Medicare for All is a fatal loser in the general election

[EveHammond13]

look at the polling.

If we run on improving the ACA we win.

If we run on crashing the system with Medicare for All we lose.

Can we please use our brains. Please.

[ancianita]

1. M4A won't crash the system. The system's already in place.

[George II]

2. If it's implemented the way it's been proposed, tens of thousands, if not hundreds of thousands....

....of people will be put out of jobs. And a big part of the administration of Medicare will have to be shifted to inexperienced government workers.

The current Medicare system would collapse.

[ancianita]

6. Only private health insurance admins and their immediate personnel layers.

Everyone else who performs some direct service in processing the same patient ratio will have a job.

Bottom line on jobs is the issue: are those jobs really more important than the 28 million Americans without health care coverage?

[George II]

7. All those thousands that I'm talking about work for the private insurance companies. If Sanders....

....puts private insurance companies out of business as he's claiming, where are they going to work?

Comparing those people's jobs to 28 million Americans without health care coverage is silly - every other candidates' plans will retain private insurance companies AND their employees, and those people will have access to health care coverage.

Certainly we can insure those 28 million AND permit thousands of workers to keep their jobs.

[ancianita]

10. I already said, and comparing health to jobs is NOT silly. It's silly to even bring up the few who'l

l need to find jobs as some argument that justifies not giving health care to the many millions.

Minus the pricing, boards and administrative jobs, the business of private "providers" will still be the business of the single payer direct health service delivery systems.

So let's not get into that "silly" judgy mcjudge bs.

Of COURSE we can keep most indirect and all direct service give health care jobs AND service those 28 million. I wouldn't use the word "permit," though.

[George II]

11. But there are other ways to provide insurance to those 20+ million without throwing thousands...

of people out of work.

There are still six candidates and six proposals. Most of them are based upon building on what we already have in place. Even Elizabeth Warren has backed off her original plan.

Millions of people are satisfied with the ACA or their current coverage, why throw all of that in the garbage in favor of something that isn't even fully defined yet and may or may not work?

[Bettie]

14. So, people dying because they can't afford care

is OK as long as the insurance companies continue to profit. Noted.

[George II]

18. Nobody said that! We have insurance plans in place for ALL Americans. But some here....

....want to throw that in the garbage, start from scratch, and try something "new" that:

1. Hasn't been fully detailed yet
2. Hasn't been proven that it will work
3. Most importantly, has ZERO chance of being passed in our lifetimes

NOBODY here advocates "people dying", why do people fall back to that insulting idea? It's like during the bush administration, if one didn't embrace his policies 110% they countered with "why do you hate America".

It's divisive, overly simplified, and quite frankly insulting.

[Bettie]

19. The insurance plans for "everyone"

don't stop people from going bankrupt over medical costs.

They often cost too much out of pocket to even use, then when you do use them, the for-profit entities decide that virtually nothing is covered. Now, keep in mind, that the they also cost more than a lot of people can even afford as a monthly premium for "benefits" that they can't afford to use.

People do die from lack of care. Currently.

You know, FDR was told that Social Security would never be passed. Same with Medicaid and Medicare, yet somehow, they got passed. Saying there is no point in trying for a better solution is literally saying you are OK with people dying.

If you are in love with the idea of people profiting if you should become ill, then, fine, enjoy it.

I want people to be able to go to the doctor when they are ill without checking if they have enough in their already stretched weekly budget to cover it.

You must live among pretty well-off people if you think everyone is covered and has the luxury of going to a doctor when they need to.

[HarlanPepper]

33. I suppose if you rely on that job to provide food and shelter it might be.

But hey, let the insurance company establishment drones eat cake.

[Midnightwalk]

56. I don't like either side of that argument

We need to get a trillion dollars a year out of healthcare savings to get our costs in line with orher countries.

Some people seem to think that all comes from evil insurance companies. I agree they are evil but the waste is throughout the system and many jobs have to be eliminated to get the savings. The alternative is to keep spending money for no productive reason

Say 20% of the savings is employee cost and that the burden rate for a worker is 100K. That’s 200 billion a year (20% of 1 trillion) divided by 100k. I think that’s 2 million people. A LOT.

Some say keep them anyway. Well only if we want to keep paying more than any other country for healthcare. Some say we don’t need whip and buggy workers as if that is a valid answer to adding 2 million people to unemployment rolls overnight. That would have severe economic and political costs.

Spread over 10 years, that is 200 thousand workers dislocated a year. I’m not an economist and don’t have a good sense of these numbers but 200 thousand people a year might be manageable particularly as they would know change was coming. It still won’t be easy.

Note that I made up the 20% of total cost is reflected in jobs. I didn’t know how to get a better number and you can plug in your own guess. Same with my burden rate guess.

I’d rather spread out reform longer and or pay for some transition subsidy than keeping unnecessary positions in the system.

[stopbush]

5. Actually, the system is NOT in place to cover 100% of the population under Medicare.

Current payroll deductions for Medicare from 100% of working folk are enough to cover only the 19% of Americans currently on Medicare/Medicaid/Disability. Those taxes would need to increase at least five-fold to cover 100%. Medicare premiums would not go away, either. They would probably rise.

Then, there’s the matter of providers who currently accept the reduced payments they get for Medicare patients who would be hard pressed to accept that lowered level of payments across the board.

No, the system does not currently exist.

[ancianita]

9. The tax structure is in place. All Internet and server systems are in place. Top regional providers

of health care are in place.

Intake of new patients is the upfront processing for 28 million uncovered Americans. That can take time, but the capacity for servicing them could actually be in place, since they might include 52.2 million Americans who already are in the system on some form of welfare.

The systems are in place for 62.2 million Americans who get VA and Medicare coverage.

This is a turnaround issue for intake on 230 million people; it's not a structural or money issue. The service will be there and paid out as new people need to show up for intake.

The systems are, indeed, in place, and as they are used, will show the argument as only having slowed down help for those who've needed it.

[stopbush]

12. The tax structure that is in place will not work for MFA.

Employers currently pay a 1.5% tax into Medicare per employee based on employee salaries. To go to 100%, employers would need to pay the same 7.5% tax on EACH employee as would each of those employees. On top of that, MFA advocates hint - they never give a concrete answer - that employers would be required to continue to pay at least a portion of what the currently pay as employee premiums into some Medicare-sustaining fund.

All this means major pushback from employers, coupled with reductions in workforce where possible to cut expenses.

The system is “in place” the same way state sales taxes are in place. The problem arises when the state sales tax jumps from, say, 6% to 30% within that system. Same thing with Medicare taxes.

[ancianita]

15. Medicare isn't paid into, it's Social Security that's paid into by employers. And it still will be.

When you start with that premise, I don't think you understand single payer structuring in M4A.

Employers are out of the whole structure of single payer. State sales tax? Seriously?

I think you're not getting what "in place" means. You're overcomplicating the tax payment structure.

But the tax and payer structures already exist at federal levels. Nothing in M4A will require any employer or state input.

If you can link plans that talk this talk, I'll take a look and get back to you.

[stopbush]

17. Er, they are both paid into. It would help if you knew the facts.

https://www.irs.gov/taxtopics/tc751

Now, who were you saying doesn’t understand?

Just to be clear: both employee and employee pay into SS and Medicare. SS is currently 6.2% and Medicare is 1.5%, for a total payroll deduction of 7.7% each, or 15.4% for both.

Now, add 6% on each side of that current total (based on the premise that five-fold increase in MFA patients would mean a five-fold increase in the Medicare withholding tax): employees and employers would be taxed 7.5% for Medicare and 6.2% for SS, or a total payroll withholding of 13.7% on each side, or 27.4% total. And that’s in addition to income tax withholding.

[ancianita]

21. Never paid into Medicare from my check for 36 years. I'm surprised it's done. Thanks for the info.

[stopbush]

23. Sure you did. It's listed as FICA on your paystub.

[ancianita]

25. Nope. No FICA allowed for Chicago teachers. They deny Soc Sec to us b/c we have a pension.

They called it "double dipping" back in the 70's and haven't changed it since.

I've earned and paid 28 quarters of FICA on outside jobs and won't see that money. It's cool, though, because it helps keep SS afloat for GenX'ers after we boomers die off.

[stopbush]

27. Ah ha, you are the union pension exception.

Yes, you won’t see the FICA money - which is SS and Medicare combined - but others will.

Most American workers have FICA taxes withheld. You're the exception that proves the rule.

[ancianita]

32. Regardless, here are two things that we can be sure will happen, employee deductions or not.

1. Small business owners will be freed up from all the paperwork of providing employee based insurance. They only do the usual FICA deduction, which will increase for each employee a bit. The insurance deductions won't have to be made any longer, so both employers and employees save money.

2. Taxes will only go up by a small amount, not anywhere beyond $2,000 a year, because 230 million people now paying ridiculous gouging prices on private insurance premiums will also afford it.

That's it. Two ways to pay: FICA and income tax. Big deal. In return, all Americans get

-- guaranteed coverage; no bs about deductibles, out of network costs, add-ons, etc.
-- all networked hospitals, both public and private, ANYwhere; and probably no more doctor networks;
-- nationwide health care, whether one lives in a car -- which over 20 million do -- nomad trailer, or suburb or with grandma; whether one lives with a P.O. box or street address, in a motel or mansion;
-- employers able to give raises, since they no longer are burdened with premium sharing as an employee benefit
-- No more Medicaid will be needed, because all that money is now rolled into M4A single payer
-- a M4A card which proves they've done the eligibility paperwork
-- no high premium bill paying, no insurance invoices, and all that other middleman bs

[R B Garr]

46. Wrong. There is 7.5% payroll tax.

Wrong. There is. 7.5% payroll tax.

Do you think the Republicans will put up with Sanders avoiding cost questions? They will fill in those numbers however they want to—just like Sanders is doing.

[ancianita]

47. Please explain the payroll tax. How would that be part of M4A?

[R B Garr]

49. May I ask, did you not know that part of it?

[ancianita]

50. Sure. It's federal and state income tax withholding. So how am I "wrong." You just give the process

some name that's already figured into M4A collection structure.

If I said paperwork would lesson, I admit I'm wrong about that.

But how would it increase? Every single year every employer has to plug in that year's figures on taxes withheld.

So how would any employers' plugging in new numbers into their payroll system change their current efforts? It wouldn't, really.

[R B Garr]

51. It's a 7.5% payroll tax. It's interesting how that is

whitewashed. Did you see the 4-year phase-in from employer to employee. Of course it’s not an ongoing employer tax since the whole selling point is supposedly that you don’t have to be employed to have insurance.

[ancianita]

52. So, do you think the entirety of benefits of M4A are outweighed by employer-employee one-time

changeover that can help 327.2 million Americans? That looks as if it's the point you make here. I could be wrong.

[R B Garr]

55. It's a 7.5% payroll tax. When did phase-in turn to

one time? No wonder these things are not discussed at his rallies, instead sticking to the concepts that people have flawed characters if they want details.

This is why the public option is superior. There are 160,000 million already insured, like us with excellent union benefits. Why force them into a 7.5% payroll tax when there are other options to provide coverage.

[ancianita]

57. I see. Thank you. That seems simple enough for an elevator pitch when you put it that way.

[R B Garr]

59. As opposed to five (5) years of campaigning for

something while omitting details like refusing to talk about his payroll tax. Sanders is now saying he can’t account for all the “nickels and dimes”. WTF. Talk about an “elevator pitch”.

But thanks again for the glaring example: anyone wanting details about M4all is insulted.

[ancianita]

60. Be honest. It's only "glaring" because none of the anti-M4A's have brought this up before you.

[ancianita]

61. No one in support of the OP until you. No one for the months we've been discussing it. If I'm wrong,

post DU links.

[R B Garr]

63. "Be honest." Oh, you too. Talking about what's

actually in the plan gets these petty insults. How is that going to work with millions of voters having questions.

Anyway, it looked like poster stopbush was talking about it.

[ancianita]

64. No insult intended at all. What I discussed you called a "glaring example." Pretty offensive to me,

making an effort post. You could have been more objective, less personal than with comments proclaiming "Wrong," or "It's the payroll tax" with little to no accompanying explanation.

I'm straight.

Though I, and probably others, could have used the key parts of this explanation long ago, when it should have come up.

If you can link those discussions, I'll declare myself a doofus.

[R B Garr]

65. ...

Okay.

It looked like you were omitting the payroll tax, but you’ve explained. Thank you.

Edit: I’m also surprised the payroll tax has been glossed over by the Sanders camp.

[ancianita]

67. ...

Fine.

I just never thought of M4A as a burden on business. More a relief. Any payroll changes they have to make, they can write off as operating expenses, anyway.

A good explanation of how M4A wouldn't burden payroll tax data input any more than any other kinds of payroll changes that businesses already have to make, could help Sanders' credibility. Maybe.

One thing I notice is that Sanders voters don't really seem to really care. Maybe they believe he's got no credibility challenge coming from the likes of 45, and they could be right.

[R B Garr]

68. The payroll tax is for individuals, out of their paychecks.

I only posted here again because your post seems employer focused.

I have also noticed that Sanders voters don’t seem to care, but Trump will sure change that. He will be happy to fill in all the $$$ blanks Sanders omits.

[ancianita]

69. Either way, it's sorted out w/ W-2's at tax time.

We all know, even the cult know, who the king of bullshit is in the general.

Sanders will be ready for 45's bullshit numbers.

[R B Garr]

70. W-2's don't change the deduction %. They just

report what was taken out. They don’t mean anything to M4all.

[ancianita]

71. If taxes get raised a bit to help pay for M4A, they will. Which will cost less out of pocket than

any current health insurer premiums and add-ons.

[R B Garr]

72. It's a payroll tax. A 7.5% payroll tax. You are changing

what the plan itself says, trying to make it about paper forms. It’s a payroll deduction.

[Bettie]

20. There is no point in arguing with some people

they figure that for profit insurance is far better than actual health CARE, because..."we can't" and "there's no chance it will ever pass" and "no one would EVER allow that!".

It gets frustrating and it is really only a tool to try and demoralize other Democrats and convince us that nothing can ever change.

I refuse to accept that things will never get any better.

[ancianita]

22. I'm with you. Especially because it really IS affordable and doable.

[Bettie]

24. If every other first world nation can do it

we certainly can. Plus, we do have the best health care infrastructure in the world, but a way of paying for it that doesn't leverage it efficiently.

It can be done, but the for-profit insurance industry has convinced people that only a for-profit system can possibly work. But, the good news is that the younger people look to Canada and Europe and say "why not us?".

[ancianita]

26. Exactly. Young people aren't going for the ol' corporate bamboozle on how "important" the

insurance racket is for health care.

[delisen]

58. Some of those European countries have mixed systems with private insurance.

Germany has what's called a universal multi-payer health care system. It encompasses both statutory health insurance for people who earn less than a certain salary, as well as private health insurance for those who earn more and choose to purchase their own.

https://www.google.com/search?client=safari&rls=en&q=germany+healthcare+system&ie=UTF-8&oe=UTF-8

[R B Garr]

48. Wrong. There is a 7.5% payroll tax. For people with great

insurance, that equates to hundreds per month. Not affordable.

There goes disposable income, a second car, credit card payments.

Everyone should be sure to get their credit lines secured now so you can start living off your credit once the 7.5% payroll tax kicks in.

[brush]

29. Medicare also only pays 80% so the other 20% has to come from somewhere.

There's still a lot to be worked out even if it ever passes.

[ancianita]

30. All Medicare recipients right now pay for supplemental. That's 55 million people. So, when

that $5 TRILLIION in big fossil yearly subsidies goes in to help pay M4A, the turnaround costs won't be on the recipients. That's every single year of no fossil subsidies paying into M4A.

The other somewhere will be through a small increase in payroll taxes. Right now I pay $2400 a year for Plan F supplement that frees me from ALL costs. I get guaranteed coverage anywhere I happen to be, with any doctor or hospital I have to turn to. That right there is cheaper and better coverage than almost any insurance premium prices that employee based private insurers charge, and which put limitations on health care only by region, or network, or "covered" diseases, or ridiculous "deductible" amounts they must spend.

The 80%, with a whole country paying in waay lower tax increase than their current premiums, will lower the M4A supplement costs. I'm not a gov accountant, but I can easily see the savings for everyone who now carries either employee based or any other kind of middleman insurance premiums.Not to mention the portability of their health care, AND the guaranteed coverage, cradle to grave.

[brush]

40. Well that clears that up for everybody.

Sure it does.

[ancianita]

41. Your cynicism is noted. If you seriously don't think that clears it up, then what've YOU got.

[brush]

43. I don't have anymore than Sanders does, but I haven't been pushing MFA for 5yrs and had 5yrs to...

figure it out.

[ancianita]

45. These guys have pushed it for 37 years. Long before Sanders. They're not political. https://pnhp.org

https://pnhp.org

https://en.wikipedia.org/wiki/Physicians_for_a_National_Health_Program

[Proud Veteran]

3. You are 100% CORRECT

Medicare for all is a loser on several fronts.Many working people like moderate Dems and Independents want to continue with employer provided insurance. Although they surely have a need for improvements.
Also why don't M4A s supporters understand that it can NOT be passed in the Senate(60 vote super majority).This is such a non-starter and all but insures a trump victory.

[Jirel]

4. Just the opposite.

People passionately want it. It will BRING people out to vote for candidates like Sanders or Warren. Same crap, different filter, which is what Bloomberg, Biden, et al have to offer, excites absolutely nobody, and will leave many votes sitting at home, allowing Trump to be re-elected.

Can we please use our brains. Please.

[Laelth]

37. +1 n/t

-Laelth

[jmowreader]

39. Other people passionately hate it

We lost both houses of Congress in 2010 over "if you like your plan, you could keep it" that didn't take into account all the garbage masquerading as "health insurance" back then.

Medicare for All won't let you keep your plan for any reason whatsoever. People who wouldn't piss on Trump if he was on fire will vote for the bastard just to stop MFA.

Screw "excitement." In this election cycle we have ONE ISSUE and ONE ISSUE ONLY: Does America survive? At this point in time we have a man in the White House who will destroy everything you hold dear if he's in office on January 21, 2021. We MUST vote him out or we're all gone.

Once we've solved the problem of a treasonous, America-hating president, then we can start making America better.

[ancianita]

42. It WILL let people keep their plans for any reason whatsoever. M4A is for ALL who need/want it.

It's single payer. If anyone doesn't want single payer, THEY can be the payer.

You really misunderstand M4A as mandatory. It isn't.

If health care for all isn't the lead election issue, then what is. Especially if, so far, they don't feel any personal effects of anything we ourselves see.

[Midnightwalk]

53. Medicare for all is mandatory

I suppose you could refuse to go to a doctor but any tax increases will be mandatory and any union or employer plan goes away.

There are at least two arguments that get confused. Some say the economics can never work out. I disagree with that.

My argument is that requiring everyone to switch to government coverage in the initial roll out is unnecessary and adds political risk. We lose ACA and prexisting condition protections if we lose the election (and many other things)

Buy in with other cost saving measures like pharmaceutical reform are better steps for the first legislation in my opinion. When a cheaper, better government plan is there people will naturally choose it and/or eliminating some exceptions will either be easier or remain unnecessary.

[ancianita]

54. I hear you. You propose the public option that's already been bashed by private insurer PR, right?

We don't lose ACA and pre-existing conditions under M4A because "pre-existing" is rolled into it, and the ACA details are part of it -- except for "plan" categories.

We're trying here, I thought, to know what is the most important issue for Americans besides "beat Trump." I'm not sure that this can be the nominee's lead, when put this way.

The ACA was supposed to be the gateway law toward the public option, as I understood the plan at the time.

Still, if the nominee repeats what you're proposing, the public option, I'm not sure the public could "get" the public option, which was divisive even within our own ranks since before the ACA was made law.

Doesn't mean it's not realistic or good, though. It is. I'm just suggesting that it's a hard sell because it requires more thought than M4A for voters.

[Midnightwalk]

62. What voters get depends on where they are

First, if a democrat wins the election I think we can make sure we don’t lose existing protections but we might need to pass something depending on the supreme court case. If we lose the election they are gone. It’s between improving healthcare and losing healthcare.

If you have no insurance today medicare for all is going to feel somewhat more secure than a promise that buy in will be fully subsidized for you. Hard to say how much for me. More sure is people in that position aren’t going to be swayed by the attacks that taxes will go up and they’ll lose choices.

If you get gold plated insurance from your job the uncertainty of what a new plan is, prospect of taxes going up and just the idea of having “something taken away” will make buy in attractive.

In the middle of those two poles is where it’ll be interesting. A cheaper alternative vs being forced into a plan seems like an easier sell to me. The attack ads and biases media will be everywhere.

In liberal strongholds like California cities and New York city area, there’s enough of a thought mass to reinforce our message whatever it is. In battleground states the conversations will have people who just listened to an hour of talking points on fox news or talk radio.

I think no new taxes and you get an extra choice with buy in is an easier counter argument there. Explaining that your taxes might go up and you can’t keep your current plan but you do come out ahead is actually difficult to explain. I’ve challenged people in threads to give us better words but they don’t seem to have any.

[David__77]

8. Cool. Gonna vote for who I want to win.

...

[jmg257]

13. Is that the polling in the swing states? Do you have those results re: M4A "that matter"?

[guillaumeb]

28. Billions spent by the healthcare industries to achieve this result.

Propaganda works.

Millions hated Obamacare, but liked the ACA.

Propaganda works.

[Moderateguy]

31. And is the Insurance industry going to just roll over and die

If Bernie is elected? The insurance companies will spend a billion dollars to ensure that M4A becomes a bad, unusable word. How does Bernie plan on preventing this?

[HarlanPepper]

34. Also

If you work for a health insurance company in any capacity, in what world would you vote for Bernie?

[earthside]

35. Because their healthcare coverage is also based on the whims of their employer.

Healthcare needs to be disassociated from employment.

It is absurd that we ever went so fully down this route in the first place.

Why is healthcare dependent upon a job? Lots of people don't work ... babies, children, disabled, senior retired folks.
And really, why should your employer be paying to insure your child or your spouse?

You have to wonder why employers aren't at the top of the list to get rid of this system -- getting out from under this expense would save them tons of money and human resources time and effort.

Single-payer can be phased in over 8 years or so ... but ultimately it is going to have to be done done way or another or the U.S. will slide even further into third world status.

[HarlanPepper]

36. If your job/career is in the industry I doubt many will see it that way.

[guillaumeb]

73. Many Americans already die every year due to lack of access to healthcare.

But we have more votes than these few executives.

[Bradshaw3]

38. You tell us to look at the polling but provide no polls

Then we're told to use our brains. How about you use your brain and google searches to back up your claim that it is "fatal"?

I haven't seen one poll showing that a large majority of voters will not for a Democrat based on it or that improving the ACA will fix the problems (it won't) or that would result in a victory. Until then this is just another scare post from a supporter of a candidate who is truly scary.

[democrattotheend]

44. I imagine there's room for some of them at CMS

Some of them could become federal workers helping to administer Medicare for All. But this is definitely a concern, and it is a little shocking to see how much people here are trivializing it. We're not just talking about the CEO's of insurance companies here. We're talking about thousands of middle-class administrative workers who would be out of work.

[Tweedy]

66. No. It is not

Never forget the Democratic nominee will be running against an unindicted co-conspirator, serial bankrupt, sadist.

We could win with a potted plant so long as we are unified.