“My fellow Americans. I am going to slash our GDP by 5% and put millions of people out of work in every community in the country for our own good. Vote for me in October.”
Hillary just stated the fact that 20 thousand miners were going to lose their jobs, so they needed retrained and she was pilloried. I don’t want to be the guy saying that we’re coming for the nurses next.
Virtually all of the job loss will be in health care administration. If anything, there will be more healthcare workers (getting paid less). Sanders’ plan includes subsidizing medical school, and the cost of education is one of the strongest pressures keeping people out of medicine. India can turn out 50,000 physicians a year; the US produces about 18,000. In other words, a country with a much lower literacy rate and far fewer resources is better at training doctors than we are. Why? Because India subsidizes the cost of medical training.
What you’re essentially saying is that if we wound the clock back 60 years, we should reject air travel because so many railroad workers will lose their jobs.
Well, no. He’s saying that no politicians will have the balls to put railroad workers out of work.
Obviously politicians are going to run on the positives of their ideas, not on ridiculous Chicken Little versions of how bad the policy is.
Honestly, the idea that national health care will result in the elimination of 5% of our economy is completely silly. It isn’t even worth discussing, really.
So was the idea that John Kerry wasn’t a war hero, and yet he’s not President.
It’s not a cliche and it’s still true. To put in in rightish wing terms, a healthy workforce is a productive workforce, an educated workforce is a productive workforce. Put both together and great things happen.
I think it’s a mistake to say things like that. The net income of workers should be the same.
That’s not a good comparison: India has over 4x the population of the US, so pro rata should be producing 72,000 doctors.
Ditto McCain.
Something does not become an investment just because the government starts paying for it. If it would be an investment when it is medicare for all then it is currently an investment. Merely changing who pays does not make an investment any better or worse.
The problem is not that the US does not subsidize the cost of medical training, the US spends billions each year subsidizing resident programs, it is that the US lets physicians groups control the supply of new doctors. No one can open a new medical school or increase the number of slots without permission from the RUC which is completely controlled by physicians groups. Since fewer doctors means that doctors get paid more the RUC strictly limits the amount of new doctors.
There are 18 million workers in healthcare, spending less money of healthcare will mean that those workers either take a pay cut or go without raises for years. Is either party strong enough to write off the votes of 18 million people?
I’m saying that to get healthcare costs to European levels per capita, it most certainly will. That’s math. You can argue that it would all come from administration or insurers pockets (It won’t. Administration is necessary and you can streamline it and make it more efficient, but you’re not going to knock off a third of what we spend on healthcare by firing some CEOs and accountants. They’ll take a chunk of it, but they aren’t going to come close to all of it.) but to say that we’re going to spend significantly less on healthcare, but not decrease the GDP is magic math.
Again, I’m not saying it shouldn’t be done, but I’m saying that very few politicians are going to win on that message and that will be the message from their opponent if they try to play up the positives.
Then why do so many doctors seem to be supporting universal health care? Are they bumpkins who don’t know what’s best for them?
Or, would all the doctors, nurses, and health care delivery people keep working, but the roughly half a million people working in administering private health insurance claims be pared down?
More than likely, the funds that you and your employer put towards expensive private insurance will be put to better use: investing in the business, you buying a new car, etc. ETA: Besides, you seem to be arguing it both ways: that $32 trillion is too expensive, and that if we pay any less, our economy suffers. Which is it?
The effects would probably be in the middle of these two extremes. Speaking more broadly about universal healthcare generally rather than Medicare for All specifically, the goal is to slash spending without negatively impacting health outcomes. So you’re going to have medical professionals continuing to work; they’re just going to be paid less. Not a vote-getter if you’re in the profession primarily for the money, and some will probably decide that the lower salary isn’t worth it (assuming they have other job prospects available to them in other fields). You figure there will be some kind of decrease in demand for highly-paid specialists and more of a demand for GPs and nurse-practioners since the whole point is to move to more cost-effective practices. So certainly some of the specialists will either be out of work for be forced into lower-paid practice areas. You’re going to outright fire a percentage of administrative staff, since you’re going to try to streamline that side of the house by simplifying and standardizing. You’re going to slash drug company profits; hopefully you leave a high-enough profit margin that most companies will keep doing R&D, but a few may decide to call it quits. There will likely be meaningful job loss and corresponding GDP reductions, and we’ll have to have a plan to deal with that.
At the same time, the whole point is to free up resources. Instead of blowing it on health care, we’d spend on other areas, whether that be education, national security, big-screen TVs, or what-have-you. The money saved is going to be spent elsewhere, except for those folks who were forced into unemployment and no longer have the income stream. So large GDP declines, while possible, are somewhat unlikely. Potential increases in unemployment, lower pay overall, and some pissed-off medical staff, sure.
On Medicare for All specifically; the proposal does specifically call for “planning for health professional education funding.” You sort-of have to, or else people aren’t going to be able and willing to work for the lower salaries.
Thanks for the reply. You got me thinking about this.
I don’t think those things are all equivalent. I’ve heard several people say that doctors are overpaid. I’ve never heard that about a coal miner.
Taking away the job of a coal miner is not the same as reducing the salary of an insurance company CEO. I think that could be done without much political backlash from the voters.
Cutting salaries of medical professionals are probably somewhere in between those two extremes.
I’m seeing this as a positive. If the doctors are in the field for the money, then it’s possible (and maybe more likely) that they care less about the patients. I’d prefer to see more practicing medical professionals who are in the field to better the lives of their patients. It’s possible that if the salaries of medical professionals were reduced, more people who go into the field would be there to help people instead of to make more money and get more status.
I was fascinated by this article from Canada, where 700 medical professionals there were refusing a pay increase in order to provide more money to the systems that allowed better access to care for everyone. That’s inconceivable in the US. But that’s only because of how the system now operates.
Hundreds of Canadian doctors demand lower salaries. (Yes, lower.)
It should be easier to get medical professionals employed in other fields since they already have the education, unlike for instance, coal miners. With unemployment as low as it is, and companies complaining about how they can’t find talent with technical skills, perhaps the displaced medical workers would fill a need that already exists. This could be another plus.
Those things I listed are an investment because you spend money up front and gain value later. Providing health care to everyone, building infrastructure, educating your populace all provide long term benefits and generate revenue.
Here is a long, wonky Twitter thread on Medicare for All. (Which I consider a misnomer - it is much better than the current Medicare program)
RUC. Royal Ulster Constabulary? It’s nice to spell stuff out sometimes.
Indeed, it would be better than our current system if we simply implemented UHC and used the saved money to simply pay the formerly employed to do nothing, because free time is a good whereas health insurance is only a necessary good because we don’t have UHC. Of course even better would be to prioritize spending or saving the savings as we choose.
RVS Update Committee