The way forward is *Medicare Extra*. Neera Tanden's "Social Contract for the 21st Century"

[Budi]

A New Social Contract for the 21st Century
It is high time to rethink the relationship—the basic bargain—between the individual, companies, and our government.
BY NEERA TANDEN FROM JUNE 23, 2020

Tanden on Health Care Policy:

SNIP
"We have the ability to provide health-care coverage to all Americans, while at the same time ensuring that people can keep private insurance through their employer if they wish.
The way forward is *Medicare Extra*, a program that would set up a public insurance option via Medicare that would provide much more affordable health care, with coverage for dental, hearing, and vision, all with no deductibles and minimal copays.

The plan would achieve universal coverage, be open to anyone, and would incorporate the ACA and other individual coverage. It would also allow people who work for large employers to keep their coverage if they chose to do so.
For those who are uninsured, as well as those who are currently purchasing insurance through the Obamacare marketplaces, or who are Medicaid beneficiaries or newborns, they would automatically be enrolled in an improved Medicare program, one that would continue to cover seniors as well."
"And this system could be put in place for a fraction of the cost of Medicare for All."
********
https://democracyjournal.org/magazine/a-new-social-contract-for-the-21st-century/

MORE....

BRAVO to the brilliant Neera Tanden.
💙👍


Neera Tanden has developed & offered perhaps, the most across the board, Workable & Cost effective Health Care policy to date.
Building on programs already in place, such as the ACA & by expanding & including Medicare & Medicaid, Tanden has her policy platform narrowed down to details that M4A has yet to present, & at far less the cost..

This defines the future forward careful planning & wonky brilliance of Ms Neera Tanden.

This is why she is perfectly suited for the position at OMB.
President Biden made an outstanding choice with Tanden.

Biden's recent staff & appointee selections along with VP Harris are indeed the face of the future of our Democratic Party.

These women don't just Talk the Talk.

Thank you President Biden.

[sheshe2]

1. No wonder 'some' don't like her.

These women don't just Talk the Talk.

"Neera Tanden has developed & offered perhaps, the most across the board, Workable & Cost effective Health Care policy to date.
Building on programs already in place, such as the ACA & by expanding & including Medicare & Medicaid, Tanden has her policy platform narrowed down to details that M4A has yet to present, & at far less the cost.."

[questionseverything]

3. I read the article and didn't find the cost,just that it was less than m4a

Do you have a link that talks cost?

[Budi]

7. I can look for it. The article is an overview of her visions & policies...

It was compiled in June , 2020.
I would like to see the difference in cost also.

Will have to do a search for the details of NT's Health Plan.

[questionseverything]

11. In general, allowing the private insurance industry to oporate

Just keeps that much more money out of the public system but

If that compromise makes people comfortable to accept more public healthcare it might work

All depends on the details

[not fooled]

14. +++++++++++

agree. Apparently more saleable; Devil in the details...

[George II]

17. Currently the "private insurance industry" administrates a good part of Medicare....

The government could never handle the magnitude of people who are signed up to Medicare.

[ehrnst]

19. In nearly all countries with universal health care, private insurance companies play a part.

Either in the administration of health care coverage, or in the coverage of such things as Dental, rx, etc.

It's like the many other tasks and services that governments contract out to the private sector.

[Budi]

4. Yup. This is what NT's been doing while others were campaigning for the Primary & General

This is what NT was doing while some were busy yelling slurs on social media.

Ms Tanden was working on the details.

This tells much about why Neera Tanden is meticulous about her policies & why she is respected among her peers:

Link to tweet

[Cha]

2. Thank you, Budi, for Neera Tandan's

article on this from way back in June!

[Budi]

5. Yup. She's been dedicated to fine tuning the Health Care issue for a long time.

I admit, I had no idea this woman was so impressive with her future visions & the depth of consideration until I read the article at the link in the OP above.

It is a remarkable but lengthy look at who she is.

[Cha]

6. Great! I just know & like her

from Twitter.

[Budi]

8. Me too. Her bio is quite a story as well.

I see how her early years developed the determination & why she takes no bs from the sideline.

Another stong smart woman of the Biden/Harris family.

[Cha]

12. "Another stong smart woman of the Biden/Harris family."

I love that about her!💙

[gab13by13]

9. Repugs are already saying,

they won't confirm her.

[Budi]

10. Of course they are & they come with a whole list of reasons which actually make them sound like the

..like the liars & hypocrites thy are.

Will be interesting to watch how the nominations go, unless Georgia delivers McConnel's walking papers.

A lot of tense moments coming up & Georgia could still present a complete turn of events.

I think the Senate Repubs would like to vote down most of Biden's picks because they're just shitty people with too much power. 🤨

[LudwigPastorius]

13. No wonder they're scared shitless of her.

McConnell and the other Senate GOP scum will probably spike her nomination.

[SunSeeker]

15. K & R

[brer cat]

16. K&R

[Gothmog]

18. K&R

[marie999]

20. There are 145 million people on Medicare, Medicaid, or VA healthcare.

That does not include people who are not on one of these three but still receive healthcare through county programs. That is over 40% of Americans. As a nation, we can afford to have everyone receiving healthcare.

[ehrnst]

21. That's what the ACA, when fully implemented has always had as a goal.

What are you referring to when you say "county programs?"

Also, where did you get the 145 million number?

[marie999]

22. We have a county program in Onslow County, NC. I know people who can't get Medicaid

who go to the free clinic in Jacksonville. A woman we know just had an MRI done at no charge at the hospital. She also has a primary care doctor and her medications are either free or very cheap. We also have a male neighbor who has diabetes and seizures and even though he has gone to court with his medical records they still won't give him SSI and he goes to the free clinic. I added up all the people on Medicare, Medicaid, and VA. The number might be slightly high because some disabled veterans have both VA and Medicare.

[ehrnst]

24. So you're talking about local free clinics, and individual hospital charity, not a system.

Hospitals charge more to others to make up for the costs of care for those who they can't bill.

Again: Where did you get the numbers that added up to 145 million?

Does that take into account those people who are dual eligible or utilize all three, or are you gathering those population numbers from separate sources?

[marie999]

25. I used Statista for Medicare 61 million and Medicaid 75 million, and the VA Healthcare 9 million.

Yes, some are probably on 2, but not 3. If a veteran is in the VA healthcare system they may also be on Medicare, but would not need Medicaid. The free clinics and hospital are partially paid for by the county and the free clinics are partially staffed by volunteers. My VA doctor retired and is now volunteering at a free clinic. I found that 12 million people are on both Medicare and Medicaid so the total would be 133 million or 40% of the population. Also, 2.2 million veterans and their families are on VA Tricare. It is hard if not impossible to find out how much single-payer would cost the government since all groups seem to use different numbers to come up with the total. Leaving out the fringe groups it seems to be between savings of $600 billion or an extra cost of $500 billion. I am not an economist but it seems that much of the savings comes from cutting out the middleman, insurance companies. I don't know what companies would do if they did not have to pay insurance companies. Since they are not altruistic, I don't know how many would increase what they pay employees. It is my personal belief that it can be done without raising taxes on the lower or middle class and not a large increase on the upper class.

[ehrnst]

26. I know four people who are on all three.

One in South Carolina only uses TriCare for glasses because she's not near a facility, so she relies more on Medicare and Medicaid, and my Grandfather juggles some health care locally with Medicare and Medicaid, and has some procedures at the VA hospital an hour's drive away.

One basis for the funding mechanism for Medicare is that the vast majority of those funding it are not eligible to use the services. That would change if everyone was put on it.

So your claim, "We can afford" to move everyone, based on this 40% number, to it isn't quite accurate or based in an understanding of how Medicare and Medicaid are funded. You state that you aren't an economist, and you make declarations on complex economic issues based on "it seems..." and "a personal belief." It's important to understand what you don't understand.

Medicaid is primarily administered at the state level, much like Canada, so the affordability and access to care of it varies widely. The vast majority of countries with universal health coverage do not use single payer, but a hybrid of payers and administrators, usually involving some involvement by private non-governmental entities.

Much of the savings involves cost controls, and it's much easier to hold down costs over a period of 75 years than it is to cut them to get to that rate in 4 years despite the promises of politicians running for office. One cost is the negotiation process for insurance companies to determine their discount.

One example of cost cutting is Maryland's "one price for everyone" las that requires hospitals and providers to charge one price to everyone - large pools, Medicare, small pools and individuals, eliminating the expense of negotiating. That has brought down prices without harming health care delivery.

"I am not an economist but it seems that much of the savings comes from cutting out the middleman, insurance companies." "It is my personal belief that it can be done without raising taxes on the lower or middle class and not a large increase on the upper class."

Every country with universal health care coverage utilizes private entities to provide some health care cost administration. They are heavily regulated, however, they are government contractors used when the government does not think they can perform that function efficiently. Canada relies on private companies, as does Medicare does to administer dental and other insurance coverage. Canada also didn't go single payer federally until all the provinces had done so independently, which took decades. Then in the 60's, a very liberal government added a federal layer to make it portable, but they were still tweaking and updating it in the 80's. That's not going to happen here, as the failures of Vermont, Colorado and California to implement their own single payer has shown. It's still run primarily at the province level, and not at the federal level like Medicare, or the proposed Medicare for All - and doesn't cover nearly the services that M4A promises to, and they still pay around 10% of their income on out of pocket health expenses. Promises and opinions always work perfectly until they are put into action.

Health care reform is far more complicated than some politicians would have you believe, especially when they are running for office. This explains it better:

https://khn.org/news/democrats-unite-but-what-happened-to-medicare-for-all/

[betsuni]

23. K&R