The ONE PAGE Health Care Bill

[tucsonlib]

"Beginning January 1, 2010, all Americans will be eligible for Medicare coverage from the moment of their birth."



Problem solved.


:fistbump: :party: :headbang:

[berni_mccoy]

1. .

[county worker]

2. Did you forget the pesky detail of payment?

You can make everyone eligible but if you don't pay the providers they won't treat you.

[tucsonlib]

3. What Are You Talking About?

You show the provider your Medicare card. The provider bills Medicare. Medicare pays the provider.

:shrug:

[bluestateguy]

4. We would have to raise payroll taxes

How much I don't know.

[emsimon33]

7. Different countries handle this different ways

Some have you pay your premiums to the government; some cover the costs through higher taxes; some... .

[MrMickeysMom]

18. Here's the reason you and everyone else does not know...

The CBO has not even BOTHERED to score the real cost of single payer (Medicare for All) health care.

They have thus far REFUSED

Why?

Because when Mr. and Mrs. America pay into at a slightly higher payroll tax percentage, they not only enroll and continue under the original model for Medicare, but costs are then spread out over a much higher number of Americans, thus taking the burden off employee health negotiated plans. This should allow business and governments to do what they do, minus the estimated 30% of cost as employee health benefits. Yes, let's here it for businesses going into business, employ US, please!!!

Medicare is already publicly funded and privately administered through a payroll tax which allows it to operate a lower cost when it's needed. We all pay into this model and it works efficiently if you leave it alone.

So under the M for A model, so many Americans would then be covered, which offsets one of the worst contributers to our HIGHEST associated health care costs - emergent and intensive care. If you are using health care AS IT SHOULD BE USED, all would drastically be reduced. Has the CBO done the costs estimates? FUCK, NO!!!

WHY?

Beat your congress critters' fucking doors down and drone this into their ears until they hear what is being said by most of us. WE COULD enhance the number of things contributing to wellness under a M for A model. We could reduce lifestyle diseases by introducing something they pretended to do during tricky Dick Nixon's time... HEALTH MAINTENANCE!

[county worker]

8. Where does Medicare get the money?

[hunter]

19. Probably from the sudden rise in taxable income all across the United States.

It might create a tsunami of real money once we were freed from the bondage and inefficiencies of the present U.S. healthcare system.

[MrMickeysMom]

21. You're making the point...

... and here's the rhetorical question.. So why hasn't the Congressional Budget Office scored the cost of providing Medical for All?

They don't want to score it because it's right in front of their faces... So, instead we get this implied, "lah-lah-lah.... I can't hear what the American people are saying..."

I agree, it would create a rise in taxable income.

[truedelphi]

26. When almost anyone over the age of forty five is looking for work

They find that it is much harder to find a job - if the people hiring can hire anyone younger, the company will be better off as the premiums will be lower.

So a whole segment of the population is without work due to the health insurance as we know it situation.

And IIRC, GM and other major employers shipped jobs out of the country,as they found the cost of providing for worker's health to be problematic.

Universal SIngle Payer Health Care would change all of that and give a lot more taxable income.

[MrMickeysMom]

28. Good point!

By the way, I'm hoping those reading this thread will join in calling their congressional rep and senators to get CBO to score single payer (which I'm clarifying as Medicare for all, since sometimes Universal is not synonymous with SP.)

[county worker]

32. The cost you pay for health insurance and heath care come after tax not before.

You may have more disposable income but not more tax able income. The deduction for health care costs doesn't cover the costs we pay.

The only increase in taxable income would be from employers who no longer deduct health insurance costs from their taxable income. That isn't going to raise enough money to pay for health care for all.

[hunter]

37. Say what?

More disposable income = more people spending money = more taxes.

Imagine if all of the sudden health care was decoupled from employment, and imagine management costs for actual health care providers suddenly plummeted 70% or more. Then imagine our government reigning in the pharmaceutical industry, forcing them to spend their surplus on research for things that matter, and not on advertising.

U.S. productivity would soar, easily absorbing all the workers displaced by the change, and people trapped in inappropriate jobs or unemployed by the circumstances of their health would be able to put their greatest skills and talents to work.

[MrMickeysMom]

20. See post #18 eom

[county worker]

33. There is not enough real explanation there to make the point.

It may be true but I doubt the CBO has sinister motivations to block medicare for all. Sounds more like a conspiracy theory to me.
So many of us take these kinds of things as truth because they fit the idea that single payer is the best and only thing out there.


I would really hate to see us vote for single payer without really investigating the possible outcome 100%. Believing that there is some reason or other to not look at single payer because congress owes its allegiance to the insurance lobby is not a good enough reason for me to be behind it. I would like to see real facts that I can take to the bank before I sign on to it. It just does not make common sense to through out everything we have and bet on the idea that single payer will take care of this nation's health care issues. We have not done enough study on single payer and looking at Canada or the Europeans does not answer our questions.

It makes more sense to me to go with a public option and improve health insurance coverage as we now have it as a first step. That way we all get covered and we can then have time to really examine single payer.

To just pass a law to dump all private insurance and the whole country go on single payer is just a really naive and foolish idea.

[MrMickeysMom]

40. You may think it's naive and foolish...

to pass a law to "dump all private insurance", and you'd be right. Where did you get that idea?

While you're answering that, where did you get the idea there are sinister motives from the CBO to not score a single payer model? Is that an assumption of what comes with that model of health care? What if the form of single payer or a Medicare for all assumes it acts as it does now? You sign up for Medicare either way. So, who's dumping private insurers? Are you saying private insurers can't compete with Medicare? The reimbursement system of care in private plans are patterned after Medicare diagnostic groups and procedural codes already. Medicare has set the pace for most private insurers' plans, so what makes you think the nature of health care delivery systems would not mimic it the same way when it starts behaving like a real health care delivery system? The entry of patients into health delivery SHOULD be changed under Medicare. There is much to fix. This is a pretty damned good way to open the door and DO IT.

You also say you'd hate to see (us vote?)for single payer, which I guess means you would like Congress to act on behalf of most Americans who favor single payer systems. Then, you say we couldn't do this WITHOUT INVESTIGATING the possible outcome 100%? Huh? How does one get a POSSIBLE outcome that will happen 100% of the time? I don't understand where you were going with that one.

If you MEAN we need to investigate the possible outcome to based on all the possibles, then wouldn't you then want it to be scored as the CBO has done with other models? That was my point. The Congressional budget office has not bothered to score the one thing that is right in front of everyone's face. I don't know why they haven't. I don't know if there is pressure from the insurance industry NOT to. That doesn't mean there is some type of conspiracy, that means that CONGRESS has not pushed the CBO to SCORE IT! Congress is supposed to represent their constituents, so why don't you act like one and ask you congressperson if they would? There's a way to find the answer to that.

I agree some public option on the way to improving the delivery of health services is appropriate, but the naive and foolish thing IMO is NOT to compare EVERY MODEL WE HAVE, especially the system that is right under your nose.

[LWolf]

22. As explained on Conyer's site:

<snip>

First, switching to a single-payer system will lead to billions of dollars saved in reduced administrative costs. Those savings will be passed on through the system and allow coverage for all Americans. Additional savings in the overall cost of health care will come from annual reimbursement rate negotiations with physicians and negotiated prices for prescription drugs, medical supplies and equipment.

Second, a "Medicare For All Trust Fund" will be created to ensure a dedicated source of funding in addition to annual appropriations. Sources of funding will include:

• Maintain current federal and state funding for existing health care programs
• Closing corporate tax loopholes
• Repealing the Bush tax cuts for the highest income earners
• Establish employer/employee payroll tax of 4.75% (includes present 1.45% Medicare tax)
• Establish a 5% health tax on the top 5% of income earners; a 10% tax on top 1% of wage earners

http://www.johnconyers.com/hr676faq
• One quarter of one percent stock transaction tax

[county worker]

34. My reply

"switching to a single-payer system will lead to billions of dollars saved in reduced administrative costs"

What administrative costs will be saved? The administrative cost of private insurance? How then does that become income to a single payer system? There is no relationship there. Cutting our private insurance administrative costs does not result in money to pay for single payer.

Also, setting up single payer would mean increasing the administrative burden that something like Medicare has. Medicare administration is farmed out to private corporations. Single payer would mean even more administrative costs to be farmed out to even more corporations who operate at a profit. So administrative costs to the government would increase not decrease.


"overall cost of health care will come from annual reimbursement rate negotiations with physicians and negotiated prices for prescription drugs, medical supplies and equipment."

First of all, if there were a single payer there would be not need for negotiations since the suppliers would have no leverage to negotiate.


Also no one would provide the service or supplies at a loss. If the negotiated price is not enough to make a profit the companies would not provide the service or supplies.



"• Maintain current federal and state funding for existing health care programs"

This does nothing to increase revenue to pay for single payer

"• Closing corporate tax loopholes"

This does not necessarily bring in more revenue to be spent on health care, it would go into the general tax revenue fund to be spent on anything. Also it could be overturned by a Republican administration.

"• Repealing the Bush tax cuts for the highest income earners"

This does not necessarily bring in more revenue to be spent on health care, it would go into the general tax revenue fund to be spent on anything. Also it could be overturned by a Republican administration.

"• Establish employer/employee payroll tax of 4.75% (includes present 1.45% Medicare tax)"

This is one idea that would increase revenue but it would also result in less after tax income to workers and more labor costs to business who may hire less because of it.

"• Establish a 5% health tax on the top 5% of income earners; a 10% tax on top 1% of wage earners"

This could easily be overturned by a Republican administration and then the revenue would be lost or would have to come from somewhere else. Personally I don't think it is right to pass the cost of all our health care on to a single group. I would rather increase all tax rates to some extent.

[LWolf]

38. Take a look at the reality.

<snip>
The Congressional Budget Office projects that single payer would reduce overall health costs by $225 billion by 2004 despite the expansion of comprehensive care to all Americans. No other plan projects this kind of savings.

http://www.pnhp.org/facts/what_is_single_payer.php

<snip>

Financing

We propose an equitable financing program in which everyone pays their fair share. Under this program, all employers and employees will pay a modest payroll tax. This will produce a dramatic savings for those responsible private employers and state and local governments which currently purchase health insurance for their employees. By drawing on the immense wealth that has accrued to the richest Americans and large corporations over the past 25 years, 95% of all Americans will pay less for their healthcare than they are currently paying. Some of the key components to financing HR 676:

* Eliminates all employer contributions to private insurance premiums—replacing them with a modest payroll tax of 4.5% (icludes the 1.45% currently paid towards Medicare).
* Eliminates all individual premiums, co-pays, deductibles and nearly all other out-of-pocket costs—replacing them with a modest payroll tax of 3.3% (in addition to the 1.45% currently paid towards Medicare).
* Relieves state and local governments of the immense burden of paying insurance premiums for medical coverage for their current and retired employees—replacing them with a modest payroll tax of 4.5% (in addition to the 1.45% currently paid towards Medicare).

http://www.healthcare-now.org/hr-676/whats-single-payer/

[Occam Bandage]

15. How does Medicare pay the provider? From the Magic Medicare Money Machine? nt

[MrMickeysMom]

24. It's called a payroll tax, and it works quite well, and would work better...

... if the source of that supplement (yes, supplement- it runs in the blue, if it's not borrowed from) were left alone.

There is no "magic" here. Ask yourself why the Congressional Budget Office hasn't bothered to score the cost of providing single payer health through that Medicare for All model.

Then, ask you Congress critter and US Senators to request the CBO score it. We'll have a real conversation then.

[librechik]

6. There are a variety of ways to pay for it--but that is a mere detail.

Make it simple--Medicare works. Let's give it to all citizens of the US.

(HR 676--call your congress person and demand this!)

[county worker]

9. Billions of dollars is a mere detail?

We are just going to give everyone the medicare they need and paying for it is a mere detail? I think it is the most important detail!

I can't believe you are serious.

[slipslidingaway]

16. Cost is an important detail - why spend all those billions on profits...

exec salaries, dividends, marketing, lobbyists, administrative costs instead of health care?

Estimates vary widely with the low end being about 300 billion and going much higher.

[bornskeptic]

25. The 2009 budget allocated $408 billion to Medicare, to cover 45 million enrollees.

That is about $750 per month for each person enrolled. How much do you think it would cost to add coverage for 225 million more people? $300 billion saving on private insurance costs is unrealistic anyway, since the annual total of private insurance company administraive costs and shareholder profits is only slightly over $100 billion. However, even if the $300 billion figure were correct, it wouldn't come close to covering the cost of insuring everybody.

[anigbrowl]

11. It's kind of an important detail

unfunded, open-ended commitments have a way of ballooning in cost. I do think single-payer is the right approach and that medicare is the ideal starting point, but it needs a lot more planning than just a congressional say-so.

[Occam Bandage]

14. Way to live up to the RW stereotype of liberals.

This is how RWers prefer to paint policy discussions:

LWer: "Wouldn't it be great if we could just give tons of government freebies to everyone?"
RWer: "How will we pay for that? I mean, the money's got to come from somewhere."
LWer: "Whatever. That's not important. What's important is the government can give us free stuff."
RWer: "But it's not free. We have to pay for it, the government is just a regulatory body determining what goes where. We can't just vote ourselves free stuff. We have to pay for it too, and if we don't even determine what we're going to be paying for, how can we ever..."
LWer: "Details, details. Gimme free stuff."

Of course, the truth is that Democrats are just as concerned about responsibility as Republicans are, if not more so. We like government programs in some situations because the free market isn't capable of safely and efficiently providing absolute necessities requiring major investment like roads, like police, like fire departments, and like hospitals. Unfortunately, it seems there are indeed quite a few liberals happy to fulfill Rush's portraiture of them as inhabiting a dreamworld where a trillion dollars is a detail.

[county worker]

31. Sometimes I am embarrassed to have some right wingers come here are read those kinds of posts you

describe. They really gives us a black eye. I'm glad others notice it too.

[librechik]

35. Singe Payer would save 400B per year. Rolling back Bush taxcuts for rich

would pay for half. The fact is, as we speak all but 1 third of the program is already offset. So, realistically speaking, let's add a 1% surcharge to everybody's medicare tax.

We are the richest nation in the world. We can pay for it, seeing as how we can afford to send troops to Afghanistan.

Let's stop the war on drugs. That would pay for it neatly.
Let's tax corn syrup drinks and fatty food one cent per item.
Let's cancel the F-22.

There are lots of ways to pay for the program. All we need is a nation- wide commitment to make it happen.

AND I DON'T GIVE A FUCK HOW RW'ERS FEEL WHEN THEY VISIT OUR BOARD AND GASP FIND LIBERALS WHO DARE TO DREAM THAT WE CAN BE BETTER AS A NATION.

It's reward enough for me that it embarrasses you, dear Occam. Great to spar with you!

[emsimon33]

5. How about before they are born? Some babies need care in the womb.

[GrantDem]

10. That would be prenatal care and would be under the mother's coverage.

[Occam Bandage]

12. How do you fund it? Medicare/Medicaid currently take up 23% of the budget.

Are you not planning on reworking/streamlining the claims, coverage, reimbursement, provider costs, and direct consumer costs of Medicare? What about prescription drug coverage; are we just going to use part D as it is? Is enrollment automatic? Are we going to allocate any funding towards ensuring Medicare can handle the massive increase in workload? Is the Medicare framework even capable of withstanding such an enormous and immediate expansion? Medicare spending is expected to double in the next 40 years as a result of an aging (and longer-living) population and increasingly expensive care; is it financially feasible over the long term to increase the program with only a short-term tax increase to cover costs?

"Let's give Medicare to everyone" is a good jumping-off point. It isn't a good ending point. Bills are ending points, not jumping-off points.

[LWolf]

23. see post # 22. nt

[SOS]

39. How to cut health care costs in half, saving $1 trillion per year:

Copy the Swedish system.

Sweden insures every Swede from prenatal to grave.
This includes dental, vision, prescriptions and nursing home care.

Sweden spends about $3,500 per person, per year.
The US spends $7,000 per person per year (with 46 million completely outside the system).

Swedes live longer too. Life expectancy in Sweden is 80.5 years vs. 78 here.

Copy the Swedish system in every detail.
$ 1 trillion saved every year, every American covered.

[slipslidingaway]

13. knr +1 n/t

[SeeHopeWin]

17. Do I have to get pre-authorization from anyone? Should my Primary Care Provider give me a referral

to see a specialist?

How do we handle x-rays?

[BlooInBloo]

27. Wow. People really do think it's just a magic wand, that one sentence can cover.

[Freddie Stubbs]

29. Except that some will not be able to, or will refuse to , pay for the premiums

[truedelphi]

30. I have to admit it:

Your one sentence ROCKS!!

Have you thought about a career in politics somewhere like Iceland or Denmark, where such intelligence would actually be utilized?

Anyway

:yourock:

[county worker]

36. I'm sure Iceland and Denmark give things a lot more thought than the OP does.

Give those countries some credit for having some intelligence please.

[MrMickeysMom]

41. Perhaps you've overlooked some of the referenced material behind the OP

We've been pointing you in the direction of that post... read Conyer's HR 676.

Reading and thoughtful debate is a good thing. Whether you end up thinking that a public option is better, or where the savings is to be realized with a Medicare for All model, as long as you ask and think, it will lead somewhere.

But if you think Iceland and Denmark are mutually exclusive from the concept of a national health service discussed in this thread, then think again. Both ideas thrive on the concept of a healthy citizenry being good for the country and its gross national product.

[Odin2005]

42. +1