Medicare For All Would Save Money

 
bbearren
 
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bbearren
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30 July 2018 17:12
 

Koch-Funded Study Finds Medicare for All Would Save Money While Covering Everyone

Last year I paid $9,341 in income tax.  I paid $19,352 in medical expenses, which includes insurance premiums for my wife which totaled $10,728 (in 2018 they went up to $1,595 per month.  Without the ACA, they would have been well over $2000 per month).  In the 6 months prior to her death, I had paid $9,570 in insurance premiums alone.  Before anyone wants to imply that it would have been less expensive in the “open” market, in January, 2014, her insurance premiums were scheduled to go up to $1,510 per month.  We signed her up under ACA under the identical plan with the very same company for half that premium.

To put that in perspective, my income tax could have been doubled (to cover Medicare for all) and it would still have been a net savings.  Read the linked article.

 
 
EN
 
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EN
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30 July 2018 18:01
 

It makes sense. Medicare is good enough for our Seniors - why not everyone?  But it will be claimed that this is Socialism.  Not really - hospitals can still be privately owned and doctors won’t be working for the government.  There will just be a single payor that will not be taking profits like the insurance companies.

[ Edited: 30 July 2018 18:08 by EN]
 
GAD
 
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GAD
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30 July 2018 20:36
 

Maybe, but probably not really. For me my whole family is covered by my employer insurance, this is premium insurance, pick my own doctor, no referrals,$35 max copay $2400 max family out of pocket and the cost to me is about $500 a month. I’m in the 30% tax bracket double that it’s 60% and no employer is going to give back money (raise your wage) on that savings if they don’t have too, so this plan would cost me 4-6 times more then now.

 
 
Poldano
 
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31 July 2018 01:14
 
GAD - 30 July 2018 08:36 PM

Maybe, but probably not really. For me my whole family is covered by my employer insurance, this is premium insurance, pick my own doctor, no referrals,$35 max copay $2400 max family out of pocket and the cost to me is about $500 a month. I’m in the 30% tax bracket double that it’s 60% and no employer is going to give back money (raise your wage) on that savings if they don’t have too, so this plan would cost me 4-6 times more then now.

You’re effectively bragging and rubbing it in toward all the people who do not have your level of benefits.

Your employer gets a hefty tax deduction for its contribution. That deduction has to cover the personnel department expenses of dealing with insurance companies. Insurance companies cherry-pick the companies that they want to sell to so as to maximize their returns, meaning minimize their risk of paying out too much. That deduction is the positive motivation for companies to offer health insurance. The main negative motivation is that it’s required by federal law for companies above a certain size. The law discriminates directly against employees of smaller companies that are exempt from the law, against companies that are too big to ignore the law but too small to be able to afford the personnel departments to effectively negotiate with insurers, and against companies and their employees that are simply not attractive customers to insurance companies.

The deduction was originally established in the Eisenhower era after it was decided within the government that government-funded universal health care would cost too much. The government put a band-aid on the situation by attempting to fund some coverage for some people through employer-funded insurance. That worked well enough for a while, but has been breaking down over the past several decades as health costs rise. One of the side effects is the increase in “quasi-permanent contract labor”, by which I mean permanent employees without the benefits that permanent employees are legally entitled to. There is growing political movement against the practice, but it will be hard to slow down, much less eliminate, because some of the Democrats largest campaign donors are technology companies and executives who extensively rely on the practice.

Companies that downsize use downsizing as an opportunity to preferentially dismiss employees that are in demographic groups that have proportionally higher costs of benefits, especially health insurance. You may be not old enough or unlucky enough to have experienced such discrimination yourself, but your are by no means entitled to your current state of affairs on account of what a great person you are.

In my own case as a consumer, Medicare is orders of magnitude easier to deal with than any of the health insurers I have previously dealt with. There is almost no issue of finding a provider who accepts Medicare or my Medicare Supplemental, although that may not be true of all supplemental providers. There will always be coverage issues with high-risk cases, non-standard treatments, and health care providers trying to game their own receipts to the detriment of patients, so Medicare cannot be plausibly criticized as exceptional on that basis. A unified payment system might make it even easier to equalize coverage decisions, so that nobody is treated unfairly simply because they picked a bad insurance company.

The first step toward bringing about Medicare for All would be to eliminate the employer deduction in phases, gradually passing the surrendered portion of that deduction into tax credits for employees, at the same time as removing employees mandate to purchase company-provided insurance and replacing it with employer-provided purchase credits. States could help a lot by preventing any insurance company from participating in the group market in their state unless they also participated in the ACA individual market in their state. Eventually, ACA exchanges should become simply a place to purchase supplemental insurance for Medicare for All, rather than an entirely separate insurance marketplace that is hamstrung by being left with those people who the insurers really don’t want to cover.

I’m not sure what the Koch brothers will make of the study. It seems to fly in the face of their Libertarian ideology. Since they don’t seem to have suppressed it, maybe they are thinking that they themselves would be better off if their companies didn’t have to bother with providing employees’ medical insurance. I’m sure a great many employers will come to think that way, especially smaller ones. They will have to fight it out with insurance companies to help make it happen.

 
 
EN
 
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EN
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31 July 2018 04:25
 

If you have a single payor that gives the payor incredible leverage to negotiate rates with health care providers, driving costs down.  Providers then work on their expense side, employing strategies to become more efficient. The big winners will be non-profits who don’t have to pay dividends to shareholders. Mergers will increase efficiencies.  This does not have to prevent people from choosing their own provider - but it probably means that the larger health care systems, who can take advantage of economies of scale, will do better.  If it lowers costs overall I’m for it.  A healthier population with full access to healthcare benefits everyone, just like a well-educated populace with access to good schools benefits all. Like defense, education and health care are things we should do together as a nation, rather than individually.

 
bbearren
 
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bbearren
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31 July 2018 06:21
 

Saying that my income tax could double and I would still come out ahead does not mean that everyone’s taxes must double in order to provide Medicare for all — it would not cost anywhere near that much, but it would require an increase in taxes to a noticeable extent.  However, that increase in taxes would still be a net benefit to most folks in that what they are now spending for healthcare would be reduced to a negligible amount.  My supplemental insurance for Medicare is $111 per month, a huge difference from my wife’s premiums of $1595 per month for less substantial coverage.  I have zero copays.  I have only one routine prescription, and that one has zero copay.  Bloodwork has zero copay.

So that $111 per month for me is all I pay for my healthcare needs.  I would not mind in the least paying higher taxes so that everyone could have the benefit of that kind of healthcare.  From the article linked in the OP, “When crunching the numbers, Blahous’ report found that Sen. Sanders’ plan for single-payer healthcare would provide more than $2 trillion in net savings in the program’s first decade.

As the People’s Policy Project noted, this savings is more than likely an underestimate, as Blahous assumes administrative costs would drop from 13 percent to six percent, when administrative costs for Medicare are actually closer to just two percent.

The new federal expenditures to cover Medicare for All would mean that Americans’ federal taxes would increase. However, when accounting for all the money American taxpayers would save by not paying monthly health insurance premiums, sky-high deductibles, and copays, even the higher federal taxes would mean American households would have more money in their pocket under a Medicare for All system.”

GAD, if that $500 per month you’re paying for healthcare turned into $500 per month in increased taxes instead, would you notice a difference in your pocket?

 
 
Jan_CAN
 
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Jan_CAN
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31 July 2018 06:42
 

Would Medicare for all save money while covering everyone?  Yes.

To provide some comparisons ...

Where I live (Canada), a person making $50,000-60,000 per year pays approximately $10,000 per year in federal/provincial income tax.

Amount paid for medical insurance:  $0
Amount paid for medical expenses:  $0
Determination re medical treatments required:  Made by physicians (not insurance companies)
Choice of physicians:  Made by patient; primary family physician makes referrals to specialists when required
Discussions with physicians regarding cost of treatments:  Never
Payment method/forms:  None – patient shows health card (everyone has one) to health care provider, and voilà, treatment provided

Not covered/exceptions (some people have coverage through employers):
– Dental:  not covered under medicare system; basic care provided for those on social assistance.
– Prescription drugs:  there is coverage provided for some (minors, seniors, low income subsidies) depending on province; there is a move to provide more consistent coverage nationwide.
– Supplementals:  ‘extras’ such as non-prescribed physio, orthopedic footwear, travel vaccines, etc.

 
 
GAD
 
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GAD
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31 July 2018 07:47
 
EN - 31 July 2018 04:25 AM

If you have a single payor that gives the payor incredible leverage to negotiate rates with health care providers, driving costs down.  Providers then work on their expense side, employing strategies to become more efficient. The big winners will be non-profits who don’t have to pay dividends to shareholders. Mergers will increase efficiencies.  This does not have to prevent people from choosing their own provider - but it probably means that the larger health care systems, who can take advantage of economies of scale, will do better.  If it lowers costs overall I’m for it.  A healthier population with full access to healthcare benefits everyone, just like a well-educated populace with access to good schools benefits all. Like defense, education and health care are things we should do together as a nation, rather than individually.

I’m for single payer, not doubling taxes.

 
 
GAD
 
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31 July 2018 07:49
 
Poldano - 31 July 2018 01:14 AM

You’re effectively bragging and rubbing it in toward all the people who do not have your level of benefits.

So I have it to good? I should have to pay 4x more to cover you?

 
 
EN
 
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EN
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31 July 2018 08:03
 
GAD - 31 July 2018 07:47 AM
EN - 31 July 2018 04:25 AM

If you have a single payor that gives the payor incredible leverage to negotiate rates with health care providers, driving costs down.  Providers then work on their expense side, employing strategies to become more efficient. The big winners will be non-profits who don’t have to pay dividends to shareholders. Mergers will increase efficiencies.  This does not have to prevent people from choosing their own provider - but it probably means that the larger health care systems, who can take advantage of economies of scale, will do better.  If it lowers costs overall I’m for it.  A healthier population with full access to healthcare benefits everyone, just like a well-educated populace with access to good schools benefits all. Like defense, education and health care are things we should do together as a nation, rather than individually.

I’m for single payer, not doubling taxes.

I don’t think it would for most of us.  It certainly wouldn’t for me.

 
nonverbal
 
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nonverbal
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31 July 2018 08:54
 
EN - 31 July 2018 04:25 AM

If you have a single payor that gives the payor incredible leverage to negotiate rates with health care providers, driving costs down. Providers then work on their expense side, employing strategies to become more efficient. The big winners will be non-profits who don’t have to pay dividends to shareholders. Mergers will increase efficiencies.  This does not have to prevent people from choosing their own provider - but it probably means that the larger health care systems, who can take advantage of economies of scale, will do better.  If it lowers costs overall I’m for it.  A healthier population with full access to healthcare benefits everyone, just like a well-educated populace with access to good schools benefits all. Like defense, education and health care are things we should do together as a nation, rather than individually.

Yes, costs could go way down if the US were to go single-payer, especially cost of medications. For instance, if the Feds thought a pharmaceutical manufacturer was overcharging for their drugs, they could (conceivably, at least) demand that drug companies open their books for auditors to research how truthful a company’s expense claims are.

 
 
burt
 
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burt
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31 July 2018 09:10
 
Jan_CAN - 31 July 2018 06:42 AM

Would Medicare for all save money while covering everyone?  Yes.

To provide some comparisons ...

Where I live (Canada), a person making $50,000-60,000 per year pays approximately $10,000 per year in federal/provincial income tax.

Amount paid for medical insurance:  $0
Amount paid for medical expenses:  $0
Determination re medical treatments required:  Made by physicians (not insurance companies)
Choice of physicians:  Made by patient; primary family physician makes referrals to specialists when required
Discussions with physicians regarding cost of treatments:  Never
Payment method/forms:  None – patient shows health card (everyone has one) to health care provider, and voilà, treatment provided

Not covered/exceptions (some people have coverage through employers):
– Dental:  not covered under medicare system; basic care provided for those on social assistance.
– Prescription drugs:  there is coverage provided for some (minors, seniors, low income subsidies) depending on province; there is a move to provide more consistent coverage nationwide.
– Supplementals:  ‘extras’ such as non-prescribed physio, orthopedic footwear, travel vaccines, etc.

A bit off on amount paid for medical insurance, for my wife and I we pay about $120 per month to BC Health.

 
Jan_CAN
 
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Jan_CAN
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31 July 2018 09:30
 
burt - 31 July 2018 09:10 AM
Jan_CAN - 31 July 2018 06:42 AM

Would Medicare for all save money while covering everyone?  Yes.

To provide some comparisons ...

Where I live (Canada), a person making $50,000-60,000 per year pays approximately $10,000 per year in federal/provincial income tax.

Amount paid for medical insurance:  $0
Amount paid for medical expenses:  $0
Determination re medical treatments required:  Made by physicians (not insurance companies)
Choice of physicians:  Made by patient; primary family physician makes referrals to specialists when required
Discussions with physicians regarding cost of treatments:  Never
Payment method/forms:  None – patient shows health card (everyone has one) to health care provider, and voilà, treatment provided

Not covered/exceptions (some people have coverage through employers):
– Dental:  not covered under medicare system; basic care provided for those on social assistance.
– Prescription drugs:  there is coverage provided for some (minors, seniors, low income subsidies) depending on province; there is a move to provide more consistent coverage nationwide.
– Supplementals:  ‘extras’ such as non-prescribed physio, orthopedic footwear, travel vaccines, etc.

A bit off on amount paid for medical insurance, for my wife and I we pay about $120 per month to BC Health.

Yes, there are differences between provinces; where I live the premiums are paid for through provincial income taxes.

 
 
Poldano
 
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01 August 2018 00:08
 
GAD - 31 July 2018 07:49 AM
Poldano - 31 July 2018 01:14 AM

You’re effectively bragging and rubbing it in toward all the people who do not have your level of benefits.

So I have it to good? I should have to pay 4x more to cover you?

You’re already paying something to cover me. It is your Medicare tax. It turns up annually in Box 6 of your W-2 form, and should also be listed on your pay stub. I’m on Medicare, and Medicare is a transfer system, properly speaking, rather than an insurance system, despite the government calling it insurance. Check your pay stub to find out what it is.

I didn’t say you had it too good. Perhaps you don’t even have it good enough. I’m indirectly criticizing your attitude, which I interpret as that health insurance coverage is entirely a personal responsibiity. My opinion is that it is also a societal responsibility. The benefits of an individual’s good health percolate to society, meaning other people in general, in ways that are not easy to measure. Therefore, we should not as a society place all the financial responsibility for good health on individuals. This is, in fact, what we do in the U.S.A., although a lot of that responsibility is placed on individuals indirectly, for example by way of pressure to get jobs at establishments that provide good health care coverage for dependents.

One thing that I’ve been thinking of for a while is Medicare-type coverage for all minor children, regardless of parental income. This would help children whose own parents are not sufficiently “responsible” to provide coverage for their dependents on their own. From a societal point of view, it would also help a lot of young small-business owners and entrepreneurs do what they are best at, without burdening them with the loss of some benefits relative to what they could get by going with the flow and working for a large employer. What would you think of that?