Is Bernie's Single Payer More Progressive Than ACA?

[discocrisco01]

Talkleft states

"'m honestly surprised to be asking the question in the title - thinking the answer would be "of course it is!" But the structure of ACA, with Medicaid expansion and means tested insurance subsidies makes this not so clear according to Austan Goolsbee:

2) Sanders is right that we shouldn't just think of his single-payer health plan as a $15 trillion tax increase. We should ask whether people would be better or worse off in total. But even by that measure, lots of low and middle income workers would, in fact, be worse off and paying higher taxes."

Read more at http://www.talkleft.com/story/2016/1/13/155122/917/Election16/Is-Single-Payer-More-Progressive-Than-ACA-

[Maedhros]

1. Ummm...let's see:

ACA: profit-driven, with the profits going to the insurance industry (who are the problem to begin with).

Single-Payer: non-profit.

Gee, which is more progressive?

[Motown_Johnny]

12. Also covers everyone

That matters too

[libdem4life]

2. I hear the chatter of Karl Rove ... If we take the insurance monoliths out of the equation

the people will pay higher taxes. See, it's easy.

And a "left" publication does nothing for veracity. We just have dueling Oligarchs vs. Reformers. EOS

[uponit7771]

3. No, not at all... I'm disappointed with it... it shifts cost and doesn't decrease them because he's

... not going to address the payments that are made to private hospital groups, doctors and medications.

For the median income is going to save what 5 - 10% at the most!? That's like taking 10,000 off the cost of a Lambo...

This doesn't solve the greater problem that the ACA doesn't address right now; HC in the US is immorally expensive

[99Forever]

4. Bullshit.

Medicare- 3% overhead.

Private Insurance thru ACA- LIMITED to 20% overhead.

To say nothing of the potential to NEGOTIATE pricing from the position of being a Single Payer.

See how stupid Camp Weathervane thinks we are?

[uponit7771]

7. Sanders plan doesn't call for everyone to go on medicare you know that right?! So that's a moot

... point... his plan ask for a shift in WHO's being payed and a 8.4% total increase in payroll taxes which doesn't lower the total amount of pack by 50 or 60% (the moral amount) its 5 - 10% for the 50,000 income

The goal is to make HCI affordable not shift cost to another provider

[99Forever]

11. More bullshit.

Keep shovelling.

[Hoyt]

13. Actually it costs more than that and Sanders' fantasy picks up 20 coinsurance.

That is a good thing, Sanders just needs to honest about the cost and what his plan will entail to control costs after the first 7 or 8% savings from relegating private insurers to claims adjudication, network management, utilization and quality management, and the like. That will be eaten up in the first year.

[99Forever]

14. Another bullshit shoveller.

[Hoyt]

15. I cant help it if you can't follow the money and cost. Everything that gets complicated

and takes a little analysis is BS to you. I'm fine with the goals of Sanders' plan if he is honest about what it is going to cost and the chances of passing. Heck, he introduced a similar bill in 2009 and it died.

[99Forever]

16. I don't follow bullshit.

Which is all you are shovelling.

[Health Wagon]

18. Agreed.

[Recursion]

19. But insurance overhead is about 4% of our national health care spending

The law limits it to 20%, but according to the Centers for Medicare Services numbers, the difference between the premiums paid to insurers and their payouts to providers is about $120 billion, or 4% of total healthcare spending (which makes an overall private insurance overhead rate of 12%, compared to 6% for public insurance programs).

Why you think getting rid of that 4% will make the system affordable, I can't tell.

[Hoyt]

5. Glad to see people taking a closer look at Sanders' plan assumptions. Under the bus

goes this guy.

From the link, one if several problems with Sanders' plan:

"The Sanders plan counts on the employers then passing all of that savings though to their employees in the form of higher wages (and not keeping part of it as higher profits). If the companies don't pass it on, then, for sure, workers will end up worse off because they will pay the 9% payroll and income taxes but not have higher incomes to compensate (remember that employers pay about 75% of the normal health insurance premium for their workers so their savings on the employee contribution for health care will not normally add up to anything close to the 9% tax hike they're paying. They need the employer to pass on the other 75% to them).. . . . "

" But even with complete pass through, there are some significant low and middle income groups that would face net tax increases under a Sanders health plan. Generally, people that currently pay less than 9% of their income on health insurance will be worse off under a plan with free health care but a 9% tax to pay for it. That makes me think the plan hasn't been well thought through.. . . . "


For more, read the article before dumping on the author.

BTW, I've supported single payer since the early 1980s. But, I think Sanders should be honest about his plan, the costs, what it will take to control utilization, assumptions, gaps in Medicare coverage, etc.

[Autumn]

6. Yes, and it makes more economic sense. Low and middle income workers would, in fact, be paying less

for Medicare for All than they currently pay to insurance companies to purchase private insurance that many can't afford to use that more than offsets any tax increase. Why isn't Austan Goolsbee addressing the tax increase from the ACA?

http://healthaffairs.org/blog/2015/05/27/the-post-launch-problem-the-affordable-care-acts-persistently-high-administrative-costs/

Traditional Medicare runs for 2 percent overhead, somewhat higher than insurance overhead in universal single payer systems like Taiwan’s or Canada’s. Yet traditional Medicare is a bargain compared to the ACA strategy of filtering most of the new dollars through private insurers and private HMOs that subcontract for much of the new Medicaid coverage. Indeed, dropping the overhead figure from 22.5 percent to traditional Medicare’s 2 percent would save $249.3 billion by 2022.

The ACA isn’t the first time we’ve seen bloated administrative costs from a federal program that subcontracts for coverage through private insurers. Medicare Advantage plans’ overhead averaged 13.7 percent in 2011, about $1,355 per enrollee. But rather than learn from that mistake, both Democrats and Republicans seem intent on tossing more federal dollars to private insurers. Indeed, the House Republican’s initial budget proposal would have voucherized Medicare, eventually diverting almost the entire Medicare budget to private insurers (the measure passed by the House on April 30 dropped the “premium support” voucher scheme).

[uponit7771]

9. No one who has been around for any time believes employers would not in some way shift the

... cost back to employee for the median income level.

That would be more unicorns

[mmonk]

8. Yes. The ACA tweaks the current system while

single payer is making Medicare, a progressive creation, available to all. The ACA is basically the Heritage Foundation alternative to a national healthcare plan.

[KingFlorez]

10. Not really

I think the issue of low and middle income earners facing tax increases is more regressive than anything else.

[Recursion]

17. Hard to say without more numbers, at least in the mathematical sense of "progressive" (nt)