Concerning healthcare coverage, I think Biden had the

[wasupaloopa]

right idea last night.

Back when we were all cheering for the ACA to become law we were for adding a robust public option.

We didn’t get it then but we could get it now if we win big in 2020.

Adding a public option on to the ACA is the fastest route to universal health coverage. Also automatically adding those who cannot afford insurance covers the poor.

Many people like their current employer insurance.

People prefer choices to being forced into something.

M4A is not even defined yet but we act as if it is ready to go when we take over Congress.

To some it is “free” health insurance. To others it is the current Medicare expanded to cover everyone.

Sanders and Warren tell us over and over what the problem is and their solution is an undefined plan that isn’t even on the drawing board yet.

Harris’s idea is similar to Biden’s. Those ideas would help add independents to our side.

[Hoyt]

1. I bet if a Public Option had been enacted in 2010, 70%

of non-Medicare/Medicaid eligible people would have selected the PO by now.

That assumes it is as good as we think, significantly cheaper than private insurance, and employers would have increased salaries or continued their contributions for people selecting PO, and the PO was not subject to political whims.

[wasupaloopa]

3. True we don't know what the public option looks like yet.

[questionseverything]

4. that is the big trouble...how much does this public option cost?

the aca is ok for those that qualify for Medicaid (altho there are co pays for specialists in Illinois and whr poor folks are suppose to get that money I don't know)

but for the older folks working the prices are horrid....at my age if we make 52 grand a year it is 18 grand for a crappy policy with a 7 grand per person deductible

reminds me of something my dad used to say,.....be careful what the govt thinks you can afford

[Hoyt]

5. That's the beauty of a PO, you'd see the premium and decide whether you want it or keep

what you have.

My guess is it would be a little bit cheaper than a comparable private health insurance plan, but not more than 10 or 15%. I bet Medicare-for-All is going to cost similarly either in premiums or taxes. But, there would be subsidies for people at certain income levels, just like under ACA.

Now, long-term, under a PO or Medicare-for-All, fees will be ratched down to levels paid in other countries, and profits wrung out of the system. That's a good thing, I think, unless you are a nurse who gets their salary cut when the docs start making less.

[questionseverything]

8. well 10 or 15% cheaper, when 18 grand a year is the starting place won't help anything

the subsidies stop at too low a rate

[Hoyt]

12. I hear you. I don't know where you live, but I've seen ACA premiums a lot cheaper in

my poor state for someone 60 with a relatively low deductible of $2K or so.

There are areas in the country where the ACA plans are very expensive, sometimes it's in high cost areas with high utilization.

I hope we figure some way out of this insurance mess, it's very frustrating.

[UniteFightBack]

2. Don't forget Pete and Amy as well. They did not skip down the garden path either. nt

[wellst0nev0ter]

6. He already had a chance to pass the public option in 2009-10

He blew it. Time to move on.

[betsuni]

9. Public option in the ACA passed Congress, didn't have the votes in the Senate.

Democrats held 60 filibuster-proof votes in the Senate for four months and ten days. Biden wasn't in the Senate then.

[wellst0nev0ter]

11. Do you know what a Vice President is?

President of the Senate, 101st vote. But he couldn't get the public option even with a fucking supermajority.

[betsuni]

13. They had 60 votes for four months and ten days, effectively giving every one of those Senators

a veto. Joe Lieberman and a few others refused to vote for the public option. The ACA saved lives.

[Hoyt]

14. The VP doesn't do much in Senate, other than break a tie.

[wasupaloopa]

15. It is rather telling that you make it Biden's fault. You have no real solution. And I mean real

not talking points!

[Thekaspervote]

16. Spot on!! Thx for posting

[wellst0nev0ter]

17. Biden bills himself as a great dealmaker

Yet he couldn't get the public option in his own democratic supermajority senate

[questionseverything]

10. thats what i say...maybe if we demand m4a...we will get a decent public option

[betsuni]

7. K&R

[Gothmog]

18. Speaker Pelosi-There's no need to reinvent health care -- just improve Obamacare

I agree with Speaker Pelosi https://www.cnbc.com/2019/09/17/nancy-pelosi-no-need-to-reinvent-health-care-improve-obamacare.html?__source=sharebar|twitter&par=sharebar

Democrats should focus on making improvements to Obamacare instead of trying to reinvent the wheel with “Medicare for All,” House Speaker Nancy Pelosi said Tuesday.

“God bless” 2020 Democratic presidential candidates putting forth Medicare for All proposals, Pelosi said in an interview with “Mad Money” host Jim Cramer. “But know what that entails.”

Pelosi’s thoughts on how to improve the nation’s health-care laws appear to align with those of former Vice President Joe Biden, who in his 2020 presidential bid is calling for building on provisions of Obamacare, formally known as the Affordable Care Act.

“I believe the path to ‘health care for all’ is a path following the lead of the Affordable Care Act,” Pelosi told Cramer. “Let’s use our energy to have health care for all Americans, and that involves over 150 million families that have it through the private sector.”

[Gothmog]

19. NBC/WSJ poll shows Biden's healthcare stance (optional Medicare buy-in) much more popular v Warren

Link to tweet

Link to tweet

[Gothmog]

20. Obamacare Has Made People Healthier

Getting rid of Obamacare is a bad move https://politicalwire.com/2019/09/30/obamacare-has-made-people-healthier/

Washington Post: “Poor people in Michigan with asthma and diabetes were admitted to the hospital less often after they joined Medicaid under the Affordable Care Act. More than 25,000 Ohio smokers got help through the state’s Medicaid expansion that led them to quit. And around the country, patients with advanced kidney disease who went on dialysis were more likely to be alive a year later if they lived in a Medicaid-expansion state.”

“Such findings are part of an emerging mosaic of evidence that, nearly a decade after it became one of the most polarizing health-care laws in U.S. history, the ACA is making some Americans healthier — and less likely to die.”

[Gothmog]

21. 73% of people favor [the] public option that would keep private insurance in place

Link to tweet

[Gothmog]

22. Support for a public option has been increasing, and for Medicare-for-All has been decreasing

Link to tweet

[Cha]

23. Thank you, Goth!

[Gothmog]

24. Why Elizabeth Warren won't talk about the cost of 'Medicare for All'

Link to tweet

The elephant in the waiting room remains the staggering cost of this new system. There's a reason why Warren avoids the conversation about how we're going to pay for Medicare for All. In fact, anyone with a pencil and paper and third-grade math skills would quickly figure out that this proposal simply cannot work.

Depending on whom you ask, cost estimates range from $2.5 trillion to $4.7 trillion per year. It's important to keep in mind that the entire federal budget for fiscal year 2020 is $4.7 trillion (including a $1.1 trillion-dollar deficit). Basically, we would have to double the size of the government through higher taxes on every American employee and fundamentally alter the structure of the American economy.....

Medicare for All fans propose to demolish our current health care system that certainly needs streamlining, more competition between insurance companies and plans and new and better technology. Other issues that must be addressed are drug manufacturing and distribution networks and hospital consolidation.

While we desperately need reform, any realistic policy proposal would recognize that 90 percent of Americans currently have health insurance. Instead, reasonable politicians should focus on how to cover those who are uninsured or underinsured in our current system.

[Gothmog]

25. Choices for Financing Medicare for All: A Preliminary Analysis

This is from a non-partisan think group that is well respected http://www.crfb.org/papers/choices-financing-medicare-all-preliminary-analysis

Proposals to adopt single-payer health care in the United States have grown in popularity in recent years, as numerous lawmakers and presidential candidates have embraced Medicare for All. However, few have grappled with how to finance the new costs imposed on the federal government. By most estimates, Medicare for All would cost the federal government about $30 trillion over the next decade. How this cost is financed would have considerable distributional, economic, and policy implications.

In the coming months, the Committee for a Responsible Federal Budget will publish a detailed analysis describing numerous ways to finance Medicare for All and the consequences and trade-offs associated with each choice. This paper provides our preliminary estimates of the magnitude of each potential change and a brief discussion of the types of trade-offs policymakers will need to consider.

We find that Medicare for All could be financed with:

A 32 percent payroll tax
A 25 percent income surtax
A 42 percent value-added tax (VAT)
A mandatory public premium averaging $7,500 per capita – the equivalent of $12,000 per individual not otherwise on public insurance
More than doubling all individual and corporate income tax rates
An 80 percent reduction in non-health federal spending
A 108 percent of Gross Domestic Product (GDP) increase in the national debt
Impossibly high taxes on high earners, corporations, and the financial sector
A combination of approaches

Each of these choices would have consequences for the distribution of income, growth in the economy, and ability to raise new revenue. Some of these consequences could be balanced against each other by adopting a combination approach that includes smaller versions of several of the options as well as additional policies.

[Hoyt]

26. Whew. Don't know how respected that group is, but if the funding sources are anywhere near those

amounts, there will never be MFA in this country without some big changes. That is rather frightening.

I think the projections are a bit high, but still very discouraging. For instance, I think the payroll tax of 32 percent includes Social Security. But even if we are talking about an additional 16 percentage points in payroll tax, there is no way.

I hope CBO will jump in at some point before we get too far into the election.

Thanks for the info.

[crazytown]

27. Win more than the 58 Dems in 2010?

If the filibuster stays the Public Option is DOA. Again.

[Gothmog]

28. A dose of reality for Medicare-for-all

Link to tweet

Now we have two more data points. The quite credible think tank, Committee for a Responsible Federal Budget, comes up with some options assuming a cost of $30 trillion over the next decade (a midway point in the range of estimates):

We estimate the cost could be covered with a 32 percent payroll tax, a 25 percent income surtax, a 42 percent value-added tax, or a public premium averaging $7,500 per capita or more than $12,000 per individual who wouldn’t otherwise be enrolled in Medicare, Medicaid, or CHIP. Medicare for All could also be paid for by more than doubling individual and corporate income tax rates, reducing federal spending by 80 percent, or increasing the national debt by 108 percent of GDP. Tax increases on high earners, corporations, and the financial sector by themselves could not cover much more than one-third of the cost of Medicare for All.

But you say, none of that is remotely feasible politically and would have all sorts of negative economic consequences.

Warren actually has an even harder task since CFRB does not exempt the middle class. Therefore, Warren cannot use “a 32 percent payroll tax, a 25 percent income surtax, a 42 percent value-added tax, or a public premium averaging $7,500 per capita” if they are going to hit the middle class to such an extent that it wipes out savings from removing insurance premiums, co-pays, deductibles, etc. This is the equivalent of trying to balance on elephant on the head of a pin.