WPost: Study: Bernie Sanders’s health plan is actually kind of a train wreck for the poor

[riversedge]

Study: Bernie Sanders’s health plan is actually kind of a train wreck for the poor


https://www.washingtonpost.com/news/wonk/wp/2016/02/25/bernie-sanderss-health-plan-is-actually-kind-of-a-train-wreck-for-the-poor/?tid=sm_tw



By Max Ehrenfreund February 25 at 7:17 AM

Millions of families among the working poor and lower-middle class would be substantially worse off under the health-care plan proposed by Bernie Sanders, according to an analysis by a public health researcher at Atlanta's Emory University.

At a press conference in Columbia, S.C. on Wednesday, Sanders told reporters that his single-payer plan -- in which the federal government, rather than the private insurance industry, would reimburse doctors and hospitals for treatment -- would take "a huge bite" out of poor families' financial distress.

Sanders estimates a middle-class family of four would pay an annual premium of $466 under his plan, with no deductible or co-pays. Less affluent households would pay less than that, or nothing at all.

But for at least 72 percent of households enrolled in Medicaid -- in which someone is working -- the costs of Sanders's plan would exceed the benefits, according to an analysis by Kenneth Thorpe, a public-health expert at Emory University.

That figure includes 5.7 million households, or 14.5 million people -- among them, 4.2 million Hispanic recipients and 2.5 million black recipients. The requirements for eligibility for Medicaid vary widely by state, so that group includes some households living in poverty as well as some that are modestly better off.

"The vast majority of low-income Medicaid workers, who are probably predominantly minority, are going to end up paying more in terms of payroll taxes, and aren't going to receive really any financial benefits," said Thorpe, a former Clinton administration health official.

Many lower-income people are already insured or eligible for insurance under Medicaid, at least in the states that expanded the program under President Obama's health-care reform. Many Medicaid beneficiaries also work, and those workers' wages would likely decline due to the additional 6.2 percent payroll tax the proposal would levy on their employers.




Thorpe has also argued that the senator from Vermont is underestimating the cost of his plan by roughly $1.1 trillion a year. Regardless of the cost, though, the plan would be detrimental for many poor households, he concluded...................







Kori Wasinger ?@KoriWasinger 5h5 hours ago

I admire a woman that stands up to intimidation.

That's why #ImWithHer #HillaryClinton @SFL4Hillary

[forjusticethunders]

1. way to take the entire article out of context

For example, not mentioning that even if poor Medicaid recipients pay more in payroll taxes (and this is assuming that nothing can be added to the plan, for example, implementing a tax deduction to cover any increase in payroll taxes), it ONLY covers states that have expanded Medicaid. Also what about poor people who *don't* qualify for Medicaid?

What a hackjob.

[yardwork]

22. That's the verbatim headline.

The OP didn't take anything out of context.

There's a lot of room to discuss what-ifs when discussing policies. Are you interested in looking at different possible outcomes of Sanders' policy proposals, or is any critical examination automatically heresy?

[Karmadillo]

2. Stunned that former Assistant Secretary in Bill Clinton's admin would

find Bernie's health care plan hurt the poor, especially minorities, and that it costs heaps more than Bernie tells us. Really. Stunned.

https://en.wikipedia.org/wiki/Kenneth_E._Thorpe

Kenneth E. Thorpe is the Robert W. Woodruff Professor of Health Policy at Emory University, the Chair of the Department of Health Policy and Management in the Rollins School of Public Health, and a former Deputy Assistant Secretary at the Department of Health and Human Services (1993–1995). He is also the Executive Director of the Partnership to Fight Chronic Disease and the Emory Institute for Advanced Policy Solutions.

Appointed as Deputy Assistant Secretary in President Bill Clinton's cabinet, he had a central role in coordinating President Clinton's health care reform proposals.[1]

[BernieforPres2016]

11. I have used up my WaPo articles for the month

And I certainly am not going to pay for that Clinton loving propaganda mill. Did they actually run that opinion piece without mentioning that the "economist" or "analyst" or whatever they called Thorpe used to work for the Clinton administration?

[yardwork]

23. They did mention it.

[BernieforPres2016]

30. Thanks. Glad they still have at least some standards.

If their standards were what they were 40 years ago, Capehart wouldn't be working for them after that failed hit piece he tried to put on Bernie about the University of Chicago photos, with no retraction after he turned out to be wrong.

[BlueMTexpat]

27. WaPo = "Clinton loving propaganda mill" -

[CdnExtraNational]

3. So the Washington Post wrote an article to quote Clinton's staff about Sander's health care plan.

Fail.

[Fawke Em]

4. Max needs to get better, unbiased sources.

Kenneth Thorpe Deputy Assistant Secretary for Health Policy in the U.S. Department of Health and Human Services from 1993 to 1995. In this capacity, he coordinated all financial estimates and program impacts of President Clinton’s health care reform proposals for the White House. He also directed the administration’s estimation efforts in dealing with Congressional health care reform proposals during the 103rd and 104th sessions of Congress.

Stop quoting Clinton cronies, M$M. We can research this.

[Human101948]

5. We have the worst healthcare system for an outrageous amount of money spent...

And some Democrats are fighting tooth and nail to keep it that way!

The United States health care system is the most expensive in the world, but this report and prior editions consistently show the U.S. underperforms relative to other countries on most dimensions of performance. Among the 11 nations studied in this report—Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2010, 2007, 2006, and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last or near last on dimensions of access, efficiency, and equity.

http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror

World Health Organization Ranking; The World’s Health Systems

1 France
2 Italy
3 San Marino
4 Andorra
5 Malta
6 Singapore
7 Spain
8 Oman
9 Austria
10 Japan
11 Norway
12 Portugal
13 Monaco
14 Greece
15 Iceland
16 Luxembourg
17 Netherlands
18 United Kingdom
19 Ireland
20 Switzerland
21 Belgium
22 Colombia
23 Sweden
24 Cyprus
25 Germany
26 Saudi Arabia
27 United Arab Emirates
28 Israel
29 Morocco
30 Canada
31 Finland
32 Australia
33 Chile
34 Denmark
35 Dominica
36 Costa Rica
37 USA

http://thepatientfactor.com/canadian-health-care-information/world-health-organizations-ranking-of-the-worlds-health-systems/

[ladjf]

6. Anti-Sanders nonsense. nt

[Billsmile]

7. More About Kenneth Thorpe, the public-health expert at Emory University...

Dr. Thorpe was Deputy Assistant Secretary for Health Policy in the U.S. Department of Health and Human Services from 1993 to 1995. In this capacity, he coordinated all financial estimates and program impacts of President Clinton’s health care reform proposals for the White House. He also directed the administration’s estimation efforts in dealing with Congressional health care reform proposals during the 103rd and 104th sessions of Congress.

Taken from Thorpe's HuffPost profile.

[TheUndecider]

8. Well let's not even try then!

Geez I kinda liked the idea of universal health care, but I guess there will be some bumps in the road so let's not even try and keep the insurance companies stockholders happy!

[yardwork]

24. Do you want to try, or do you want somebody to wave a magic wand?

Our health care system is a complicated mess. If there was an easy obvious solution we would all quickly agree on it, but there's no easy solution.

[TheUndecider]

36. Well the magic wand option would be awesome

But I don't believe in magic wands so I guess we will have to work

[Jitter65]

9. I think we really need to understand that Bernie is a great champion for the middle-class but.

he is primarily the champion for the upper middle-class maybe the top 20% of the middle class. If you study his proposals closely you will find that there is relatively little policy about the poor or the bottom 6% of the middle class. He is speaking to those issues now, almost as an after thought, but not much is on the table about policies directed at them. Free college is not really directed at them either because there will be strong admission standards that many in the lowest level of the middle class and the poor will not be able to meet.

[BernieforPres2016]

13. What a complete load of garbage

and bigoted to boot. Congratulations.

[Cobalt Violet]

25. $15hr wouldn't help the poor?

Hillary's miserly, stingy $12. is better?

[Jitter65]

34. Only if they have a job. nt

[Cobalt Violet]

35. Are you saying raising the minimum wage would kill jobs?

Gee who else often claims that?

[Yavin4]

10. So, any critique of Sanders' proposals is an agent for the Clintons

And cannot be trusted. Sanders' plans are above criticism.

[BlueMTexpat]

28. Spot on! eom

[Bluenorthwest]

12. Washington Post- Reporting today what others will research tomorrow....

After the Capehart episode revealed the pervasive lack of any sort of protocols or standards at Washington Post I see no reason to take their candidate advocacy seriously. According to Washington Post, gossip and insinuation is as good a source as any, bias and presumption are seen as insights and agenda passes takes the place of objectivity.

[Jarqui]

14. Cherry pick one segment of the population and have it spun

by one of Clinton's lackeys in the Washington Post to distort the information the American people receive about their choice. hmm

And the person behind this repeated daily dishonesty is the person some want as President of the United States?

[WhaTHellsgoingonhere]

15. Interesting twist from Obamacare supporters: Leaving 19 million out in the cold more important than

figuring out a way to insure 100%.

Glad to see you're jumping for joy while you ignore 19 million people.

[kennetha]

18. This is a completely uninformed comment.

Ask yourself why the number of uninsured remains fairly high?

Largely because stupid Republican governors out of rigid ideological purity and pique and a cynical opposition to all things Obama decided, against the interest of the people of their various states, to refuse to expand Medicaid as called for by the ACA.

And they were able to do that because a conservative court decided, on a 5-4 vote, to gut that provision of the ACA that REQUIRED states who wanted to continue to receive Medicaid funding, to expand it. The court decided in its infinite non-wisdom, to say no they don't have to expand Medicaid.

Now ask yourself, which is an easier slog to getting those folks covered?

Option A: Tearing up the ACA entirely and starting over to try to get Single Payer passed.

Option B: Pushing the holdout states to do right by their citizens? And tinkering with ACA at the edges in other ways?

Only a rigid ideologue with Europe envy, who is blind to context and also to path dependency of the politically possible could possibly choose option A.

Option A is a fools errand. It's worst than tilting at windmills. It's a strategy for undoing everything that has been achieved.

[WhaTHellsgoingonhere]

21. Let me explain to you people, again, everything you need to know about this primary

What does Hillary have to do to get Obamacare?
Nothing

What does Bernie have to do to get Obamacare?
Nothing

Will Hillary get her pie-in-the-sky minor tweaks to Obamacare?
Not a chance (ergo, pie-in-the-sky)

Will Bernie get his overhaul?
Nope

This election is a choice between:
"The lesser of two evils (Democratic Party)" that's very best effort has put this country in the crapper. In other words, stay the course. This time will be different!...right. Now that's some serious pie-in-the-sky thinking.

And (Now pay attention)

Someone brave enough to say, "This lesser of two evils form of governing is, today, an abject failure. To say that it hasn't devolved thusly is delusional. To believe doing more of the same will dig us out of this quagmire is pie-in-the-sky thinking. I reject the 'Lesser of two evils' approach to governing and I am laying forth a new vision. We, as Progressives, have got to want more than 'stay the course.' This is the very best it can do. My opponent says, 'It's good enough.' I don't think it is!"

Class dismissed for now, but school remains in session.

[Stuckinthebush]

16. Yes it is. But it doesn't matter

This thing is over. Hillary will be our candidate.

[kennetha]

17. Sanders is an intellectually rigid, ideological blowhard who is incapable of evolution.

Look this passage right here contains the key:

Many lower-income people are already insured or eligible for insurance under Medicaid, at least in the states that expanded the program under President Obama's health-care reform. Many Medicaid beneficiaries also work, and those workers' wages would likely decline due to the additional 6.2 percent payroll tax the proposal would levy on their employers.

Like a robot, Sanders goes on and on about the 29 million (out of over 300 million) uninsured in this country. But ask yourself WHY that number is as high as it is?

Answer: Partly because the Supreme Court, in its infinite non-wisdom, partially gutted the ACA by striking down the provision that compelled states to expand Medicaid, as a condition of keeping Medicaid. The court declared that States had the right to opt out, while still keeping their current Medicaid coverage. Many Republicans, contrary to the interest of their own citizen, out of pure ideological pique and purity -- the kind of thing that drives Sanders supporters too -- refused to expand Medicaid.

Ask yourself which is the more politically feasible way to get to universal coverage -- which we are within less than 10% of achieving -- now that the ACA is law.

Should we work to expand Medicaid and tweak the ACA's cost controls around the edges, and make other similar such adjustments?

Or should we start from scratch and take on this huge and exhausting political fight from scratch.

Only a rigid, foolish, ideologue with Europe envy, and is utterly blind to context and the path-dependency of the politically possible could opt for Sander's approach.

It's a fool's errand. Count me out.

Count almost the entire democratic party out -- even long time advocates of single payer.

Frankly, I will be so glad when Clinton finally wraps this thing up so we can stop arguing over stupid strategies that amount to nothing more than tilting at windmills and genuflecting on the alter of rigid ideological purity.

[riversedge]

19. One of the main reasons I oppose Sanders plan is that he would turn it over to the states. Living

in a Red state is a death sentence for many.

[BlueMTexpat]

29. +1! eom

[yardwork]

26. Harsh but accurate assessment.

The main reason I can't support Sanders is that his major policy positions on healthcare, education, and the economy are over-simplifications that (1) have zero chance of being made law by the Republican congress (or even a Democratic congress in these times) and (2) aren't very good policies to begin with.

There's a difference between wanting universal healthcare, subsidized higher education, working wages, etc. - all of which I support - and following a weak leader with half-baked ideas down the primrose path to failure.

[nichomachus]

20. Corporatist rag WaPo has been in the bag for Hillary since Day 1

They're just amping up the propaganda. If you believe their nonsense, you'll fall for anything.

[guillaumeb]

31. THE UNITED STATES RANKS 37th IN THE WORLD FOR HEALTHCARE OUTCOMES.

THE UNITED STATES RANKS 37th IN THE WORLD FOR HEALTHCARE OUTCOMES.
THE UNITED STATES RANKS 37th IN THE WORLD FOR HEALTHCARE OUTCOMES.
THE UNITED STATES RANKS 37th IN THE WORLD FOR HEALTHCARE OUTCOMES.
THE UNITED STATES RANKS 37th IN THE WORLD FOR HEALTHCARE OUTCOMES.
THE UNITED STATES RANKS 37th IN THE WORLD FOR HEALTHCARE OUTCOMES.
THE UNITED STATES RANKS 37th IN THE WORLD FOR HEALTHCARE OUTCOMES.

All of the countries that rank ahead of the US have single payer. Medicare for all is single payer. All of the foolish attempts to claim that single payer does not work are refuted by the reality that it does work.

WHAT DOES NOT WORK IS THE SYSTEM IN THIS COUNTRY.

[Billsmile]

32. Robert Reich Replies to this Artile

From Reich's Facebook page.

What exactly does the Washington Post have against Bernie Sanders? Today it highlighted a study by Kenneth Thorpe, of Emory University and a former health official in the Clinton administration, alleging that Bernie’s single-payer plan would make the working poor and lower-middle class worse off – because they’d lose their Medicaid.
Wrong.
1. Thorpe doesn't take account of the fact that Bernie is also calling for an increase in the minimum wage to $15 an hour, which would (according to the well-respected Citizens for Tax Justice) increase the take-home pay of those at the bottom by almost $1,500 a year, on average.
2. Bernie’s plan would cover the estimated 2.9 million poor adults now ineligible for Medicaid because they live in states that didn’t expand the program under the Affordable Care Act.
3. It would also cover the 8.8 million now eligible for Medicaid but haven’t signed up. They wouldn’t have to sign up under a single-payer plan.
4. Bernie’s plan would eliminate the huge co-payments and deductibles now paid by many lower-middle class workers.
Considering all this, lower-income Americans would come out way ahead with Bernie's economic plan.
What do you think?

[libtodeath]

33. Medicaid is largly funded by local property taxes so Bernies plan would eliminate that need

This helps everyone.