Bernie Sanders’s single-payer plan isn’t a plan at all

[Beacool]

Sanders' long-awaited health care plan is, by turns, vague and unrealistic.

Hillary Clinton has made a lot of bad arguments about Bernie Sanders's support for single payer. But her best argument was her simplest: with mere weeks to go before the Iowa caucuses, Sanders still hadn't released any details about his plan. And absent a real plan no one could really say what he was proposing, or whether it was a good idea. As Clinton said in an interview with MSNBC's Rachel Maddow, "the devil's in the details when it comes to health care."

On Sunday night, mere hours before the fourth Democratic debate, Sanders tried to head off Clinton's attacks by releasing his plan. Only what he released isn't a plan. It is, to be generous, a gesture towards a future plan.

To be less generous — but perhaps more accurate — this is a document that lets Sanders say he has a plan, but doesn't answer the most important questions about how his plan would work, or what it would mean for most Americans. Sanders is detailed and specific in response to the three main attacks Clinton has launched, but is vague or unrealistic on virtually every other issue. The result is that he answers Clinton's criticisms while raising much more profound questions about his own ideas.

--------

In the absence of these kinds of specifics, Sanders has offered a puppies-and-rainbows approach to single-payer — he promises his plan will cover everything while costing the average family almost nothing. This is what Republicans fear liberals truly believe: that they can deliver expansive, unlimited benefits to the vast majority of Americans by stacking increasingly implausible, and economically harmful, taxes on the rich. Sanders is proving them right.

http://www.vox.com/2016/1/17/10784528/bernie-sanders-single-payer-health-care

[MADem]

1. It's a chimera. Congress will never pass it. His math is vague, too.

[KittyWampus]

47. Ideologues work within a small area using broad strokes-

by covering a larger area with few details they give a greater semblance of capability.

[ucrdem]

2. Sounds like his too-big-to-fail bill.

Which is a very poor excuse for legislation and a complete waste of time.

[JonLeibowitz]

3. As a Sanders supporter, I am sad to have to agree with Ezra Klein.

I hope that Sanders has more details he will release shortly, and over the course of the campaign.

His released plan today was a start, but about a fifth of what is needed. And I say that as a supporter of single payer healthcare.

I'll still support him, for basically every other position he has (most notably, campaign finance), but I was let down by this proposal.

[in_cog_ni_to]

5. It gives people a very good look at what to expect. Do all candidates release massive, completed

policy papers before they know whether or not they're the nominee? I'm sure we'll get all the details when he's the nominee?

PEACE
LOVE
BERNIE

[JonLeibowitz]

6. You're right, but I think he needs more evidence that what he is proposing can work.

I say that both politically, to build consensus, and simply to verify that this idea can work practically.

I think Healthcare is important enough that he should provide details now. Remove all doubt that Hillary is in the pockets of the healthcare industry by eliminating petty criticisms. Force her to acknowledge her true objections. Substance is always appreciated by me.

[Kentonio]

17. Why wouldn't it work?

It works in the endless list of other countries around the world, so why not in the most powerful and richest country of all?

[JonLeibowitz]

18. Oh I think it *can* work, but it requires diligence to ensure that the plan put forward will.

There are infinitely many Single Payer programs in the U.S. which would fail. There are many, but fewer, programs that would be successful. I want to see more details to decide if this single payer system he is proposing is one of these.

Fundamentally, I think there's no question that single payer is the way forward. I don't know that Sanders' plan is fleshed out enough yet to hold up and support as the single payer healthcare plan ideal.

In my opinion, of course.

[Kentonio]

19. I don't disagree, but at this moment in time a huge policy document

Would mainly just give the Clinton campaign something complex enough to obfuscate the issue. I think the simple almost bullet pointed document they put out was enough to get people interested and allow the public to understand what it is he's trying to achieve.

[JonLeibowitz]

23. +1. You're right. I just hope they have more specifics in mind, that this isn't the extent

to which they have thought of implementation.

[Kentonio]

26. I doubt this is the extent.

From what I understand he's had extremely knowledgeable people working hard on this for some time now.

[JDPriestly]

35. We are fortunate in that we can look at the many existing single payer plans to see what

works and what does not. Getting the for-profit companies out of healthcare insurance is in and of itself a winner. Each European country has a unique plan. Single payer is not just one system. But virtually all single payer systems provide good health care for less than our for-profit system does. And they provide universal healthcare which is the aspect of single payer that Bernie is emphasizing.

[mikehiggins]

25. I assume you are kidding, right?

Sanders' plan lays out what he wants to do and how he wants to pay for it.

Isn't that what HRC was asking for earlier in the day and on Rachel Maddows show last week?

Okay, there it is. As to the "devil in the details" tale, the more information included in the plan simply provides more ammunition with which to attack it.

Surely, no one can truly believe that the opposition is really looking for a principled, honest discussion of how the thing will work. If so, Chris Christie has a bridge he'd like to get rid of.

[JonLeibowitz]

27. No, I'm not kidding. Yes it answers HRC's disingenuous attacks. It does not completely satisfy me.

You are of course correct about devil in the details.

We may have to wait for a fully fleshed out plan until after he wins the primaries.

[Meldread]

29. Um... This is more than a "devil is in the details" scenario.

I am a staunch supporter of Single Payer Healthcare. I stand at this position for two reasons: 1) Because I believe healthcare is a fundamental right. 2) Because I believe it is immoral for a health insurance company to expect to make a profit off of people seeking healthcare--it creates perverse and immoral incentives. This means a Single Payer system is necessary.

I am extremely disappointed, and more than a little bit insulted by this proposal by Bernie Sanders. This is not a "devil is in the details" problem. No one should expect him to release a fully written up bill that he would like to see Congress pass. However, he should put out a decently detailed white paper on how such a system would function in practice. This is what candidates normally do--even if it is sometimes total bullshit fantasy land nonsense. It still lets us know what they intend to do, and we can call them on their bullshit.

Sanders dropped this plan right before the debate. The plan just so happens to magically address the main attacks Clinton has leveled at him, the main one being that he had no plan. However outside of that there were two more.

1. The Plan will be entirely managed by the Federal Government, thus (hopefully) preventing ACA-style problems when dealing with the states. This is actually good in my opinion, though there are some side issues that need to be discussed, as I don't think you can cut states out entirely (neither should we want too).

2. The real insulting part here is that Sanders basically tells everyone, particularly the Middle Class that it will essentially cost them nothing. In fact, it is only going to cost them around $450. That is a savings of more than $5,800. This is complete and utter bullshit. There is no single payer plan that could be conceived of under the sun that would reduce healthcare costs by that much. Anyone who is serious about single payer and is even remotely knowledgeable about what such a system would look like will instantly see this for the bullshit that it is--the only real way he can achieve those type of savings is if his plan essentially denied scores and scores and scores of people access to medical services. However, the real kicker is that we have no idea how his plan makes this type of savings because he hasn't told us.

To make matters worse, he is also promising to cover everything. He is also promising to eliminate copays and deductibles. Medicare already has both. He is essentially telling everyone that he is creating a system that is BETTER than Medicare and is going to cost LESS than Medicare would cost if extended to everyone as it currently is... this, my friends, is bullshit.

This is not a real plan. It is insulting to every Bernie Sander supporter and to every supporter of Single Payer out there, because his campaign assumes that people are too stupid to realize that he is making promises that he just can't keep. That is exactly what this "plan" is: a promise that he can't keep. Even if he was made absolute dictator of the United States and given unlimited power with zero opposition he could not implement this plan, because it is not based in the realm of reality. This type of nonsense is supposed to be beneath Bernie Sanders.

[JDPriestly]

31. If your claims are true, then why do France and the UK, just to cite two examples,

deliver healthcare, excellent healthcare, better than we do for a fraction of the money we spend?

I lived in Europe for years. If we eliminated a lot of the paperwork we now have, we could reduce the cost of healthcare by a lot.

If we had less expensive ways to treat drug addiction and mental illness than just waiting until there is a huge crisis and then housing addicts and the mentally ill in our hospitals for periods of time that are far longer than they should be, then we could save a lot of money.

Think of the savings if we could change our gun culture, or our drug culture? It can be done and universal healthcare for all is a big part of the solution.

In particular, our system of care for the mentally ill is just horrible and very expensive.

On edit, I have to add that if we could reduce alcoholism, smoking and sugar consumption through doctor/patient cooperation, patient education and incentives for healthy lifestyles -- like free memberships in health clubs included in a supplementary insurance policy for little money, we could reduce our healthcare costs a lot.

But mental illness is the big one. It leads to a lot of other illnesses and high medical costs. It's a tough issue, but not all of the secrets to lower healthcare costs are easily entered on a spread sheet and calculated. So many of them have to do with lifestyle and responding to issues we do not necessarily associate with "health" although they are health issues.

Also, I have been told that in some European countries, nurse practitioners do much more than they do in our country. When we adopt a system in which we hire nurse practitioners for specialized kinds of work that we now have doctors performing, we will also save money.

There are lots of procedures that doctors are now doing that nurse can do like removing warts or treating certain common problems that are not likely to develop into something life threatening. That will save money. And it's easier to employ nurse practitioners and organize healthcare to save money when you have single payer health insurance.

In Europe, a lot of problems are treated by visits to spas and other natural healing methods. We don't always have to choose the most expensive treatment.

Exercise and eating right can prevent a lot of illness. Doing yoga in some cases can reduce blood pressure. I'm not advocating for only natural healthcare, but natural remedies and especially exercise of the right kind as well as diet are not as much a part of our healthcare as they should be. To some extent that is because of our fee for procedure or service system, I suspect.

We have a lot of inefficiencies in our for-profit healthcare system.

And by the way, much of our healthcare insurance used to be not-for-profit. Check the history on that. I remember when we had non-profit healthcare. We still have it in some instances. And it is very good.

Bernie's point is to get the profit motive out of our health insurance. I'm with him on that. He is not talking about reducing payments to practitioners or hospitals that are already nonprofit.

[Meldread]

37. They do deliver it for a fraction of the cost.

However, you have to examine how they are doing it. We could do it too. My point isn't that we can't have Single Payer--I believe we can! I want Single Payer. That is why I am upset.

Bernie Sanders is literally telling everyone via his plan that he is going to create a system that is better than Medicare (as it currently exists), that it is going to cover everything, and that it is going to be cheaper than if we simply expanded Medicare to everyone as is right now. This is clearly unrealistic and I am sure Bernie Sanders has to realize this is unrealistic.

This is damaging to the fight for Single Payer, because it makes it look like some pie-in-the-sky fantasy. It makes it look like some dream that only loony people have, and that serious policy people just shake their heads as if it is unworkable. One way that you overcome this problem is being honest about the costs, and then explaining why the costs are worth it. You make the moral argument rather than the dollars and cents argument.

I am genuinely shocked that Bernie Sanders has done this, but I am willing to eat every negative word that I have written if he can justify those low numbers. So long as it is realistic and doesn't look like some dystopian healthcare system where people who have treatable cancer are told that they won't get treatment because it will cost too much--because that's what this plan would look like if put into practice to keep those numbers that low. You would literally see pregnant women being forced to give birth at home, without medical assistance, either because all nearby hospitals have shut down or because the plan would refuse to cover women who have "low risk pregnancies" or some such dystopian nonsense. I know that isn't a plan that Bernie supports, so it boggles the mind why he would put a plan out that would require it in order to keep the numbers that low. The only answer that I have to that question, and the most obvious one, is that it is cynical politics. He just assumes that most of his supporters will support it because he put it out, and that by having it out there he can create enough confusion to sway just enough Hillary supporters to win the nomination. Maybe it works for that purpose--in fact, I believe it does. However, it will come at a cost later down the road. This is not a cost-free move.

[Recursion]

41. By paying providers much less than we do

Also by either running the hospitals (UK) or making the patients pay 30% of the cost of treatments (France).

[JDPriestly]

64. France must have changed its plan.

I had a baby with lots of complications when I lived in France. At the time, I paid nothing for the birth. So that must have changed. I don't recall paying anything for the health care for my children either when we lived in France. And when you have two children under three, there are lots of medical visits especially since one of mine had problems.

[Recursion]

65. Perinatal care and some surgeries are exempt

I'm talking about the routine and chronic care that makes up the majority of health care spending.

[enid602]

52. France

France does not have single payer. Universal Healthcare, yes but administered through insurance companies.

[Armstead]

45. I think the concept is what is important at this point

The problem is that peopke's eyes glaze over when it gets to tge weedsvof healtgcare reform.

And they've been sold the basic message that we havevto do what the insurance industry will allow. THE first step is to counter and sell that to people, and how it would work in basic terms, rather than get into a lot of formulas, legeleeze and green eyeshade details.

There'll be plenty of time and opportunity tonhash out details. But first people have to bevpresented with the basic idea as a real alternative

[KittyWampus]

48. Considering the fact this is Sanders wheelhouse and it's the best he can come up with?

AFter these many months?

When a plan that doesn't work could jeopardize the progress we made under Obama?

Sorry, your attempt to make excuses for him appears weak.

[draa]

8. Can we at least wait until Robert Reich looks at it and not rely on Ezra Klein.

I'm not saying your wrong but if it's not at least a foundation, which is what I believe it is since no one could come up with a complete overhaul of our health care system in 7-14 days, then Reich or another economist would be the better authority. 170 endorsed his plan for Wall Street. If this isn't good enough they'll tell us.

[JonLeibowitz]

15. Can someone brief me on why Ezra Klein is bad? I seem to have missed it.

I did find his critique of Hillary Clinton's recent attacks to be honest and level-headed.

Otherwise, I would contend those 170 are not for the most part thought leaders. A wonkish approach to policy is warranted, if only so we don't screw single payer up when implementing it.

[draa]

22. For one, he's not an economist as far as I know.

Knowing that, his word isn't anymore credible than mine.

Even less so when you know that Vox is always pumping sunshine for Clinton. Moulitsas from Dkos co-founded Vox (I think he's out now) and he always pumping sunshine for Clinton. Even going so far as to piss Dkos subscribers off last year with an article bashing Bernie.

I've never been much of a fan of Klein but admittedly I don't watch much political news anymore. He also pumps sunshine for Clinton though. Vox does cover Bernie but it's like msm covering Trump. Except that it's Clinton. Which makes sense considering who owns Vox.

Anyway, I'd rather wait for Reich. At least I trust him.

edit: those 170 that endorsed his WS plan were economists. Leading economists. They'll get to look this plan over and we'll know.

edit edit: As an example of what I was saying, I don't trust this article either. And it's pumping sunshine for Bernie. We need some experts to weigh in before we cheer or freak.

http://www.huffingtonpost.com/entry/bernie-sanders-health-plan_569c3ddde4b0b4eb759ecf51

[in_cog_ni_to]

4. I knew it was Ezra before I clicked the link.

Enough said.

PEACE
LOVE
BERNIE

[Kalidurga]

7. Hillary lost the debate on health care.

It probably gives you a headache to know this. But, at least it will be covered under your medicare.

[ucrdem]

10. No, she defended ACA and Sanders couldn't. That's a win for Hill. nt

[Kalidurga]

11. The audience gasped

Bernie won them over. I heard it in real time.

[Fast Walker 52]

46. Indeed-- Bernie was powerful on healthcare, Hillary really flailed

[cascadiance]

28. Oh, she loves insurance companies leeching off of us! Do you too! Yay for you!

If you like being ripped off! Most of the rest of us don't, and would rather SAVE money from these vultures that Hillary seems to like keeping fed!

ACA was a good first step to help us stop people from dying by giving them health care. But as long as the leeches are allowed to feed with it, as they've paid to have happen, it is NOT a long term sustainable plan, and we need something more like the rest of the civilized world has the wisdom to put in place that takes out the leeches from the system and focuses on giving us health care like they get.

Hillary's assertion that Bernie wants to "tear our current system down" is a LIE!!!! Where does he ever say he wants to vote to take it down without replacing it first with something that works in terms of a single payer system. Hillary and those that agree with that BULLSHIT are basically calling him a Republican!

[uponit7771]

33. +1, Sanders WOULDN'T defend ACA... he didn't like it from the beginning.

Last edited Mon Jan 18, 2016, 06:05 AM - Edit history (1)

[Armymedic88]

9. So her plan is to tinker with the ACA....

Lets be honest here she has no plan either.... I just rummaged thru her website to find nothing but fluff when it comes to health care. Millions of Americans still cant afford to purchase health care on the open market and those people still go to the ER for medical treatment. Which we all still pay for and they pay for with their health. Look the ACA did a lot of good things but must continue to strive for a day when no one goes bankrupt because they get sick. Until Sec. Clinton has a plan for that to happen I will not support her or other Democrats who support her. Because thats the vision FDR had for America and our party over 50yrs ago.

[Kalidurga]

12. Welcom to DU

fasten your seat belt the primaries are about to begin.

[Armymedic88]

14. Thanks for the Welcome

Oh it wont be that stressful for me this go around. In '08 primaries I was traveling the country campaigning... im sitting this one out (have a newborn at home) Hints why im here to get my politics fill...

[uppityperson]

56. If Clinton gets the Dem nomination, who will you support for Pres?

[Armymedic88]

57. I will support progressive dems on the local level

To keep her honest if she wins....

[uppityperson]

58. That is good, and for Pres?

I wish the system were different, we had more true choices.

[Armymedic88]

61. I honestly havent decided because that had yet to occur

Im a stick to my morals kinda guy... It would be a no win situation... My biggest dissapointment so far is Sherrod Brown endorsing Sec Clinton.. his views and mine are almost to a tee... Us rust belt progressives are a rare breed these days

[uppityperson]

62. If I were queen of the universe, things would be different.

[GP6971]

59. I guess the question is if

she wins the nomination, will you vote for her?

[oasis]

13. "Puppies-and-rainbows approach". Yup, sounds familiar. (eom)

[AgingAmerican]

16. He addressed that during the debate

But don't let that stop you.

[ejbr]

20. He posts on the sensible center.com?

Sensible Center


Seems to really like Clinton...not sayin, just sayin

[Kall]

21. Gee, memory fails me

Did Obama lay out the details of his ACA during the primaries? Seem to recall him campaigning against the individual mandate.

[MichMan]

44. Obama promised savings of $2500 per family n/t

[SunSeeker]

24. Vermont proved that. nt

[JDPriestly]

30. The only reason that Bernie's plan seems vague is that those who criticize it have not

looked at what is going on in other developed countries and don't understand how single-payer works.

Fact is that single payer can take many forms, and precisely what form we want to have is something to be negotiated.

After all, Obamacare is not precisely the plan that Obama envisioned even a couple of weeks before the bill was passed. I was on a conference call with Obama and other Obama supporters. He clearly stated he wanted a public option. We have no public option.

Bernie has clearly stated the advantages of adopting a single payer plan. Namely, while our taxes will rise, our health care costs will decline. Thus, we will shift and pay the government rather than the for-profit insurance companies. We will build on Obamacare but recognize that, in this day and age, and in out wealthy society, healthcare is a right not a privilege.

It's not hard to understand if you try.

Hillary strongly argued for single payer. She was unable to get enough people, enough voters or members of Congress behind her to get passage of a single payer bill.

It may have simply been that the American people weren't ready.

At this point, I think that Hillary is kind of put out that her plan for single payer was rudely rejected and that now, Sanders' plan is being greeted more warmly. She is, as she has been on some other issues, simply jealous. She should support Bernie's plan. It's a plan whose time has come.

It's ridiculous to think that we in America cannot have single payer insurance when so many other countries in the world have it. Just ridiculous.

[Meldread]

34. The problem with this plan has nothing to do with it being vague.

Yes, it would be nice to see a plan with more details. However, no one should expect Bernie to put out something that he would put before congress. What we should expect is a decently detailed white paper. ...but even that isn't necessary here, because what he is promising is completely unrealistic and a flat out lie.

Any honest person who supports Single Payer knows that taxes have to go up in order to cover everyone. It is easy to understand why. There are still 9%-10% of people right now who lack coverage. They will be brought in and be covered. People with sub-optimal plans (such as only having the catastrophic plan from the Health Exchange) will get upgraded. All of this is going to cost more money. People without health care are usually too poor to pay for it, and as a result the tax burden shifts up the economic ladder to the middle and upper classes. This means the wealthy and the middle class pay more in taxes to ensure that everyone is covered.

However, what Bernie Sanders is proposing is pie-in-the-sky-blow-smoke-up-your-ass nonsense. First, he is telling everyone that EVERYTHING will be covered. This is not how Single Payer works--at least not if you want to keep costs down. Second, he is telling everyone that it will be like Medicare, but he is going to make it even better by getting rid of the copays and deductibles. Third, he is telling everyone that it is going to be MUCH cheaper than the current Medicare system if we simply expanded it--as is--to everyone. Specifically, he is telling people in the Middle Class that it is going to cost them around $450 and save them around $5,800.

This is just a flat out lie. None of this is possible. It is insulting that such a plan would even be put out. It is insulting to Bernie Sander supporters, and it is insulting to single payer supporters, because it is basically a cynical move that assumes that we are too stupid to do math. It is beneath the dignity of Bernie Sanders, and he should fire whomever told him doing this was a good idea. It undermines the fight for Single Payer, by making it seem like an unrealistic pipe dream. This is actually damaging to the cause.

[JDPriestly]

36. Yet European plans are cheaper than ours and far more generous.

When I lived in Austria, they introduced a co-pay for medications. It was almost too small to even count. They introduced it at that time to discourage people from overusing the system.

Right now, in our system, Americans tend to underuse the system, that is seek medical help only after their problem has reached a critical stage. That's because of the cost of the care in spite of insurance.

It's been a long time, but I recall having a cesarean and a two-week hospital stay -- yes two weeks back then -- and virtually no charges.

Single payer really does save a lot of money. I was a horrible patient. I was very American about going to the doctor too late and too rarely. I didn't realize how American that was until I came back to the US and had to fight with our healthcare system.

Single payer really does save a lot of money and makes preventive care more likely to occur.

When I was having a September baby, the local pediatrician in the small town in which I lived called all of her patients who were having babies in late summer and early fall in to her office and advised us on parenting. She told us to watch and make sure our children were really ready for school before the September when they turned six, the age at which Austrian children start school. She explained that children who are not mature enough to start school even though they are six in September have a big disadvantage later in school.

I will never forget that she told us to never say "no" to her children. (I tried, but that system did not work well for me. I soon realized that what she really meant was that we should not over-discipline or hit or yell at a small child. Because of the culture of child-rearing in Austria, she went to a bit of an extreme in her advice. As an American, I tended to be a bit too lax so I had to say "no" gently but say it and it worked well. She told us that if our babies wanted to tear up books or something, we should just give them newspaper to tear up. This sounds odd to Americans, but it was great in the social context of Austria. It's things like that, extras, that you get under single payer that actually save money in the end. It's hard to explain to you why advice from a pediatrician on child psychology and gentle discipline might save healthcare problems later on. It's a cultural thing. In a culture in which maybe corporal punishment was at one time condoned, in a single payer system having a pediatrician discuss communication with children with expecting mothers is a good thing.

Here, we might want the pediatrician to warn mothers about guns in the home or about alcohol abuse during pregnancy, smoking during pregnancy, watching for signs of maturity in a child about to begin school. We might want a pediatrician to warn about the signs and activities that constitute child abuse -- like whipping or beating a child. Our juvenile dependency courts deal with parents who are amazingly ignorant when it comes to how to treat young children.

Single payer offers opportunities for preventing medical problems that our for-profit insurance system simply does not offer. We need not only universal, but also comprehensive health care. Doctors and nurses should be teaching us how to take care of ourselves and others and not just healing us after we have hurt ourselves. There is little incentive to do that in a pay for procedure for-profit healthcare insurance system.

I must say that Kaiser is a healthcare insurance plan that does a lot more of this kind of preventive care than some other insurance companies.

So the savings in single payer plans is there and if you enjoy such a plan you can see it but it is hard to quantify on a spread sheet.

One less child with whip marks and a skull fracture is the kind of thing that single payer can be better for than is for-profit insurance.

I am writing this based on my experience living in four European countries and enjoying their single payer plans when my children were born and were young.

[Meldread]

38. I am not saying that Single Payer isn't cheaper than the overall system we have right now.

It clearly is cheaper, overall. However, you cannot compare the United States to other countries like that. Austria, the country you used in your example, is a country with a population of 8,623,073. It has a total area of 32,386 square miles. The United States has a total population of around 322,369,319, and a total area of 3,535,932 square miles. The size matters because huge chunks of our nation are rural, which drives up medical costs, at least if you want to service those areas. The population matters because we have to cover more people. There are numerous other factors as well--I don't know how healthy Austria is compared to the United States, for example. However, I do know that we have roughly 10% of Americans currently without healthcare. Most of these people are poor, and will have to be subsidized by the Middle and Upper Class--all 32,236,931 of them. As you point out these systems are typically more generous than our own, which means that--to match them--that millions upon millions more will get a healthcare upgrade. This means that the Middle and Upper Class must also subsidize that.

Now, we can control costs. One way we can control costs is by placing limits on the types of procedures that can be performed and under what circumstances that they can be performed. This is how a lot of Single Payer systems manage costs. However, this means that we are no longer 'covering everything' as Bernie Sanders has promised. We can also limit payments to doctors and hospitals, but this means that hospitals that service rural areas are almost certainly going to shut down. This means that some areas could face a 2 to 3 hour drive the nearest hospital, virtually ensuring that anyone in a serious medical emergency dies. To prevent that we could nationalize the hospitals like the U.K., but by keeping them open it will cost us more money.

The simple fact is that Bernie Sanders has promised people everything, and has told them that it will cost them essentially nothing. That just isn't how things work. The reason democratic socialist systems work is because people understand that there are costs associated with supporting everyone, but people fundamentally believe at their core that it is the right thing to do. Yes, you are helping to subsidize your neighbor, but if you hit economic hard times people will support you as well. It's a safety net for a reason, and not everyone can be winners in a capitalist system.

The best measure for what a single payer system will look like for the United States in terms of cost is something like Medicare. Bernie Sanders is promising a more generous system that is cheaper (by far) than what currently exists. Medicare is already vastly cheaper and more efficient than private insurance. In fact, Medicare consistently outperforms private insurance plans in terms of patients' satisfaction with the quality of care, access to care, and overall insurance ratings and cost. All those Single Payer savings you are talking about? They already exist in Medicare. Bernie Sanders is promising something cheaper that will be more generous and cover everything.

[eridani]

40. His plan does indeed cost 'essentially nothing' when compared to what we now have

Sanders is promising Medicare for all without the deductibles. WA State's proposed single payer plan covers everyone, with people 18-64 paying $150-$250/month and businesses paying a payroll tax of 1% of the first $500K of payroll and 10% after that. Kids ride free. People over 65 would be able to get parts B and D for $75-$150/month.

[uponit7771]

32. That was snuffed out in the first line where employers were to pay 6.2% and not pass a dime of it ..

... of to the employee which, from their past actions they'll most likely do.

[Warren Stupidity]

43. employers currently providing health insurance will on average be paying much less

per employee under this plan, so I assume you mean that they will be passing the savings on to their employees.

[eridani]

39. So Hillary's plan is for the 28 million uninsured to fuck off and die?

Any Democrat who is not in favor of covering 100% of the population is morally bankrupt.

[tazkcmo]

49. No, it's not Hillary's plan.

It's the DLC/Third Way plan and she's just a founding member of it. She doesn't care as long as she gets to be President. I listened to a brief part of her talking about what SHE wanted. "I want..." over and over. I personally care less what she wants but of course her campaign is about her, not we.

[mythology]

54. Considering the Sanders plan is pie in the sky underfunded nonsense

I'm not sure he should get credit for a plan that won't actually ever even come close to passing or meeting it's stated goal.

There's a reason that Sanders waited this long to put the plan out and then did so on a holiday weekend right before a debate. He wanted to hide it.

[eridani]

66. "Underfunding" is pure unadulterated horseshit. We are currently paying nearly twice--

--what other industrialized countries pay for better health care, so we already have the funding available to cover everyone. As Kucinich said in 2004 "We are already paying for universal health care--we just aren't getting it."

Anyone who would rather pay a $900/month "premium" instead of a $200/month "tax" should not be running around outside without adult supervision.

[Beacool]

63. That's absurd!!!

Hillary knows more about this issue than most candidates. It has been one of her causes since the 70s. But, she's also a realist who knows that single payer will not pass through Congress.

Dreaming is great, but one must also be a realist, and the reality is that this Congress is even more conservative than the one in place when Obama took office. Hillary knows that, Sanders seems to prefer to ignore the elephant in the room.

[eridani]

67. I'm sure glad you aren't trying to sell my used car for me.

You'd probably ask for $3000 and be shocked when you didn't get any more than $1000. Anyone with sense would ask for $6000 to get $3000.

"Reality" is this--we will never get the government back to working for the 99% unless we stop being chickenshit gutless wusses and ask for what we want instead of what we think we can get. Had we demanded single payer in 2009, we would have likely at least gotten a public option.

[Warren Stupidity]

42. wtf - it is almost identical to the bill he filed in 2013 in the senate and is a plan.

It spells out what is covered and how it is funded and how it is administrated.

[KingCharlemagne]

50. HRC's "plan": 32 million Americans can just Fuck off and die. - nt

[NCTraveler]

51. Similar to his Too Big To Fail Bill.

When one is scared to talk to experts, this is what happens.

[Gothmog]

53. Ezra Klein is correct in his analysis

[taught_me_patience]

55. huge K&R

Ezra Klein to completely correct in this analysis.