PLEASE stop saying (or wishing) that "You can keep your coverage"

[ProfessorPlum]

I address this mostly to Harris's recent health care proposal, but it goes for everyone on here or on the debate stage when it comes to the implications of Single Payer, Universal Coverage.

Most people who have insurance have it through their employer. And so, in a world where a government plan exists along side of private plans, it would make a world of sense for employers to stop their fight with insurance companies on skyrocketing premiums and reduced coverage and just let their employees go on the government plan.

And in any case, the decision to "keep your coverage" is one that employers will make, not their employees.

Further, the people who actually do choose and buy their plans independently may or may not get to "keep their coverage", because "their coverage" changes every year depending on the whims of the insurance companies.

so, really, how employers and insurers react to a public option will determine who can keep their coverage. Not the consumer.

It's a dumb talking point - I get that they are trying to allay fears, but they need to be more honest about it.

[DemocratSinceBirth]

1. The larger debate isn't between

The larger intramural debate isn't between those who favor a public option and those who don't but between those who favor a public option and those who favor putting everybody under one government plan.


As long as everybody has the same coverage as everybody else I don't care how we get there as long as we do.

[MyOwnPeace]

2. Well,

it was like the Senator trying to explain it to Tweetie last night - "but who's gonna pay the taxes........ they'll rise, right?"

Look, SOMEBODY pays for something everywhere. It would change WHO is paying for the coverage, and hopefully allowing more control of costs and expenses, while reducing the costs elsewhere.

[ProfessorPlum]

9. I like the frame that "private taxes go way down and public taxes go up a little"

with private taxes being your copays, premiums, and deductables

[stonecutter357]

3. just let their employees go on the government plan. HELL NO !

HELL NO ! HELL NO !

[Buzz cook]

6. The employees will have no choice

Even in the current situation, it isn't the employees that pick the coverage, its the employer.

The only exception is with a strong union and even there coverage is negotiated with the union not picked by the union.

[Amimnoch]

17. Why not?

Setting up a healthcare for all/medicare for all plan could work best that way.

Right now, those on medicare alone really don't get great benefits unless they happen to be very healthy and have very little actual use for it. Getting into a supplemental plan during annual open enrollment for the vast majority provides the most bang for the buck. Getting into a BlueCross/BlueShield, or Humana or other 3rd party handler that's a HMO or PPO that also adds in certain features that case-by-case beneficial such as vision, or dental, or prescription drug plans, all available at MUCH lower monthly cost plans than what it would be without Medicare.

Allowing businesses to continue to provide tailored programs for their employees using the same model seems the smartest way to go, and best of all worlds:
1. Allows employers to setup the same, or even better structure they have to their current plans now, at a MUCH lower cost to the employers and employees since most of the benefit coverage will now be handled by the federal program.

Amount that the employer has to pay goes down. Amount that the employee has to pay goes down, and may even be incentivized to no employee payment paycheck reduction at all. co-pays and annual deductibles will go WAY down for the vast majority even if kept at the Medicare plan levels.

[Buzz cook]

4. People are neophobes

THey want certainty and familiarity in their lives.
I agree that "keeping your coverage" is a looser. especially because of its association with the ACA roll out. But what is the alternative? What snappy phrase or sound bite is going to reassure people who are nervous about change?

[ProfessorPlum]

10. It's a good question that you ask

How about "cradle to grave coverage that you can never lose, never be kicked off of, covers medical, dental, and vision, and costs nothing when you go to use it".

that is a reassuring idea to me, but I think you make a good point about people's nervousness.

[Buzz cook]

14. We also have people good at stoking up fear

And a media that will enable them.

What about, you won't have to worry about some bean counter refusing your child cancer treatment?

[Demsrule86]

5. They need to drop MFA...and start working on ACA...the only health care plan we are likely to have

for decades and popular...smart. It insures those who need not everybody...so keep the ACA and offer a public option to those in states that did not expand medicaid.

[Chemisse]

8. I agree, only keep expanding the public option.

And reducing the role of private insurance over time.

We don't need to get there in the snap of a finger, especially if trying to do so could cost us the election.

[Buzz cook]

16. 4 years is not a snap of the fingers

That's how long the Medicare for all roll out would be.
https://www.npr.org/2017/09/14/550768280/heres-whats-in-bernie-sanders-medicare-for-all-bill

Or two years for the Jayapal plan.
https://www.vox.com/policy-and-politics/2019/2/26/18239630/medicare-for-all-pramila-jayapal-bill


Don't misrepresent the facts.

Here's a fact you might like to know. One of the most effective things about the ACA was the Medicaid expansion.
https://www.kff.org/medicaid/issue-brief/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-march-2018/

National research found that there were no significant increases in spending from state funds as a result of Medicaid expansion and no significant reductions in state spending on education, transportation, or other state programs as a result of expansion during FYs 2010-2015.307
A Louisiana annual report on Medicaid expansion reported that expansion saved the state $199 million in FY 2017 due to multiple factors, including the higher federal match rate for Medicaid populations that were previously funded at the regular state match rate, additional revenue from a premium tax on managed care organizations, and a decrease in state disproportionate share payments to hospitals as the uninsured population decreased.308

In other words the "free stuff" is saving money.

One analysis found that in 2014, among those states reporting both spending and enrollment data, spending per enrollee for the new adult group was much lower than spending per enrollee for traditional Medicaid enrollees.320
A June 2017 study showed that per enrollee Medicaid spending declined in expansion states (-5.1%) but increased in non-expansion states (5.1%) between 2013 and 2014. Researchers attributed these trends to the ACA Medicaid expansion, which increased the share of relatively less expensive enrollees in the Medicaid beneficiary population mix in expansion states.321

Not giving away that same free stuff cost other states money.

[Demsrule86]

20. I agree about the public option which competes with insurance...but I believe we will have insurance

in our universal plan like France, Germany and Switzerland off the top of my head...there may be more. There are fewer single payer systems than hybrids...like the ACA will become.

[Kurt V.]

7. good point.

[brooklynite]

11. Saying "your employer will take away your coverage"...

Isn’t a batter argument to make than “the Government will take away your coverage”.

[Midnightwalk]

12. It's partly about time frame

Proposals, such as medicare for all, that push to eliminate private insurance make it plain what the goal is but also set up the attack that you “ can’t keep your plan/doctor”. The attacks will have to be addressed both before the plan is enacted but also after and even after the provisions take effect. Those attacks will be used against Democrats and if successful against the plan.

Proposals like buy in delay the issue. Some employers would like the option of pushing their employees into the buy in if it is cheaper for the employer. Large companies have self funded plans that are administered by private insurance companies so the buy in cost would have to be less than the internal cost plus admin cost to make sense. I think that’s possible.

As an employee I might opt for that or might want to pay more to keep my doctors in the current plan.

One thing buy in has to address at some point are the low wage workers who are currently screwed by employers who limit hours to avoid having to provide insurance.

It isn’t clear what the market might look like 5 or 10 years after the provisions kick in. If single payer saves as much money as believed we should see some of that benefit with buy in which makes further steps to push people to “MFA”. If the implementation is shaky at least we might stay in power long enough to fix the problems.

I like being able to make some big improvements over the next 5 years and then start working on the next steps that make sense. We should also be pushing for prescription price reform independent from the other parts of the plan.

[comradebillyboy]

13. You want Swedish style welfare benefits you have to pay

Swedish style taxes. Hello 20% VAT on all sales in addition to local sales taxes. Hello much higher income taxes.

[ProfessorPlum]

15. not necessary

taxes may go up some. But the truth is our government is already paying as much for healthcare per capita than countries with great single payer systems. And then we have the private payments on top of that. VAT and sales taxes are grossly regressive and are not a great way to fund things.

[comradebillyboy]

18. Just reporting on what I saw in Sweden and Denmark.

I can either believe Bernie's rosy projections or look at what the European countries actually do to finance their health care systems.

[SouthernProgressive]

21. The employer/health insurance connection is toxic for many reasons.

The reasons increase every year as we move away from pensions and employment stability.

Change scares people. Honesty is a must.

[Uncle Joe]

22. Kicked and recommended

Thanks for the thread ProfessorPlum.