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Post by Merge on Nov 1, 2019 12:55:23 GMT
This has been a recurring question for many people - how will she pay for it? This is her campaign's outline of her plan. (ETA: Link now leads to NPR article with full text of plan embedded.) She says that individuals below the top 1% will not pay any additional tax and will in fact see costs decreased and more money back in their pockets. More summary in the Twitter thread. I'd welcome discussion on this topic if anyone is interested.
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Post by jeremysgirl on Nov 1, 2019 13:25:02 GMT
I am all about an employer share. My employer is paying $17,000 worth premiums for my insurance annually. And then I pay an amount on top of that.
But with that said, I specifically work where I do because of my insurance benefits. I know from discussions with others that what my employer is paying and what benefits I have are not universal. I am curious how the plan will make this equitable. For example, some minimum wage jobs are playing games with part time workers in order to not have to provide insurance. Will my employer be required to pay $17,000 while theirs pays nothing? There needs to be some equity. I need more details.
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Post by iamkristinl16 on Nov 1, 2019 13:34:41 GMT
I don't know what the answer is, but I know that we can't afford to pay more. We pay $700 a month for insurance and still can't afford to go to the doctor due to the deductibles. AND the clinic/hospital system here has decided that all invoices must be paid in 3 months or they go to collection. I am curious how many people can afford to pay thousands of dollars in three months? That being said, from a provider standpoint, Medicare for all would be horrible if the rates stay the same. I can't imagine many providers being able to do well in that scenario. I have always envisioned Medicaid for all (benefits are better and reimbursements are better for providers) rather than Medicare for all. jeremysgirl makes a good point.
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Post by Merge on Nov 1, 2019 13:36:23 GMT
I am all about an employer share. My employer is paying $17,000 worth premiums for my insurance annually. And then I pay an amount on top of that. But with that said, I specifically work where I do because of my insurance benefits. I know from discussions with others that what my employer is paying and what benefits I have are not universal. I am curious how the plan will make this equitable. For example, some minimum wage jobs are playing games with part time workers in order to not have to provide insurance. Will my employer be required to pay $17,000 while theirs pays nothing? There needs to be some equity. I need more details. Sorry, the link I originally posted with the full plan details wasn't working. I've fixed it now. Here's what she says about employer contributions: Replacing Employer Health Spending with a New Employer Medicare Contribution Let’s start with a basic fact: American companies are already paying a lot for health care for their employees. They are projected to pay nearly $9 trillion over the next ten years, mostly on employer contributions for employee health insurance and on health-related expenses for employees under workers’ compensation and long-term disability. My idea is that instead of these companies sending those payments to private insurance companies, they would send payments to the federal government for Medicare in the form of an Employer Medicare Contribution. In fact, it’ll be a better deal than what they have now: companies will pay less than they otherwise would have, saving $200 billion over the next ten years. To calculate their new Employer Medicare Contribution, employers would determine what they spent on health care over the last few years and divide that by the number of employees of the company in those years to arrive at an average health care cost per employee at the company. (Companies would count part-time employees towards the total based on the number of hours they worked during a year.) Under the first year of Medicare for All, employers would then take that average cost, adjust it upwards to account for the overall increase in national health care spending, and multiply it by their total number of employees that year. Their Employer Medicare Contribution would be 98% of that amount – ensuring that every company paying for health care today will pay less than they would have if they were still offering their employees comparable private insurance. A similar calculation would apply to pass-through entities, like law firms or private equity funds, even though many of the people that work there technically aren’t employees. People who are self-employed would be exempt from making Employer Medicare Contributions unless they exceed an income threshold. Small businesses – companies with under 50 employees – would be exempt from this requirement too if they aren’t paying for employee health care today. When either new or existing firms exceed this employee threshold, we would phase in a requirement that companies make Employer Medicare Contributions equal to the national average cost of health care per employee for every employee at that company. Merging firms would pay the weighted average cost of health care per employee of the two firms that are merging. Employers currently offering health benefits under a collective bargaining agreement will be able to reduce their Employer Medicare Contribution if they pass along those savings to workers in the form of increased wages, pensions, or other collectively-bargained benefits. New companies or existing companies who enter into a collective bargaining agreement with their employees after the enactment of Medicare for All will be able to reduce their Employer Medicare Contributions in the same way. Employers can reduce their contribution requirements all the way down to the national average health care cost per employee. That way, my plan helps unions that have bargained for good health care already, and creates a significant new incentive for unionization generally by making collective bargaining appealing for both workers and employers as a way of potentially reducing the employer’s Employer Medicare Contributions. Over time, an employer’s health care cost-per-employee would be gradually shifted to converge at the average health care cost-per-employee nationally. That helps make sure the system is fair but also gives employers and employees time to adapt to the new system. If we’re falling short of the $8.8 trillion revenue target for the next ten years, we will make up lost revenue with a Supplemental Employer Medicare Contribution requirement for big companies with extremely high executive compensation and stock buyback rates. There are a variety of ways to structure an employer contribution to Medicare for All. This particular approach has the benefit of helping American employers in a few ways: ● Employers would collectively save $200 billion over the next ten years. ● Employers receive far more certainty about how their health care costs will vary over time and affect their finances. ● Small businesses – who often suffer when competing for employees because they can’t afford to offer health care coverage – would no longer be at a competitive disadvantage Employers can reduce their Employer Medicare Contribution by supporting unionization efforts and negotiating with workers to provide better wages and benefits – reducing costs and promoting collective bargaining at the same time. ● Because my plan holds health care cost growth to GDP levels, businesses will have stable balance sheets that grow with the economy instead of crowding out other priorities. By asking employers to pay a little less than what they are already projected to pay for health care, we can get almost halfway to where we need to go to cover the cost of my Medicare for All plan.
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Post by Merge on Nov 1, 2019 13:38:37 GMT
I don't know what the answer is, but I know that we can't afford to pay more. We pay $700 a month for insurance and still can't afford to go to the doctor due to the deductibles. AND the clinic/hospital system here has decided that all invoices must be paid in 3 months or they go to collection. I am curious how many people can afford to pay thousands of dollars in three months? That being said, from a provider standpoint, Medicare for all would be horrible if the rates stay the same. I can't imagine many providers being able to do well in that scenario. I have always envisioned Medicaid for all (benefits are better and reimbursements are better for providers) rather than Medicare for all. jeremysgirl makes a good point. I fixed the link in my OP to include the text of the full plan. I think it's worth reading, though a bit long. A big part of her plan is reducing healthcare costs overall mainly by reducing administrative costs. She also mentions increasing Medicare reimbursements to cover the full cost of service, so providers are able to stay in business.
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scrappinmama
Pearl Clutcher
Posts: 4,852
Jun 26, 2014 12:54:09 GMT
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Post by scrappinmama on Nov 1, 2019 13:41:21 GMT
It does sound like a possible solution to the problem. Every year, my husband's employee insurance gets worse and worse, while the cost continues to go up. They just announced that the maximum out of pocket will go up to $7900 per year. That's a $2,000 increase from this year! Yet the monthly amount we will pay for insurance has gone up again. Something has got to give!
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Post by Merge on Nov 1, 2019 13:41:24 GMT
Let me try posting just the link to the actual text of the plan and see if that works: click here.
(ETA: this works for me. You can also search the text of the plan for specific key terms, like employer or reimbursement, to find answer to specific questions you may have.)
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Post by jeremysgirl on Nov 1, 2019 13:46:50 GMT
Thanks for the further information. What I find bothersome, too, is that there isn't a personal share. I do believe we ought to have copays. I think every citizen needs to have a stake in their own healthcare. I am afraid that without a stake in their healthcare that healthcare services might be abused. I am specifically thinking of the emergency room. Under my healthcare plan, I can go to urgent care for $20. A trip to the ER costs me a $200 copay, unless the person is admitted. If admitted to the hospital, the copay is waived. But this, IMO, keeps people from abusing the ER.
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Post by Merge on Nov 1, 2019 13:56:26 GMT
Thanks for the further information. What I find bothersome, too, is that there isn't a personal share. I do believe we ought to have copays. I think every citizen needs to have a stake in their own healthcare. I am afraid that without a stake in their healthcare that healthcare services might be abused. I am specifically thinking of the emergency room. Under my healthcare plan, I can go to urgent care for $20. A trip to the ER costs me a $200 copay, unless the person is admitted. If admitted to the hospital, the copay is waived. But this, IMO, keeps people from abusing the ER. I hear what you're saying - but the flip side of that is all the people who go without necessary medical care - even emergency care - because they can't afford the copay. I believe that this plan would actually reduce ER abuse. Lots of people go to the county ER because the county ER can't turn away the uninsured, while a private urgent care clinic can. If you know that you're covered at the urgent care, why would you go to the ER when your child spikes a fever? Now, I do think some kind of triage system is necessary - perhaps we go back to the days of needing a referral to a specialist after you've seen a GP or NP who can rule out routine issues before going on. (I'll share a personal story here. I grew up next to an Air Force base, and almost all our neighbors were Air Force families. We were not. My dad used to complain about the free/cheap healthcare the AF families received, saying that it caused them to visit the doctor or ER every time a kid stubbed their toe. But then I came down with pneumonia at the age of 7, and my parents avoided getting me necessary medical care because of the expense when I "wasn't that sick," until my grandmother insisted that I was actually seriously ill and needed to be taken in. I ended up being admitted and hospitalized for a week. The doctor said if they'd waited another day, I could have died. I don't want that for any family. I think we have a national problem with not wanting anyone to have anything because some people might abuse it. I say I'd much rather have some people abuse it than have one child die from a treatable illness.)
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lindas
Pearl Clutcher
Posts: 4,146
Jun 26, 2014 5:46:37 GMT
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Post by lindas on Nov 1, 2019 14:07:23 GMT
I don't know what the answer is, but I know that we can't afford to pay more. We pay $700 a month for insurance and still can't afford to go to the doctor due to the deductibles. AND the clinic/hospital system here has decided that all invoices must be paid in 3 months or they go to collection. I am curious how many people can afford to pay thousands of dollars in three months? That being said, from a provider standpoint, Medicare for all would be horrible if the rates stay the same. I can't imagine many providers being able to do well in that scenario. I have always envisioned Medicaid for all (benefits are better and reimbursements are better for providers) rather than Medicare for all. jeremysgirl makes a good point. I fixed the link in my OP to include the text of the full plan. I think it's worth reading, though a bit long. A big part of her plan is reducing healthcare costs overall mainly by reducing administrative costs. She also mentions increasing Medicare reimbursements to cover the full cost of service, so providers are able to stay in business. It's been estimated, and she's acknowledged this would happen, that 2 million jobs will be lost under her plan. How does she intend to handle that. I agree that health care costs need to be dealt with but the federal government taking over isn't the answer.
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scrappinmama
Pearl Clutcher
Posts: 4,852
Jun 26, 2014 12:54:09 GMT
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Post by scrappinmama on Nov 1, 2019 14:10:25 GMT
Thanks for the further information. What I find bothersome, too, is that there isn't a personal share. I do believe we ought to have copays. I think every citizen needs to have a stake in their own healthcare. I am afraid that without a stake in their healthcare that healthcare services might be abused. I am specifically thinking of the emergency room. Under my healthcare plan, I can go to urgent care for $20. A trip to the ER costs me a $200 copay, unless the person is admitted. If admitted to the hospital, the copay is waived. But this, IMO, keeps people from abusing the ER. I agree. Having some kind of additional copay for ER visits is necessary. And a decent copay for doctor appointments is a good idea as well. I am hoping this next election will bring positive change. We just can't keep going in the direction we are going. Families are going broke trying to pay for medical expenses.
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Post by Merge on Nov 1, 2019 14:11:42 GMT
I fixed the link in my OP to include the text of the full plan. I think it's worth reading, though a bit long. A big part of her plan is reducing healthcare costs overall mainly by reducing administrative costs. She also mentions increasing Medicare reimbursements to cover the full cost of service, so providers are able to stay in business. It's been estimated, and she's acknowledged this would happen, that 2 million jobs will be lost under her plan. How does she intend to handle that. I agree that health care costs need to be dealt with but the federal government taking over isn't the answer. So what I hear you saying is that we all need to keep paying exorbitant healthcare costs, while many go without healthcare, to keep insurance company employees working. Is that what you mean? It's funny to me that conservatives have no problem with the idea of cutting government waste and putting people out of work that way, but when it comes to cutting private sector waste that Americans are required to pay for, well, that we can't do.
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Post by Merge on Nov 1, 2019 14:12:05 GMT
Thanks for the further information. What I find bothersome, too, is that there isn't a personal share. I do believe we ought to have copays. I think every citizen needs to have a stake in their own healthcare. I am afraid that without a stake in their healthcare that healthcare services might be abused. I am specifically thinking of the emergency room. Under my healthcare plan, I can go to urgent care for $20. A trip to the ER costs me a $200 copay, unless the person is admitted. If admitted to the hospital, the copay is waived. But this, IMO, keeps people from abusing the ER. I agree. Having some kind of additional copay for ER visits is necessary. And a decent copay for doctor appointments is a good idea as well. I am hoping this next election will bring positive change. We just can't keep going in the direction we are going. Families are going broke trying to pay for medical expenses. What happens to people who can't afford the copay?
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Deleted
Posts: 0
Apr 24, 2024 12:46:23 GMT
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Post by Deleted on Nov 1, 2019 14:16:10 GMT
linkABC News... “Not one penny': Warren offers plan to pay for Medicare for All, promising no hike on middle class taxes”From the article. “Warren’s plan pulls more than $20.5 trillion in funds for Medicare for All over ten years by calling for budget cuts and increased regulation across far-reaching corners of the U.S. economy. She proposes tightening up tax loopholes on the rich, taxing financial companies more, making money off of comprehensive immigration reform and cutting military spending.” The plan also increases taxes on billionaires, going $3 trillion deeper into the pockets of the wealthy than she has already proposed. The new proposal includes a tax of six cents on every dollar over $1 billion a person has in wealth, which is double what she previously proposed as part of her wealth tax and would generate another $1 trillion of revenue over ten years, according to the plan. Warren also proposed implementing a yearly capital gains tax, rather than a tax that would have to be paid only once at the time an heir offloads assets, which the campaign estimates would generate another $2 trillion over ten years. The majority of the funding, however, would come from employers. Warren proposes asking employers to pay slightly less than what they are already paying to provide private health care for their employees and instead pay it to the government, “ensuring that every company paying for health care today will pay less than they would have if they were still offering their employees comparable private insurance.” This, Warren’s campaign estimated, would generate around $8.8 trillion over 10 years, or about half of her expected cost. “Existing total private sector employer contributions to health insurance will continue in the form of contributions to Medicare -- but employers would be better off because under the design of my plan, they’d pay less than they would have otherwise,” Warren wrote. In a nod to labor unions, Warren also proposed that employers give union members back money out of their paychecks that they were previously putting toward health care and allow those employees to then pay less to the government for Medicare contributions. The plan suggested passing along those savings to workers “in the form of increased wages, pensions, or other collectively-bargained benefits.” Then, about 5% of the funds necessary in Warren’s plan would come from cutting defense spending and achieving immigration reform -- two revenue streams that would be contingent upon making their way through Congress. Immigration reform, in particular, has faced years of back-and-forth on Capitol Hill without much movement.“ Ok, now where is she going to get the money to - Pay down the debt.
- Make 4 year college free
- Fight Climate change
- Fix the infrastructure
- Forgive all student loans
And while in the past I have questioned military spending, recent events in the world makes me think that might not be the smartest move to cut military spending even by 5%.
As important as health care is, the same arguments can be made that paying down the debt, fighting climate change, and fixing the infrastructure are just as important. Especially since the ACA can be fixed and cost a lot less to do it.
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Post by iamkristinl16 on Nov 1, 2019 14:18:53 GMT
I can see both sides of the coin regarding copays for service. I do think that having higher copays for things like the ER is a deterrent. On one hand that is good--people won't abuse it. I didn't think this was really that big of an issue until talking to my MIL this summer. She and her husband were here visiting. He is diabetic and has a history of strokes. The whole time they were here she said she didn't think he was ok health-wise. I told her if she was concerned she should take him to urgent care here. She insisted that she would just take him to the ER when they got home. She also was on the phone with someone else whose relative was having medical problems and she was advising her to go to the ER as well (for a non-emergent situation). When I asked her about this and explained that it was a waste of money, even if it is the insurance company paying more (and that that costs us all in the end) she didn't seem to get it.
On the other hand, after my experience I feel like I will never go to the doctor again. I am sure that isn't true but I am very bitter today. I originally went to urgent care due to thinking I might have had a minor stroke. They told me that they closed in an hour (there was no wait there) so I needed to go to the ER. I really debated about it due to the time and the cost but decided I better go. Thousands of dollars later, I still didn't have a diagnosis and I also have other strange symptoms now. But I am not going back to the doctor at this point. Anyway, when I was checking in at the ER the intake person commented that she was sick of urgency center sending everyone to the ER. There was a huge wait there, and many of the people looked like they could have been seen at the urgency center instead. Now I wonder if that is the goal of the company (they own all of the clinics and the hospital)...send people to the ER where it makes them more money.
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Post by Merge on Nov 1, 2019 14:20:30 GMT
linkABC News... “Not one penny': Warren offers plan to pay for Medicare for All, promising no hike on middle class taxes”From the article. “Warren’s plan pulls more than $20.5 trillion in funds for Medicare for All over ten years by calling for budget cuts and increased regulation across far-reaching corners of the U.S. economy. She proposes tightening up tax loopholes on the rich, taxing financial companies more, making money off of comprehensive immigration reform and cutting military spending.” The plan also increases taxes on billionaires, going $3 trillion deeper into the pockets of the wealthy than she has already proposed. The new proposal includes a tax of six cents on every dollar over $1 billion a person has in wealth, which is double what she previously proposed as part of her wealth tax and would generate another $1 trillion of revenue over ten years, according to the plan. Warren also proposed implementing a yearly capital gains tax, rather than a tax that would have to be paid only once at the time an heir offloads assets, which the campaign estimates would generate another $2 trillion over ten years. The majority of the funding, however, would come from employers. Warren proposes asking employers to pay slightly less than what they are already paying to provide private health care for their employees and instead pay it to the government, “ensuring that every company paying for health care today will pay less than they would have if they were still offering their employees comparable private insurance.” This, Warren’s campaign estimated, would generate around $8.8 trillion over 10 years, or about half of her expected cost. “Existing total private sector employer contributions to health insurance will continue in the form of contributions to Medicare -- but employers would be better off because under the design of my plan, they’d pay less than they would have otherwise,” Warren wrote. In a nod to labor unions, Warren also proposed that employers give union members back money out of their paychecks that they were previously putting toward health care and allow those employees to then pay less to the government for Medicare contributions. The plan suggested passing along those savings to workers “in the form of increased wages, pensions, or other collectively-bargained benefits.” Then, about 5% of the funds necessary in Warren’s plan would come from cutting defense spending and achieving immigration reform -- two revenue streams that would be contingent upon making their way through Congress. Immigration reform, in particular, has faced years of back-and-forth on Capitol Hill without much movement.“ Ok, now where is she going to get the money to - Pay down the debt.
- Make 4 year college free
- Fight Climate change
- Fix the infrastructure
- Forgive all student loans
And while in the past I have questioned military spending, recent events in the world makes me think that might not be the smartest move to cut military spending even by 5%.
As important as health care is, the same arguments can be made that paying down the debt, fighting climate change, and fixing the infrastructure are just as important. Especially since the ACA can be fixed and cost a lot less to do it.
Can you point me to someone's plan to "fix the ACA" while providing coverage to ALL Americans, at a lower cost? Does this person also have a plan to pay down the national debt, fight climate change, and fix the infrastructure without raising taxes? Or is perfection only something you require of Elizabeth Warren?
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Post by Merge on Nov 1, 2019 14:25:32 GMT
I can see both sides of the coin regarding copays for service. I do think that having higher copays for things like the ER is a deterrent. On one hand that is good--people won't abuse it. I didn't think this was really that big of an issue until talking to my MIL this summer. She and her husband were here visiting. He is diabetic and has a history of strokes. The whole time they were here she said she didn't think he was ok health-wise. I told her if she was concerned she should take him to urgent care here. She insisted that she would just take him to the ER when they got home. She also was on the phone with someone else whose relative was having medical problems and she was advising her to go to the ER as well (for a non-emergent situation). When I asked her about this and explained that it was a waste of money, even if it is the insurance company paying more (and that that costs us all in the end) she didn't seem to get it. On the other hand, after my experience I feel like I will never go to the doctor again. I am sure that isn't true but I am very bitter today. I originally went to urgent care due to thinking I might have had a minor stroke. They told me that they closed in an hour (there was no wait there) so I needed to go to the ER. I really debated about it due to the time and the cost but decided I better go. Thousands of dollars later, I still didn't have a diagnosis and I also have other strange symptoms now. But I am not going back to the doctor at this point. Anyway, when I was checking in at the ER the intake person commented that she was sick of urgency center sending everyone to the ER. There was a huge wait there, and many of the people looked like they could have been seen at the urgency center instead. Now I wonder if that is the goal of the company (they own all of the clinics and the hospital)...send people to the ER where it makes them more money. I'm so sorry about what has happened to you. Respectfully, though, I'm not sure how that would be made worse by providing a single payer plan. The thing about higher copays is that they really only discourage the poor from getting medical care. Just like the prospect of a fine for parking or speeding really only discourages the person who can't afford it. The upper middle class and rich don't care about a $200 copay or a parking fine. Only the poor and middle class are deterred by these things.
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lindas
Pearl Clutcher
Posts: 4,146
Jun 26, 2014 5:46:37 GMT
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Post by lindas on Nov 1, 2019 14:30:17 GMT
Old Liz isn't stupid, she knows this plan, along with all her other freebies, won't work so she left herself an out;
During that same interview with New Hampshire Public Radio, Warren vowed that she would “not sign any legislation into law for which costs for middle-class families do not go down.”
Everything she's put forward is going to cost the middle class is some way.
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Deleted
Posts: 0
Apr 24, 2024 12:46:23 GMT
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Post by Deleted on Nov 1, 2019 14:31:06 GMT
Yes I’m being Debbie Downer on Warren and Sanders Medicare for All plans and the reason is I want health care for all. I mean not “let’s talk about it” but “It’s a done deal”.
But right now I’m not seeing it as “a done deal”, especially since there are other obligations just as important. Plus I’m sick and tired of politicians promising stuff so they get elected and then can’t make good on what they are promising.
From the catch all thread.
”From Committee for Responsible Federal Budget...
“Choices for Financing Medicare for All: A Preliminary Analysis”
From the article..
Proposals to adopt single-payer health care in the United States have grown in popularity in recent years, as numerous lawmakers and presidential candidates have embraced Medicare for All. However, few have grappled with how to finance the new costs imposed on the federal government. By most estimates, Medicare for All would cost the federal government about $30 trillion over the next decade. How this cost is financed would have considerable distributional, economic, and policy implications.
In the coming months, the Committee for a Responsible Federal Budget will publish a detailed analysis describing numerous ways to finance Medicare for All and the consequences and trade-offs associated with each choice. This paper provides our preliminary estimates of the magnitude of each potential change and a brief discussion of the types of trade-offs policymakers will need to consider.
We find that Medicare for All could be financed with:
* A 32 percent payroll tax
* A 25 percent income surtax
* A 42 percent value-added tax (VAT)
* A mandatory public premium averaging $7,500 per capita – the equivalent of $12,000 per individual not otherwise on public insurance
* More than doubling all individual and corporate income tax rates
* An 80 percent reduction in non-health federal spending
* A 108 percent of Gross Domestic Product (GDP) increase in the national debt
* Impossibly high taxes on high earners, corporations, and the financial sector
* A combination of approaches
Each of these choices would have consequences for the distribution of income, growth in the economy, and ability to raise new revenue. Some of these consequences could be balanced against each other by adopting a combination approach that includes smaller versions of several of the options as well as additional policies.
Consequences could also be mitigated through aggressive efforts to lower per-person health care costs and/or by substantially scaling back the generosity or comprehensiveness of Medicare for All.
&
“Conclusion”
Regardless of its impact on national health expenditures, Medicare for All would shift substantial costs from the private sector to the federal government. By most estimates, a comprehensive Medicare for All plan that expands coverage to every U.S. resident for nearly all medical services and eliminates premiums and cost sharing would cost the federal government roughly $30 trillion over a decade.
Policymakers have a number of options available to finance the $30 trillion cost of Medicare for All, but each option would come with its own set of trade-offs.
In this preliminary analysis, we estimate the cost could be covered with a 32 percent payroll tax, a 25 percent income surtax, a 42 percent value-added tax, or a public premium averaging $7,500 per capita or more than $12,000 per individual who wouldn’t otherwise be enrolled in Medicare, Medicaid, or CHIP. Medicare for All could also be paid for by more than doubling individual and corporate income tax rates, reducing federal spending by 80 percent, or increasing the national debt by 108 percent of GDP. Tax increases on high earners, corporations, and the financial sector by themselves could not cover much more than one-third of the cost of Medicare for All.
Rather than adopting any one of the proposals above, policymakers could also consider a combination of approaches to finance Medicare for All. Reducing the cost, scope, or generosity of Medicare for All would also reduce the magnitude of needed financing.
In deciding how to finance Medicare for All, policymakers must consider the distributional, economic, and policy consequences of replacing premiums and cost sharing with various alternatives. Most of the options we put forward are more progressive on average than current law but would shrink economic output and bring the top tax rate up to its revenue-maximizing level – leaving little capacity for further taxes.
This paper will be followed by a more detailed analysis of the various consequences of different financing options.
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Post by iamkristinl16 on Nov 1, 2019 14:31:33 GMT
I can see both sides of the coin regarding copays for service. I do think that having higher copays for things like the ER is a deterrent. On one hand that is good--people won't abuse it. I didn't think this was really that big of an issue until talking to my MIL this summer. She and her husband were here visiting. He is diabetic and has a history of strokes. The whole time they were here she said she didn't think he was ok health-wise. I told her if she was concerned she should take him to urgent care here. She insisted that she would just take him to the ER when they got home. She also was on the phone with someone else whose relative was having medical problems and she was advising her to go to the ER as well (for a non-emergent situation). When I asked her about this and explained that it was a waste of money, even if it is the insurance company paying more (and that that costs us all in the end) she didn't seem to get it. On the other hand, after my experience I feel like I will never go to the doctor again. I am sure that isn't true but I am very bitter today. I originally went to urgent care due to thinking I might have had a minor stroke. They told me that they closed in an hour (there was no wait there) so I needed to go to the ER. I really debated about it due to the time and the cost but decided I better go. Thousands of dollars later, I still didn't have a diagnosis and I also have other strange symptoms now. But I am not going back to the doctor at this point. Anyway, when I was checking in at the ER the intake person commented that she was sick of urgency center sending everyone to the ER. There was a huge wait there, and many of the people looked like they could have been seen at the urgency center instead. Now I wonder if that is the goal of the company (they own all of the clinics and the hospital)...send people to the ER where it makes them more money. I'm so sorry about what has happened to you. Respectfully, though, I'm not sure how that would be made worse by providing a single payer plan. The thing about higher copays is that they really only discourage the poor from getting medical care. Just like the prospect of a fine for parking or speeding really only discourages the person who can't afford it. The upper middle class and rich don't care about a $200 copay or a parking fine. Only the poor and middle class are deterred by these things. I agree. I was referring to the idea of having a copay and people avoiding the care If they didn’t have the money (vs not having a copay and people going to the Er when it isn’t the correct level of care). Hopefully that makes sense. My experience is that most of the burden of the costs falls on the lower middle/middle class. Poor people are eligible for Medicaid (at least in my state, not sure if that is similar across the country). Everything is covered at no cost to them.
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Deleted
Posts: 0
Apr 24, 2024 12:46:23 GMT
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Post by Deleted on Nov 1, 2019 14:37:59 GMT
It's been estimated, and she's acknowledged this would happen, that 2 million jobs will be lost under her plan. How does she intend to handle that. I agree that health care costs need to be dealt with but the federal government taking over isn't the answer. So what I hear you saying is that we all need to keep paying exorbitant healthcare costs, while many go without healthcare, to keep insurance company employees working. Is that what you mean? It's funny to me that conservatives have no problem with the idea of cutting government waste and putting people out of work that way, but when it comes to cutting private sector waste that Americans are required to pay for, well, that we can't do. Funny how the capitalists LOVE job losses when it means mergers, and "reducing duplication", and downsizing and off-shoring and automating, and less money for PAYROLL and MORE MONEY FOR DIVIDENDS isn't it?!But when it comes to job losses related to bloated insurers taking a giant slice of our health care dollars with duplicative HR, legal, advertising, PR, sales, ginromous mangement salaries etc., suddenly they care about job losses. What a joke.
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Post by Merge on Nov 1, 2019 14:48:19 GMT
Old Liz isn't stupid, she knows this plan, along with all her other freebies, won't work so she left herself an out; During that same interview with New Hampshire Public Radio, Warren vowed that she would “not sign any legislation into law for which costs for middle-class families do not go down.” Everything she's put forward is going to cost the middle class is some way. Did you read the plan?
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Montannie
Pearl Clutcher
Posts: 3,486
Location: Big Sky Country
Jun 25, 2014 20:32:35 GMT
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Post by Montannie on Nov 1, 2019 15:13:31 GMT
We all know that campaign plans are ideas -- the President alone can't do this, it takes Congress to work on it, too. We just need to elect people who admit the status quo is not working, and pledge to help work on finding a solution!
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Post by crazy4scraps on Nov 1, 2019 15:27:50 GMT
So what I hear you saying is that we all need to keep paying exorbitant healthcare costs, while many go without healthcare, to keep insurance company employees working. Is that what you mean? It's funny to me that conservatives have no problem with the idea of cutting government waste and putting people out of work that way, but when it comes to cutting private sector waste that Americans are required to pay for, well, that we can't do. Funny how the capitalists LOVE job losses when it means mergers, and "reducing duplication", and downsizing and off-shoring and automating, and less money for PAYROLL and MORE MONEY FOR DIVIDENDS isn't it?!But when it comes to job losses related to bloated insurers taking a giant slice of our health care dollars with duplicative HR, legal, advertising, PR, sales, ginromous mangement salaries etc., suddenly they care about job losses. What a joke. This was my thought too. None of the so-called conservatives seem to care too much about all the good paying government jobs that have *already* been lost with all of the cuts this administration has implemented to the various agencies that protect our national parks, the environment, consumers, etc., resulting in major loss of institutional knowledge. Oh, wait, those are just GOVERNMENT jobs and nobody should care about *those* job cuts because it saves us all money. But at what other ultimate cost? I’m pretty sure all of those displaced insurance company workers would be able to find other employment as those skills are fairly universal. And if everyone has no fear of going bankrupt due to a lack of adequate health care, it might not matter as much where those people are ultimately employed.
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Post by jeremysgirl on Nov 1, 2019 15:32:30 GMT
I agree. Having some kind of additional copay for ER visits is necessary. And a decent copay for doctor appointments is a good idea as well. I am hoping this next election will bring positive change. We just can't keep going in the direction we are going. Families are going broke trying to pay for medical expenses. What happens to people who can't afford the copay? They don't pay. Just like with Medicaid. We all like to talk about what miracles we want the government to provide, then get upset when the government wants to tax us. I think we all need to have some level of personal responsibility for things. We need a stake in the game. And for most of us, this wouldn't be a change from what we currently do. We would have relief from outrageous deductibles. But we would be personally responsible for a portion of our medical care. And I think you'd actually be better able to sell this plan to the middle of the road voters who tend to swing conservative and like the concept of personal responsibility. And then you can frame it as not a complete and total tax on the rich for care of the rest of us, which doesn't go over well with the pride of the middle class.
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Post by Merge on Nov 1, 2019 15:39:34 GMT
What happens to people who can't afford the copay? They don't pay. Just like with Medicaid. We all like to talk about what miracles we want the government to provide, then get upset when the government wants to tax us. I think we all need to have some level of personal responsibility for things. We need a stake in the game. And for most of us, this wouldn't be a change from what we currently do. We would have relief from outrageous deductibles. But we would be personally responsible for a portion of our medical care. And I think you'd actually be better able to sell this plan to the middle of the road voters who tend to swing conservative and like the concept of personal responsibility. And then you can frame it as not a complete and total tax on the rich for care of the rest of us, which doesn't go over well with the pride of the middle class. We have personal responsibility because we pay taxes. With all due respect, I think this is another case of the middle class voting against their own interests. A $200 copay is no big deal for the rich and sort of rich, but it's a major deal to a middle/working class family living mostly paycheck to paycheck. I feel like there are so many people who feel like a poor person/person of color might get something the middle class white person feels they don't "deserve," that the MCWP is willing to sell themselves out to make sure that doesn't happen. I'd rather see us educate folks than continue to cave to that limiting mindset. We don't make people pay a co-pay for their child's public education. I see this as the same thing.
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Post by crazy4scraps on Nov 1, 2019 15:59:41 GMT
They don't pay. Just like with Medicaid. We all like to talk about what miracles we want the government to provide, then get upset when the government wants to tax us. I think we all need to have some level of personal responsibility for things. We need a stake in the game. And for most of us, this wouldn't be a change from what we currently do. We would have relief from outrageous deductibles. But we would be personally responsible for a portion of our medical care. And I think you'd actually be better able to sell this plan to the middle of the road voters who tend to swing conservative and like the concept of personal responsibility. And then you can frame it as not a complete and total tax on the rich for care of the rest of us, which doesn't go over well with the pride of the middle class. We have personal responsibility because we pay taxes. With all due respect, I think this is another case of the middle class voting against their own interests. A $200 copay is no big deal for the rich and sort of rich, but it's a major deal to a middle/working class family living mostly paycheck to paycheck. I feel like there are so many people who feel like a poor person/person of color might get something the middle class white person feels they don't "deserve," that the MCWP is willing to sell themselves out to make sure that doesn't happen. I'd rather see us educate folks than continue to cave to that limiting mindset. We don't make people pay a co-pay for their child's public education. I see this as the same thing. Exactly. And if the poorer person had better access to affordable or free care when the health problem is lower risk, I’d be willing to bet more of them wouldn’t put off care until it becomes a bigger more serious problem. I’m definitely not poor, but even I hesitate to go in for any and every little thing and we have insurance. I know if my kid is sick and I take her in to the clinic or to Urgent Care, it’s going to set me back $300 not including any prescriptions she might need. Same for me. I keep getting these reminders that I should go in for an annual physical which is supposed to be “free”, but yet whenever I do that and the doctor asks me if I have any other concerns and I mention ANYTHING, suddenly my free visit just turned into at least $150 office visit copay. So yeah, I think I’ll just skip that physical and wait until I have something that’s an actual concern and just pay for that office visit then. Same with a well child visit. What’s the point of that if she’s not due for some vaccine? I’m not going to do that either because if history repeats itself my kid will probably be out sick with something in another three weeks anyway so I’ll just drag her in then, and in the meantime look for somewhere that has the flu mist since her pediatrician’s office doesn’t offer it.
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Post by jeremysgirl on Nov 1, 2019 16:04:13 GMT
Merge , I see your point of view and I respect it. I offered my experience with a $200 ER copay. In no way was I suggesting that this be the actual agreed upon amount. And I don't disagree with your logic of voting against their own interests. But it happens all the time. People vote against their interests in every single election. Middle class pride is a very real thing. And the socialism/entitlement argument is going to come up. With public schools, look at it from the perspective of, I can't tell you how many people I've heard make the argument that they don't use them so they shouldn't have to pay for them. And we've been paying for public schools a very long time and people still cannot seem to wrap their heads around collective good. P.S. I'm enjoying the conversation. I'm looking at things from all angles. I hope it stays this productive.
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scrappinmama
Pearl Clutcher
Posts: 4,852
Jun 26, 2014 12:54:09 GMT
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Post by scrappinmama on Nov 1, 2019 16:12:58 GMT
I agree. Having some kind of additional copay for ER visits is necessary. And a decent copay for doctor appointments is a good idea as well. I am hoping this next election will bring positive change. We just can't keep going in the direction we are going. Families are going broke trying to pay for medical expenses. What happens to people who can't afford the copay? Good question. Maybe the amount of copay can be based on income? So if you fall under a certain income, you do not have a copay. Just a thought. I don't know what the right answer is. I just know we can't keep doing what we are doing because it is not working.
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Deleted
Posts: 0
Apr 24, 2024 12:46:23 GMT
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Post by Deleted on Nov 1, 2019 16:27:41 GMT
Ok, now where is she going to get the money to - Pay down the debt.
- Make 4 year college free
- Fight Climate change
- Fix the infrastructure
- Forgive all student loans
And while in the past I have questioned military spending, recent events in the world makes me think that might not be the smartest move to cut military spending even by 5%.
As important as health care is, the same arguments can be made that paying down the debt, fighting climate change, and fixing the infrastructure are just as important. Especially since the ACA can be fixed and cost a lot less to do it.
Can you point me to someone's plan to "fix the ACA" while providing coverage to ALL Americans, at a lower cost? Does this person also have a plan to pay down the national debt, fight climate change, and fix the infrastructure without raising taxes? Or is perfection only something you require of Elizabeth Warren? I raised some questions and concerns about her plans. I think they are legitimate concerns that all voters should raise their concerns about anyone’s plans running for the office of President. Well actually any office. And it’s not expecting “perfection” from candidates running for office to have them explain how they are going to accomplish all they are selling. As to the ACA, I just checked and find the moderate candidates have their own plans that build on ACA. Which I’m ok with that. Especially if they provide coverage quality health care for all Americans. And because the plans are more moderate the cost are as well which leaves room to pay for all the other important items like climate change and the infrastructure to name a couple items that need to be addressed as well. And no I don’t like Elizabeth Warren, but if I thought she could do the job I would support her regardless of how I felt about her personally. And I just don’t think she can do the job. I want what is best for this country and I don’t have to like the person who I think can do the job and will support.
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