4 ms·

Lost in points like this, where you’re trying to scare people by saying a large number, is that the distinction between a Medicare for All type of system and th

by wycy 7y ago

Lost in points like this, where you’re trying to scare people by saying a large number, is that the distinction between a Medicare for All type of system and the current private system is less about how much it costs and much more about who the middleman is. * In M4A, Americans will pay ~$30T/10yr to providers through the government as a middleman. * In the current private system, Americans will pay ~$30T/10yr to providers through whichever company their employer has selected as a middleman. The only cost question re: M4A is whether Americans will spend slightly more or slightly less overall when costs are increased because coverage is extended to 10% more people, and costs are decreased by: - massive efficiency gains of a single payer, - elimination of profit to shareholders who siphon money away from care, - better preventative care that reduces or eliminates more expensive catastrophic care. And additional intangible benefits like: - not having your healthcare decided by your employer, - having the ability to be an entrepreneur and/or start a small business while having the security of healthcare, - the fact that small business will be able to better compete with huge corporations for desirable employees because they won’t have to offer health benefits themselves.

rayiner 7y ago
My point wasn’t to take a dig at M4A. (I'm a proponent of universal healthcare, though I'd prefer extending ACA.) I mentioned it because OP talked about sweating medical bills. The point is that the cost of providing healthcare to everyone is vastly more than the wealth of even billionaires. (By the way, the expert estimate linked from Warren's own site is $52 trillion/10 years, not $30 trillion.)
- gremlinsinc 7y ago
  No, but her plan isn't the only one out there. Bernie's plan was estimated I believe at 23 billion over 10 years, which a right wing think tank actually (accidently) proved would cost less than we're paying now. But in 25 years how much does the system improve, what if it's like 50T over the 1st 10 years, then 30T the 2nd because of gains in efficiency? There's a lot of 'in the air' variables as well, where it could end up being 30 or 40T over 10 years if the efficiencies are higher than expected or if we can better negotiate terms w/ drug companies. If we legalize weed and shrooms and tax them at the national level, that itself would also be a great way to gain money for healthcare. We also can easily halve our military spending and still have a strong national defense. Also adding a VAT may be a good idea, we could even give discounts to citizens so immigrants and visitors travelling in America also help offset our healthcare costs. For instance say vat is 4%, and we charge 12% for non-citizens it would A. discourage illegal immigration, and B. it would stop people worrying about immigrants because they'd have to pay higher VAT than everyone else, so they'd be tax payers and not just 'using the system'...
  - deleted 7y ago
    [deleted]
enraged_camel 7y ago
The other thing about rayiner's post is that the language he uses is quite informative of his political views. Notice how he uses the phrase "confiscate wealth" to describe taxation, as opposed to, say, "paying their fair share".
- rayiner 7y ago
  My political views are pro-taxation and pro-public services. (Except we should have the Swedes or Singaporeans come over to run our public services.) Which is why I think waging a class war against billionaires for a piddling $275 billion in additional revenue, while not increasing taxes on people making up to $250,000, is pure insanity. European countries have figured out how to pay for public services with middle class taxes. We should follow their lead instead of dreaming about wealth taxes. Also, I used “confiscate” in the context of literally taking all of billionaires’ money.
  - manthedudeguy 7y ago
    Why not both?
  - enraged_camel 7y ago
    Warren's tax plan starts at the $50 million threshold. Not sure why you are counting only billionaires, or only the top 400. Her math adds up. https://www.washingtonpost.com/politics/2019/11/05/warrens-plan-pay-medicare-for-all-does-it-add-up/ https://www.washingtonpost.com/politics/2019/11/05/warrens-p... https://www.nytimes.com/2019/11/01/opinion/did-warren-pass-the-medicare-test-i-think-so.html https://www.nytimes.com/2019/11/01/opinion/did-warren-pass-t...
    - rayiner 7y ago
      Warren’s wealth tax doubles to 6% at the billionaire level. (France’s and Sweden's highest wealth tax was 1.5% until they got rid of it.) Warren’s calculations just prove why the whole fixation on billionaires and income inequality is a distraction. You're talking about a wealth tax that is unconstitutional, at levels that are completely unprecedented. You're talking about risking capital flight, and setting political capital on fire, to move the United States far to the left of Europe. (What a great campaign ad for Donald Trump! Warren is proposing to do something that even France realized was a bad idea.) And for what? Is it going to pay for M4A? Or balance the budget? No. Not even theoretically. I say this all as someone who wants universal healthcare to be implemented (even though I'm pessimistic about it saving any money). I think Warren's proposal with respect to employer-side payments is actually pretty clever. But the wealth tax is a huge political liability, and it could take M4A with it. And when that happens, it won't be the fault of billionaires (the wealth tax wasn't going to raise the necessary revenue anyway). It'll be the fault of people making $200,000 who think they are "middle class" and shouldn't have to pay the same level of taxes their counterparts in Europe pay.
tptacek 7y ago
This is maddening. The problem with the US healthcare system is that we're paying ~$30T/10yr†, not who we're paying it to. The idea that locking those exorbitant costs in would be a win is baffling. The efficiency gains of single payer are overrated. We pay more than other countries do in admin overhead, but admin overhead itself is a small fraction of total costs, and as a percentage of our spend, admin costs would necessarily rise, probably dramatically, if Medicare starts covering 30 year olds in addition to 68 year olds. † I'm just taking your number here, not interrogating it.
- xyzzyz 7y ago
  Indeed. We already effectively have single payer system for large segments of the population, the Medicare itself. It still didn't push the costs down to European levels for Medicare recipients. The US needs cheaper healthcare, but single payer won't achieve that.
  - wycy 7y ago
    Part of the reason for that is that Medicare is forbidden by law to negotiate prices the way other insurance companies can as a result of the GOP's Medicare Prescription Drug, Improvement, and Modernization Act of 2003.
    - tptacek 7y ago
      It can't be much of the reason, because prescription drugs are, contrary to popular opinion, actually a relatively small component of US healthcare spending.

by wycy 7y ago

rayiner 7y ago

My point wasn’t to take a dig at M4A. (I'm a proponent of universal healthcare, though I'd prefer extending ACA.) I mentioned it because OP talked about sweating medical bills. The point is that the cost of providing healthcare to everyone is vastly more than the wealth of even billionaires. (By the way, the expert estimate linked from Warren's own site is $52 trillion/10 years, not $30 trillion.)

gremlinsinc 7y ago
No, but her plan isn't the only one out there. Bernie's plan was estimated I believe at 23 billion over 10 years, which a right wing think tank actually (accidently) proved would cost less than we're paying now. But in 25 years how much does the system improve, what if it's like 50T over the 1st 10 years, then 30T the 2nd because of gains in efficiency? There's a lot of 'in the air' variables as well, where it could end up being 30 or 40T over 10 years if the efficiencies are higher than expected or if we can better negotiate terms w/ drug companies. If we legalize weed and shrooms and tax them at the national level, that itself would also be a great way to gain money for healthcare. We also can easily halve our military spending and still have a strong national defense. Also adding a VAT may be a good idea, we could even give discounts to citizens so immigrants and visitors travelling in America also help offset our healthcare costs. For instance say vat is 4%, and we charge 12% for non-citizens it would A. discourage illegal immigration, and B. it would stop people worrying about immigrants because they'd have to pay higher VAT than everyone else, so they'd be tax payers and not just 'using the system'...
- deleted 7y ago
  [deleted]

enraged_camel 7y ago

The other thing about rayiner's post is that the language he uses is quite informative of his political views. Notice how he uses the phrase "confiscate wealth" to describe taxation, as opposed to, say, "paying their fair share".

rayiner 7y ago
My political views are pro-taxation and pro-public services. (Except we should have the Swedes or Singaporeans come over to run our public services.) Which is why I think waging a class war against billionaires for a piddling $275 billion in additional revenue, while not increasing taxes on people making up to $250,000, is pure insanity. European countries have figured out how to pay for public services with middle class taxes. We should follow their lead instead of dreaming about wealth taxes. Also, I used “confiscate” in the context of literally taking all of billionaires’ money.
- manthedudeguy 7y ago
  Why not both?
- enraged_camel 7y ago
  Warren's tax plan starts at the $50 million threshold. Not sure why you are counting only billionaires, or only the top 400. Her math adds up. https://www.washingtonpost.com/politics/2019/11/05/warrens-plan-pay-medicare-for-all-does-it-add-up/ https://www.washingtonpost.com/politics/2019/11/05/warrens-p... https://www.nytimes.com/2019/11/01/opinion/did-warren-pass-the-medicare-test-i-think-so.html https://www.nytimes.com/2019/11/01/opinion/did-warren-pass-t...
  - rayiner 7y ago
    Warren’s wealth tax doubles to 6% at the billionaire level. (France’s and Sweden's highest wealth tax was 1.5% until they got rid of it.) Warren’s calculations just prove why the whole fixation on billionaires and income inequality is a distraction. You're talking about a wealth tax that is unconstitutional, at levels that are completely unprecedented. You're talking about risking capital flight, and setting political capital on fire, to move the United States far to the left of Europe. (What a great campaign ad for Donald Trump! Warren is proposing to do something that even France realized was a bad idea.) And for what? Is it going to pay for M4A? Or balance the budget? No. Not even theoretically. I say this all as someone who wants universal healthcare to be implemented (even though I'm pessimistic about it saving any money). I think Warren's proposal with respect to employer-side payments is actually pretty clever. But the wealth tax is a huge political liability, and it could take M4A with it. And when that happens, it won't be the fault of billionaires (the wealth tax wasn't going to raise the necessary revenue anyway). It'll be the fault of people making $200,000 who think they are "middle class" and shouldn't have to pay the same level of taxes their counterparts in Europe pay.

tptacek 7y ago

This is maddening. The problem with the US healthcare system is that we're paying ~$30T/10yr†, not who we're paying it to. The idea that locking those exorbitant costs in would be a win is baffling. The efficiency gains of single payer are overrated. We pay more than other countries do in admin overhead, but admin overhead itself is a small fraction of total costs, and as a percentage of our spend, admin costs would necessarily rise, probably dramatically, if Medicare starts covering 30 year olds in addition to 68 year olds. † I'm just taking your number here, not interrogating it.

xyzzyz 7y ago
Indeed. We already effectively have single payer system for large segments of the population, the Medicare itself. It still didn't push the costs down to European levels for Medicare recipients. The US needs cheaper healthcare, but single payer won't achieve that.
- wycy 7y ago
  Part of the reason for that is that Medicare is forbidden by law to negotiate prices the way other insurance companies can as a result of the GOP's Medicare Prescription Drug, Improvement, and Modernization Act of 2003.
  - tptacek 7y ago
    It can't be much of the reason, because prescription drugs are, contrary to popular opinion, actually a relatively small component of US healthcare spending.