plan looks a little bit like a standard Republican tax-cut plan, which relies on fantasies about huge supply-side effects to make the numbers supposedly add up. Only a little bit: after all, this is a plan seeking to provide health care, not lavish windfalls on the rich — and single-payer really does save money, whereas there’s no evidence that tax cuts deliver growth. Still, it’s not the kind of brave truth-telling the Sanders campaign pitch might have led you to expect.

Again, as noted by Prof. Krugman this plan does not add up.

[kristopher]

30. Well ACA isn't working and still leaves nearly 30M people without coverage

Runaway health care costs — we’re #1!
The latest Trustees’ reports from Social Security and Medicare show, once again, that there is no such thing as Socialsecuritymedicareandmedicaid. Social Security, the subject of thousands of demands that we get “serious” and cut benefits, is doing relatively well. The real problem lies in health care costs.

I am, of course, a big proponent of health care reform. But is there any reason to think that reform would curb the growth of costs?

Well, I was browsing some of the charts at CMS, and thought I’d share some information from Chart 2.1. This table shows health care spending as a percentage of GDP in some major countries, 35 years ago and recently:


We’re #1!
Everybody knows that the US spends much more on health care than anyone else, without getting better results. Everyone also knows that health spending has outpaced GDP growth everywhere, thanks to medical progress. What I didn’t realize was just how clearly the evidence shows that the rising trend is steepest in the US. We have the biggest increase as well as the highest level. We’re #1!

What this suggests is that a more integrated system wouldn’t just achieve a one-time saving, but also flatten the upward trend. Among other things, this would help the long-run fiscal picture. Moral: stop bashing Social Security, start demanding health care reform.

http://krugman.blogs.nytimes.com/2008/03/28/runaway-health-care-costs-were-1/

Or this pithy response to a reader's comments in 2007:

Paul Krugman: Health care turns out to be one area in which the magic of the marketplace pretty much consistently fails: I have yet to see any good examples of the private sector doing it better.

The record is replete with Krugman arguing that something needs to be done, but apparently only Hillary is allowed to do anything.

[Gothmog]

133. Bernie Sanders's fiction-filled campaign

Tell the Washington Post that these numbers have been debunked https://www.washingtonpost.com/opinions/bernie-sanderss-fiction-filled-campaign/2016/01/27/cd1b2866-c478-11e5-9693-933a4d31bcc8_story.html

Mr. Sanders’s story continues with fantastical claims about how he would make the European social model work in the United States. He admits that he would have to raise taxes on the middle class in order to pay for his universal, Medicare-for-all health-care plan, and he promises massive savings on health-care costs that would translate into generous benefits for ordinary people, putting them well ahead, on net. But he does not adequately explain where those massive savings would come from. Getting rid of corporate advertising and overhead would only yield so much. Savings would also have to come from slashing payments to doctors and hospitals and denying benefits that people want.

He would be a braver truth-teller if he explained how he would go about rationing health care like European countries do. His program would be more grounded in reality if he addressed the fact of chronic slow growth in Europe and explained how he would update the 20th-century model of social democracy to accomplish its goals more efficiently. Instead, he promises large benefits and few drawbacks.

Meanwhile, when asked how Mr. Sanders would tackle future deficits, as he would already be raising taxes for health-care expansion and the rest of his program, his advisers claimed that more government spending “will result in higher growth, which will improve our fiscal situation.” This resembles Republican arguments that tax cuts will juice the economy and pay for themselves — and is equally fanciful.

The Washington Post is agreeing with Prof. Krugman's analysis

[kristopher]

134. Blah, blah, blah, blah...

The Economist Intelligence Unit’s Democracy Index 2015
Democracy in an age of anxiety

The Economist Intelligence Unit’s Democracy Index provides a snapshot of the state of democracy worldwide for 165 independent states and two territories—this covers almost the entire population of the world and the vast majority of the world’s states (micro-states are excluded). The Democracy Index is based on five categories: electoral process and pluralism; civil liberties; the functioning of government; political participation; and political culture. Based on their scores on a range of indicators within these categories, each country is then itself categorised as one of four types of regime: “full democracies”; “flawed democracies”; “hybrid regimes”; and “authoritarian regimes”.

This is the eighth edition of the Democracy Index. It reflects the situation in 2015, a year in which democracy was tested in the face of war, terrorism, mass migration and other crises, and, in some cases, suffered serious setbacks. The title of this year’s report reflects the threat to democracy emanating from the fearful mood of our times, which informs the reactions of ordinary people and political elites alike. An increased sense of personal and societal anxiety and insecurity in the face of diverse perceived risks and threats—economic, political, social and security—is undermining democracy, which depends on a steadfast commitment to upholding enlightenment values (liberty, equality, fraternity, reason, tolerance and free expression) and fostering democratic institutions and a democratic political culture.

In many democracies, political elites worry about their inability to relate to the electorate and fear the challenge that populist parties pose. In some cases, established parties have colluded to exclude or marginalise the populists. In the face of terrorist threats, democratic governments have reacted in anti-democratic ways, calling into question freedom of speech or adopting draconian laws. In non-democratic countries, authoritarian political elites fear the threat from the masses and seek to bolster their rule by imprisoning opponents, restricting the media, limiting popular freedoms and repressing protest. Meanwhile, electorates are ever more anxious—about economic insecurity, about their personal safety, about the consequences of immigration, about the threat of terrorism—and angry that their concerns are not being represented by the established parties. This mood of fear and insecurity represents one of the main threats to democracy today.

Almost one-half of the world’s countries can be considered to be democracies, but, in our index, the number of “full democracies” is low, at only 20 countries; 59 countries are rated as "flawed democracies”. Of the remaining 88 countries in our index, 51 are “authoritarian” and 37 are considered to be “hybrid regimes”. As could be expected, the developed OECD countries dominate among “full democracies”; there are two Asian countries, one Latin American country (Uruguay) and one African country (Mauritius), which suggests that level of development is not a binding constraint, but is a constraint, nevertheless. Slightly less than one-half (48.4%) of the world’s population lives in a democracy of some sort, although only 8.9% reside in “full democracies”. Around 2.6bn people, more than one-third of the world’s population, still live under authoritarian rule (with a large share being, of course, in China).

“Flawed democracies” are concentrated in Latin America, eastern Europe and Asia...

http://64.37.52.189/~parsifal/EIU2015.pdf

They rank the US 20th out of 20 in their set of "full democracy" nations.

[AzDar]

41. K & R

[retrowire]

44. knr nt

[Elmer S. E. Dump]

55. I work for a Health Insurance company and I vote single-payer even if it cost me my job.

[MrMickeysMom]

87. The industry will survive, I believe...

It will not resemble its former self, which is what I think you're also saying. It is not sustainable.

Many, many systems in the country, including the present model of the health insurance industry, are unsustainable.

[Jarqui]

62. I love it because it's at least a 4 for 1 deal

1. It will save lives
- tens of thousands are dying annually because they do not have healthcare

2. It's single payer that will reduce costs
- Americans will not longer have to pay health insurance company profits off individual health misfortune
- it dramatically reduces administration costs
- the bigger all-in insurance pool will reduce healthcare costs - one big negotiator for services
- it will probably lead to reduced drug costs

3. It's a move towards income equality
- it's a Robin Hood plan that makes the wealthy pay more and the less fortunate save four figures

4. It will boost the economy
- American worker costs will go down and therefore, make them more competitive globally = more jobs
- reduced labor costs will bring American product costs down and make them more competitive globally = improve trade deficit
- average American will have more disposable income and from that boost the American economy.

The catch: It's going to be very hard to get. If Bernie Sanders gets elected and his supporters get more Dems elected to the House and Senate, then there's a shot. That's what it's going to take.

[kristopher]

107. Great list. Can I add one under #4 - 'portable' gives way to 'untethered'

What I mean is that mom and pop business enterprises will explode. That manifests as a resurgence in people moving to successful self employment in arts, crafts and trades. I don't know the stats but the opinion is based on studying Japanese culture (over there) for more than a decade.

Some people think a very low unemployment rate is a good thing.
Others like it a lot when the unemployment rate is really high.

I wonder if there is a correlation between those who oppose single payer and those who profit when there is extreme competition for jobs...

[FairWinds]

65. There are alternative ways of going about this . .

1. Let people buy into Medicare if they choose to do so. In fact, that is the public option.

2. Bernie could use an executive order to lower the Medicare age to 62? 55? and add children.

In general, the HRC-istas are playing the old game of making the perfect the enemy of the good.

As Trump might say, the savings from Medicare for All (Single Payer) would be HUUUUUUGE!
Moving to a Canada type system should save 40%, and Canada-style drug buying would save another
$200 billion per year.

A lot of the excess costs are from paper-shuffling. In Canada, Medical Records is NOT a college major.

I don't think Bernie's critics understand the magnitude of the rip-offs in the current
predatory health care system.

Now the down side. We saw in 2009 & 2010 that the medical profiteers are prepared to use intimidation to
keep their racket going. Would they resort to violence if they thought it was necessary to block real reform? I believe they would.

[blackspade]

76. K&R

[lumberjack_jeff]

78. So Bernie's plan has no copays or deductibles? I'm fer it either way. n/t

[katsy]

80. Wouldn't current employees of health insurers continue

working as payment facilitators,,, kinda like they used to act before for profit health?

If so, the only losers would be the obscenely paid CEOs and useless VPs.

So I'm in favor of Bernie's plan. All in.

[ecstatic]

83. Do those numbers take into account the increased price of nurses aides, home health care workers,

and other medical workers who currently make less than $15/hr?

[MrMickeysMom]

86. I want to thank you, Kristopher...

I've tried to explain, but you took it a step further. I'm sure some of these people will still squeeze their eyes shut and hold their mouth like kids not wanting their Maypo.

The same posters who so far seem to be on the side of the insurance and pharmaceutical industry are simply astounding with their inability to look at this data. It's been as available to them as it is to us.

Meanwhile, they curse their own darkness rather than light a candle.

[Uncle Joe]

91. This is an excellent OP.

Thanks for the thread, kristopher.

[liberal_at_heart]

103. K&R

[mhatrw]

105. It's amazing. How in the hell can so many people be against paying a lot less for a lot more?

Oh, I forgot. They are all selfish motherfuckers who are ecstatic about the fact that they and they alone CURRENTLY enjoy subsidized healthcare plans that the rest of us can only dream about.

[Recursion]

109. Because a lot of us think we'll end up paying more for less

If you believe those revenues and cost savings are accurate predictions, I agree it would be idiotic to oppose the plan.

Can you at least accept that not everybody believes them?

Very few countries worldwide have single payer, because most looked at the analogous calculations and didn't like what they saw.

[mhatrw]

113. Really? Which first world countries have the best healthcare per tax dollar spent?

All I know for a fact in that the USA's current system has the worst healthcare per tax dollar spent.

So which other countries do you think have the best? Which would you have us emulate and why?

[Recursion]

114. France and Italy consistently top most rankings

France subsidizes 70% of the cost of allowed procedures. In Italy the government runs low-cost clinics for primary care; specialist care and upgrades to primary care, e.g. not having to wait for an appointment are financed out of pocket or by private insurance. More importantly, both have global budgeting for providers (this is also the key to O'Malley's plan): the government actually has the political will to tell doctors and hospitals to make less money, something the US has a lot of trouble doing.

[mhatrw]

115. France ranks 4th per capita in healthcare spending.

How about Malta's, Singapore's, Spain's, Norway's, Portugal's or Iceland's systems? All would provide far more bang for buck than what we currently have.

[Recursion]

116. The problem is we're focusing on the financing, which is the least important part

Last edited Wed Jan 27, 2016, 07:04 AM - Edit history (1)

There are a billion different ways to finance health care, and that doesn't matter very much. What makes the difference is that other governments have figured out how to tell providers they have to make less money.

If we adopt single payer without figuring out how to do that, I'm absolutely confident it will cost more than we are spending now.

[mhatrw]

120. It's not just providers who have to profiteer less. It's also Big Insurance and Big Pharma.

Don't shill for Big Insurance and Big Pharma at the expense of healthcare providers. Yes, big hospitals will also have to tighten their belts as well as profiteering doctors. But the salaries of the majority of doctors and nurses are not the reason that our healthcare costs our ridiculously high. The reasons are corporate profiteering, systematic inefficiencies, and the fact that preventative medicine simply costs a lot less than emergency services.

[Recursion]

121. Pharma is part of "providers"

Insurance profits are 4% of our annual health care spending. Sure, I'd like that to go down or away, but it's just not realistic to think that's the problem.

Pharma is an issue, though we're doing a decent job; Canada spends more ondrugs per capita than we do (barely, but still).

US physicians make twice the OECD average, and payments to physicians are about 25% of our total healthcare spending (and that doesn't count payments that go through hospitals). American doctors are going to have to make less, while treating 30 million more people.

[mhatrw]

130. Pharma costs are NOT under control.

In the U.S., $728 per capita is spent each year on drugs, while in Canada it is $509.[92] At the same time, consumption is higher in Canada, with about 12 prescriptions being filled per person each year in Canada and 10.6 in the United States.[94] The main difference is that patented drug prices in Canada average between 35% and 45% lower than in the United States, though generic prices are higher.[95]



Furthermore, why compare how much we spend compared to Canadians when Canadians send the most out of any other country.

As for insurance costs, it just makes more bargaining sense at every step of the cost containment process to have one pool of people with every American citizen in it.

[questionseverything]

129. about providers making less money...

cost controls have to be the first thing addressed, that is true

i know lots of docs that are on board with the single payer idea because they are tired of insurance companies dictating care,tired of paying for employees that do nothing but deal with insurance companies

the important thing is, we make healthcare a right not a privilege

we also need to train way more doctors/physician assistants because there are around 70 million people being underserved now

[november3rd]

112. Great thread.

Thanks!

[LWolf]

123. Fear, uncertainty, and doubt

are the opposition's only weapons.

Just another reason why I won't be supporting their candidate.

Who the fuck supports a candidacy based on fear, uncertainty, and doubt???

[liberal_at_heart]

128. This deserves a kick. I'm tired of all the lies we keep hearing about Bernie's health care plan and

I am tired of hearing people use raising taxes as some sort of boogey man.