Progressives (Liberals)

It takes a certain evil genius to write true gibberish.

The Brits and Canadians I know certainly love their single-payer health care systems. If one of their politicians suggested they should switch to the American health care model, they’d throw him out the window.

So single-payer health care, or in our case “Medicare for all,” is worth taking seriously. I’ve just never understood how we get from here to there, how we transition from our current system to the one Bernie Sanders has proposed and Elizabeth Warren, Kamala Harris and others have endorsed.

Despite differences between individual proposals, the broad outlines of Medicare for all are easy to grasp. We’d take the money we’re spending on private health insurance and private health care, and we’d shift it over to the federal government through higher taxes in some form.

Then, since health care would be a public monopoly, the government could set prices and force health care providers to accept current Medicare payment rates. Medicare reimburses hospitals at 87 percent of costs while private insurance reimburses at 145 percent of costs. Charles Blahous, a former Social Security and Medicare public trustee, estimates that under the Sanders plan, the government could pay about 40 percent less than what private insurers now pay for treatments.

If this version of Medicare for all worked as planned, everybody would be insured, health care usage would rise sharply because it would be free, without even a co-payment, and America would spend less over all on health care.

It sounds good. But the trick is in the transition.

First, patients would have to transition. Right now, roughly 181 million Americans receive health insurance through employers. About 70 percent of these people say they are happy with their coverage. Proponents of Medicare for all are saying: We’re going to take away the insurance you have and are happy with, and we’re going to replace it with a new system you haven’t experienced yet because, trust us, we’re the federal government!

The insurance companies would have to transition. Lots of people work for and serve this industry. All-inclusive public health care would destroy this industry beyond recognition, and those people would have to find other work.

Hospitals would have to transition. In many small cities the local health care system is the biggest employer. As Reihan Salam points out in The Atlantic, the United States has far more fully stocked hospitals relative to its population and much lower bed occupancy than comparable European nations have.

If you live in a place where the health system is a big employer, think what happens when that sector takes a sudden, huge pay cut. The ripple effects would be immediate — like a small deindustrialization.

Doctors would have to transition. Salary losses would differ by specialty, but imagine you came out of med school saddled with debt and learn that your payments are going to be down by, say 30 percent. Similar shocks would ripple to other health care workers.

The American people would have to transition. Americans are more decentralized, diverse and individualistic than people in the nations with single-payer systems. They are more suspicious of centralized government and tend to dislike higher taxes.

The Sanders plan would increase federal spending by about $32.6 trillion over its first 10 years, according to a Mercatus Center study that Blahous led. Compare that with the Congressional Budget Office’s projection for the entire 2019 fiscal year budget, $4.4 trillion. That kind of sticker shock is why a plan for single-payer in Vermont collapsed in 2014 and why Colorado voters overwhelmingly rejected one in 2016. It’s why legislators in California killed one. In this plan, the taxes are upfront, the purported savings are down the line.

Once they learn that Medicare for all would eliminate private insurance and raise taxes, only 37 percent of Americans support it, according to a Kaiser Family Foundation survey. In 2010, Republicans scored an enormous electoral victory because voters feared that the government was taking over their health care, even though Obamacare really didn’t. Now, under Medicare for all, it really would. This seems like an excellent way to re-elect Donald Trump.

The government would also have to transition. Medicare for all works only if politicians ruthlessly enforce those spending cuts. But in our system of government, members of Congress are terrible at fiscal discipline. They are quick to cater to special interest groups, terrible at saying no. To make single-payer really work, we’d probably have to scrap the U.S. Congress and move to a more centralized parliamentary system.

Finally, patient expectations would have to transition. Today, getting a doctor’s appointment is annoying but not onerous. In Canada, the median wait time between seeing a general practitioner and a specialist is 8.7 weeks; between a G.P. referral and an orthopedic surgeon, it’s nine months. That would take some adjusting.

If America were a blank slate, Medicare for all would be a plausible policy, but we are not a blank slate. At this point, the easiest way to get to a single-payer system would probably be to go back to 1776 and undo that whole American Revolution thing.

These frivolous charges only serve to detract and diminish acknowledgment of true anti-Semitism like the massacre committed at the Pittsburgh synagogue for self-serving political purposes.

maporsche wrote:

I do wish they’d convert from pensions to something like 401k accounts with generous matches to replace pensions. At least then future citizens wouldn’t be saddled with unfunded pensions and the costs associated.

Interesting. What's your opinion of conservative proposals to do the same thing with Social Security?

At the end of it all, there is no financial security guarantee.

401Ks are not as good as pensions used to be. A pension is guaranteed. If the market crashes, 401Ks start dwindling fast.

I wouldn't vote a dime for more teacher pay without a companion legal provision that teachers don't have to join or pay dues to a union. In such circumstances, when the so-called beneficiaries of union activities are given free choice about whether they're getting their moneys worth for their dues, most opt to stay out.

In the video, Walker is shown meeting with Beloit billionaire Diane Hendricks before an economic development session at a the headquarters of a firm Hendricks owns, ABC Supply Inc., in Beloit.

After Walker kisses Henricks, she asks: “Any chance we’ll ever get to be a completely red state and work on these unions?”

“Oh, yeah!” says Walker.

Henricks then asks: “And become a right-to-work [state]?”

Walker replies: “Well, we’re going to start in a couple weeks with our budget adjustment bill. The first step is we’re going to deal with collective bargaining for all public employee unions, because you use divide and conquer.… That opens the door once we do that.”

That's because they want free stuff.

So it really is time the rest of us said, "**** you. We have had it with your selfishness, your greed

and your pathological need to dominate others."

It recovered, but they did not return the money my 401k lost.

The people of the United States are about to get a long overdue education about exactly who runs this country and how they do it.

I still haven't heard the media report on this - except for Fox. It's the biggest story in the history of the country. Watch what happens to KimDotCom and Hannity.

Here's the statement from Kim.com

#SETHRICH WAS A HERO
I KNOW THAT SETH RICH WAS INVOLVED IN THE DNC LEAK.

“I think Bob Mueller’s an American hero. … a justice oriented person.”

“I was able to prevent the president from going on the attack against Mueller.”

“I don’t feel the investigation is a witch hunt.”

When ABC News' George Stephanopoulos asked why Trump lied as part of the scandal, McCarthy said he'd have to ask the president, though the California Republican added, "You've seen politicians do this exact same thing in the past."

Yes, of course, it's a story has old as time. Politician has extra-marital affair with porn star; politician makes hush-money payment; politician breaks federal law while conspiring with his fixer; politician lies; politician gets caught. If I had a nickel for every time I've seen a politician do "this exact same thing," I'd have ... exactly one nickel.