Bernie Sanders Thinks He Can Vanquish Health Insurers. He's Wrong.

[mia]

His “Medicare for all” plan is the best known—and the most politically impractical.

Whether they’re running for president or just hoping to hold onto their seats, Democratic lawmakers face growing pressure to endorse one of Bernie Sanders’s signature causes. “Doc, they keep coming—pressing me to sign onto Medicare for all,” a somewhat hesitant and confused congressman told me recently. “Should I?”

“It all depends what you mean by ‘Medicare for all,’” I said. He was hoping for a better answer than I had. About 70 percent of Americans say they support the idea—under which Medicare, the federal program that now provides health coverage for about 60 million seniors and disabled individuals, would expand to cover millions more people.

Yet Medicare for all is a messy concept. At least four different approaches to health reform could truthfully carry the Medicare for all label. Sanders’s plan is the best known, but it’s also the most politically impractical. It ignores the brutal history of repeated defeats for all Democratic health reform proposals that try to abolish private health insurers.

In the Vermont senator’s proposal, the federal government—Medicare—would become the primary payer for health care services. Private insurance companies would be relegated to selling small, specialized plans for medical services not covered by Medicare. According to some bad-faith criticisms of his plan, Sanders is proposing socialized medicine—a government takeover of the whole health care system. That’s not so. Hospitals, physician and dental practices, pharmacies, home health care agencies, hospices, and other providers would remain privately owned and operated under Sanders’s plan....

https://www.theatlantic.com/ideas/archive/2019/03/bernie-sanders-thinks-he-can-beat-insurers-hes-wrong/584731/

[qazplm135]

1. the whole underpinning of Bernie's campaign

is it requires a majority of voting Americans to, in effect, be secret democratic socialists/progressives.

The reality is, they aren't. They like in the general things he says, but once he gets into specifics and those specifics are attacked in a GE, his popularity is going to drop by quite a bit.

[Freddie]

5. Agree

Lots of people (myself, before I retired) have a great employer-provided plan and pay only a small % of premiums and very little out of pocket. They’ll soon figure out that the Bernie plan won’t be as good FOR THEM (selfish Americans, y’know) and he’ll be toast.
Improve Medicare. Make it available as a public option. Make it available for employers to offer instead of private insurance.

[vsrazdem]

34. Maybe back in the day but no longer. Most employer premiums have skyrocketed.

Before I recently went on Medicare, my premium for my employer plan was $300 a month. That got me a 6,000 deductible, and 500 coinsurance on any ER visit. A few years ago I had the same premium for an 80/20 plan with $500 deductible and a $100 copay for the ER. Employer sponsored health premiums have gone up and coverage shoved in the toilet just like everyone else.

[sacto95834]

49. private insurance

i don't think private insurance will ever go away. there will always be those that want "better" plans that what is offered to the majority. nothing wrong with that. but i do think everyone should be covered on some kind of health plans that covers cradle to grave care. i was thinking something along the lines of the Canadian system. the Feds will have to block grant $ to assist the regions/states with payment for medical services paid for via employer-employee taxes or some other scheme.

i do agree that i don't think one can switch it on say on jan 1, 2022. it will probably roll out via regions or states. the goal should be by some date insurance should be available to everyone. however i think universal coverage is possible even in a country like the US.

[Mr Tibbs]

74. Private insurance has a place

Plastic surgery. Elective stuff. But it has no place denying basic care to enhance profit.

[Mr Tibbs]

72. Is that what happened in the 60s? All that change?

A mass movement is what brought great change. Not a political party movement.

Mass movements are organic and cannot be stopped by political parties. Ultimately they overcome the political system if people are angry enough. That's what happened in the 60s.

A mass movement is brewing and the party would be well-advised to latch onto it

[qazplm135]

75. No it's not

If it we're Trump wouldn't have won. If it we're Trump wouldn't still be in the 40s. If it we're Sanders would have much higher support.

[Me.]

2. Brave Post Mia

WE need a flame shield smilie.

+1

[mia]

6. It looks like you know a lot about health insurance.

What would be the objections to your plan? Who would be the winners and losers?

[Demsrule86]

8. Medicare has deductibles first of all and if you tell folks they lose workplace insurance which

in many cases cost less than what you suggest...the support drops to 17%. Anyone who runs on this will lose.

[Demsrule86]

19. You pay premiums for Medicare...and then you need a wrap too...for the 20%.

Medicare for all would have higher taxes, premiums and deductibles. There is no such thing as a family plan either. And my guess is that the supreme court loaded with right wingers, they would find it unconstitutional. But it wouldn't matter because voters would toss us out of office and would have nothing. And ignore the jobs losses this program would cost is foolish too.

[Demsrule86]

28. And it won't be a small tax...already many of us are paying 50% with state and federal.

[Demsrule86]

29. What about those who can't afford a 'small tax'?

[Mr Tibbs]

55. Under a single payer model there are no premiums

[stopbush]

77. Right, because taxes take the place of premiums.

Current Medicare patients pay $135 a month for a plan that doesn’t cover catastrophic situations or prescriptions. Those cost extra. To keep funding at current levels, that $135 premium would become a tax to fund single payer. Now, multiply that by a family of four, and you end up with $540 a month in taxes to pay for single payer. That’s $6480 a year.

On top of premiums, 100% of workers currently pay a Medicare payroll tax to support the current program. Those payments barely support Medicare for the 19% of Americans over 65. So what happens if 100% of Americans are put on Medicare? Well, that payroll tax would need to increase five-fold.

Those are the raw numbers you can’t ignore.

[Mr Tibbs]

83. It would cost about half of what we pay now

And nobody would go bankrupt due to medical bills ever again.

[stopbush]

84. Not true. The devil is in the details.

I have yet to see real numbers to support your claim that it would cost half of what it does now. Please provide.

[Mr Tibbs]

89. Taxes aren't premiums

And "Medicare for all" wouldn't be "Medicare."

And it would cost us about 60% of what we pay now, with universal coverage, zero medical bankruptcies (60+% of bankruptcies have a medical component). The insurance based system we have now is a money skimming operation that makes it's billions denying medical care. We can do better.

[stopbush]

93. Again, where is the data to support your assertions?

I haven’t seen it. Last time around Sanders’ proposals did not show how he would pay for things. Just a bunch of platitudes. People who did run the numbers came up with taxes having to be raised considerably.

Look, I’m for universal care, but let’s have an HONEST discussion around REAL numbers. If people think those numbers smack of “socialism,” then make the case for that level of socialism. Better that than selling a rosy panacea that makes us just as big of liars as the Rs.

[ehrnst]

95. Where did you get those figures? They aren't in the MFA text.

It sure didn't turn out that way in Green Mountain Care.



There's no evidence to support your claim.

[Demsrule86]

85. That is not true. You will always have premiums...whether you call it taxes or what have you and som

can't afford it now so I just think it is not going to work

[Mr Tibbs]

98. For individuals, there would be no costs -- no deductibles, no copays or coinsurance.

And no more medical bankruptcies.

[Mr Tibbs]

96. "Medicare for all" wouldn't be "Medicare"

Though it would be similar

For individuals, there would be no costs — no deductibles, no copays or coinsurance.

[Demsrule86]

101. There is no such thing as free health care. And you would still be forcing this on many who have

workplace insurance who don't want...way better ways to get to universal coverage than something like...the time has passed for a program like this in my opinion. And there are very few who have this sort of system in the world today.

[Mr Tibbs]

103. It's paid for with taxes

And is about 40% cheaper than what we have now, with automatic universal coverage, and no more medical bankruptcies.

For individuals, there would be no costs — no deductibles, no copays or coinsurance.

[Demsrule86]

108. Much higher taxes...and that still costs us money that some can't afford.

[WeekiWater]

11. All Americans aren't covered under your scenario.

These are the thoughts that hold me back from supporting Medicare for all.

[WeekiWater]

18. Not according to what you have written.

It seems that all people would receive limited benefits, to be determined by legislators. You seem to hold a system up that sill shows economic bias in receiving healthcare.

[WeekiWater]

23. You never said "limited benefits"

But it is clearly there. I don't do semantics like that when discussing things.

[Demsrule86]

27. People die right now who are on Medicare becaus they can't afford the premiums and deductibles or

medicine. My sis in law had to pay her entire deductible before the surgeon would fix her hip. I know of some on Medicare who can't afford the Chemo...it simply is not as good as some think.

[Mr Tibbs]

99. For individuals under M4A, there would be no costs -- no deductibles, no copays or coinsurance.

So it's a moot point.

[Demsrule86]

100. That is not true. Somehow it has to paid for whether it is higher taxes or a premium...doesn't

matter. It is a bad idea to try to create this from scratch when few want it when they are informed worker related insurance goes away. Add a public option to the ACA...let's insure those who need it...not try for a huge omnibus type bill that will get us tossed out of office and end the only health care available -the ACA . And those running on this are unlikely to be able to pass this anyway.

[Bradshaw3]

105. Yes it is as good - I KNOW

I don't think. I've had insurance through employers, through Obamacare and now through Medicare and a supplmental. The deductible is $135. I've met that so everythian I get this year costs nothing. So your sister's "entire deductible" cpnsists fo $135 unless she didn't have supplemental. Compare that to ANY private insurance plan and it is worse.

Anecodotal stories not supported by fact mean nothing. People aren't stupid; there are reasons they are wanting some kind of Medicare fo rall option and it's because of this horrible system we have now which bankrupts millions. Your comments about how Medicare is killing people is ridiculous. Our for profit system is what's killing people. Ask anyone on this board who has Medicare and a supplemental if they want to go back to their old insurance and not a one of them would agree with you.

[Demsrule86]

107. My sister in law is on Medicare. She could not afford her plan or medicine if she didn't live with

us. That is a fact. She has a Medicare deductible and she has a wrap around plant to cover the 20% Medicare doesn't cover...the first wrap around plan she had cost about $5000 if you were in the hospital...we found out after she need surgery. The doctor refused to do the surgery unless the deductible was paid ( plan deductible) and the hospital wouldn't admit her unless she came up with the $5000.00 in advance of surgery. We paid the money so I absolutely know my comments are correct. She pays $300. a month for her medicine Medicare and the wrap come to over $300.00. We changed the plan to a higher premium plan after getting burned by the hospital bill and as I mentioned before she pays about $300.00 for her medicine out of pocket.
I would not want to see anything happen to our current plan but it would not work for the entire country. I would pay more no doubt than our work based insurance. And voters would toss us out office if we try to force the 50% of folks who have work place based insurance onto Medicare for all...only 17% support this plan if workplace insurance goes away. A public option is he way to go with a lowering of Medicare age.

[Bradshaw3]

109. There isn't one Medicare for all plan

Soe don't include doing away with all other insruance but it would be great if we could get profit out of our healthcare system. Most people's insirance through work sucks. I know mine and millions of others had plans that were awful and much worse than Medicare. So the numbers, including the poll number you cite and the plans, are all speculative. Sounds like your sister had a bad plan but that doesn't mean we all do. As I said, if you did a poll here of people on Medicare they would take it over their previous plans. I certainly would.

[Demsrule86]

110. Before Reagan health insurance was non-profit.

I looked into every wrap available. And they are not cheap if you are on a fixed income...you have to have a wrap. And you don't always know how bad a plan is until you need it as in my sis's case. Medicare for all is a non-starter in my opinion as it would cause havoc to try to put every person on it, get us kicked out of office and cost more than many working folks work based plans...and we would lose any say in health care for quite a while...I would imagine such a plan would fail in the end just as Hillary care did and we would be left with nothing...no ACA-nothing. Far better to improve the ACA and add a public option. Also lower the age of Medicare to say 50 or 55. Give insurance to those who need it now. Don't try to force folks off their work based plans...and regulate the insurance industry. This will give us universal coverage which is what we want. Plenty of countries don't have top down Governmental insurance. And after looking at it , I can see why. It is not the panacea people think it is. Imagine if Trump could control everyone's medical...that alone should give you a chill.

[pandr32]

4. Medicare has become a wasteful system

Health care providers have become increasingly corporate owned and bureaucratic(and not efficiently so). Prescription prices are sky high and not covered without a supplementary plan such as Part D. So many private hands are taking money every step of the way that would be better served if there was a straighter line between patients and care givers.

[zipplewrath]

7. What a crock

The author is a guy that has helped design an alternative. He gets paid to run around pitching the plan. And his only real criticism of Bernie's approach is some belief that it is politically impossible. And his belief is based upon a presumption that people actually like insurance companies.

[ehrnst]

9. The author disagrees with Sanders, and that makes you mad. That's understandable.

However, you may want to read up on the Center for American Progress:

https://www.americanprogress.org/

And actually compare the different UHC plans being submitted to Congress:

https://www.kff.org/interactive/compare-medicare-for-all-public-plan-proposals/

You're welcome.

[zipplewrath]

33. Not mad

But the guy should admit that he has a huge bias in his analysis.

[mia]

40. The author stated his bias in the article.

(Full disclosure: I helped design it. I’ve also received speaking fees from groups representing insurers, hospitals, doctors, and employers.)

He is also an oncologist, bioethicist, and vice provost of the University of Pennsylvania.

[zipplewrath]

41. not a politican or an economist

But he speaks very authoritatively on these subjects, and in fact it is the underpinning of his entire analysis.

And his disclosure doesn't not admit to the huge amount of bias his analysis contains.

[marylandblue]

56. He said he helped create one of the version he is promoting in the article.

That doesn't give you a clue that he might be favorable to the thing he worked on and is paid to promote? As for speaking authoritatively, do MD/bioethicists have some sort of intellectual deficiency that makes them unable to speak intelligently about healthcare? Or do only politicians and economists have that ability?

[zipplewrath]

66. Politics and Economics

He criticize the plan based upon political insights and economic assertions. Neither of which he particularly demonstrated any particular expertise. Nor did he make reference to people who did have an expertise in those subjects. He asserted his plan was better without making any effort to actually show that it was superior, merely that Bernie's had weaknesses and that insurance companies would be more popular.

[marylandblue]

67. Yes, that's his opinion. Does he need to demonstrate "expertise" before he may have one?

What's your expertise to disagree with him? If you disagree with him on the politics of the situation, that's fine. But attacking his credentials isn't a very convincing argument.

[zipplewrath]

68. He should support it

If he is going to make assertions in areas in which he has little if any expertise, he should support those assertions with references to either people who do, or other related information. Mostly he just made vague references to the 1990's to assert what will and won't work in 2020. He makes economic assertions without any reference to any economic studies supporting his positions. And he does little to support his own plan on either these basis, or even medical bases in which he DOES have some expertise to rest upon. His entire basis for claiming his plan was better was that it didn't suffer the weaknesses he asserts, without support, of Bernie's plan.

It's not so much that I disagree with him as it is I think he made a real crock of a case and it was dripping with hubris and self service.

[marylandblue]

70. Turns out he does have the relevant expertise

He has PhD in political philosophy, has written books on healthcare reform and even was at the center of some political controversies in health care.

https://en.m.wikipedia.org/wiki/Ezekiel_Emanuel

As for his supposed hubris, perhaps you can suggest he see a therapist?

[TexasTowelie]

78. .

It's not so much that I disagree with him as it is I think he made a real crock of a case and it was dripping with hubris and self service.

Meanwhile, there are plenty of people including Democrats that Bernie has made a real crock of a case with his M4A plan and that it is dripping with hubris and self service because he wants to be president.

[katmondoo]

53. I have Medicare and would be dead today without it

[Demsrule86]

10. It is not a good plan. it just isn't. First of all it is politically impossible and would fail just

as Clinton care failed and we would be tossed out of office and there goes all health insurance. There are copays in Medicare...there are jobs in insurance....to insure those who already have coverage at great cost is just foolish and will never work. Lower the Medicare age and offer a public option. We will get to universal coverage. Insurance must be regulated and the pharmacies too. But to die on the sword that is Medicare for all indicates a lack of political savvy that will be fatal to progressives in the end...one must consider the reality of our situation.

[ehrnst]

12. Indeed - we lost the chance to have something close to what the rest of the world does because

Democrats told Ted Kennedy to not negotiate with Nixon in 1971 - but to walk away from anything but Single Payer.

The plan that Nixon came back with was farther to the left than the ACA.

Imagine if we had started it back in 1974.

Ted said that it was one of his biggest career regrets. It's not suprising that he put his energy into achievable goals like CHIP (working with Hillary), and didn't sign on when Bernie made MFA it his political brand.

[Demsrule86]

13. You are right and we lost another chance with Carter because of the feud between him

and Kennedy. I know a woman who worked with him in his later years...health care was his biggest regret in terms of the Senate.

[Mr Tibbs]

97. Medicare for all isn't medicare

For individuals, there would be no costs — no deductibles, no copays or coinsurance.

The health insurance industry is simply unnecessary. All it does is make people go bankrupt.

[Power 2 the People]

16. Bingo!

Does anyone think Coke would ever sing the praises of Pepsi??

[Demsrule86]

25. Bernie's approach is unrealistic for the reason detailed here.

Any attempt to force Medicare for all down the throats of Americans who if work place insurance goes away don't want it (only 17% approve) would get us tossed out of office and end the ACA as well. It is foolish and I seriously think Sen. Sanders is should not run on it...no one should. It would cause higher taxes and cost many folks more than what they currently have...it is a bad idea. and always was.

[zipplewrath]

36. You won't have to force

On a cost basis alone it will convert most folks. I suspect it'll take about 10 years. Quite honestly I suspect that in the early years we'll have to limit the number of eligible people so as to not swamp the system.

[TexasTowelie]

79. That's human nature.

I've never met a person that doesn't want things that are free.

[Demsrule86]

86. Beto has talked about a different kind of system and implementation but it gets to universal

coverage. Can you imagine how another Trump could fuck with a single payer system?

[zipplewrath]

94. Not once "everyone" is on it

The problem they had early on with ACA is that the immediate impact was on about 7% of the population. After a few years that number went up, as people with pre-existing as well as people with children affected by it began to understand what was going on. But a huge majority of the country saw very little obvious benefit changes due to the ACA (although there were changes they didn't completely understand). Any kind of Medicare for all plan that is introduced, a bit more smoothly than the ACA was, will quickly build up a collection of at least 30% of the population that is covered, if not more. You don't mess with that anymore than you mess with the current Medicare, including the Medicare Advantage plans.

[Demsrule86]

102. I don't believe it will happen and there is no way it will be smooth and we will be in court over

this for years...just not worth it for a plan that won't work particularly well.

[Mr Tibbs]

90. "Medicare for all" wouldn't be "Medicare"

Though it would be "Similar" to Medicare. It would provide automatic, universal coverage. It would provide a basic level of care for all citizens. 60% of bankruptcies have a medical component. Medical bankruptcies would no longer exist. The upside is too good to brush off

And it's 40% cheaper, meaning the 40% goes in your wallet or purse as disposable income.

[BooScout]

21. Here's the rub...

From a purely practical standpoint, the US is NEVER going to get rid of health insurance. The insurance industry is a trillion+ dollar industry. It employs either directly or indirectly several million people. It's business contributes to almost 3% of the GNP.

Fact...Medicare is mediocre at best and crappy at worst. Why do you think everyone supplements it? Fact...Doctors currently make a fairly good living. Some even make an excellent living. If you take away private health insurance and switch totally to a publicly funded alternative, those Doctor's salaries and by extension, other health care professionals salaries are going to fall...substantially. It is not unrealistic to expect Doctors to move to greener pastures if health insurance suddenly disappears.

If you want universal healthcare for all, the way to get there is gradually and not by bludgeoning the electorate with shock value scenarios. Something the Democrats are well aware of. The idea is start with something as your base (oh, I dunno...maybe Obamacare) and gradually chip away at the status quo. If you go in with guns blazing, promising the world and failing to achieve it, you're gonna get burned.

Sanders clarion call for 'Medicare For All' makes a dandy campaign slogan, but most people see it for what it really is at this time....impractical and unsustainable. He will never get such a broad and sweeping change past congress, regardless of either the Democrats or Republicans being in power.

[Demsrule86]

24. +10,000

[Thekaspervote]

26. Agree!! Had we done like the UK post WWII we might have

[BooScout]

69. Exactly.

[zipplewrath]

35. We're getting rid of coal

Never say never. The coal industry is slowing dying. The steel industry has all but collapsed. Both of these industries used to hugely dominant in American economics. The health insurance industry won't disappear in a day, but it can be converted.

[comradebillyboy]

37. There you go again, living in the real world...

MFA proponents ignore the fact that most folks have employer subsidized health care and for the most part they like it. I'm on Medicare now but during my career I had employer paid health plans that were far superior to Medicare. I also pay for all the extra medicare coverage and a supplemental policy for the 20% Medicare doesn't cover. It ain't free.

[workinclasszero]

32. Yeah we can't have universal health care because the HC CEO's are raking in the dough

But all these countries can...


1 Africa

1.1 Algeria
1.2 Botswana
1.3 Burkina Faso
1.4 Egypt
1.5 Ghana
1.6 Mauritius
1.7 Morocco
1.8 Rwanda
1.9 Seychelles
1.10 South Africa
1.11 Tunisia

2 Asia

2.1 Bhutan
2.2 Georgia
2.3 Hong Kong
2.4 India
2.5 Israel
2.6 Japan
2.7 Macau
2.8 Maldives
2.9 People's Republic of China
2.10 Singapore
2.11 Sri Lanka
2.12 Taiwan
2.13 Thailand

3 Europe

3.1 Austria
3.2 Belgium
3.3 Croatia
3.4 Czech Republic
3.5 Denmark
3.6 Finland
3.7 France
3.8 Germany
3.9 Greece
3.10 Guernsey / Jersey
3.11 Iceland
3.12 Ireland
3.13 Isle of Man
3.14 Italy
3.15 Luxembourg
3.16 Netherlands
3.17 Norway
3.18 Portugal
3.19 Romania
3.20 Russia and Soviet Union
3.21 Serbia
3.22 Spain
3.23 Sweden
3.24 Switzerland
3.25 United Kingdom
3.25.1 England
3.25.2 Northern Ireland
3.25.3 Scotland
3.25.4 Wales

4 North America

4.1 The Bahamas
4.2 Canada
4.3 Costa Rica
4.4 Cuba
4.5 Mexico
4.6 Trinidad and Tobago
4.7 United States
5 South America
5.1 Argentina
5.2 Brazil
5.3 Chile
5.4 Colombia
5.5 Peru
6 Oceania
6.1 Australia
6.2 New Zealand

https://en.wikipedia.org/wiki/List_of_countries_with_universal_healthcare

[Devil Child]

38. American exceptionalism demands we stay the course workingclasszero!

We can't go down the dangerous road of socialism you know. Best to bankrupt our citizens every time they need to visit the doctor.

[workinclasszero]

39. Yup

Hell people are dying right now even as we speak because they can no longer afford the insane price of insulin in this country, and that's just one thing.

These Health care CEO's and their for profit insurance companies will bleed us all to death!

Top boss at Blue Cross Blue Shield of Michigan earned $19M in 2018
JC Reindl, Detroit Free Press Published 1:45 p.m. ET March 1, 2019 |

https://www.freep.com/story/money/business/2019/03/01/blue-cross-blue-shield-michigan-daniel-loepp/3028558002/

[Nanjeanne]

50. That's a lot of people who had to be denied healthcare in order to have that much money for the CEO!

[workinclasszero]

52. For sure

A lot of human suffering goes into those huge CEO paydays.

It’s sickening that we have this system in this country when all other industrialized nations make sure their citizens are taken care of.

[namahage]

47. Point 4.7.

Not sure this list says what you think....

[workinclasszero]

48. About the ACA?

That is so far away from universal health care it’s not funny.

If you live in a redstate totally controlled by the GOP like I do the only thing the ACA did was offer me insurance I could not afford with 7000 dollar deductibles and then made me an outlaw for not buying what I could not afford.

Fined and f***ed over by the IRS, just wonderful!

[marylandblue]

59. Well that's a problem, but I have good insurance through my employer.

Of course, I want you to have good insurance too, but why do I have to give up mine for that?

[Uncle Joe]

65. It's

?itemid=5156858

[TexasTowelie]

80. Actually there are plenty of countries on that list that do not have universal healthcare,

including #4.7 United States. Some of the countries have health insurance mandates, but not universal coverage. Other countries have hybridized systems, and others have systems to pay a percentage of health care expenses.

You probably should have read the Wikipedia page before presenting it as evidence that all countries have universal health care.

[BlueMTexpat]

106. I live in Switzerland.

I am not sure what you mean by "universal health care." You might want to think about that before posting something that is not quite accurate about a lot of countries in your list.

It is MANDATORY to have health insurance in Switzerland. Period.

If you mean that the system is accessible to all who have health insurance or who happen to be so poor that they are considered wards of the State (a small percentage of Swiss), then Switzerland has "universal health care." But I don't think that is what you meant.

If you are employed, your health insurance is provided through your employer. If you are not employed, not married to someone who is employed and receiving health insurance coverage, or are a retiree and for some reason did not meet qualifying requirements for your post-retirement health insurance, then you must purchase health insurance on the open market. Here is a site that describes the basic coverage that ALL health insurance companies must provide. https://en.comparis.ch/krankenkassen/info/glossar/leistungen-krankenpflegeversicherung

One pays more for more benefits, but ALL companies must provide the basics. They cannot refuse to pay claims, cannot refuse to insure because of pre-existing conditions, etc. and they do not put anyone through having to justify the expenses, so long as those expenses are deemed to be necessary by a medical professional. There is also no nonsense whatsoever about having insurance coverage for birth control, etc.

I am a US national who originally came to Switzerland as an employee of the UN. I spent seven years with that organization and another six with a different international organization. Unfortunately, each had a different health insurance system, so that I did not meet the ten-year requirement for either organization's post-retirement health care coverage. And, as a permanent resident, I must furnish proof of health insurance.

In addition to premium costs, I must pay out of pocket costs for up to my deductible (I chose CHF 1500 because it reduces my monthly premiums somewhat and I am generally pretty healthy) and another CHF 700. After that, the insurance pays everything, except dental. Dental insurance is not required.

As you may or may not know, Medicare does not apply to US expats, although I do have access to Medicare when I am in the US, having paid into SS/Medicare when I worked in the US before moving abroad and because I also currently pay Medicare premiums.

While I take care of most routine medical requirements when I visit the US, last year I fell and broke my left hip in Montreux while showing some guests around. I had to have emergency hip replacement surgery in a local public hospital. I was amazed to discover that the entire cost for that surgery, including the doctors' fees and ambulance was approximately CHF 8000, all of which was paid by my insurance once my deductibles were met! Rehab (18 sessions), medications, etc. didn't cost me anything because I had met my deductibles by then.

In 2003, I had a scheduled hip replacement surgery on my right hip, also in Switzerland. That took place in a private clinic and cost approximately CHF 35,000. While part of that was due to my remaining in the clinic longer than I did in the hospital (10 days versus five), private versus shared room, and the food at the clinic was specifically tailored to my needs and could be called "gourmet," etc., I received excellent care in both places.

I believe that the health care/access/insurance system in Germany is more akin to that of Switzerland than that of France or the UK.

Please be careful with your facts and with the term "universal health care" because it means different things in different countries. And please also keep in mind that it is not only the cost of health insurance in the US that is problematic, it is the COST of the care itself.

We have a truly f***ed-up system. It needs a LOT of tweaking.

[Blue_true]

42. Pete Buttigieg so far has the most sensible plan.

He would put Medicare as an option in the ACA, along with private insurers. People would then choose the plan they want. Mayor Buttigieg's plan could end up improving insurance coverage and driving down rates as private insurers are forced to compete with Medicare to keep their policyholders. Mayor Buttigieg's plan would also most likely cause consolidation in the health insurance industry as companies seek to grow as large as Medicare to compete with Medicare on coverage and rates, but that is not a bad thing given the benefits to policyholders.

[TexasTowelie]

81. But even if Buttigieg's plan was adopted

there would still be Democrats here that would be upset that corporations control health care. Some people will never be satisfied.

[Blue_true]

91. Yep. And that is sad.

I am convinced that we will get to universal coverage by biting off pieces of the problem and getting people to fall in love with the changes, then we move to the next level of changes.

[OrwellwasRight]

43. "LBJ Thinks He Can Pass a Law Guaranteeing Civil Rights for All. He's Wrong."

I'm sure there were people like this in 1964 as well.

Thinking small never got anyone anywhere.

Defending those who profit from the suffering of others doesn't garner new voters. It turns them off.

Think big. Always.

[workinclasszero]

46. Totally agree!

"Defending those who profit from the suffering of others doesn't garner new voters. It turns them off."

[brooklynite]

44. Most Americans are conservative...

NOT Big C "Conservative", but small "c". It's not an ideological view, it's a discomfort with radical change. That works in our favor when Republicans try to privatize social security, but it also resists "Government run" or "Government paid" insurance mandates. You can move their incrementally, and the next step would be an optional Medicare buy in or public option, but moving the entire society to "Medicare for All" will be extremely difficult and risky.

[Nanjeanne]

51. Yes that must be why only a conservative 70% of all American want Medicare For all. They don't like

those government run things . . . like Social Security.

[brooklynite]

54. There is difference between a polling response and actual support sufficient to drive policy.

If the demand is so strong, why didn't Speaker Pelosi and the House Democrats pass such a Bill immediately?

[Nanjeanne]

58. Oh gee I don't know. Speaker Pelosi must

have more knowledge about what the American people want by talking to each of us individually because polls aren’t accurate. She just hasn’t gotten around to everyone. It must take so much time to talk to all 300+ million of us. I’m waiting for her to give me a ring.

It can’t have anything to do with Congress not actually passing bills that Americans want. Kind of like gun control and higher taxes on the wealthy. Hmmmm.

[marylandblue]

57. These polls are often phrased poorly.

I am not in favor of Medicare-for-all. But if asked in a poll with no other choices, I will say yes, because what I really mean is universal healthcare. I really want a system with both public and private insurers, but that wasn't one of the choices so I say yes to the next best thing.

[Nanjeanne]

60. Yea that must be right. You aren't in favor of it and

the polls are worded so people are saying they are for Medicare For All when they really aren’t.

But I agree. The polls are often badly worded. If they really explained Medicare For All the percentage would probably be higher.

[marylandblue]

61. In the changeover to ACA, one of the biggest complaints was having to change insurance

So, yeah, badly phrased. If they said you'd have to lose your current coverage and your taxes would go up, how many would say yes?

On edit: This idea was in the original article. There are multiple ideas that could be called "Medicare-for-all." I like one of them, but not the one Sanders is promoting.

[Nanjeanne]

63. OMG that is so funny. If they did that no

One would. It would also be incredibly wrong and ill informed.

But here is the thing. The ACA is all private insurance so switching is problematic because the insurance agency decides which doctor you can see and what hospital you can go to.

People don’t LIKE their insurance company. They like having being able to go to the doctor if they get sick. If the check comes from Aetna to their doctor or from the US government they would care less who pays the bill.

How about phrasing it like you give up your insurance provider paying your doctor and the government pays your doctor instead. You will pay an additional amount in your taxes but you will not pay premiums or deductibles and the amount you pay in your tax will be less than what your premiums and copays and deductibles are now. And the government won’t give you a narrow group of doctors to go to or force you to use one hospital.

Any takers?

[marylandblue]

64. That's my point, depending how you describe it, you'll get different answers

What you describe sounds great, except Medicare has premiums and copays now, plus I doubt that I could get the coverage you describe for less in tax than my current premium.

[TexasTowelie]

82. Welll,

People don’t LIKE their insurance company. They like having being able to go to the doctor if they get sick. If the check comes from Aetna to their doctor or from the US government they would care less who pays the bill.

There are also plenty of people that don't like their government---I certainly don't when Republicans are in charge like they have been in Texas for the past 25 years.

I'm on indigent care myself, but I only have one option as to who my doctor is and to be honest I don't particularly like him. Last year he had me admitted to a hospital because of a cat bite on the calf of my leg that was infected and swollen to the size of a tennis ball. After I was released I had a follow-up appointment with him and I told him that the doctor at the hospital changed his prescription regimen. His ego got in the way and he got all huffy about it so I told him that if he had an issue with it that he could contact the doctors at the hospital. I was polite about it, but I also was somewhat pleased to be able to tell him off since he has the "I am God" complex that I've seen in many physicians. The hospital also is stuck with a $5K unpaid bill because they didn't get their act together and send the bill within three months after I was admitted so indigent care won't pay it. All of the bills related to the hospitalization were sent directly to me even though I presented my indigent care card when I was admitted so I had to forward all of the bills to the indigent care agency. If I am ever fortunate enough to find employment again I'll probably be harassed by the bill collectors forever. I've completely given up on ever having a decent credit rating again.

BTW, I am also limited to one hospital and can only see certain specialists, much like I was when I had good private health insurance when I was employed. I'm three years overdue for a colonoscopy, but I could never get it arranged because my physician, the enterologist, and the indigent care provider would never act in tandem with each other. I placed repeated phone calls among that trio for months until I finally gave up.

I'm pointing these things out because health care provided through government programs sucks. And while I've had my hassles will health insurance companies over the years, there was at least a system that I could appeal their decisions (fortunately I never had to do so). No such process exists within the indigent care system. Even though I have a college degree and an impressive resume, I'm viewed as an unproductive member of society so it is cheaper and less hassle to just let me die if my medical care exceeds a certain amount each year. I'm grateful that indigent care is paying for my insulin and that I can go to the doctor occasionally, but it is also a take-it or leave-it situation. It's very easy to envision a M4A system that will ration health care which is why I can't support Bernie's proposal.

[Demsrule86]

87. Only 17% it Medicare for all when it means workplace insurance goes away...we would lose

just like with Hillary care...and we lose the ACA as well...build on the ACA...instead of a huge bill that is doomed in my opinion.

[Mr Tibbs]

45. Other countries did it successfully

All it takes is a mass movement. That's how things get done. That's how the 60s brought so much fundamental change to this country, because politicians cannot ignore mass movements at their own peril.

Based on medical bankruptcies alone, the medical insurance industry sows misery.

[Laura PourMeADrink]

62. Is it a possible strategy to just say we want everyone to have health care and leave

the details for further study? I just say this because it is such an immensely complicated subject. And, the more detail you throw out there - the more fodder for the GOP to criticize.

Anyone who just suggests something without having any idea how you transition from a large and growing for-profit industry industry - with rollout and cost/benefit plans is naive. Besides, all those details will change as we actually implement.

[Demsrule86]

88. Brilliant! and You are correct. Look at the ACA roll out...and it was small considering if you

try to insure everyone.

[NurseJackie]

71. Agreed. He's wrong about so many things.

Especially the smears against the Democratic party. The lies make me sick.

[dlk]

76. There are Multiple Avenues to Accomplish Health Care Coverage for All Americans

Sometimes as people age, they become more rigid and inflexible in their thinking, and they aren’t as open to alternatives as they may have been in the past.

[NurseJackie]

92. He's wrong about many things. Trump would mop the floor with him.

BS is a weak candidate... we need a strong candidate with new ideas. We need someone with stamina and energy. I'm looking for a candidate who has has stellar charisma, someone who's likeable and who has empathy. The candidate that vote for is someone who has realistic ideas and plans. No more pie in the sky.

[CentralMass]

104. And their lobbyists are spending massive amounts of money to make that so.

https://www.opensecrets.org/lobby/indus.php?id=H

Sector Profile, 2018

Total for Health: $556,276,018
Total Number of Clients Reported: 1,293
Total Number of Lobbyists Reported: 2,800
Total Number of Revolvers: 1,453 (51.9%)
Campaign Contributions from this sector

Industry Total spending
Pharmaceuticals/Health Products $280,305,523
Hospitals/Nursing Homes $99,686,787
Health Professionals $89,724,045
Health Services/HMOs $79,352,992
Misc Health $7,206,671

This why we can't have nice things.