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Old 11-02-2019, 12:58 PM
Linden Arden is offline
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Warren's new "detailed" MFA plan relies on a ' Employer Medicare Contribution' she never defines


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There’s wide variation in the quality of insurance employers purchase, and this plan has the consequence, at the outset, of punishing employers who purchased better insurance for their employees — now they’re paying more than stingier competitors, but without any recruiting benefit. Over time, Warren says she’ll adjust all employers to the same level, though the details of how that will work are sparse.

There’s an even worse inequity for employers with fewer than 50 employees. They’re not required under law to provide health insurance, but a bit over half do. Warren’s plan says that small businesses “would be exempt from the Employer Medicare Contribution unless they are already paying for employee health care today.” That’s a fairly direct penalty to small businesses that offer health insurance today: They have to keep paying a cost their competitors have dodged, but paying that cost no longer gives them an advantage in hiring.

Altogether, holding the employer contribution constant gets Warren almost $9 trillion. What comes next reads like a grab-bag of tax hikes and policy changes, but taken together, it’s an ambitious tax and immigration agenda even if it weren’t connected to Medicare-for-all:
https://www.vox.com/2019/11/1/209425...axes-explained

So, that $9 trillion in "Employer Medicare Contribution" (EMC) replaces private heath insurance costs. Okay.

But how is that $9 trillion EMC levied? She won't say.

By employee? Then employers would want to replace FTE's with contractors. Do contractors/gig workers get a free ride? Vox notes that she exempts employers with less than 50 employees. How do they pay the EMC? Do they even pay it?

Would the $9 trillion be levied in the form of higher corporate income taxes?

It is kind of an important detail. I went to Warren's web site and the info is just as lacking. In fact what is given is completely worthless.

She pays for the rest of the eye-popping $52 trillion with a grab bag of taxes that will never be realized like immigration reform tax collected and defense spending cuts and the go-to ridiculous financial transactions tax. And of course "cost savings" that cannot be confirmed.

This "plan" is awful and is just a way for her to falsely claim that middle class taxes won't go up.

She deserves to lose for this absurd "plan" which is nothing more than misdirection and political hucksterism.
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Old 11-02-2019, 01:19 PM
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From the Warren web site:


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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.
Employers will lay off or convert as many employees as they can to lower their tax bill.
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Old 11-02-2019, 01:36 PM
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Penalizing employers - rather than just income or VAT or something you can apply broadly and you can't really evade - is a bad move.
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Old 11-02-2019, 01:44 PM
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It seems like levying it equally on all employers would be far preferable. That way, employers who've already calculated health care into their compensation packages would see no effects, whereas employers who've not done so would face a de facto penalty, and would have to catch up with their more worker-friendly competitors.

In fact, if it were levied on everyone, not just folks already offering health insurance, those already offering it could pay a little less.

I don't have much patience with small businesses who say they can't afford to provide health care. If you can't afford to treat your employees right, you can't afford to run a business.
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Old 11-02-2019, 01:52 PM
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Originally Posted by Left Hand of Dorkness View Post
I don't have much patience with small businesses who say they can't afford to provide health care. If you can't afford to treat your employees right, you can't afford to run a business.
Ok, sure. What about "self employed"?
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Old 11-02-2019, 02:09 PM
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Medicare for All is a fine idea, Warren......just be honest and upfront about the details and stop hiding.
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Old 11-02-2019, 02:10 PM
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Originally Posted by Left Hand of Dorkness View Post
I don't have much patience with small businesses who say they can't afford to provide health care. If you can't afford to treat your employees right, you can't afford to run a business.
You obviously have no experience buying corporate plans as a small employer. For companies with less than 10 employees it is almost twice as expensive to buy a corporate plan then it js for each person to buy their own plan. I tried to get insurance for myself and my two employees and it was better for us all for me to just give them a raise to go buy their own insurance because our pool wasn't large enough. Of course neither of them chose to use the raise to buy the top insurance plan since one was covered by his wife and the other chose to get the cheapest bronze plan. If every employer was taxed I'd have to give them both large pay cuts.
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Old 11-02-2019, 02:12 PM
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Originally Posted by Linden Arden View Post
From the Warren web site:




Employers will lay off or convert as many employees as they can to lower their tax bill.
I’m struggling to understand why you think this would happen—mind clarifying?
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Old 11-02-2019, 02:14 PM
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Originally Posted by Oredigger77 View Post
You obviously have no experience buying corporate plans as a small employer. For companies with less than 10 employees it is almost twice as expensive to buy a corporate plan then it js for each person to buy their own plan.
The reason for this is that a very small business can just buy a corporate plan when/if one of the covered family members of the owner actually is sick. I knew someone who did this very thing. (and he, uh, was a proud Republican and Trump voter, even though his kid needed 250k in treatment)
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Old 11-02-2019, 02:14 PM
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I’m struggling to understand why you think this would happen—mind clarifying?
AIUI, it means that employers have as much incentive to have a "high-cost-per-employee" ratio as they can, because the higher the ratio, the more beneficial it is to them. So they will trim their workforce down to achieve a high cost-per-employee ratio.
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Old 11-02-2019, 02:28 PM
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I’m struggling to understand why you think this would happen—mind clarifying?
Let's say today's average health plan is $18,000 per employee. The employer might withhold (for tax reasons) $12,000 of that and require the employee to pay $6000.

When the new EMC is calculated the employer would owe Uncle Sam all $18,000 times 98%. A big tax hike per employee.

As a cost accountant I would advise my employer to fire me and contract me back at 80% of my pay package. I would gladly accept that and let other working stiffs pay for my MFA.


Edit (Remember my pay package includes FICA, SS withholding, PTO, etc. 80% of my pay package would be over a $10,000 income increase for me)

Last edited by Linden Arden; 11-02-2019 at 02:33 PM.
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Old 11-02-2019, 02:45 PM
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Originally Posted by Oredigger77 View Post
You obviously have no experience buying corporate plans as a small employer. For companies with less than 10 employees it is almost twice as expensive to buy a corporate plan then it js for each person to buy their own plan. I tried to get insurance for myself and my two employees and it was better for us all for me to just give them a raise to go buy their own insurance because our pool wasn't large enough. Of course neither of them chose to use the raise to buy the top insurance plan since one was covered by his wife and the other chose to get the cheapest bronze plan. If every employer was taxed I'd have to give them both large pay cuts.
I don't have that experience, you're right. The folks I know who don't get employer health care coverage are also working very low-income jobs, below-living-wage jobs.

In the circumstance you're talking about, sure: give them a pay cut to pay for the taxes. Then they get to stop paying for insurance. Under this plan, their pay cut plus their cut in expenses will be a net gain for the vast majority of workers.
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Old 11-02-2019, 03:36 PM
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I don't have that experience, you're right. The folks I know who don't get employer health care coverage are also working very low-income jobs, below-living-wage jobs.

In the circumstance you're talking about, sure: give them a pay cut to pay for the taxes. Then they get to stop paying for insurance. Under this plan, their pay cut plus their cut in expenses will be a net gain for the vast majority of workers.
For the workers that still have non-independent contractor jobs that is.
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Old 11-02-2019, 03:59 PM
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Medicare for All is a fine idea, Warren......just be honest and upfront about the details and stop hiding.
Exactly. Many of us are fine with a middle class tax to help pay for M4A.
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Old 11-02-2019, 09:53 PM
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Can I just say that the fetishization of Democrats' fiscal responsibility is driving me absolutely nuts on the whole M4A discussion. Literally nobody pesters the GOP when they refuse to articulate how their tax cuts and limitless military spending will be financed, but the Democrats are now just *hammering* each other over 'OMG but how will you PAY FOR IT?!'

Just have them all say that M4A will pay for itself like GOP tax cuts always do, and move on.
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Old 11-02-2019, 10:19 PM
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Can I just say that the fetishization of Democrats' fiscal responsibility is driving me absolutely nuts on the whole M4A discussion. Literally nobody pesters the GOP when they refuse to articulate how their tax cuts and limitless military spending will be financed, but the Democrats are now just *hammering* each other over 'OMG but how will you PAY FOR IT?!'

Just have them all say that M4A will pay for itself like GOP tax cuts always do, and move on.
Exactly right. Hell, say you will pay for it with a tax cut.

Or if you want to a bit more detailed just say "we will recapture some fraction of what employers are currently spending on health insurance for their employees" without trying to spell out the nitty gritty details. As pointed out there are plenty of ways to do it.
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Old 11-02-2019, 10:51 PM
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Anybody who voted for Trump has no credibility when they claim to suddenly care about practical details.
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Old 11-02-2019, 11:17 PM
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Anybody who voted for Trump has no credibility when they claim to suddenly care about practical details.
Or treason. Or competence. Or patriotism. Or foreign policy. Or honesty. Or rule of law. Or democracy. Or national security. Or integrity.
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Old 11-02-2019, 11:21 PM
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Exactly right. Hell, say you will pay for it with a tax cut ...
A fair fraction of us do not want to see our candidates modeling themselves in the image of what we despise of GOP candidates.
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Old 11-03-2019, 12:13 AM
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The obsession by the candidates (all of them) with writing this kind of massive legislation in advance is just bizarre, let alone their desire to "pay for" all of their fictitious details in advance.

Like, the actual best-case health care bill is going to be bribing Chris Coons to vote for a tax-advantaged health savings account system that nobody knows how to use because you need a crystal ball and a six-page IRS form to use it, and even that is going to be derided as a communist takeover of healthcare and lead to a 70-vote swing to the Republicans in 2022, so why do this whole dance where everyone (again, not just the M4A folks) fights over whose imaginary pony gallops the fastest.

Oh well, I'm sure this will be a fun hour of the next debate! *snooze*

Last edited by Lord Feldon; 11-03-2019 at 12:17 AM.
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Old 11-03-2019, 12:51 AM
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And for what it's worth, as someone who plans to vote for her for reasons entirely unrelated to healthcare (there isn't really any way to express a position on that issue through one's vote in a presidential primary IMO, regardless of how much time is wasted on it), I actually breathed a sigh of relief when she came out with this. My preference would have been continuing to duck and weave, or just finding all the money in increased growth or an elimination of fraud, waste, and abuse, but I actually think she managed to find money that won't sound like a tax increase to most people. (Whether it would work is a minor concern to me, so I don't see any value in telling hard truths and trying to make unpopular compromises in advance.)

Last edited by Lord Feldon; 11-03-2019 at 12:53 AM.
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Old 11-03-2019, 12:53 AM
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Can I just say that the fetishization of Democrats' fiscal responsibility is driving me absolutely nuts on the whole M4A discussion. Literally nobody pesters the GOP when they refuse to articulate how their tax cuts and limitless military spending will be financed, but the Democrats are now just *hammering* each other over 'OMG but how will you PAY FOR IT?!'

Just have them all say that M4A will pay for itself like GOP tax cuts always do, and move on.
So because Republicans are fiscally irresponsible, means Democrats should follow suit?

I think a lot of these partisan "eye for an eye" opinions miss that it's the nation losing its eyesight.
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Old 11-03-2019, 01:10 AM
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Originally Posted by Linden Arden View Post
Let's say today's average health plan is $18,000 per employee. The employer might withhold (for tax reasons) $12,000 of that and require the employee to pay $6000.

When the new EMC is calculated the employer would owe Uncle Sam all $18,000 times 98%. A big tax hike per employee.

As a cost accountant I would advise my employer to fire me and contract me back at 80% of my pay package. I would gladly accept that and let other working stiffs pay for my MFA.


Edit (Remember my pay package includes FICA, SS withholding, PTO, etc. 80% of my pay package would be over a $10,000 income increase for me)
"Let's say?" Last time I came into one of your threads with numbers, I was completely ignored. So let's go with reality as opposed to "let's saying", shall we?

Monday afternoon at 2pm I give an enrollment meeting to a small employer, who is offering a BCBS S665CHC plan with the following premium structure:

Employee-Only - $579
E+Spouse - $1,158
E+Family - $1,737

I can tell you, for a fact, that the "average employer plan is" not "$18,000 per employee", and I truly have zero idea why you would think fake numbers support any argument around here. Where in God's name did you come up with $18k per employee? Seriously, would love a cite.

So, having made that point, let's see what this gets them:

Deductible: $4,000
Max Out of Pocket: $7,900

Now, here's the thing: all Obamacare plans are the same in regards to coverage, the only difference in these plans are the financial arrangements you make with the insurance company and your employer. What this means in actuality for my small group is this:

The insurance company and medical industry require them to spend approximately $10,000 before they reach first-dollar coverage.

This doesn't matter if they want a gold-plated plan with low-assed deductibles (this will have a gold-plated premium as well), or a bare-bones catastrophic plan with highest deductible allowed by law (and cheap, cheap premiums). If it weren't such a PITA to remove all the HIPPA stuff I'd be glad to upload the 56-page renewal so we can go over this in excruciating detail, but in the end, the math is simple:

Amount you must spend before you receive your first dollar in coverage = (Annual Premium + Deductible)

Amount you are required to spend annually if you are hit with catastrophic health care costs: Annual Premium + Max Out of Pocket ($7,900 cap here in Texas).

So, my group:

1. Spends $6,948 per covered individual just on premium
2. Must spend $3,000 before they receive any benefits beyond copays
3. Must spend an additional $4,900 beyond that if they are truly sick
4. Must repeat this process every year for the rest of their employment
5. Breathes a sigh of relief when they can get on Medicare

If you are going to make these arguments, Linden, please do so from a basis of fact, with citations.

Thank you.
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Old 11-03-2019, 01:17 AM
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I can tell you, for a fact, that the "average employer plan is" not "$18,000 per employee", and I truly have zero idea why you would think fake numbers support any argument around here. Where in God's name did you come up with $18k per employee? Seriously, would love a cite.
$18k is pretty close to what I've seen as the average for a family plan.

Edit: This says 20.

Last edited by Lord Feldon; 11-03-2019 at 01:18 AM.
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Old 11-03-2019, 01:30 AM
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Originally Posted by 2ManyTacos View Post
Can I just say that the fetishization of Democrats' fiscal responsibility is driving me absolutely nuts on the whole M4A discussion. Literally nobody pesters the GOP when they refuse to articulate how their tax cuts and limitless military spending will be financed, but the Democrats are now just *hammering* each other over 'OMG but how will you PAY FOR IT?!'

Just have them all say that M4A will pay for itself like GOP tax cuts always do, and move on.
This, and subsequent replies along these lines are a hijack. This thread is about Warren's MFA plan, not a comparison to Trump or other GOP actions. Drop the line of discussion that is about GOP, Trump, or other opponents plans unless it is directly relevant to Warren's M4A plan.

[/moderating]
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Old 11-03-2019, 01:32 AM
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But that's not what he said. He said $18k per employee, and that's not even close or the correct way to look at it as it should be per named insured. And even then, in the small group market in Texas, a State which rejected Medicare expansion to make insurance more adfordable, the number to use is $7k/person, not $18k/family.

Standing by my experience and math. Yes, the family plan is $18k but that does not mean that the average employee gets $18k in insurance - in our experience, 60% get the Employee-Only plan, and most employers only pay for the e-only portion.

Last edited by JohnT; 11-03-2019 at 01:36 AM. Reason: Reply to Lord Feldon
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Old 11-03-2019, 01:06 AM
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My basic view is that MFA is dead on arrival even if Warren wins and the Dems retake the Senate so this plan is only interesting in terms of its short-term political effect and it's a mixed bag. Warren probably solves her immediate problem of explaining how she will pay for it without raising middle-class taxes though critics will call the Employer Medicare Contribution a tax anyway. OTOH she creates new problems for herself by being unnecessarily specific about how she will cut costs and targeting doctors and hospitals. She should have just said she would target pharmaceutical companies and hand-waved the rest (there is a huge amount of hand-waving in her plan anyway).

Overall I still think this is going to be a big political burden for her. She will face months of incisive critique from Buttigieg and other primary opponents as well as moderate Democrats in general. If she wins the nomination, she will face the biggest avalanche of corporate money in political history as well as strong opposition from most of the healthcare sector including doctors and hospital. The Republican party will be completely united while the Democrats will be divided and many candidates running in purple districts/states will explicitly reject MFA making Warren look more extreme.
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Old 11-03-2019, 07:59 AM
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But that's not what he said. He said $18k per employee, and that's not even close or the correct way to look at it as it should be per named insured. And even then, in the small group market in Texas, a State which rejected Medicare expansion to make insurance more adfordable, the number to use is $7k/person, not $18k/family.

Standing by my experience and math. Yes, the family plan is $18k but that does not mean that the average employee gets $18k in insurance - in our experience, 60% get the Employee-Only plan, and most employers only pay for the e-only portion.
So it's not a "fake number" like you wrote. It may be the wrong number, but it's not made up.

And my plans are not "per named insured". I could have 20 kids and the family plan doesn't change. Seems odd. I don't know how common it is.
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Old 11-03-2019, 09:44 PM
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The obsession by the candidates (all of them) with writing this kind of massive legislation in advance is just bizarre, let alone their desire to "pay for" all of their fictitious details in advance.

Like, the actual best-case health care bill is going to be bribing Chris Coons to vote for a tax-advantaged health savings account system that nobody knows how to use because you need a crystal ball and a six-page IRS form to use it, and even that is going to be derided as a communist takeover of healthcare and lead to a 70-vote swing to the Republicans in 2022, so why do this whole dance where everyone (again, not just the M4A folks) fights over whose imaginary pony gallops the fastest.

Oh well, I'm sure this will be a fun hour of the next debate! *snooze*
Pretty much. Best case scenario, the democrats will pass some increased subsidies for the 3% of people who get private insurance via the exchanges. Medicare for all, a public option, Rx negotiation, Rx importation, etc all offend the rich and powerful and the democratic congress aren't going to pass them. They'll just talk about them. If we're really lucky, they'll give medicaid to the states that didn't expand it somehow too.

And sadly thats the best case, more subsidies to buy private insurance in a broken, brutal, overpriced system.

IMO we won't get real UHC until the 2050s, and it won't be M4A. It'll probably be more like the systems in the Netherlands or Switzerland.
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Last edited by Wesley Clark; 11-03-2019 at 09:45 PM.
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Old 11-04-2019, 06:12 PM
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Warren says that middle class taxes won't go up for MFA -- why not?


I feel like I'm perpetually out of the loop on the details for these various MFA proposals. To my ignorant mind, it seems relatively "simple" to implement --

1) Make everyone automatically covered under Medicare
2) Jack up taxes in order to get all of the money currently going towards private insurance
3) Companies currently offering private insurance as a benefit stop doing so, and give the money they were spending to the government instead as a payroll tax (for the convenience of the individual)
4) If people want insurance above and beyond Medicare they can still get that from private insurers

I've been rather, confused, let's say, that some of the proposals being kicked around don't adhere to this basic pattern, e.g. proposals that will ban private insurance. But what's the story with not raising taxes on the middle class? Where does the money for MFA come from if not, to some degree, the middle class? Where does the money currently going to private insurers covering the middle class go? Is this a semantics thing or do I fundamentally misunderstand the concept of universal healthcare?
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Old 11-04-2019, 06:30 PM
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People were too stupid to understand that your taxes going up $1000 while your insurance premiums went down $2000 was ultimately a better deal and she kept on getting hammered on "You'll make teh taxes go up" so she said fine and released a plan where you aren't being taxed more but your employer is being taxed more, making this technically not a middle class tax increase. It's a stupid dodge to avoid a stupid talking point that ultimately makes the entire system slightly worse but that's how you play the game in a democracy.
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Old 11-04-2019, 06:40 PM
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People were too stupid to understand that your taxes going up $1000 while your insurance premiums went down $2000 was ultimately a better deal and she kept on getting hammered on "You'll make teh taxes go up" so she said fine and released a plan where you aren't being taxed more but your employer is being taxed more, making this technically not a middle class tax increase. It's a stupid dodge to avoid a stupid talking point that ultimately makes the entire system slightly worse but that's how you play the game in a democracy.
But if I'm self employed, and paying $2000 a month directly to an insurance company, won't my taxes go up under Warren's MFA plan? How could they not?
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Old 11-04-2019, 06:44 PM
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If you're earning over a certain amount, I'm guessing your taxes will go up. However, as the previous poster said, your value would, in theory, be better overall.
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Old 11-04-2019, 06:53 PM
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If you're earning over a certain amount, I'm guessing your taxes will go up. However, as the previous poster said, your value would, in theory, be better overall.
Well "earning over a certain amount" sounds like it would have to include most of what we think of as the "middle class," and "I guess I their taxes would go up" sounds like a big ol' nuclear "If you like your plan you can keep it."

I'm not saying convince me MFA is a good value, I'm saying, explain how she can say middle class taxes won't go up and still pay for MFA.
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Old 11-04-2019, 07:25 PM
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Well "earning over a certain amount" sounds like it would have to include most of what we think of as the "middle class," and "I guess I their taxes would go up" sounds like a big ol' nuclear "If you like your plan you can keep it."

I'm not saying convince me MFA is a good value, I'm saying, explain how she can say middle class taxes won't go up and still pay for MFA.
I'll let her explain it.
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Old 11-04-2019, 07:36 PM
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There is already a Warren MFA plan thread:
Warren's new "detailed" MFA plan relies on a ' Employer Medicare Contribution' she never defines

Last edited by CarnalK; 11-04-2019 at 07:37 PM.
  #37  
Old 11-04-2019, 07:42 PM
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Thank you. I'm embarrassed to admit that even though I put this in the same forum, I somehow missed it. I can see that many other dopers are also confounded and annoyed at the specifics of this plan.

Mods, you can lock this up and I'll take my interest to that other thread.
  #38  
Old 11-04-2019, 07:48 PM
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Moderating


Post 30-37 were merged from a parallel thread started today.

[/moderating]
  #39  
Old 11-04-2019, 07:55 PM
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Medicare for All is a fine idea, Warren......just be honest and upfront about the details and stop hiding.
No, just the opposite; just be vague, promise the moon, promise to soak the rich, and then compromise. That's how this works.

By trying to analyze the trees, she's getting lost in the forest.
  #40  
Old 11-05-2019, 01:14 AM
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This is seriously turning into a "Read my lips, no new taxes" moment.

https://www.nytimes.com/2019/11/03/u...lionaires.html

Warren claims that only billionaires will bear the burden for the plan and that nobody who falls under the threshold of "billionaire" is going to pay "a penny more." This is just asking for trouble.

Last edited by Velocity; 11-05-2019 at 01:17 AM.
  #41  
Old 11-05-2019, 07:57 AM
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Medicare for all does that include congress?
  #42  
Old 11-05-2019, 10:09 AM
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In the long run tax incidence theory is that the employee will pay all of the payroll taxes just like the employee currently pays all of the FICA taxes.
  #43  
Old 11-05-2019, 01:39 PM
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In the long run tax incidence theory is that the employee will pay all of the payroll taxes just like the employee currently pays all of the FICA taxes.
The same could be said of health insurance premiums.
  #44  
Old 11-05-2019, 01:46 PM
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This is seriously turning into a "Read my lips, no new taxes" moment.
Are you sure it's not a "grab her by the pussy" moment?

Or a "they are sending rapists" moment?

Or a "Mexico will pay for the wall" moment?

Need I go on?

The point is how can your side still be banking on this gotcha stuff with what you have put into the oval office? Seems to me you've made that kind of political calculation obsolete now. Isn't it kind of quaint to think that a 1988 era political miscalculation has any kind of relevance to the reality shit show of our current politics?
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  #45  
Old 11-05-2019, 08:34 PM
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The point is how can your side still be banking on this gotcha stuff with what you have put into the oval office?
Because for Republicans, the ends justify the means; they don't need to win epistemic arguments.
  #46  
Old Today, 09:37 AM
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"Let's say?" Last time I came into one of your threads with numbers, I was completely ignored. So let's go with reality as opposed to "let's saying", shall we?
I tend to ignore you because you post non-sequiturs that have no bearing on the topic.

For instance this time you quibble about how the total cost of family premiums are constructed. I used $18,000 as an example of a total premium burden. You tried to misdirect the conversation into detail about how each person in a family is billed.

The total is the total.

also, after some shabby poll numbers this week (11% on Ipsos/Reuters) Warren is walking back on her ridiculous "plan".

Quote:
Elizabeth Warren Retreats From Medicare for All

Her plan to pass a public option before pivoting to single-payer is too clever for its own good.
https://newrepublic.com/article/1557...reats-medicare
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