What if everyone had Medicare?

[Panaconda]

What if everyone had Medicare?

Henry Abrons
San Francisco Chronicle September 24

The Census Bureau released its annual report on income, poverty and health insurance coverage in the United States earlier this month, and it's no surprise to learn that we're in bad shape. The number of people living in poverty was 43.6 million (14.3 percent), up sharply from 2008, and real per capita income declined 1 percent.

Looking at health insurance, the situation is truly dire. There was a dramatic spike in the uninsured - 4.3 million more, to a record 50.7 million - in spite of the expansion of government health insurance rolls by nearly 6 million.

Those opposing government health insurance should ponder the fact that private health insurance coverage dropped to the lowest level since comparable data were first collected in 1987. On the other hand, those who look to the new health reform law - the Patient Protection and Affordable Care Act (PPACA) - for a solution should be deeply disturbed.

PPACA was not designed to provide universal coverage. In fact, if the new law works as planned, in 2019 there will still be 23 million uninsured. Yet the consequence of being uninsured can be lethal: Research published last year shows about 45,000 deaths annually can be linked to lack of coverage. That number is probably more than 50,000 today.

...

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/09/24/EDRK1FFRST.DTL

[xchrom]

1. recommend

[Vinca]

2. If we had Medicare for all we would be more healthy as a nation,

both physically and fiscally. Take the burden of health insurance away from business and see how many new ones sprout.

[greymattermom]

5. being insured doesn't protect you

Don't forget that the cooks, even in the most upscale restaurants, don't have insurance. It's a public health issue. Why don't we ever argue it that way?

[Vinca]

6. Excellent point. Nothing like a dose of hepatitis in your salad.

[Xenotime]

15. Agreed. People wouldn't be scared to seek treatment.

[HillbillyBob]

32. That and Preventative and food education would result in healthier

citizens. Getting corpses like Monsanto and Cargills out of our food chain would be a big step toward better health.

Folks who would like to start a small biz would not have to be so in the rut in a job they hate just for the insurance and would be more productive in what they do.

[kcass1954]

3. If Congress had to put up with the prescription drug "donut hole," it would be gone. n/t

[old mark]

7. Congress gets a lot of stuff most of us don't ever have - guaranteed pension, perks

like a gym at work, and wonderful government health coverage...they just don't think everyone else should have it.

mark

[stray cat]

4. We would have to pay more for Medicare then currently as it is not funded sufficiently

Still would probably be cheaper than insurance system -if fraud were better conteoled . If you have good insurance your level of medical care would drop but it would improve if you had poor coverage

[ejpoeta]

8. imagine us paying what we currently pay for our private insurance towards medicare.

i bet we could have great healthcare. sure medicare has problems. but the idea that the only people who can access it are those who tend to need to use it more is insane. we pay into the private system all the time we are healthy and then if we are lucky enough to live to be eligible for medicare, how many are on multiple medications and have things like diabetes and heart problems. you paid into the private system and then they get to keep all that money once you go on medicare. it's bs. if we all just paid into medicare then everyone would be putting money into the same pool and using that same money we put in when we get sick. i don't understand why people don't see this. we pay into the private system and then when we get sick and lose our insurance they don't have to spend anything. they get to keep all that money!!

[Recursion]

37. Nobody really knows what it would cost

We already have been kicking a 20% reimbursement cut to providers down the road for years now, but doing all our budget projections as if it were going to be made.

Those of us not on Medicare or Medicaid subsidize them in two ways: levies from our paychecks, and our insurance (if we have it) being charged more to make up for losses on Medicare and Medicaid services by providers.

Even with both those subsidies, the full Medicare premium is $800 (not counting part D). People who pay less than that (most just pay the subsidized part B premium) are having the rest come from the Medicare Trust Fund, which is projected to last another 20 years. Bringing younger, healthier people in to the pool will lower that premium, but again we don't know by how much; simply dividing all healthcare costs equally among everybody would make the universal "premium" $600 per person per month. That in itself is not affordable. Also, younger healthier people are going to be the hardest group to convince to do this, because we're the ones who like our insurance plans.

Making Medicare For All affordable would require significantly reducing how much it costs to deliver health care in the first place. However, if we had the political will to do that, we wouldn't need to have Medicare For All, since health care would be affordable.

[blindpig]

9. If everyone had Medicare...

the rich would be very sad, the libertarians would be outraged and the people would get their due.

There is no higher aspiration than the general welfare.

[Dappleganger]

13. Most definitely!!

:toast:

[Scuba]

10. If every American had healthcare, the wealthiest would lose....

...one of the most effective controls they have on the populace. Fear of losing one's health insurance keeps many in jobs they would leave if they could.

[Xenotime]

16. Exactly. It would take the leverage away from their greed.

[TBF]

19. Actually I would guess that the big corporations would adjust

their thinking once they realized that they didn't have to pay premiums (makes it easier to compete against other multi-nationals). It is the insurance lobby itself that is fighting this because they are going to lose massive profits.

Groups like this:
http://www.namic.org/
http://www.aiadc.org/aiapub/
http://www.naic.org/

[Scuba]

22. Bingo....

Why should the insurance companies get ANY of our healthcare dollars? They add NO VALUE to the process of delivering care.

Insurance used to be about sharing risk. Now it's just about making profits and insurance companies use the sleaziest tactics imaginable to do that.

Our automakers and other manufacturers would be competitive against other developed countries if the cost of healthcare - and insurance company profits - didn't have to be tacked on to every product they make.

Why should the US be second-rate? Why does Canada have a three-year advantage over us in terms of life expectency?

Why do stockholders who don't work a minute delivering care - or, in many cases, doing any work at all - deserve our healthcare dollars?

[COLGATE4]

11. It would be called "Single Payer" - what the public wants

and what was pulled off the table before the debate even started.

[kctim]

12. Pulled off the table

because it is NOT what the public wants.

[TBF]

18. Do you have a link for that?

What gives you the idea that people don't want affordable single-payer insurance? Define "public" - your rich friends??

[kctim]

21. Well, I'm not a big poll guy

but this is usually the poll people try to spin to support everybody wants it.

http://www.cbsnews.com/stories/2009/06/19/opinion/polls/main5098517.shtml

Less than half, around 43%, of Americans are willing to pay just $10 a week in order to have government provide them with government health care. 2/3 are also concerned about how the quality will go down if government takes over health care.

Those and the fact that the majority of Americans do not like no choice government mandates, are what gives me the idea most do not want single-payer yet.

[bvar22]

23. Here's a couple of polls for you:

* Would you favor or oppose the national government offering everyone the choice of a government administered health insurance plan — something like the Medicare coverage that people 65 and older get — that would compete with private health insurance plans?

Favor 82%

Oppose 14%

Not Sure 4%
http://www.ourfuture.org/blog-entry/2010010320/poll-shouts-message-massachusetts-voters-were-sending

I use the above poll because it was
an Exit Poll of voters who just gave Ted Kennedy's Senate seat to a Republican

Here's a good one from 2005:

In recent polls by the Pew Research Group, the Opinion Research Corporation, the Wall Street Journal, and CBS News, the American majority has made clear how it feels. Look at how the majority feels about some of the issues that you'd think would be gospel to a real Democratic Party:

1. 65 percent (of ALL Americans, Democrats AND Republicans) say the government should guarantee health insurance for everyone -- even if it means raising taxes.

2. 86 percent favor raising the minimum wage (including 79 percent of selfdescribed "social conservatives").

3. 60 percent favor repealing either all of Bush's tax cuts or at least those cuts that went to the rich.

4. 66 percent would reduce the deficit not by cutting domestic spending but by reducing Pentagon spending or raising taxes.

5. 77 percent believe the country should do "whatever it takes" to protect the environment.

6. 87 percent think big oil corporations are gouging consumers, and 80 percent (including 76 percent of Republicans) would support a windfall profits tax on the oil giants if the revenues went for more research on alternative fuels.

7. 69 percent agree that corporate offshoring of jobs is bad for the U.S. economy (78 percent of "disaffected" voters think this), and only 22% believe offshoring is good because "it keeps costs down."

http://alternet.org/story/29788/

The American Public (Democrats & Republicans) overwhelmingly (+70%) OPPOSED Mandates without a Public Option.

[kctim]

24. Seen them

and they don't dispute what I said.

First one is a Mass. poll and is not representative of midwest states.
It also does not ask the question in an unbiased way: "offering everyone the choice of a government administered health insurance plan" means one would have the CHOICE to pay for and use the plan of THEIR CHOICE. In order for a government health care plan to work, EVERYBODY must pay for it, and since most people cannot afford to pay for two plans, they would have no choice but to have the plan they are forced to pay for.

The second poll states basically what the cbs poll does, it just leaves out the little fact that less than half are willing to pay for it. In order for single-payer to work, it must be funded by the people and the people are not willing to pay even a tenth of what it will cost them.
IF the people were willing to pay for and accept single-payer, it would already be in place.

[bvar22]

31. Don't like a poll?...Ignore it!

Howse that working for ya?

[sabrina 1]

33. I don't know where to begin with your post, you are so wrong

about nearly everything you just posted.

First, people would be paying LESS for National Health Care along with their employers, if they didn't have to fund the profits of the middlemen.

As it stands now, over 20%, more like 30% of the money paid into the HC system if for-profit, and to try to increase those profits, the Insurance Industry spends millions finding loopholes so they do not have to cover sick people. And they are still doing it.

Remove the middlemen and we have that extra 30% to spend on actual HC. Overhead for the Medicare system is 3%, ten times less than the for-profit system.

If you think people are too stupid to be able to understand first, that HC is NOT a commodity although that is how it is treated in this regressive society we live in, and second that when you remove those whose only interest is profit, you SAVE those profits. Let them get real jobs instead of living off the tax payers for a change.

All it takes is about five minutes to explain to the average person, the difference in the cost of a for-profit, privatized HC system and a National HC system, and overwhelming the votes go to the latter.

And that is why the polls supporting a National HC system are so high. Once the facts are understood.

Your insinuation that people don't think they will have to pay for this system, is just plain garbage, and a rightwing talking point which has apparently been accepted by some on the left.

Yes, they will have to pay, on a pro-rata basis, and it will be a lot less than they are paying to keep the CEOs from the for-profit Private Ins. Industry in the style to which they have become accustomed.

[TBF]

25. Why would it have to be "no choice gov't mandate" -

I would start by simply removing the age restriction on Medicare to let anyone buy in. The way to get around some folks not wanting to buy in is to come up with some sort of "uninsured health fee" like we do here in TX for uninsured motorists (ie you buy Medicare or another private policy, or you pay your uninsured fee).

I would hope in the future, once we got the ball rolling, there would be a certain level of basic healthcare based on income (from free going up dependent upon income). Current health care companies could still offer their private policies like they do now, and those who are rich could buy them if they so desire.

Medicare is not perfect, but it's a working program & it seems like the easiest way to get something in place because so many are already using it. Then you go from there to make changes as you need/want to.

[kctim]

26. It has to be or it will not work

That is true for Social Security and it is true for government health care. That is why they are both taken out of our paychecks.
An 'uninsured health fee' is a mandate.
I actually support you're idea of opening up Medicare and letting people buy into Medicare if they choose or buying a private policy if they choose. We should also have the choice to not do either.

People should not have to be rich in order to have a choice.

[TBF]

28. The problem with the choice of being allowed to "not do either" -

is that everyone else pays for that "choice". Someone may decide they are healthy, and not buy insurance, but then they have a bad car accident & end up in ER without even knowing it. If they can't/won't pay the rest of us will foot that bill. So, yes, I guess I am for mandating that everyone has insurance.

[kctim]

29. Yep

which is why we are in the position we are now.
The hard part is for us to convince others so that they will either vote for candidates who agree or are willing to accept that they must live with the outcome of not having insurance.

[bvar22]

14. Don't confuse the low information voters with terms like "single payer".

I live in a very RED part of a Southern State.
Poverty & Ignorance abound.
During Tea Bagger Summer I had conversations with a lot of them.
Most of them have a family member or neighbor on Medicare.
They KNOW Medicare, and aren't afraid of it.
When asked individually if they would like to buy Medicare too, every single one of them said "YES!".
As soon as I said something like "Single Payer" or "Public Option", their eyes glazed over and they started mumbling things like "Big Government Takeover" & "Death Panels".

Keep it SIMPLE!
Expanding Medicare was a Easy Sell here.

[Scuba]

17. I agree. Better to use "Medicare for All"

[bluethruandthru]

30. ding, ding, ding!!!

There has NEVER been an honest discussion of the single payer issue in this country. Unfortunately, like they do with every issue...the repukes screamed their lies about it so loudly and so often that they succeeded in scaring and confusing a huge portion of the population.

It's really sad that we, as a country, can't have an honest discussion about the problems we face and how to go about fixing them.

[TBF]

20. Health care for all - recommended. nt

[area51]

27. It's 100,000 deaths per year, in this "civilized" country.

Each day, 273 people die due to lack of health care in the U.S.; that's 100,000 deaths per year.

We need single-payer health care, not a welfare bailout for the serial-killer insurance agencies.

We don't need the GingrichCare of mandated, unregulated, for-profit insurance that is still too expensive, only pays parts of medical bills, denies claims, bankrupts and kills people. Republinazi '93 plan:

"Subtitle F: Universal Coverage - Requires each citizen or lawful permanent resident to be covered under a qualified health plan or equivalent health care program by January 1, 2005."

"We will never have real reform until people's health stops being treated as a financial opportunity for corporations."

[maryf]

34. Medicare for all! Expanded, Improved, NOT FOR PROFIT!!!!

What misanthrope conceived the notion of making a profit off of someone's health or lack thereof? Profit has no place when it comes to human needs, and health care is a human need denied to far too many in this country and this country alone when considering developed countries. For shame.

The crazy thing is Medicare for All would save just about everybody money!! full everything including dental and vision...the only losers are the profit mongers...sounds like a win win win to me.

[Recursion]

38. There are plenty of not-for-profit insurers; mine is one

Most Blue Cross insurers are not-for-profit (originally all were). They aren't any cheaper than for-profit insurance plans. Profit in insurance is morally odious, but it's not the reason costs are so high.

[maryf]

40. But profit is one of the reason costs are high

Administration adds 35% of the cost, that's why a single payer system would be much more cost effective...and again, I say, (and bully for your insurer), there should be no profit on any healthcare. Medicare for all, everybody in, nobody out, not for profit health care. with everybody in it would be more than solvent...does you insurance cover full dental and vision?

[southmost]

35. medicare for all

needs to be pushed past the failure of health insurance reform

[Recursion]

36. The 23 million projected uninsured are illegal immigrants

Find a political solution for that issue and you'll get a medal.

[TexasObserver]

39. Everyone should have medicare.

[Yo_Mama]

41. We can't afford Medicare either....

Under current law, Medicare doctor reimbursements are scheduled to drop almost 30% by January. If that were to occur, most Medicare patients would have a lot of trouble getting care in a year or two. As it is now, Medicare is only "cheap" because a great deal of spending is paid for directly from the General Fund (in other words, income taxes). The other source of hidden funding for Medicare is that unlike private insurers, which negotiate fees for services, Medicare sets its own reimbursement rates to hospitals and doctors. To offset this, costs to private insurers and the uninsured are jacked up.

If everyone were on Medicare at current reimbursement rates right now, many hospitals would be going out of business, and we would have to raise Medicare reimbursement rates.

There are no magic bullets.

To get Medicare for all we would probably need to raise a lot of reimbursement rates significantly, and then we would probably need to tax payrolls at about 16-18%. We would also need to cut coverage to balance the books. (Most private plans pay for some things that Medicare doesn't).

Anyway, the good part would be that everyone would be covered. The bad part would be that higher-income earners would be paying significantly more for coverage than now for less benefits. And that is why this is politically impossible.

Suppose you have two yuppies, and the payroll tax is 17%. One makes 100K as a college professor, and the other makes 60K as an engineer. They would pay over 27K each year for insurance, and that would be for an 80/20 major medical reimbursement rate. They'd have to pay additional to get drug coverage or to cover the 20% of unreimbursed costs. Politically, this is death for a good part of the Democratic constituency. Also, you would have to change the income tax structure to adjust for it.

But still, many such families would abruptly default on their debts as a result. They simply wouldn't have the income.

This would work much better for lower income families, but there is a high percentage of Democratic support in the wealthier echelon, and they will never stand for it.