Universal health care has saved other countries billions while insuring everyone, yet Republicans can't wrap their ideologically limited minds around the benefits.
Well, we finally have the definitive CBO study, with 5 different scenarios. I've written a lot about health care in the past, but nothing like this have been done researched so thoroughly. Thankfully, because Trump's daily disasters out of the way, this has surfaced. Now we know.
Republicans Refuse to Save $42 billion to $743 billion in 2030 alone!!! No, Really: Here's the breakdown...
The most exhaustive study on Medicare for All just came out (n Dec.). The Congressional Budget Office (CBO) released an estimate of the cost of implementing a single-payer health insurance program in the United States. Its conclusion: a single-payer system would guarantee health insurance to all people while reducing overall health spending by hundreds of billions of dollars every year.
1. The CBO answered these questions for four different single-payer designs and found that a single-payer system would save $42 billion to $743 billion in 2030 alone.
2. The CBO option that most closely approximates current Medicare for All proposals is Option 3, which features low payment rates and low cost-sharing. That option produces $650 billion of savings in 2030. Adding Long Term Service and Supports to that option, which also approximates what many current Medicare for All proposals do, looks like it would bring the savings down to around $300 billion.
3. Medicare for All advocates have historically pointed towards the 2 percent administrative costs of traditional Medicare as what we should expect in a Medicare for All system. Yet, private Medicare Advantage plans have a similarly sick and elderly enrollment population, but manage to spend a whopping 13.7 percent of their revenue on administrative expenses. Thus, the payer administrative costs we could expect under single-payer are not the 6 percent touted by Urban and Mercatus. They are not even the 2 percent of the traditional Medicare program. Rather, they are more like 1.5 to 1.8 percent. These other estimates are therefore missing hundreds of billions of dollars of savings per year on this item alone.
4. The barriers to the policy are not technical deficiencies or costs, but rather political opposition from Republicans and conservative Democrats who would rather spend more money to provide less health care.
The Covid-19 pandemic is the system shock exposing every wrong Republican policy bragged about for the last 20 years. Wisconsin's Scott Walker was a walking/talking checklist of right-wing clichés and truisms. We now have real world proof our gerrymanders Republican overlords were wrong about almost everything. Let's take a look.
First, shouldn't we start by determining the actual minimum cost to run state government, build in cost of living increases per year, and then spend surplus revenue (profit) on improvements and debt before ever cutting taxes. Not paying for health care, transportation, state parks, clean water, and education doesn't actually save money as we're finding out. Note: Democrats opposed every failure below, and they're the extreme party?
It Starts with Tax Cut Madness: Returning money back to overtaxed Wisconsinites, saying it's their money and not the governments sounded so ridiculous and resentful. Below I've listed the most recent examples of backfilling their failed policy. First, Rep. Robin Vos with the same logic that W. Bush used to take tax surplus dollars that would have balanced the US budget 15 years ago, and the reason he kinda "won" (close/supreme court):
All Failed Ideological Theories...
1. RETURNED FUNDING to STATE PARKS: Republicans cut taxpayer funding that supported our state parks, using only admission fees. Didn't work:
________________________________________________________________________________________ 2. CUT UW SURPLUS/NO STATE FUNDING TO BACKFILL TUITION FREEZE: They must think running state colleges is magical. What now after the pandemic?
Plus, No estimate for the collective financial loss of its 26 campuses, some of which were grappling with multimillion-dollar deficits before the coronavirus even emerged. Republican lawmakers vowed to freeze UW System tuition, seizing on a report that shows the system has amassed a huge $414 million surplus of tuition dollars … only about $82 million isn’t committed to a specific purpose … citing dwindling state aid and the need to recruit and retain top-tier faculty with competitive compensation packages.
__________________________________________________________________________________________ 3. PAID SICK LEAVE REPEALED STATEWIDE: Big government Republicans didn't like Milwaukee's voter approved sick leave benefit, so they passed a one-size-fits-all ban statewide. The COVID-19 pandemic exposed why that was a bad decision and why other countries have paid sick leave:
Level of Compensation Required for Paid Sick Leave. Covered employers are required to pay every employee who takes emergency paid sick leave at a rate of compensation no less than the employee’s “regular rate” of pay (as that term is defined under the Fair Labor Standards Act.
_____________________________________________________________________________________________ 4. OPPOSITION TO UNIVERSAL HEALTH CARE/MEDICARE FOR ALL: With over 26 million uninsured still, and at twice the cost of other nations, there's nothing "fiscally conservative" or morally justifiable for not having universal health care, as recently documented here...
5.TAX CUTS, IMAGINE THE PAINFUL SPOT WE'D BE IN NOW: From an earlier post:
Democratic Gov. Tony Evers vetoed a major $250 million Republican-led tax-cut package that would have used unanticipated revenues to reduce the average taxpayer’s income tax bill by $106. The veto came one year and a week after Evers' first veto, which was of a similar income tax cut passed by Republicans.
Eh, Sen. Scott Fitzgerald plays down what was always a Bad Idea: The COVID-19 outbreak exposed the GOP again, but did they notice? Nope. Republicans don't govern, they simply pass ideologically driven ideas, devoid of any real world connection to the consequences of their actions.
Another question is how much the coronavirus, paired with a national economic slowdown, could affect the state budget — A recession would likely erase the surplus. “That’s definitely on our minds,” Republican Sen. Scott Fitzgerald said. “Hindsight is 20-20, but that projection could change dramatically, and as a result of that, things could be a lot tighter than where we thought they were.”
___________________________________________________________________________________________ 6. NO RURAL BROADBAND URGENCY: With closed schools now online, guess what, no internet or deathly slow.
Already, Wisconsin lags behind the national average in broadband coverage. An estimated 43% of Wisconsin’s rural residents lack access to high-speed internet, compared to about 31% of rural residents nationwide, according to the Public Service Commission of Wisconsin. “We have such a long ways to go,” said state Sen. Jeff Smith, a Democrat who has tried unsuccessfully to increase the state’s investment in broadband.
From an earlier blog post: It all started when Walker turned down $23 million in stimulus money to expand broadband everywhere in the state. Like the Journal Sentinel wrote in this Feb. 18, 2011 editorial:
The state is turning down $23 million because state taxpayers would have been on the hook for the entire amount if the state could not meet the grant's precise requirements, Mike Huebsch, secretary of the state Department of Administration, said in a memo to school and library associations. "This is simply not an acceptable risk," Huebsch wrote. Actually, it is. High-speed Internet is part of the necessary infrastructure that is vital to communities that want to grow. The state will get there anyway, but this money could have speeded up the journey.
7. PANDEMIC FORCES GOP TO ELIMINATE PUNISHING UNEMPLOYMENT WAITING PERIOD: Well, we could have saved a lot of time and a lot of jobless pain if this bad idea never made it into law. Guess Vos/Fitzgerald were wrong again:
Under current law, workers do not receive unemployment
benefits for their first week of unemployment, effectively denying them one
week of benefits. Lawmakers support eliminating the waiting period for at least
the rest of the year. “People need help right now that lost their job,” Fitzgerald
said. Evers has been pushing for the elimination of the one-week
waiting period, which he originally included in his 2019-21 state budget
request.
8. A BALANCED BUDGET AMENDMENT STRAIGHTJACKET, NOW, DURING A PANDEMIC?: Imagine if the federal government were blocked from spending $2 trillion-$4 trillion during the COVID-19 pandemic. Yet Republicans like Scott Walker are unfazed and undeterred. This is beyond tone deaf, it's sociopathic. Besides, the truth is, TAX CUTS ARE DRIVING DEFICITS.
Believe it or not, Walker tweeted this jaw-dropping demand for a balanced budget amendment...today:
We know Republicans will never increase spending or taxes, heck they didn't want to spend anything to help the COVID-19 affected unemployed. Will some reporter please interview Walker, and get his take the points below. From a previous blog post:
1. Many economists say federal deficit spending can be necessary to fund wars, combat economic recessions or respond to natural disasters. 2. Matt Rothschild, executive director of the Wisconsin Democracy Campaign said, "It's like the economy has cancer and you won't let the economy get chemotherapy or radiation, it's like the economy has diabetes and you won't give the economy insulin — you'd be killing the economy." 3. Democratic lawmakers as well as the John Birch Society, a far-right advocacy group say a balanced budget amendment would make it harder for the federal government to respond to economic downturns and natural disasters. 4. EPI: A balanced budget amendment would mandate perverse actions in the face of recessions. In economic downturns, tax revenues fall and some outlays, such as unemployment benefits, rise. These so-called built-in stabilizers increase the deficit but limit declines of after-tax income and purchasing power. To keep the budget balanced every year would aggravate recessions. Unlike many state constitutions, which permit borrowing to finance capital expenditures, the federal budget makes no distinction between capital investments and current outlays. Private businesses and households borrow all the time to finance capital spending. 5. It would prevent federal borrowing to finance expenditures for infrastructure, education, research and development, environmental protection, and other investment vital to the nation's future well being. 6. It would invite Congress to enact unfunded mandates, requiring states, localities, and private businesses to do what it cannot finance itself. It also invites dubious accounting maneuvers (such as selling more public lands and other assets and counting the proceeds as deficit-reducing revenues), and other budgetary gimmicks. 7. Disputes on the meaning of budget balance would likely end up in the courts, resulting in judge-made economic policy. So would disputes about how to balance an unbalanced budget when Congress lacks the votes to inflict painful cuts. 8. An overall spending cap would further limit Congress’s ability to fight recessions. Even during expansions, a binding spending cap could harm economic growth because increases in high-return investments — even those fully paid for with additional revenue — would be deemed unconstitutional if not offset by other spending reductions. A binding spending cap also would mean that emergency spending (for example on natural disasters) would necessitate reductions elsewhere, leading to increased volatility in the funding for non-emergency programs. 9. The budget not only attained balance, but actually recorded surpluses and reduced debt, for four consecutive years … Between 1998 and 2000, President Bill Clinton’s Treasury Department paid off more than $360 billion in debt. As a result of 115 straight months of economic expansion that began after an increase in the top income tax rate — which was virulently opposed by the right — the huge deficits left by 12 years of Republican rule had been transformed into a surplus. Within months after taking office George W. Bush had begun to turn that surplus back into deficits that grew and grew, despite funding two wars on emergency supplemental bills that were not figured into the budget.
Here's yet another estimate of a single payer system by the CBO, but this time focusing in on how such a switchover would be done and at what cost.
The nonpartisan Congressional Budget Office weighed in: "The
transition toward a single-payer system could be complicated, challenging, and
potentially disruptive," budget analysts wrote.
Oddly, none of the “problems” pointed out by the CBO are new
or unexpected, so any doom and gloomers out there are just showing us how
little they know about our complicated health care in the first place. The report also said:
1. A single-payer system could substantially reduce the number
of uninsured, which currently averages about 29 million people a
month. But if undocumented immigrants are not allowed to participate,
about 11 million U.S. residents could end up without coverage. (About half
of undocumented immigrants have coverage now.) 2. The changes could significantly affect the U.S. economy. The
magnitude of the effect is hard to predict because the evidence CBO would rely
on to make those predictions comes from much smaller changes to the health care
system. 3. Whether the nation would end up spending more or less on
health care would depend on key features such as how much health care
providers would be paid and whether patients would be required to
share some of the costs. 4. Benefits of a single-payer system could include lower
administrative costs and more incentives to improve people’s health. But
patients may also have longer wait times or reduced access to care if there
aren’t enough physicians to meet increased demand. 5. Expanding access to health insurance through a multi-payer
system instead of a single-payer model could be less disruptive and give
patients greater choice. But the nation would probably spend more on health
care than it would under a single-payer system.
Throughout the analysis, the CBO showed reasons for the current costliness. For instance, the office found that in 2013 the "three major insurers" paid hospital rates that were 89% higher on average than Medicare rates for the same services. The federal government's administrative costs for Medicare were about 1.4% of total Medicare expenditures in 2017. For Medicare Advantage and Part D plans, administered by commercial insurers, those costs rose to 6% of total expenditures. For commercial insurers, those expenditures averaged about 12% of total costs. The CBO said that the projected administrative savings could be one of the "opportunities" of developing a single payer system ... the system would have more incentive to invest in preventive medicine and improve overall population health if it could eliminate the turnover seen in the employer and individual markets. Dr. Doris Browne, a retired military medical officer and immediate past president of the National Medical Association argued that a universal coverage option would force widespread adoption of preventive medicine, which has so far baffled the U.S. "If you put prevention into practice, you're not going to have many of these hospitalizations that end up in the ICU. We have not practiced prevention. We have been talking about it for years and years and it has gone by the wayside." New York City emergency physician Dr. Farzon Nahvi used personal anecdotes from the treatment room to advocate for single payer. In one instance, he said he treated a woman who had overdosed on fish antibiotics she bought from a pet store to manage a fever, as she didn't think she could afford seeing a doctor. The overdose affected her brain, and she fell down a staircase and was rushed to the emergency room. In another story, a patient who had a urinary infection treatable with antibiotics couldn't get her insurer to cover the $300 medicine. She bought cranberry juice instead only to come to the emergency room with sepsis from a subsequent infection — costing thousands of dollars. "We're paying more for bad outcomes, and that needs to be part of the discussion too," Nahvi said. "There's no way to account for what we're seeing on the ground level."
There is so much health care news to cover. Here's what's important. Trump pushed forming complicated business associations so employers could take advantage of group buying power. Small government? don't think so.
Since Trump became president, Americans are losing health insurance, a big story almost no coverage. Steve Rattner covered sounded the alarm the other day:
_________________________________________________________________________________________ Surprise Medical Bills...Finally, someone Noticed??? This has cost me plenty in the past, so we're finally dealing with this problem. NOTE: This would not be a problem under Medicare-for-all or any other universal health insurance program:
The biggest debate will be what policy solution they settle on to fix surprise bills. Most legislators agree that they want to help patients who end up seeing an out-of-network provider at an in-network facility (and get a surprise bill from that out-of-network provider as a result). Those I've spoken with agree: This is a billing dispute between an insurer and a doctor or hospital. Patients shouldn't be caught in the middle.
_______________________________________________________________________________________ Association Health Plan Con Game: This is the first time I've heard a judge call out con-man Trump for trying to get around the law. NOTE: This again would not be a problem with Medicare-for-all
A federal judge has rejected Trump's attempt to expand association health plans in a 43-page ruling, DC District Judge John Bates said that the Department of Labor's rule oversteps the administration's authority:
1. The rule is clearly aimed at skirting compliance with Affordable Care Act coverage requirements, Bates said in the opinion. "The final rule is clearly an end-run around the ACA. Indeed, as the president directed, and the Secretary of Labor confirmed, the final rule was designed ... to avoid the most stringent requirements of the ACA." 2. Department of Labor deploys a "magic trick" in the way it defines employers and employees to make it fit within Employee Retirement Security Income Act (ERISA) requirements, (giving) owners with no employees ... "both hats," (both owner and employee) as it were. He said the definition borders on "absurdity.""DOL’s explanation is pure legerdemain," Bates ruled. 3. The expansion of association health plans, as critics argue, are plans that amount to "junk" coverage because they're not required to meet ACA coverage standards and lack consumer protections.
_________________________________________________________________________________________ Medicaid Work Requirments Blocked, Designed to get People Jobs: This was a no brainer, yet it did have to go through the legal process. The fact that Kentucky created this program without any research, and then experimented on their citizens without ever tracking how the program affected recipients or on those that lost coverage should tell you a lot about Republicans. NOTE: This would not be a problem with Medicare-for-all or some other national universal plan:
In twin rulings, District Court Judge James E. Boasberg rejected for a second time Kentucky’s attempt to require recipients to work or volunteer as a condition of coverage and blocked a similar rule in Arkansas, which has resulted in more than 18,000 people there losing coverage since last summer ... it had not adequately considered whether it “would, in fact, help the state furnish medical assistance to its citizens, a central objective of Medicaid.” The Trump administration had asserted that some people in Kentucky who lost Medicaid would gain commercial insurance coverage. But Judge Boasberg appeared skeptical, writing that federal officials “cited no research or evidence that this would happen.”
This is so far removed from any basic understanding of the Constitution that it defies explanation. The last time I looked, conservative media made up 92 percent of the public airways, but that was okay because that kind of programming sells. And isn't that what freedoms all about, profit?
ObamaCare Unconstitutional? Leave it to conservative columnist Jennifer Rubin to clearly make the case, Trump Republicans can no longer hide their lies, like the one about those "activist judges" "legislating from the bench." Was Republican Sen. Roy Blunt on something when he said, "that doesn't mean that legislators can act like judges..." What the...?
CHUCK TODD: But didn’t this federal judge act like a legislator? And he decided, on his own, what the law is going to be? Isn’t this a form of judicial activism? He said, “Well, I’ve decided that Congress said this is a zero tax. I’ve decided it’s no longer a tax.” That’s the definition of a judge writing legislation, is it not? BLUNT: That doesn’t mean, that doesn’t mean that legislators can act like judges, just because, just because judges sometimes act like legislators. TODD: So you acknowledge, in this case... BLUNT: No...
Will Medicare Go Away? Yes, because now everyone will have health care!!! The media is driving me crazy letting Republicans frame "Medicare-for-all" as the horrifying end of Medicare? No, we won't need Medicare or Medicaid because surprise, now everyone has health care! Seriously, is it that difficult? Will someone please stop this idiotic talking point before it starts making sense to the drooling Trump base.
BLUNT: You know, the one thing I think we would be able to unite on is Medicare-for-all would wind up meaning Medicare for none. If Democrats want to take that view to the American people, and seniors, particularly, people who are now covered by Medicare, understand the ramifications of that. There is no way that will happen. And there’s no way voters will let it happen.
Chuck Todd did not correct this lunacy. What is wrong with media reporters who hear this and then don't think right away that it doesn't make any sense?
Paul Ryan decided to leave office by repeating outright lies and fabrications about universal healthcare. This guy is playing Americans for fools and Trumpian dumb asses. He even uses the word "socialism." Ouch.
His latest tweet and video are embarrassing, especially since every industrialized country has the kind of insurance he says just won't work... Ryan: "...it is the hollow empty promise of socialism..." Ryan says it ends "having choices." Uh, no, Medicare for all would give everyone the choice of any doctor and any hospital. And since we don't have a universal system, why would we create one that lets the government get between ourselves and our healthcare as Ryan claims?
What universal health care does is that it simplifies everything and eliminates the complicated maze we have now, that encourages overcharges, fraud, and bureaucratic red tape.
Paul Ryan has been saying this stuff for years, and for years, the media has been letting him get away with it. So it's no surprise that he keeps repeating this utter nonsense:
Ryan→ Single-payer, government-run health care would essentially destroy and obliterate the private health insurance system.
Truth-Yes: First, where is this clueless person who loves paying expensive premiums every month, has high deductibles and can't wait for the next major yearly increase that might force them out of coverage? Yes, obliterate private insurance slowly or...some single-payer systems rely on private insurers to manage their national health care plans or offer elective coverage etc.
Ryan→ Single-payer, government-run health care would essentially destroy and obliterate→ the employer-sponsored health insurance system.
Truth: Yes: Hello, that's what single-payer/universal healthcare does. Plus, employers no longer have the administrative burdened. Plus, it puts us on equal footing with every other industrialized country.
Ryan→ Single-payer, government-run health care would essentially destroy and obliterate →Medicare as we know it.
Truth: Yes: Again, that's what single-payer/universal healthcare does. All the money already in Medicare will be used to help pay for universal insurance.
In what should be a cakewalk for Randy Bryce to replace Paul Ryan (except for the fact Republicans blindly vote party and not their own self-interest), challenger and scary Ryan clone Bryan Steil failed to mention our current health care system costs $2 trillion more than Medicare for all:
Steil repeatedly criticized Bryce's stance, calling it "a $32 trillion government takeover of health care. The plan to pay for the program — so people aren't hoodwinked here — the plan to pay for the program is to raise taxes," he said. Steil called for improving health care by giving more control to patients and doctors.
Note: This is part 2 of Medicare for All (M4A). See part 1 here.
Medicare for All (M4A), or universal health care, is the one major driving force in the upcoming elections for Democrats. Modern Healthcare (subscription):
I thought the analysis below added a few more interesting points. It’s extremely important to note that none of the arguments presented by this report even mentioned the elephant in the room; saving lives. Odd?
Co-pays and Deductibles: I also believe an income-based office visit fee would help bring down the cost further (not "skin in the game"), somewhere in the range of $1 to $30. The report suggests...
“It would likely lead to a huge spike in overall healthcare utilization because it bans any co-pays or deductibles.”
With that said, check out the list of possibilities:
Libertarian think tank Mercatus Center of George Mason University senior research strategist Charles Blahous alleged that the Medicare for All plan backed by Sen. Bernie Sanders would put the brunt of the proposal's costs on provider pay cuts
1. Reduce provider payments by $384 billion in the first year, and by nearly $660 billion in 2030. 2. The plan could save the United States more than $2 trillion over 10 years in national healthcare spending ... Increase the federal government's costs to nearly $33 trillion above current levels. 3. “To the extent that the cost of M4A is financed by new payroll taxes, premium collections, or other revenue increases, the net effect on the federal budget deficit would be substantially less." 4. The healthcare system would save billions every year on drug spending … allows the HHS secretary to negotiate prescription drug prices with the manufacturers. 5. The paper acknowledged that phasing out employer-sponsored health care would translate into a huge increase in taxable wages, as it would free individuals, families, and employers from hefty healthcare spending. States would also no longer have to fund Medicaid, consistently their largest budget item. 6. Benedic Ippolito, a health economist with the right-leaning American Enterprise Institute says (that) while the U.S. health care system does need to grapple with the "right price to pay for health care," how it will impact provider behavior—investments in equipment and buildings, patient access and health outcomes. 7. Blahous cited the CMS' Office of the Actuary's projections that current payments would lead to negative operating margins for nearly half of hospitals by 2040. By 2019, over 80% of hospitals will lose money treating Medicare patients. A dramatic structural change to reimbursement structure could shutter many provider doors.
The Republicans continue to push health care plans the will cost more money with none of the savings upsides. Anyone think high deductible HSA’s makes sense?
The latest House Republican push to leverage health savings accounts to cut spending on superfluous services … runs counter to (the report) … passed a packet of bills originally projected to cost more than $90 billion to expand use of HSAs. HHS Secretary Alex Azar praised HSAs as a way to lower unnecessary spending, saying that from his own behavior when he had an HSA he was much more cautious about the number and manner of services on which he was willing to spend a limited number of dollars.
That’s called self-rationing, where Americans delay or don’t get the treatments they need, costing them their health, lives, and money.
But Ippolito said the new paper highlights that single-payer proponents will need to acknowledge the political fight on their hands. "In my time of listening to these single-payer proposals, a lot of emphasis is on administrative savings—they appeal to that because they don't rile up constituencies," he said. "But going after provider payment rates means taking on one of the most well-organized constituencies in domestic policy.”
The price tag for universal health insurance in the U.S. is in, and it comes out to $32 trillion over 10 years. $3.2 trillion a year. Wow, that's crazy, isn't it? It may sound like a lot but that's what we're paying now, even with high deductibles and tens of millions of uninsured. Americans are tired of the uncertainty:
So a national health plan sounds like a better deal because everyone gets covered and everyone as a gigantic group pays a whole lot less. When you consider a universal single-payer program would 1) cover every single American, eliminating uninsurance and 2) provide much more robust benefits, covering more services than getting covered right now, then it starts to look like a good deal. More people covered. More services covered. Same price, more or less. Medicare for All (M4A) would expand the range of services covered by federal insurance (for example, dental, vision, and hearing benefits). Mercatus is projecting a $32 trillion increase in federal spending ... In terms of overall health care spending in the United States over the same period, however, they are actually projecting a slight reduction ...the country is going to spend about the same. "Lower spending is driven by lower provider payment rates, drug savings, and administrative cost savings." A brand-new estimate from the libertarian-leaning Mercatus Center at George Mason University ... (and) the left-leaning Urban Institute came up with the exact same number in 2016. Conservatives hopped all over the figure. But there are a lot of ways to think about $32 trillion — and one might be that it's actually kind of a bargain. Many Americans still hold real reservations about making Big Government any bigger ... but a closer look at these new estimates reveals "$32 trillion" isn't quite as much as you might think. The Mercatus Center scholars assume (as the Sanders bill dictates) that hospitals and doctors would be paid at Medicare rates, a cut from private insurance rates but an increase from Medicaid rates ... Still, this seems like a reasonable estimate from a group that we would expect to be pretty skeptical of single payer — and it still looks like kind of a good deal. Single-payer supporters are going to have to come up with a persuasive case that, yes, the federal government is going to spend more, but overall spending won't go up. Taxes are going to rise for somebody, but many or even most Americans could end up saving money on their premiums or on out-of-pocket costs. It could be a winnable case, given evolving attitudes about a person's right to health care. But polling shows many people's opinions on this are still malleable. Persuasion is necessary.
Paul Ryan's Shop-for-Healthcare doesn't Work: Why do we need Medicare for all? Because supposed "patient-centered" free market insurance doesn't work. Here's why:
Shopping for Health Care Simply Doesn’t Work. So What Might? It’s often too complicated. And even when it isn’t, almost no one does it. A body of research — including randomized studies — shows that people do in fact cut back on care when they have to spend more for it. The problem is that they don’t cut only wasteful care. They also forgo the necessary kind. This, too, is well documented, including with randomized studies. People don’t know what care they need, which is why they consult doctors. There’s nothing inherently wrong with relying on doctors for medical advice. But it runs counter to the growing trend to encourage people to make their own judgments. Some care is elective, and so potentially “shoppable.” Scholars have estimated that as much as 30 or 40 percent of care falls into this category. It includes things like elective joint replacements and routine checkups. And yet very few people shop for this type of care, even when they’re on the hook for the bill. Maybe it’s just too complex. Even when price transparency tools are offered to consumers to make it easier, almost nobody uses those them. A National Bureau of Economic Research working paper published Monday adds a lot more to the story. Even if 40 percent of health care is shoppable, people are not shopping. What seems likelier to work is doing more to influence what doctors advise. For example, we could provide physicians with price, quality and distance information for the services they recommend. Leaving decisions to patients, and making them spend more of their own money, doesn’t work.
UPI: Proponents also argue that Medicare-for-all is more fiscally hawkish than Romney's new running mate.
"Research shows that private insurance bureaucracy and paperwork consume 31 percent of every health care dollar," said Dr. Diljeet K. Singh, who is a board member of Physicians for a National Health Program, a Chicago-based nonprofit of 18,000 physicians across the country who support a Medicare-for-all system. "Streamlining payments through a single nonprofit payer system would save the United States more than $400 billion a year, enough to provide comprehensive, high-quality coverage for all Americans."
