On single payer, examples of how to pay for a national plan

[ProSense]

This was a proposal by John Conyers.

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How will the transition to the new system work?

The full conversion to a non-profit, single-payer universal health care program will not take place overnight once the bill is passed. The total transition time will be roughly a 15-year period. Important elements of the transition will include:

• Private health insurance companies will be prohibited from selling coverage that duplicates any benefits included in the universal national health care program. The private companies will, however, still be able to sell coverage for services that are not deemed medically necessary, such as many cosmetic surgery procedures.
  
• Private insurance company workers who are displaced as a result of the transition will be the first to be hired and retained by the new single-payer entity. Any of the displaced workers who are not rehired will receive two years of unemployment benefits.

How will the universal program be paid for?

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
  
• One quarter of one percent stock transaction tax

http://www.johnconyers.com/hr676faq

Obviously, this would be a hard sell in the current political environment, but single payer is more efficient and saves billions in the long run.

Here's another:

Financing

The program would be federally financed and administered by a single public insurer at the state or regional level. Premiums, copayments, and deductibles would be eliminated. Employers would pay a 7.0 percent payroll tax and employees would pay 2.0 percent, essentially converting premium payments to a health care payroll tax. 90 to 95 percent of people would pay less overall for health care. Financing includes a $2 per pack cigarette tax.

http://www.pnhp.org/facts/what-is-single-payer

[RC]

1. Additional funds would be available if we would stop our wars and World Conquest ambitions.

[Cleita]

2. The money that goes to the insurance companies for premium payments

could go to the government instead to finance the health care system. Since most countries manage to deliver health care for half the cost that we pay, it would seem the premiums would be half of what we pay today. Sure, there would have to be some tweaking to make the taxes less regressive than insurance premiums are, but the money is there, it just needs to be diverted from the profit taking insurance companies and put into the fund that pays for universal health care.

[ProSense]

4. That's likely

"The money that goes to the insurance companies for premium payments could go to the government instead to finance the health care system. "

...covered by the 3.3 percent increase in the payroll tax.

[freshwest]

3. Medicare4All can happen. They've put a great deal of thought into this. Thanks for the details.

And this is why the GOP and health insurance companies hate Obama. This is a win win for all but those who wanted to bilk people.

[JDPriestly]

5. Some countries, Germany I think, have intermediary

non-profit insurance companies.

I suppose though that if the mandatory purchase of health insurance is struck down, there could be no mandatory purchase of non-profit insurance either.

We would have to go with a government-run health care agency funded by tax revenue. That would be fine, but I liked the German system better than the British one.

[ProSense]

9. Here's some

good information:

Health Care In Germany Works
http://www.dailykos.com/story/2012/04/01/1079750/-Health-Care-In-Germany-Works) and Switzerland.

Here's Krugman on various health care systems:

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Every wealthy country other than the United States guarantees essential care to all its citizens. There are, however, wide variations in the specifics, with three main approaches taken.

In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false. Like every system, the National Health Service has problems, but over all it appears to provide quite good care while spending only about 40 percent as much per person as we do. By the way, our own Veterans Health Administration, which is run somewhat like the British health service, also manages to combine quality care with low costs.

The second route to universal coverage leaves the actual delivery of health care in private hands, but the government pays most of the bills. That’s how Canada and, in a more complex fashion, France do it. It’s also a system familiar to most Americans, since even those of us not yet on Medicare have parents and relatives who are.

Again, you hear a lot of horror stories about such systems, most of them false. French health care is excellent. Canadians with chronic conditions are more satisfied with their system than their U.S. counterparts. And Medicare is highly popular, as evidenced by the tendency of town-hall protesters to demand that the government keep its hands off the program.

Finally, the third route to universal coverage relies on private insurance companies, using a combination of regulation and subsidies to ensure that everyone is covered. Switzerland offers the clearest example: everyone is required to buy insurance, insurers can’t discriminate based on medical history or pre-existing conditions, and lower-income citizens get government help in paying for their policies.

In this country, the Massachusetts health reform more or less follows the Swiss model; costs are running higher than expected, but the reform has greatly reduced the number of uninsured. And the most common form of health insurance in America, employment-based coverage, actually has some “Swiss” aspects: to avoid making benefits taxable, employers have to follow rules that effectively rule out discrimination based on medical history and subsidize care for lower-wage workers.

- more -

http://www.nytimes.com/2009/08/17/opinion/17krugman.html

Healthcare in Switzerland is universal[1] and is regulated by the Federal Health Insurance Act of 1994 (Krankenversicherungsgesetz - KVG). Health insurance is compulsory for all persons residing in Switzerland (within three months of taking up residence or being born in the country). International civil servants, members of permanent missions and their family members are exempted from compulsory health insurance. They can, however, apply to join the Swiss health insurance system, within six months of taking up residence in the country.

Health insurance covers the costs of medical treatment and hospitalisation of the insured. However, the insured person pays part of the cost of treatment. This is done (a) by means of an annual excess (or deductible, called the franchise), which ranges from CHF 300 to a maximum of CHF 2,500 as chosen by the insured person (premiums are adjusted accordingly) and (b) by a charge of 10% of the costs over and above the excess up to a stop-loss amount of CHF 700.

http://en.wikipedia.org/wiki/Healthcare_in_Switzerland

The problem in the U.S. is that the health insurance companies are motivated by greed. With loose regulations and a lack of enforcement, that greed is driving the system toward collapse.

[JDPriestly]

10. I have posted this so often: I lived in several of those

countries, and I loved the single payer system.

French medical care cannot be beat in my opinion.

[libtodeath]

6. Cut defense spending by 75% and tax the income of the wealthy at 75%

The economy would take off and we would have fairness and social justice.

[HiPointDem]

7. Provisions for the displaced workers are great, but what about the provisionsfor the poor insurance

corps?

They're going to lose a bundle...poor babies.

But seriously, I like it.

Except that we ALREADY spend more per capita on health care than any other country, and get less. So WHY WOULD WE NEED ADDITIONAL FUNDING SOURCES?

[ProSense]

8. It's mostly

"Except that we ALREADY spend more per capita on health care than any other country, and get less. So WHY WOULD WE NEED ADDITIONAL FUNDING SOURCES?"

...the cost to transition.