Bernie needs a better answer about the $15T Swift Boats!

[Admiral Loinpresser]

Bernie needs a better answer about the $15T BS.

1. The WSJ lied about Bernie’s platform by attacking pending House legislation (the Conyers single payer bill).

http://www.wsj.com/articles/price-tag-of-bernie-sanders-proposals-18-trillion-1442271511

2. They claimed that Bernie’s single payer program would cost an additional $15T in federal spending over ten years (a double lie).

3. The lie about the $15T was rebutted the next day by Professor Gerald Friedman, author of the study on which the WSJ was based. Friedman, in an open letter to the WSJ published in the Huffington Post, stated that under his study, the federal government would SAVE about $5T in expenditures over ten years.

“Because of the nearly $10 trillion in savings, it is possible to fund over $4.5 trillion in additional services while still reducing national health care spending by over $5 trillion. With these net savings, the additional $14.7 trillion in federal spending brings savings to the private sector (and state and local governments) of over $19.7 trillion.”

http://www.huffingtonpost.com/gerald-friedman/the-wall-street-journal-k_b_8143062.html

4. This morning, Bernie appeared on CBS and was grilled about the WSJ $15T lie. CBS perpetuated the lie with a graphic stating: “Cost of Sanders’ New Programs—Medicare for all: $15T.” See CBS video at 3:35.

http://www.democraticunderground.com/128052672

5. In response, at 3:10 of the video, Bernie said that businesses would no longer have to buy private health insurance for their workers and the per capita cost of healthcare would come down. His answer was true, but inadequate, imo.

6. I believe the Swift Boating on this issue has just begun and will only grow much greater.

7. The correct response, imo, is political judo: a single payer plan will NOT cost anything extra, in fact, it will SAVE the federal government trillions of dollars over ten years, as well as saving individuals and businesses over $10T over the same period.

So here is my suggested response to $15T questions:

“Let’s be clear: the Wall Street Journal, a right wing newspaper owned by billionaire Rupert Murdoch lied about single payer health care. The Conyers single payer plan now pending in Congress will NOT cost anything extra, in fact, it will SAVE the federal government about five trillion dollars over ten years, as well as saving individuals and businesses over $10T over the same period.

In an open letter to the WSJ, Gerald Friedman, the author of the study said exactly that the day after the spurious attack. In due course I will come out with my own plan that will have comparable savings with the Conyers plan.”

Bernie’s answer was good, but not adequate in my view. We must meme the public into associating single payer with SAVINGS, not COST. Otherwise we may lose this battle, and this is central to Bernie’s platform. The Swift Boats are already in the water. Now is the time to sink them with the torpedoes of optimally-framed truth.

[DanTex]

1. The problem is that the government will actually have to spend $15T more over ten years with SP.

Bernie's answer is the right one (and the only one) -- yes, the government will spend a lot more, and taxes will be a lot higher, but people and businesses will no longer have to pay insurance premiums, and the amount of savings will be higher than the additional costs. Basically, instead of writing a check to insurers, instead people and businesses will be writing a check to the federal government, a check which is smaller on average.

But that doesn't change the fact that taxes will have to go up and the government will be spending a lot more money. And that is why this failed in Vermont. Trying to pretend that the federal government will actually end up spending less money like this OP tries to will just get him laughed at and pretty much end his campaign on the spot.

[HooptieWagon]

3. You are still spouting the RW lie.

Read the OP. The AUTHOR of the study Murdoch's fish wrap cited accused them of omitting data on purpose, in order to mislead. You aren't doing Hillary any favors by parroting the RW lie.

[DanTex]

5. No, I'm not. The author of the study didn't deny that it would cost $15T, he just pointed out that

the savings in private sector healthcare spending would be greater then that, yielding a net savings to society. Which is what Bernie said also.

But it's a simple fact that single payer will cost the government a huge amount of money, in fact, probably even more than $15T over a decade. And in order to raise that money, there will be more taxes. Everyone knows this.

[HooptieWagon]

6. And out of pocket costs will be greater than any additional taxes.

It saves families money. It saves businesses money. It saves governments money (thus saving families and businesses taxes).
It cuts the obscene profits raked in by Health Care Inc. you are siding with Health Care Inc in their greed. Says a lot about you.

[DanTex]

8. But the government still ends up spending (a lot) more. And taxes go up.

The argument you are making is the one Bernie is making. The OP, on the other hand, is trying to pretend that the government would actually be spending less. This isn't true. Obviously, the government spends more. And that's the political issue.

Like I said, if this was such a slam dunk, then it wouldn't have failed in Vermont.

[HooptieWagon]

11. Not necessarily.

The govt savings alone will cover much additional coverage.
And youre still ignoring the fact that saving a $5000 insurance premium for an additional $2500 in taxes represents a $2500 savings to the taxpayer.

[DanTex]

12. Yes, necessarily. Paying for the healthcare of everyone who currently has private care

and everyone who is uninsured will cost a lot of money. Everyone knows this, including single payer advocates.

And, no, I'm not ignoring the fact that the average person would save money, at least in the long run, I'm just pointing out that taxes are going to go up and the government will be spending a lot more money. These are simple facts.

Again, if this were a slam dunk, it would have happened in Vermont.

[HooptieWagon]

14. It has saved lots of money in every country that has adopted it.

I guess the US is just too stupid to implement a plan that even some 3rd world countries are capable of....or its being blocked by those who make obscene profits, and those who spread their propaganda.

[DanTex]

15. It hasn't saved the government money (obviously).

It may have saved in overall healthcare expenditures, although there are also plenty of examples of non-single-payer systems that provide effective care at reasonable cost. The WHO rated France's healthcare system number one, and that's not a single payer, it's a two-tiered model where the government pays for about 3/4ths of health care, as opposed about 1/2 here in the US.

I'm not sure why Bernie fans insist that, of all the health care models out there, single payer is the only possible one for the US.

[HooptieWagon]

16. Who cares if the govt administrated it?

Only anti-govt right wingers.
I just care about a more cost-efficient system, I don't care who runs it. If the govt operates it at half the cost of private enterprise, the only people that will object are bloody fascists.
You would rather pay $5000/ year to an insurance company (plus co-pays and drugs), rather than $2500/year extra in taxes for the govts to cover everything? That's what you're arguing for. I think it's fucking stupid.

[DanTex]

21. Not me. The question is whether the electorate will care.

On the other hand, I also don't care if the private sector administers it, which is why I'm not gung-ho single payer either.

There are efficient universal systems which combine private and public healthcare, some that resemble Obamacare. The problem is that ours isn't currently one of them, but I don't agree that single payer is the only or even the best way to fix it.

[Admiral Loinpresser]

18. I was wrong!

In my haste to post this to stop the misinformation, I misread the $5T savings as federal, but on an a focused study of Friedman's rebuttal, I am pretty sure he meant $5T in overall SOCIETAL savings. Shame on me for the haste.

Having said that, I am still having trouble deciphering all the data because he is not a good writer. His table descriptions are not very clear.

What is clear is that the $15T in additional spending is a gross figure, not a net increase in federal spending. For example, he includes a figure of $3T in deficit reduction in the first table of his rebuttal letter. Applying this to the federal health care budget immediately brings the total to $12T.

http://www.huffingtonpost.com/gerald-friedman/the-wall-street-journal-k_b_8143062.html

In addition, his figure of $10T in savings does not differentiate between federal and nonfederal savings, so it is unclear how much of that will further reduce the figure of $12T.

I am, of course, ignoring the moral benefits of this plan with medicare for all, expanded to include full dental, no mdeicare gaps, etc.

However, Friedman makes a very important point about the nature of his STATIC projections. There is tremendous upside in additional tax revenues when businesses compete globally and domestically without the burden of baking health care costs into their goods and services. There are incalculable huge benefits economically that will further reduce federal spending requirements, for example, fewer disease-related deaths in the US, no more personal bankruptcies due to catastrophic health problems, etc., etc.

Here is Friedman acknowledging that his projections are way too conservative, because they are static:

The economic benefits from Senator Sander's proposal would be even greater than these static estimates suggest because a single-payer plan would create dynamic gains by freeing American businesses to compete without the burden of an inefficient and wasteful health insurance system. As with Senator Sanders' other proposals, the economic boom created by HR 676, including the productivity boost coming from a more efficient health care system and a healthier population, would raise economic output and provide billions of dollars in additional tax revenues to over-set some of the additional federal spending.

Also, the tax relief to state and local government will be huge, when their health care costs are eliminated. So there are so many upsides it is hard to quantify.

What we need is a health care system which is not dysfunctional, immoral and insane.

We need to change the meme to the tens of trillions of dollars we will save as a society. Single payer saves America tens of trillions of dollars and makes America a 21st century nation in health care policy.

I am going to email Friedman to see if I can at least get a static estimate of the NET fiscal effect of the Conyers plan. Clearly it is much, much less than $15T.

[DanTex]

20. Yes, $5T in societal savings. That's what he should be emphasizing, and I believe he is doing that.

You're also right that $15T is a gross figure, but it still is an increase in federal spending. It's not an increase in the deficit though, because he will offset that with taxes, but it's still an increase in federal spending. And talking about federal spending in gross terms is the norm. For example, if you ask how much the government spent last year, the answer is about $3.5 trillion. The government also collected a little over $3 trillion in taxes, so the "net spending" (i.e. the deficit) is a little less that $500 billion, but I don't think you can argue that "federal government spending", in common parlance, means anything other than the gross number.

Aside from that, I mostly agree with you, except that I think Bernie has done an adequate and honest job explaining what that number actually means. And I also don't think that single payer is politically feasible, and I do think that that $15 trillion number will leave him vulnerable if he were nominee, if only because some people are too dumb to understand the rest.

And I don't think that single payer is the only viable model for universal healthcare, either in the US or anywhere else. But I agree about the basic point that despite the increase in government spending, single payer would represent a net savings for society, particularly in the longer term. Plus the inherent morality of insuring everyone.

[Admiral Loinpresser]

24. I'm glad we have areas of agreement, but

I can't take your point on "gross" vs. "net." When talking about expenditures, we have to talk about net ones. This isn't expenditures vs. revenue, this is reducing expenditures by economies of scale, negotiating with drug companies and reducing admin costs.

So while the Conyers plan provides funds for buying out health insurance companies (those stocks will plummet), expanded care, etc., it also means current appropriations will be offset by cheaper medicare costs per patient in drug costs and treatment fees. So the net effect to the federal health budget will be something dramatically less than $15T in increased expenditures over ten years.

All of this discussion may be rendered moot by Bernie proposing his own plan. He has no duty to defend a very specific plan created by somebody else. I would expect that plan to emphasize much bigger tax increases for the 1%, which is a politically very viable approach.

The problem with a public option is that the health care/insurance complex will take a huge hit because they won't be able to compete with the efficiencies of the fed gov and will thus take a huge hit in the stock market. Maybe private health insurance would be able to find a niche, as in the UK.

The bottom line: our current system is unsustainable. To become economically efficient, we must have universal health care. In promoting it, we should emphasize the tens of trillions in savings obtained by individuals, businesses and state and local governments.

[Recursion]

31. Bingo. $5T less will be spent on healthcare

But the government will be spending $15T more over 10 years.

[Admiral Loinpresser]

32. Not a net $15T.

The tables are not constructed to actually show the fiscal impact. It is much more geared to a societal spending impact.

If you carefully study the tables in the rebuttal letter, you will find almost $3T in fiscal surplus. If you buy a car for $15k and then get a $3k rebate from the dealer, did you spend $15k? Literally, yes, but your net price was $12k, clearly.

If you look upthread, there are other static offsets I mention which will clearly reduce the figure of $12T, but how much is federal fiscal savings is unclear.

In addition, the dynamic savings (from having a much more robust economy not hampered by a dysfunctional health care system) in the form of additional tax revenues is hard to predict, but could also have a dramatic offset impact, as noted by Friedman in his rebuttal letter.

What is the actual figure for the investment in net federal spending required? Certainly lower than $10T over ten years. Could it be as low as $5T? Friedman would perhaps be the best one to set upper and lower guesses based on all static and dynamic criteria.

To say that the Conyers plan requires a net federal investment of $15k over ten years would be demonstrably false under Friedman's study, or in the case of the WSJ, probably a willful lie. Will the investment yield about $20T in societal savings? Yes.

[Recursion]

34. Personally I think every scoring drastically understates usage increase

I think there is an obscene amount of care going unprovided right now, and any zero-cost-at-provider plan is going to increase usage by maybe as much as a third.

[Admiral Loinpresser]

38. It's in his tables,

I believe to the tune of about $5T. I have no idea how he made those projections. I agree, the amount of usage will be much heavier. But it will also be a much more efficient usage because people will go earlier (prevention) and not nearly so much ER usage.

Gotta go to sleep. Big Bernie day tomorrow!

[HassleCat]

2. The old TV commercial

I think it was for an auto repair business, but not sure. A guy came on and said, "You can pay me now, or pay me later." Same thing with health insurance. We can pay "now" if we send some tax dollars to the government to fund a single payer system. Or we can pay "later" if we insist on making the heath insurance companies rich enough to pay their CEOs 250 times what they pay the receptionist. I think a message like that might make people see the difference.

[Schema Thing]

4. This is succint: "If something cost 15T and saves 20T, it's not an honest headline...

to lead with "program cost America 15T", can we assume you want to be honest in your reporting?".

[HooptieWagon]

7. If he was honest, it would be a first.

All I've ever seen posted was RW lies and talking points.

[SonderWoman]

9. Corporations are off the hook. Congrats Bernie.

More money in their pockets, less in ours.

[AgingAmerican]

10. What you are describing is the system we have now

Self awareness is a positive thing.

[SonderWoman]

17. Sorry, but I enjoy only paying $20 when me or my kids need to see a doctor.

[AgingAmerican]

19. So you pay no premiums

To corporations? Must be nice.

[Warren Stupidity]

25. I don't think the poster understands how the current system works and how it is paid for.

Either that or she is being deliberately misleading.

[Scootaloo]

26. Do you even know what the subject is about?

[Cheese Sandwich]

13. He wrote a direct response to the WSJ piece

http://www.wsj.com/articles/ill-create-jobs-provide-better-care-for-less-1442434046

I’ll Create Jobs, Provide Better Care for Less
It is true that I would invest $1 trillion into rebuilding our crumbling infrastructure.
September 17, 2015

Your article “Price Tag of Sanders Proposals: $18 Trillion” (page one, Sept. 15) is misleading.

It is true that I would invest $1 trillion into rebuilding our crumbling infrastructure. Not only would this long-overdue investment make our country more productive and efficient, it would put 13 million Americans to work in good-paying jobs. It is true that I would invest in making all public colleges and universities tuition free and substantially reduce student debt. This higher-education proposal, estimated to cost about $75 billion a year, would be more than paid for by a tax on Wall Street speculation. It is true that I proposed to extend the solvency of Social Security until the year 2065 and to expand benefits. This proposal would be offset by lifting the cap on taxable income above $250,000 a year.

But, here’s where the article is mistaken. While a Medicare-for-all program may cost $15 trillion over 10 years, this proposal would eliminate all payments made by Americans and businesses to health-insurance companies. At a time when the U.S. spends substantially more per capita on health care than does any other country on earth, a single-payer health-care program would substantially lower our total health-care costs and would guarantee health care to all Americans. This approach would end the international embarrassment of the U.S. being the only major country on earth that doesn’t already do this. For The Wall Street Journal to ignore the enormous savings that Medicare-for-all would bring to our wildly inefficient and dysfunctional health-care system is irresponsible.

Sen. Bernie Sanders (I., Vt.)

[Admiral Loinpresser]

22. Thanks.

I like this better than his oral response today. I would only amend that written response to add the word "savings" at least two more times. (I only saw "savings" once in a cursory reading.)

I believe this is where the battle lines will be drawn with corporate media. I hope I am wrong, but I believe the Swift Boats are coming to attempt to turn one of his greatest strengths (proposing a sane health care system) into a weakness.

[Cheese Sandwich]

23. Also this response from Robert Reich: WSJ's claim of $18T price tag "entirely bogus"

http://www.democraticunderground.com/?com=view_post&forum=1280&pid=52321

[Hoyt]

27. I agree, they are unfairly portraying the cost of the legislation. But, even Vermont could not

make single payer acceptable to the electorate. I think it's more people are too stupid to understand we are paying for it now through premiums, profiteering, unacceptable outcomes, etc. But that is still a big hurdle.

[Admiral Loinpresser]

28. I read Vermont got screwed up by ACA

and is waiting to get a waiver in 2017 to proceed with SP.

[Hoyt]

29. I think it is over for foreseeable future in Vermont. People just don't understand.

There are numerous links to explanations. Here's just one.
http://www.politico.com/story/2014/12/single-payer-vermont-113711

[Admiral Loinpresser]

36. Yeah, state-level SP

is not simple, so you don't get the same cost reductions you get under a federal SP plan.

[Recursion]

39. It's what Canada does

I personally think if we wind up with SP that's how it will happen. Though I think a system like Germany is much more likely.

[TheKentuckian]

41. No it isn't. Canada has five provinces not fifty states plus territories it isn't anything like an

apes to apples comparison. It would be more like regional plans yet the entire population of Canada is less than that of California just spread out over one of the largest land masses.

Why do you think we will develop a system of strictly regulated non profit insurance for the vast majority and maintain a private system for roughly the top 10% of the country then throw a hodgepodge of supplemental coverage and why is that desirable?

[Recursion]

42. Canada does its Medicare by province, not nationally

Of course Canada is different; but even they with their much smaller population didn't try to do it nationally.

I think we'll wind up with something like Germany because that's much closer to what we have now than Canada or the UK.

[TheKentuckian]

45. How is it actually closer? We don't have anything strictly regulated and nonprofit that

isn't run by the government nor have we ever been able to maintain such that start those way on a generational basis.

Your principle comparison points only appear the same from 50,000 feet. In reality it is no smaller lift and no less sensible build that single payer or a NHS and far less likely than either to successfully reduce costs.
Germany also never had to undo our behemoth insurance cartel and did not make them effectively too big to fail as a step toward such a goal.

When the rubber meets the road the German system is no more similar to ours than anything else, we don't have similar structures or oversight systems or even mentality toward oversight and nonprofits.

Germany has like 80 million people (and we aren't really talking all of them) and has like 130 non profit insurers, what is going to make all of these nonprofit plans spring into existence here? Who is going to keep them in line with what budgets?

I find it annoying that so many Democrats seem to consider health care mostly a marketing issue whatever type of plan they support.
One group wants to sell a 80/20 plan with no maximum out of pocket and a really poorly designed, costly, and wonky drug plan and others insisting they are taking us somewhere we aren't actually heading to at all but why we are supposedly is because it is a more bridgeable gap to sell and yet still others just want to polish the current turd and sell the shine.

[Recursion]

46. Most private insurers in the US are not-for-profit

I think I've had one for-profit insurance plan in my life, and that wasn't noticeably more expensive. This is why I keep coming back to saying that insurance profit, while a problem, isn't the chief problem: provider cost is.

http://www.payscale.com/research/DE/People_with_Jobs_as_Physicians_%2F_Doctors/Salary

Average German physician salary is about $56K; it's $150K in the US.

[TheKentuckian]

47. Of course provider costs are high and in our society build there is no way to get

them under control without at least the power of the purse along with significant government investment along with robust, active regulation and oversight. Possibly things are so far gone that we will need a NHS to truly get a handle on that side of the equation.

I don't agree that the entire issue is provider driven though even as I want to clearly acknowledge significant issues on that side, yes the cartel is a significant portion of the issue.

I'm glad you've done well with your Kaiser or Harvard or whatever you've had but of course they don't save much (though my guess is you were getting the best value you could whatever notice you gave it after), they don't have the network power to do so.

[Hoyt]

48. That may be true, but problem is people are too stupid to understand a seemingly high tax hike

to cover it, would actually be cheaper than what they pay now and produce a better system (hopefully). That's the problem. If people don't believe in it, it's doomed to failure, massive criticism, underfunding and obstruction from Congress like we have now, etc.

That's why I believe for the foreseeable future, the ACA approach is the way to go -- with a public option -- tight rules for private insurers, etc. Not saying it's the best way to do it, but necessary because we have a lot of stupid idealogues in this country. Besides, even Medicare uses insurance companies to administer it, and some of the Advantage plans have better outcomes than traditional Medicare.

[Recursion]

30. Except it will actually increase government spending by that much

You can wave your arms about how that "really" is saving money in the bigger picture, but the actual outlays by the government are going to go up, a lot.

[Admiral Loinpresser]

33. False, not a NET $15T will be invested federally.

Please see post #32 for details.

[Recursion]

35. And see my response: millions of people are going without care right now

Usage will go way, way up, I think more than people want to admit.

[Admiral Loinpresser]

37. That's accounted for in the Friedman analysis.

It's baked into his tables in the rebuttal letter.

[TheKentuckian]

40. We can't afford to save FIVE trillion dollars. It is just too expensive!

We're talking saving 25% of cost here.

Give me an explanation of how we can afford not to? Especially when we consider the literally out of control cancerous growth rates threatening to unbalance to broader economy now band aided by the Wealthcare and Profit Protection Act, the hemorrhage only slowed slightly by granting the big insurers too big too fail status.

The only other structure that will help us get any handle of this monster is a NHS.

The other models aren't sustainable in our society we aren't to be remotely trusted with a generational regulatory and oversight system and are way too inept, disinclined, and greed oriented to even make an honest effort at such a thing.

The cooperative utility type thing is corrupted by profit chasing and privatization instantly.

I would think the flaws of the savings plan deals as the base would be readily apparent in the scale of our health care economy.

[in_cog_ni_to]

43. It should become part of his stump speech!

He should condense it all down to a sentence or two and tell the people how much will be saved Five Trillion savings should be heard by everyone attending his rallies and town hall meetings.

[delrem]

44. They ought to examine Canada's universal health care system.

It works.

Of course you'll have to remodel your own variation to better fit your own culture, but you should be able to see that such a thing as an universal health care system works, and isn't too expensive.