Bernie proposes biggest savings in US history.

[Admiral Loinpresser]

Last edited Tue Sep 15, 2015, 09:13 PM - Edit history (1)

When the USA joins all the major nations in providing universal health care, per capita health care will be cut in half. That is a massive savings to the American people, while reducing personal bankruptcies and providing a boon to small businesses which can quit worrying about the financial and administrative leap to a company health plan.

Displaced workers who are currently shuffling papers in the private health care/insurance complex will have the career choice under full employment to work in child care or rebuilding infrastructure at a living wage.

Sure the 17 million uninsured will add cost to the system, but their will be great savings from freeing up Emergency Rooms and catching illnesses when they are much less costly to treat. In addition, Big Pharma will have to agree to huge reductions in prices to get a scale rate from Uncle Sam. If not, the Medicare-for-all system can simply import much cheaper drugs from Canada and Europe.

When considering the huge increases in revenue from corporations and the wealthy individuals finally paying some reasonable, Kennedy-style taxes, along with the taxes from 13 million new, good jobs, as well as the cost reduction of ending perpetual war, this will result in a massive transfer of wealth from the 1% to the 99%. Not as massive as the reverse-robin-hood transfer of the last 35 years, but it's a nice start.

https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_%28PPP%29_per_capita

[DanTex]

1. And magic unicorns for everyone!

Sorry, but single payer will not cut health care expenditures in half. Even optimistic estimates put the number at something like 20% or less. For example:

http://www.pnhp.org/facts/single-payer-system-cost

[jeff47]

3. This is in reference to today's WSJ hit job.

Which tried to claim a $15T-over-10-years single-payer system was worse than our current, $30 to 42T-over-10-years system.

Yes, the WSJ used shitty numbers.

[DanTex]

33. Again, $15T is not the total cost of single payer, it is the additional cost to the government

on top of the approximately $1.5T per year that the government already spends. This is obvious to anyone who actually reads the study. Why Bernie fans are trying to pretend that $1.5T is the total cost, and compare that number to the total costs of the current system is beyond me. But it is in keeping with the tenuous relationship with facts that I've noticed from the far left.

[jeff47]

36. Does it matter if your paycheck is reduced to pay Blue Cross, or if it is reduced to pay taxes?

In the end, it really doesn't matter what the text side of the paycheck deduction says. The important part is the amount it was reduced.

So the line paying $400 to Blue Cross becomes a line paying $200 to the government.

The horror of that extra $200 in your pocket. How dare the far left think that is a good thing!!

[DanTex]

41. I'm not sure why you're still insisting on the 50% reduction in costs.

Because that's magic unicorn territory.

[jeff47]

43. Because we are paying Blue Cross and similar $3T per year.

The evil, satanic single-payer proposal means paying $1.5T per year. For the same service. Which means no longer paying Blue Cross and others $3T per year.

If we stop paying $3T, and start paying $1.5T, that's a 50% reduction.

[DanTex]

45. Really, you still don't get it?

We're paying $3T total (actually a little more than that). But the government already pays about half of it (you may have heard of Medicare, Medicaid, VA, etc.). The amount that goes to private insurance is actually something like $1.8T.

The cost of single payer is $1.5T in addition to the approximately $1.5T that the government already pays.

[Fearless]

49. Umm... YOU pay medicare and medicaid... look at your paycheck.

[jeff47]

54. No Dan, you don't get it.

The single-payer proposal does not keep Medicare, Medicaid, VA, etc around either (at least in their current form). They become superfluous because they're offering the same services as the single-payer program.

Why, specifically, do we need a health insurance program for the poor or seniors or veterans in addition to a single-payer program? You put everyone in the single payer-program instead.

[DanTex]

55. Wow. This is getting really silly.

Of course single payer doesn't keep them around, but (also of course) it still pays for the healthcare of all the people currently on it. It's not like the cost of healthcare for everyone currently under government coverage will drop to zero.

The $1.5 trillion cited in that study is the additional cost to the government of single payer. The total estimated cost to the government is $2.964 trillion. Which, basically, is the amount that the government currently spends plus another $1.5T. Have you even bothered to read it? It's pretty short.

From the study:

The health care improvements and transition costs of a singlepayer
system ($394 billion, Table 2), including expanding
coverage to 44 million uninsured Americans and upgrading
coverage for everyone else, would be funded under HR 676
by $592 billion in savings on administrative costs and reduced
pharmaceutical prices. As a result of implementation of HR
676, health spending in the first year would fall by $198 billion
to $2,964 billion (Table 6).

http://www.pnhp.org/sites/default/files/Funding%20HR%20676_Friedman_7.31.13_proofed.pdf

[jeff47]

57. Again, you are pretending that the money is not already being spent.

Let me highlight the part you should have highlighted:

The $1.5 trillion cited in that study is the additional cost to the government of single payer.

Right now, I pay Blue Cross and my doctors/pharmacists/whatever around $10,000 a year. I do not know the portion of Blue Cross's bill that my employer pays. From what I gotta pay to add people, it looks like around $5k-10k/year.

The government pays $0 for my healthcare. (Ignoring indirect things like infrastructure)

If this evil, satanic single-payer system comes to pass, and I pay $8,000 a year in taxes to implement it, you are claiming I am spending more money.

You keep ignoring what people like me already pay, we just have to pay twice as much money to corporations instead of the government. If we change that by incurring "additional costs to the government" but zero costs to corporations, I'm still ahead.

[DanTex]

58. No I'm not. Obviously, it's currently being spent, just not (all) by the government.

Right now the government pays about half. With single payer the government pays the other half also. Less some small amount of savings. This results in the government spending an additional $1.5 trillion dollars.

What you can't seem to understand is what the word "additional" means. You want to believe that with single payer the government will only spend $1.5T total, which is utterly preposterous.

[jeff47]

69. You can't seem to understand what the phrase "by the government" means.

Btw, you better call up FAIR and demand a correction:
http://www.democraticunderground.com/1251600148

But it wouldn’t be a dollar-for-dollar transfer from the private to the public sector. According to Gerald Friedman, an economist at the University of Massachusetts at Amherst who authored the analysis cited by the Journal, that transition would reduce American healthcare costs by almost $10 trillion over 10 years through economies of scale, better control of pharmaceutical costs, and savings on administrative bloat.

[HooptieWagon]

78. Of course not.

He's being deliberately obtuse.

[kenfrequed]

60. Uhm I work in a clinic

A massive amount of the waste in the cost of medical care IS from insurance companies. Premiums, deductables, required copayments. Oh, and then there is the magic when they refuse to cover something after you have received the procedure or medication in question.

This all works out to be profit and waste.

Clinics, hospitals, and healthcare outfits have to maintain staff whose only job it is to wrestle with insurance companies to get them to pay the frigging bill.

The US medical care system is a model of inefficiency and failure to provide care.

[DanTex]

61. A "massive amount," sure, but not nearly "half".

[Admiral Loinpresser]

62. Canada spends about half of what we do per capita.

So do most of the other comparable nations, . Why can't we do that? Are you that skeptical of American know how? I'm not. Check out the link in the OP.

[kenfrequed]

63. I would recommend you do a bit of research on this.

The numbers would probably astound you and I garauntee any estimate is going to be short.

[Admiral Loinpresser]

38. WSJ's sophistry

is in not addressing all the economic benefits. The only cost savings claimed by Friedman are admin and drug price savings. I saw nothing about the savings from radically reducing ER utilization by the poor and earlier detection of illness, leading to lower treatment costs. Another benefit is getting useless private health care and insurance paper shufflers doing something productive in our society.

Coming up with $1.5T will not be hard as the progressive platform of Bernie will greatly expand tax revenue from multiple sources and cut costs on our bloated military/intelligence spending for wars which only make us less safe.

[DanTex]

42. I agree, the WSJ is not addressing the economic benefits.

And yet, we still have $1.8 trillion per year in additional government spending, which is something that is going to go down very poorly with the electorate.

As far as Friedman's estimate, if you can find any study that shows a 50% reduction in healthcare costs if we switch to single payer, then I would be very interested in reading it. Friedman's 20% estimate is optimistic given the range of numbers I've seen.

The reasons we pay so much more than the rest of the world are varied and complex. There are plenty of first world countries that don't have single payer, and still have much lower costs than us. The best overview of the factors I've seen is here, a link that I found via Paul Krugman. Basically, there are no easy answers. Drugs, doctor salaries, insurance beaurocracy, and all the other usual suspects are there but they are all only a small part of the total.
http://theincidentaleconomist.com/wordpress/what-makes-the-us-health-care-system-so-expensive-faq/
http://theincidentaleconomist.com/wordpress/what-makes-the-us-health-care-system-so-expensive-introduction/

[Admiral Loinpresser]

44. Friedman disagrees with you.

Drugs and admin costs in the private sector account for $600B in waste every year. So 20% of the national health expenditures are pure waste. This does not include the profits of the various elements of the system, which are also waste from an efficiency perspective, in this industry.

And your figure is off roughly $200B per year. $1.8T is the total annual cost of Bernie's platform. But he has already said how about $200B of that will be covered. Let me repeat what I posted yesterday about other aspects of his platform that will lead to US budget cost reductions and increases in revenue:

1) the military budget is full of fat-- $200B-300B could easily be achieved with no threat to national security;

2) Homeland Security is another bloated budget with similar cuts available;

3) Intelligence Agencies have no accountability and need to be cut dramatically;

4) Most of the subsidies and administrative costs of the ACA can be done away with due to universal health care;

5) 13 million new jobs in infrastructure means lots of new tax revenue from the previously underemployed and unemployed;

6) huge increases in revenue from wealthy individuals and big corporations;

7) reducing or eliminating corporate welfare for Big Pharma, Big Oil, Wall Street, etc.

8) reasonable policy on estate tax will also yield much more revenue over ten years;

9) increased competition due to the break-up of big corporations will lead to a surge in small business, meaning more tax revenue; and

10) full employment (real unemployment at a "noise level" of 3-4% at better wages) will mean great consumer confidence and a mega surge in consumer spending, leading to an extremely healthy economy and yet again more revenue.

In toto, I believe this will more than match a purported increase of $1.6T in spending per year.

[DanTex]

46. Maybe he secretly disagrees, but his published study puts the number just under 20%.

Sure, maybe he has some additional double secret savings that for some reason he didn't want to include in his study.

[Admiral Loinpresser]

50. Can you point me to your figure? n/t

[DanTex]

51. Sure. It's all over the paper, for example:

The health care improvements and transition costs of a singlepayer
system ($394 billion, Table 2), including expanding
coverage to 44 million uninsured Americans and upgrading
coverage for everyone else, would be funded under HR 676
by $592 billion in savings on administrative costs and reduced
pharmaceutical prices. As a result of implementation of HR
676, health spending in the first year would fall by $198 billion
to $2,964 billion (Table 6).

Actually I was mistaken, it's much lower than 20%. As he points out, despite the $592 Billion of savings (which is about 20% of the total), there would also be $394 billion of additional costs associated with single payer, so the net savings is actually $198 billion, or about 6% to 7% of total healthcare costs.

[Admiral Loinpresser]

56. Whoa, cowboy.

You are comparing apples to oranges. You are apparently using a figure (about $3.1 trillion annually spent by America on health). This is nowhere near the actual expenditures of the federal government for health care currently.

Once we have that issue resolved we can move on to other major upsides not considered by Friedman's plan and keep in mind we have no idea whether Bernie will propose the same expansions, such as dental and mental health.

Here are other major fiscal upsides:

An end to extreme health care/insurance inflation. I believe ten-year projections for US societal health spending are about $42T. In other words, the status quo has about $11T in added societal expenses if we do nothing.

Healthcare DEFLATION due to a single payer system. If you check the OP link, you will see that not only are we the worst system in the world for per capita cost, but that we are also the worst by over 50% in the per centage of GDP in societal spending. USA =17.7% of GDP; next worst is Holland at 11.9%.

In other words, major countries unanimously spend much less per capita, because they all provide some form of universal health care. To think that the USA will somehow be an exception to this rule of reduced costs seems highly improbable. Friedman does not address this factor at all, other than reductions in drug prices.

Also, part of the cost savings Friedman addresses is temporary, i.e. transition costs of at least $52M go away (after the first year or the tenth is not clear), while the costs savings are permanent. More importantly there is a vast array of societal costs for the status quo that are not considered by Friedman, but that result in real federal fiscal costs. We can get into that later.

Do you really think that we will stay anywhere near 17.7% of GDP in societal health costs with universal health care, when no other major economy in the world performs that poorly by over 50%? I find that highly dubious. Taking out the profit and greed factors and injecting new efficiencies of scale militate in the opposite direction. Americans are good enough to do what the rest of the world is already doing, at least close to as well, if not better.

[DanTex]

59. Umm, it's plain English.

Yes, $3.1T is the total amount that American currently spends on healthcare. With single payer, the government assumes all costs, and thus the savings is $3.1T minus the total cost of single payer. Friedman's estimate puts the savings at $198 billion, which is about 6.4% of the total of $3.1T. This is a believable number. In your OP, you claimed it would cut healthcare costs in half, which is a ludicrous number.

As to other cost savings that Friedman left out, you are free to speculate, there might some, and there might also be other cost increases as well. But the only numbers that have come from an actual study are Friedman's and he estimates the savings at 6.4%. And he's a pro-single-payer economist.

[Admiral Loinpresser]

64. Friedman doesn't deal with big picture.

The reason the US system is extremely inefficient and grossly inflationary is because of a lack of regulatory control. The reason the rest of the world is vastly more efficient than the US is because not only are drug prices controlled, but also hospital and care provider fees are also controlled. US prices for services are out of control.

Single payer allows the federal government to radically change that dynamic. No more $30 aspirin tablets or exorbitant fees for services and equipment. That is why the rest of the world kicks our ass on costs. We will no longer be paying 17.7% of GDP for health care. If we merely get down to the efficiency of the next worst (Holland at 11.9%), that translates to $1T in efficiency savings.

Hospitals and doctors offices will be able to absorb that loss of revenue as they dramatically reduce admin staff. Those people will have good jobs waiting for them doing something productive.

You also do not address my argument about status quo inflation of an additional $11T over ten years!

Friedman's analysis is extremely pessimistic by not addressing the efficiencies enjoyed by every major country except America. He also does not account for status quo inflation in his analysis.

[DanTex]

65. Maybe not, but it's the only study that has been introduced into the discussion.

Is it pessimistic? I don't know. He is, after all, a pro-single-payer economist. The argument could also be made that he's optimistic about the difficulty of transitioning from what we have now to a single payer system. Look at what happened in Vermont.

Like I said, the reasons we have so much more expensive care are complex and varied. Not all European countries have single payer, and even the ones with other systems still do a much better job than we do about costs.

I agree that single payer would have been a better way to go about health care from the start, but getting there from where we are now is going to be very difficult. And, as Vermont found out, there will have to be huge amounts of new taxes, which politically makes it a non-starter.

I think a wiser course of action is to build on Obamacare, for example, by adding a public option.

[PosterChild]

68. Thanks to Dan and the Admiral for . ..

... an interesting and informative discussion !

[Admiral Loinpresser]

71. Every major country has universal health care except the US.

That is why we are so inefficient. The data in the OP link demonstrates that universal health care is much cheaper than our disastrous system. We must get our % of GDP figure down to about 12% from the current ridiculous number: 17.7%

The only way to do that is universal health care. SP is the best way to do that.

ACA is not the way. It's bad news for some people in red states, e.g. me. It is not nearly as progressive as Conyer's bill and I expect that Bernie's eventual plan will have more realistic cost savings.

What I find most interesting is your assertion that SP is not the way to go, while throughout this thread you have canonically relied on Friedman's data. Yet the conclusion he draws is that SP is the most efficient way to go and very achievable.

So you adopt in toto his data, but reject his conclusions?

[DanTex]

74. Right, but universal health care does not necessarily mean single payer.

Holland and Switzerland, for example, basically have better versions of Obamacare. So, obviously, single payer is not necessary for providing quality care with reasonable cost.

The reason I cite Friedman's numbers is because he is pro-single-payer, and yet even his study finds that the cost savings will be much lower than the 50% you claimed in the OP. The point being, even people who agree with you about the conclusion that SP is the way to go don't believe your 50% savings claim.

Personally, I think the costs of transitioning to single payer from where we are now will be greater than Friedman's estimates, and since we already have Obamacare in place, it's better to improve it to the point where it functions like the Swiss or Dutch systems. This is simpler logistically, and also has the advantage of being much more feasible politically.

[Admiral Loinpresser]

75. Your interpretation of Friedman is false,

according to Friedman. Please see post #73.

[DanTex]

77. No it's not. Also, that's peripheral to the question of whether single payer is

the only way to bring down healthcare cost inflation. If Holland and Switzerland can do it with a version of Obamacare, why do we need single payer in the US?

[Recursion]

83. But single payer is pretty much the least common way to do it

It's really just Canada and Austria that went that way.

[Admiral Loinpresser]

73. Timeout!!

Apparently, the author you keep citing has a different interpretation of his study altogether from you:

 But it wouldn’t be a dollar-for-dollar transfer from the private to the public sector. According to Gerald Friedman, an economist at the University of Massachusetts at Amherst who authored the analysis cited by the Journal, that transition would reduce American healthcare costs by almost $10 trillion over 10 years through economies of scale, better control of pharmaceutical costs, and savings on administrative bloat.

Friedman also projects that, as every American got coverage, we’d spend close to $5 trillion more on actual healthcare services. So we would get more healthcare and still end up saving around $5 billion on net. In other words, Sanders’s Medicare expansion would cost $15 trillion, but without it American businesses and taxpayers would spend $20 trillion over the same period, while still leaving millions uninsured.

Turns out he agrees with me about economies of scale.

Check and mate.


http://www.thenation.com/article/what-the-wall-street-journal-gets-totally-wrong-about-bernie-sanders-agenda/

[DanTex]

76. Umm, $15 trillion is not half of $20 trillion.

Yes, this is a pro-single-payer economist, I know that. Like I said, I think his numbers are optimistic, but even if you accept his assumptions about healthcare growth with and without single payer, it still falls well short of the 50% savings you claimed in the OP.

[Admiral Loinpresser]

82. Better take it up with Friedman.

My quote from the cited Nation article makes it very clear he disagrees with your analysis of his study. Economies. Of. Scale.

[Admiral Loinpresser]

87. You are so busted. By Friedman himself.

He explains the math of his study in an open letter rebutting the WSJ article. Really consider next time whether you want to rely on a deceitful RW rag like the WSJ when debating.

http://www.huffingtonpost.com/gerald-friedman/the-wall-street-journal-k_b_8143062.html

Based on the OP linked OECD data from 2011, I believe a 50% reduction in per capita spending is achievable. Once we adopt a sane system, we are certain to have reductions way over 20%. Will it be only 40%? Possibly. But the huge economic secondary efficiencies discussed up thread will certainly happen.

According to Friedman, not doing anything will result in a very expensive path with the current shitty system we have now. Adopting Conyer's plan will SAVE money and give universal, expanded Medicare for all. Friedman's explanation of the math supports the headline of the OP: "Bernie supports biggest savings in US history."

I think people have enough info to decide whether Friedman is correct, or you. I'll let you have the last word, if you want it.

[DanTex]

88. It's simple math, really. Sure, people who think 15 is half of 20 will disagree, but

I think that kind of person is pretty rare. I'd say the 6% cost savings from the Friedman study is plausible, I suspect that his projections about the growth rate of health care under single payer are highly optimistic, but regardless, nobody in their right minds thinks that the savings will be 50%, which is what you claimed in the OP.

[HooptieWagon]

79. You're still spouting Murdoch RW talking points.

The WSJ deliberately misstated facts. You are deliberately repeating them.
https://www.washingtonpost.com/blogs/plum-line/wp/2015/09/15/no-bernie-sanders-is-not-going-to-bankrupt-america-to-the-tune-of-18-trillion/

[sabrina 1]

80. It will eliminate the middle men who cost us approx. 20%

of the money that they pocket for doing nothing that relates to actual HC.

Are you arguing against Single Payer? If so, why?

Every other nation in the civilized world manages to afford to keep their citizens alive by providing them with adequate HC, even countries like Iraq and Libya BEFORE we invaded them.

We are alone among developed nations that have a For Profit HC System, it is simply immoral. 44,000 Americans died every year since 9/11 due to lack of HC. THAT is a disgrace, to put it mildly.

To argue about money when it comes to life and death situations, is simply obscene. To argue against providing all Americans with the opportunity to live in the richest nation in the world that has trillions to spend on war, is simply inconceivable.

Bernie plans to cut the over bloated Military Budget, one tenth of which could pay for HC for all Americans.

[Admiral Loinpresser]

4. From your cited source:

“If the US were to shift to a system of universal coverage and a single payer, as in Canada, the savings in administrative costs [10 percent of health spending] would be more than enough to offset the expense of universal coverage” (“Canadian Health Insurance: Lessons for the United States,” 90 pgs, ref no: T-HRD-91-90. Full text available online at http://archive.gao.gov/d20t9/144039.pdf).

Before I deal with your point, I quote your source for the premise that US universal health care is very affordable. Thank you for making my over-arching point: universal health care is a good thing economically, as well as a boon to the 99% in reducing personal costs.

As to your point, perhaps Americans will not catch up per capita with the other major countries. But I seriously doubt that figure of 20% is a reasonable ceiling, as opposed to 50%. Or are we simply incapable of governing as well as the other major countries?

Did your cite consider the vast reductions in drug prices available with single payer? Did they consider the secondary economic benefits to individuals and small business? Did they factor in the huge new numbers of workers at a living wage? Those factors introduce secondary benefits in terms of cost reduction to society as well as the federal government.

[PosterChild]

18. I'm not sure why you cited the excerpt you did...

The text from that citation (emphasis added) clearly supports the point being made:

“If the US were to shift to a system of universal coverage and a single payer, as in Canada, the savings in administrative costs (10 percent of health spending) would be more than enough to offset the expense of universal coverage” (“Canadian Health Insurance: Lessons for the United States,” 90 pgs, ref no: T-HRD-91-90. Full text available online at http://archive.gao.gov/d20t9/144039.pdf).

10% is not even the 20% savings mentioned. And certinally not half. In addition this 10%is supposed to cover the administrative costs, so it isn't even net savings. So what is your point?

[Admiral Loinpresser]

25. That's only the savings on admin costs

not total gross savings or even net.

The subtitle of the study is "How we can afford a national single-payer health plan." You do understand that the cited article cuts for my overall point: we can afford it and it cuts costs. You understand that is the overall conclusion of the study, correct?

[PosterChild]

30. You are right, the statement. ....

.... should be interpreted as you suggested . I went to the report that is linkes, and it has a direct comparison between us and Canadian per capita expense, figure 1-1. The overall gap , in 1999, sugests what looks like 20 to 25%, about what was stated above. It's been a while since then - it would be intersting to see an updated extension of that comparison .

[Admiral Loinpresser]

35. Actually, my cited data indicates Canada spending about 50%

per capita of what we spend. See post #34.

[PosterChild]

31. Sure, it does! Particularly per capita,

And on an individual basis, including subsidies, it could be a bigger savings for some who are in need. But as noted, it principally represents a wealth reallocation not an intrinsic savings and not one that will pay for itself. Since more people will be included, even with real per capita savings, costs over all may (probably will) go up.

The best argument for universal health care is a moral one, not a fiscal one. In truth you can't get much more of something without paying more overall .

[Admiral Loinpresser]

34. TIMEOUT!!

Let's consider the best data available. In post #1, DanTex cited obsolete, 20th Century data. The US has experienced incredible healthcare inflation in the 21st Century, so we need more accurate data.

I linked to a wiki source in the OP (using 2011 OECD data) asserting Canada spends 53% per capita on healthcare of what the US does (roughly $8,5k per person in US, vs. $4.5k in Canada).

I also now cite the UMass study infamously used by the WSJ to claim a net increase of $15T in spending over the next ten years (under the Conyers bill):

http://www.pnhp.org/sites/default/files/Funding%20HR%20676_Friedman_final_7.31.13.pdf

What the study actually says is that with EXPANDED coverage, including dental, mental health and filling in gaps in Medicare, the Conyers proposed plan would have a shortfall of about $1.5T per year, which is where WSJ gets their figure. I don't think the UMass proposal is necessarily the way to go, since it assumes a complete buyout of the private sector healthcare is necessary. We may well start with a mixed national plan where millions of affluent Americans keep their current private healthcare, just as the UK does. This would greatly reduce transition costs, resulting in even greater savings than the $600B per year asserted by Friedman of UMass (Figure 1). The Friedman analysis is complicated but there are certain issues not in dispute:

1) the cost of health care per capita in the US is by far the highest; 2) going to a single payer system will greatly reduce the US per capita figure; and 3) the savings will be huge. What mechanism is used to cover the shortfall in projected federal expenditures for universal, expanded coverage is up to Bernie.

What is clear is that the overall economic efficiency of the US economy will be greatly improved and most of the 99% will pay much less for much expanded coverage.

[PosterChild]

39. Thanks! I'll take a closer look at the link in the OP. (NT)

[Admiral Loinpresser]

40. You bet. Love your avatar. n/t

[TheKentuckian]

7. We can't afford to save 20%!!!

[NCjack]

8. Yes. The savingsare too large. It will drive some CEO's down into the middle

class. How embarrassing for them and us. /s/

[JDPriestly]

10. Hard to say without serious economic analysis. You have to consider the impact that

insuring everyone would have on days lost from work, disease prevention and many costs we do no relate to healthcare that are in fact related.

What if chronic conditions like diabetes and high blood pressure and similar problems including cancer could be diagnosed and treated earlier in uninsured populations? What would be the savings? What would be the effect on our longevity statistics, on birth diefects, on accident and even crime rates". Yes. What if siingle payer coverage meant that mental health care counseling was affordable for disturbed people.is is

Would single payer healthcare reduce the costs of settlements on personal injury cases? Would it even effect the amount we spend asa nation our courts and legal services as well as insurance not directly related to health care?

To assume that you can jut add up amounts spent on health insurance does not lead to an accurate answer.

[R.A. Ganoush]

53. An interesting question on one of your points...

In my experience participating in the utilization review of company-sponsored health insurance benefits, when the carrier initiates case and/or disease management with the member, the response rate is in the neighborhood of 10%.

So, in the event we manage to implement something similar to SP or UHC, how do we increase participation in CM/DM in order to increase/realize the potential savings (by getting out in front of a problem before it becomes a bigger problem)? Obviously if the member isn't worried about incurring additional costs engaging in the process that may help a bit, but how do we help the people not willing to help themselves?

Often, human nature can be the biggest impediment to the progress that we need.

[JDPriestly]

67. I have Kaiser insurance. That is a doctor-managed health insurer and care provider.

It is a good model that works well. Healthcare providers should be in charge of patient care, not businessmen and shareholders who are not focused on the medical outcome but since they are corporations, for-profit corporations, on profits for their shareholders.

Non-profit management with government oversight and the non-profits managed by doctors like those at Kaiser would be my idea.

Doctors take an oath to do no harm and to care for patients not shareholders. They should with patients and the government manage our healthcare system.

Government and non-profits can do a great deal to educate the public about healthy living. Here in California smoking is declining. State laws that make it harder to smoke, that cause smokers to smoke less have helped as has a government advertising and education campaign.

[Admiral Loinpresser]

16. This.

http://pnhp.org/blog/2013/07/31/friedman-analysis-of-hr-676-medicare-for-all-would-save-billions/

Universal health care means "yooge" savings for Uncle Sam!

[A Simple Game]

20. Gee, save 20%? Why bother hardly enough to pay for unicorns? Can I still get the Volvo though? n/t

[HooptieWagon]

27. Even 20% savings is a lot of dough, no?

the only people against a 20% savings would be Big Pharma shills.

[whatthehey]

37. Strange that every other developed country pays much less per capita then.

[rhett o rick]

66. Wow you got the number one response spot. What a good place to disparage an OP.

I guess you try to distract from the fact that your candidate has no plan.

[PatrickforO]

81. Right now, I already pay 'taxes' out the nose for inferior health care. These 'taxes' are called

'premiums' and go to insurance companies, whose profit motive lies in direct conflict of interest with providing me good care.

I among millions of other Americans, have rationed healthcare. My healthcare at an HMO whose main value is not to give patients the very best care, but is to cut costs. Seriously. And the cost of that care keeps going up double digits while the services they give me go down and my copay goes up. What I have now SUCKS. And I'm lucky - at least I have something.

Over 18% of my paycheck goes to healthcare.

This is why I would far rather pay an expanded Medicare tax and have Medicare. Because then I wouldn't have to still worry about getting sick.

You know, if the 30+ Fortune 500 companies actually paid their fair share of income tax, instead of being able to salt away billions in untaxed profits offshore, it would bring in an estimated $900 billion. If the payroll tax cap on Social Security was removed, Social Security would be fine as well.

Let me ask you, Dan, why is it so bad to want OUR tax dollars to be used for programs that benefit us instead of for a forever war?

[MisterP]

2. that's two-thirds of "health" insurance cost that people can get to keep

besides, what percentage of Medicare recipients hate the system? Sanders is targeting those who want the government to butt out of it, gently reminding them that *it's a flipping government program*

[Uncle Joe]

5. Kicked and recommended.

Thanks for the thread, Admiral Loinpresser.

[Admiral Loinpresser]

6. Always for you, Uncle Joe! n/t

[mountain grammy]

9. Universal health care in my lifetime!

DO IT! I now enjoy America's single payer health care; Medicare. Thanks, LBJ.

[Spitfire of ATJ]

11. Meanwhile Republicans were talking about privatizing the Post Office.

[appalachiablue]

13. Been working at that since Bush or longer. I love the USPS! The greedy effers will profitize and

commodify everything including us, until we're unusable and discarded. My father said how the Army would use and wear out the horses and then eat them.

[Spitfire of ATJ]

14. One of the things I use as an example...

I say someday government run healthcare will be as controversial as government run streetlights.

[appalachiablue]

15. That's good...

[Spitfire of ATJ]

19. There's only one problem with it.....

Some tax grump might say, "Why should I pay for streetlights in THAT part of town? I never go there. I certainly would never do it at night."

Then show them this:



Tell them their money is paying for the power bill to keep those lights on ALL NIGHT. Even after everyone should be in bed. Besides, don't cars have headlights?

You can really get them going.

[appalachiablue]

23. The immensely wealth- funded media machine that's turned ordinary citzens against the US govt.-

the people- is an extraordinary feat in the last 30 years. Assured and rabid in their righteousness, combined with fear and hate is too much at times. Trying to reason how they are used by the powerful and complicit in their own demise is difficult but not impossible. And many are secure with survivor mentality, bunkers & ammo for when the system/apoclypse h*ll breaks loose. Fine.

I don't encounter many RW extremists, not from being in a high liberal area but through instinct and horse sense that usually detects negative human character. Sunburn I also avoid!, (fair complexion), and jumping into shark tanks with hustlers.

Posters amaze me by the patience and willingness to debate pig headed, mean and selfish conservatives lacking scruples and heart. But somebody has to do it. I've little talent for it, never will, so steer clear. Hurling a metal folding chair would be preferable in instances, an antisocial behavior but endemic to the blood line. Whadda ya gonna do. Cheers!

[Spitfire of ATJ]

24. What's funny is when you take one on and notice their wife is snickering that he's losing.

[Capn Sunshine]

47. not to derail the topic , but the USPS plan is fiendish in many ways

without the USPS, private firms that now piggy back the USPS to get to rural addresses will no longer deliver there.

Plus, with the huge swing to absentee voting, the cost associated with delivering your voted ballot might be an expense you cannot afford. Or you may have to drive to a service center to send it.

Either way, voting by rural, poor and elderly will be significantly impacted, and THAT is their ultimate plan.

[appalachiablue]

12. K & R. Health Ins. expert Wendall Potter spoke with Thom Hartmann tonight on The Big Picture

about the US transition from non profit health insurers, to privatized for profit companies under Reagan mostly and the enormous changes and cost increases ever since. During that time the life insurance companies also jumped into the field.
Very concerning now is that we will soon have only 3 major carriers apparently, with the recent mergers/takeovers of Cigna, Aetna and maybe Anthem. I forget which ones exactly. This is real trouble and must be challenged, Bernie's plan is the best and only way.
Thanks for the informative post.

[cantbeserious]

17. Roger That

eom

[d_legendary1]

21. Every major country has some sort of universal care for its citizens

while we have leeches that live off our backs and the government. Healthcare should be a right, not a privilege based on how big someone's pocket books are.

[HooptieWagon]

28. Even some third world countries have universal care.

They're just a lot smarter than we are.

[d_legendary1]

29. Costa Rica comes to mind

since el rusho swore ( ) to head out there if Obama care got passed.

[Recursion]

85. Right, but very few of them use a single payer system to do it

That's why we need to focus on the end, not the means. There's no particular reason we have to use single payer as our way of achieving universal care; in fact, it's relatively unpopular among other countries so that should probably tell us something.

[RufusTFirefly]

22. Not only is universal health care more cost effective and competitive, but....

... there's also a powerful but intangible sort of "we're all in this together" aspect that has a priceless effect on a country's overall sense of democracy and solidarity.

Obviously, we can't have that!!!

[Rosa Luxemburg]

26. I want Bernie!!!!

[Scuba]

32. Using our precious healthcare dollars to fatten the bank accounts of corporate investors ...

.... in London, Tokyo and Hong Kong isn't just poor economic policy, it's immoral.

[Capn Sunshine]

48. Washington Post article succinctly sums up what is real.

I posted a link to this, but it's subscriber only so I'll post relevant paragraphs here:

The answer isn’t quite so dramatic: while Sanders does want to spend significant amounts of money, almost all of it is on things we’re already paying for; he just wants to change how we pay for them. In some ways it’s by spreading out a cost currently borne by a limited number of people to all taxpayers. His plan for free public college would do this: right now, it’s paid for by students and their families, while under Sanders’ plan we’d all pay for it in the same way we all pay for parks or the military or food safety.

But the bulk of what Sanders wants to do is in the first category: to have us pay through taxes for things we’re already paying for in other ways. Depending on your perspective on government, you may think that’s a bad idea. But we shouldn’t treat his proposals as though they’re going to cost us $18 trillion on top of what we’re already paying.

And there’s another problem with that scary $18 trillion figure, which is what the Journal says is the 10-year cost of Sanders’ ideas: fully $15 trillion of it comes not from an analysis of anything Sanders has proposed, but from the fact that Sanders has said he’d like to see a single-payer health insurance system, and there’s a single-payer plan in Congress that has been estimated to cost $15 trillion. Sanders hasn’t actually released any health care plan, so we have no idea what his might cost.
:snip:

But health care is nevertheless a good place to examine why these big numbers can be so misleading. At the moment, total health care spending in the United States runs over $3 trillion a year; according to the Centers for Medicare and Medicaid Services, over the next decade (from 2015-2024), America will spend a total of $42 trillion on health care. This is money that you and I and everyone else spends. We spend it in a variety of ways: through our health-insurance premiums, through the reduced salaries we get if our employers pick up part or all of the cost of those premiums, through our co-pays and deductibles, and through our taxes that fund Medicare, Medicaid, ACA subsidies, and the VA health care system. We’re already paying about $10,000 a year per capita for health care.

So let’s say that Bernie Sanders became president and passed a single-payer health care system of some sort. And let’s say that it did indeed cost $15 trillion over 10 years. Would that be $15 trillion in new money we’d be spending? No, it would be money that we’re already spending on health care, but now it would go through government. If I told you I could cut your health insurance premiums by $1,000 and increase your taxes by $1,000, you wouldn’t have lost $1,000. You’d be in the same place you are now.

By the logic of the scary $18 trillion number, you could take a candidate who has proposed nothing on health care, and say, “So-and-so proposes spending $42 trillion on health care!” It would be accurate, but not particularly informative.

(emphasis mine)
There’s something else to keep in mind: every single-payer system in the world, and there are many of them of varying flavors, is cheaper than the American health care system. Every single one. So whatever you might say about Sanders’ advocacy for a single-payer system, you can’t say it represents some kind of profligate, free-spending idea that would cost us all terrible amounts of money.

Since Sanders hasn’t released a health care plan yet, we can’t make any assessment of the true cost of his plan, because there is no plan. Maybe what he wants to do would cost more than $15 trillion, or maybe it would cost less. But given the experience of the rest of the world, there’s a strong likelihood that over the long run, a single-payer plan would save America money. Again, you may think single-payer is a bad idea for any number of reasons, but “It’ll be too expensive!” is probably the least valid objection you could make.

:snip:

The conservatives who are acting appalled at the number the Journal came up with are also the same people who never seem to care what a tax cut costs, because they think cutting taxes is a moral and practical good, in the same way that liberals think providing people with health coverage is a moral and practical good. For instance, Jeb Bush recently proposed a tax cut plan whose 10-year cost could be as high as $3.4 trillion. That’s a lot of money that the government wouldn’t be able to spend on the things it’s doing right now, although the campaign argues that we’d get much of that money back in increased revenues because of the spectacular growth the tax cuts would create. If you remember the claims that George W. Bush’s tax cuts would create stunning growth and prosperity for all, you might be just a bit skeptical of the Jeb campaign’s similar assertions. But in any case, we can’t evaluate the value of Jeb’s plan just by saying that $3.4 trillion is a big number. If you knew that the average family in the middle of the income distribution would get less than $1,000 from Jeb’s plan, while the average family in the top one percent would get a tax cut of over $80,000, then you’d have a better sense of whether it’s a good or bad idea.

:snip:
The question when it comes to government should always be not what we’re spending, but what we’re getting for what we spend.

[Admiral Loinpresser]

52. I agree with this in principle.

Also, I think the author underestimates the economic costs of our current health spending. For example, the disadvantages to both big business and small businesses. In the auto industry, e.g. GM's cost per car used to about 24% for health care. I don't know what the current cost is. This very expensive health insurance puts American car companies at a disadvantage relative to the rest of the world's auto companies.

Small businesses usually have to address that growth point where they will take on the administrative and direct costs of providing a health plan. This is a huge drag on the expansion of small businesses, that disappears with a single payer plan.

Also, the author does not mention other economic costs of the status quo, such as litigation costs in personal injury cases, etc., bankruptcies caused by no insurance, under insurance or loss of insurance with catastrophic illness. Also premature deaths and the secondary familial economic consequences due to inadequate health coverage.

Having said all of that, it is traditional in political debate, when proposing an increase in government spending to propose how to pay for it. Bernie already has proposed a Wall Street Speculation tax that is intended to pay for college tuition, iirc. I believe he will also propose how to pay for everything else before the first debate, or at least have a defense if HRC tries to go after him.

See post #44 for a laundry list of revenue increases and cost savings available to cover the added federal costs of single payer.

[TexasBushwhacker]

70. It also saves by saving lives and keeping people

from becoming disabled. Someone who has poorly managed diabetes can have complications including blindness and amputations. They are more likely to have heart and kidney disease. Well managed diabetic patients who are compliant with their diet and medication can be as healthy as anyone else. Less disability and premature death means people live longer, work longer and PAY MORE TAXES.

Let me give you a real life example. I met a young man while I was in the hospital a few years ago. He was 30 tops. He worked in construction and had no health insurance. There was an accident on the worksite and his leg was badly mangled. He was rushed to the ER. If he had insurance, they might have tried to save his leg. That would have been expensive surgery and a long rehab. Since he was uninsured, they just saved his life. To stop the bleeding they had to amputate his leg.

So he was then in a wheelchair. He was profoundly depressed over the amputation. He would no longer be able to do construction work, at least not until he got a prosthetic leg and that wasn't going to happen because he HAD NO INSURANCE. Sure, he could get workers comp insurance IF his employer had it (it's not required in Texas) or he could sue his former employer but that wouldn't get his leg back. This was in 2012, before the ACA.

[Admiral Loinpresser]

72. Excellent example of the efficiency of SP. n/t

[Admiral Loinpresser]

86. Citing 2011 OECD data. n/t