# Ms. Ocasio-Cortez, on How to Pay for Medicare for All **URL:** \ **Category:** The BBQ Pit\ **Created:** [December 3, 2018, 6:43pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514 "2018-12-03T18:43:36Z")\ **Posts on this page:** 20\ **Page:** 12
**Author:** ![CaptMurdock](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/captmurdock/32/11736_2.png) [@CaptMurdock](https://boards.straightdope.com/u/CaptMurdock)\ **Post date:** [December 7, 2018, 4:23pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/221 "2018-12-07T16:23:27Z")
> [@eschereal](#): > > Nobody has directly addressed the other half of the argument: the defense budget. It is a major liberal cause, cutting the absurdly large amount of revenue we pump into the MIC. But just cutting defense (which ought to happen) does have significant ramifications. My neighborhood has more than half a dozen large bases in a fairly compact area, that support several cities and towns. Those communities would suffer or collapse with those bases shut down or severely curtailed, as would almost certainly happen with realistic cut to the defense budget. > > Even if the money is just accounting errors, some of it finds its way into the economy, into which Defense is deeply intertwined. Anyone who advocates for deep cuts fucking well better be putting forth a plan to offset the serious effects that those cuts will have on the lives of ordinary Americans. [gravelly Mafia-esque voice] “Ya’d better keep pumping the funds into this base, or the mom-and-pop down the road gets it!” [/] :dubious: ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [December 7, 2018, 5:03pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/222 "2018-12-07T17:03:44Z")
> [@Fiddle\_Peghead](#): > > Why? Someone is paying for them now. Somebody would pay under M4A. Please explain this to me. Maybe I don’t understand your question. If we pay the same drug prices under M4A as we would anyway, what’s the advantage of M4A? The premise of the report previously cited was [ul][li]We dramatically cut payments to health care providers[/li][li]We dramatically cut drug prices[/li][li]We cut administrative costs[/li][li]We charge the same in taxes that people now pay in premiums[/ul][/li] The alleged effect is that we then save $2T over ten years, which is offset by the fact that it will increase the federal budget deficit by an undetermined amount, and also doesn’t account for increased utilization. Just saying “well somebody will pay for it anyway” is [AOC thinking](https://dailycaller.com/2018/11/06/ocasio-cortez-medicare-for-all-pay/). Regards, Shodan ---
**Author:** ![CarnalK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnalk/32/486_2.png) [@CarnalK](https://boards.straightdope.com/u/CarnalK)\ **Post date:** [December 7, 2018, 5:18pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/223 "2018-12-07T17:18:17Z")
It doesn’t matter because your point, that we’d lose out on drug advances if we don’t buy _potentially_ effective expensive drugs, defies reality in two ways. Private insurance is already reluctant to pay for those drugs and there’s plenty of pharmaceutical research in countries with universal health coverage. ---
**Author:** ![Fiddle\_Peghead](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fiddle_peghead/32/3506_2.png) [@Fiddle\_Peghead](https://boards.straightdope.com/u/Fiddle_Peghead)\ **Post date:** [December 7, 2018, 5:31pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/224 "2018-12-07T17:31:32Z")
> [@Shodan](#): > > Maybe I don’t understand your question. If we pay the same drug prices under M4A as we would anyway, what’s the advantage of M4A? > . > > Regards, > Shodan I am saying that even if drug prices stay the same, there are other benefits to M4A. Why does not cutting drug prices invalidate the whole thing? ---
**Author:** ![Fiddle\_Peghead](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fiddle_peghead/32/3506_2.png) [@Fiddle\_Peghead](https://boards.straightdope.com/u/Fiddle_Peghead)\ **Post date:** [December 7, 2018, 5:47pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/225 "2018-12-07T17:47:02Z")
IOW, in comparing single payer to private insurance, set aside for the moment the things that will be needed for both. In this case, drugs. Then only consider the cost reductions for things that can be gotten rid of, like profit, _some_ administrative costs, and the like. Then, even if drug prices stay the same, there will still be economic benefits for the insured. ---
**Author:** ![Punoqllads](https://avatars.discourse-cdn.com/v4/letter/p/d2c977/32.png) [@Punoqllads](https://boards.straightdope.com/u/Punoqllads)\ **Post date:** [December 7, 2018, 6:06pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/226 "2018-12-07T18:06:48Z")
> [@Shodan](#): > > She seems somehow to believe that we can squeeze $21 trillion out of a total yearly budget of almost $700 billion. This is the kind of fresh, outside [del]reality[/del] the box thinking that we need in Congress. If only there was some way to [Google](https://missingmoney.solari.com/dod-and-hud-missing-money-supporting-documentation/) where she got her figure of $21 trillion of missing money from. In Shodan’s defense, the number is from both Defense and HUD. ---
**Author:** ![Try2B\_Comprehensive](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/try2b_comprehensive/32/65_2.png) [@Try2B\_Comprehensive](https://boards.straightdope.com/u/Try2B_Comprehensive)\ **Post date:** [December 7, 2018, 10:03pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/227 "2018-12-07T22:03:09Z")
> [@Shodan](#): > > The alleged effect is that we then save $2T over ten years, which is offset by the fact that it will increase the federal budget deficit by an undetermined amount, and also doesn’t account for increased utilization. > > Just saying “well somebody will pay for it anyway” is [AOC thinking](https://dailycaller.com/2018/11/06/ocasio-cortez-medicare-for-all-pay/). > > Regards, > Shodan Dude, for one you are citing the Daily Caller. That is Tucker Carlson’s outfit i.e. sheer propaganda. It might be useful as toilet paper except I am getting the digital version. Fox and the GOP promote the idea that tax cuts for the wealthy increase revenues because they are owned by the same wealthy interests. Tax cuts btw are the sole legislative achievement of full Fox control of Congress and the WH. Your people have lost the right to lecture anyone about finances. For two, the claim that it Has to increase the deficit is a bare assertion. Pubbies have all apparently forgotten that revenues can be set to match expenditures, and then there is a balanced budget. So, socialize medicine And balance the budget and the deficit does not increase. For three, your link covers the same ground we have already covered. She asks, “How do you pay for something that is cheaper?” Because, we are already paying for it. OK. All I want is better cites for the costs of the current system and the M4A system. Don’t cite Tucker Carlson if you want to be taken seriously. ---
**Author:** ![eschereal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/eschereal/32/18939_2.png) [@eschereal](https://boards.straightdope.com/u/eschereal)\ **Post date:** [December 7, 2018, 11:18pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/228 "2018-12-07T23:18:07Z")
> [@Try2B\_Comprehensive](#): > > … all apparently forgotten that revenues can be set to match expenditures, and then there is a balanced budget. So, socialize medicine And balance the budget and the deficit does not increase. … There was a guy a couple decades ago who got the deficit down to nil (perhaps even into positive territory) and managed to do it while getting head. Lamentably, that guy also signed the repeal of Glass-Steagall. ---
**Author:** ![CarnalK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnalk/32/486_2.png) [@CarnalK](https://boards.straightdope.com/u/CarnalK)\ **Post date:** [December 7, 2018, 11:29pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/229 "2018-12-07T23:29:04Z")
> [@Banquet\_Bear](#): > > …the bit “you already quoted” is out of context. My post wasn’t a “complaint” about “how bad Giuliani is”. Its obvious you didn’t read my entire post. Perhaps you should do that before accusing me of being “like the people who defend Trump with It’s not like he’s Hitler.” Subtly and nuance really don’t seem to be your thing. > > My post wasn’t a "defence of Ocasio-Cortez. If I had intended to offer a defense of Ocasio-Cortez then I would that would have been crystal clear: but that wasn’t my intent. I’m not lying. > > I’m going to sit here again and offer to clarify things for you but it seems clear that you aren’t interested in hearing it, and as my responses seem to be increasingly making you angry its probably best I don’t interact with you any more. > [@survinga](#): > > Deflecting is a defense. You were defending by deflecting. > > People who are pro-Trump do it all the time, when they are defending Trump. Whataboutism is a trademark defense tactic in politics. You were defending ACO (which I don’t care about, because she gets too much attention as it is). But it’s strange that you would deny something so obvious. Thanks for this. It was getting really frustrating when it was indeed so obvious. ---
**Author:** ![Try2B\_Comprehensive](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/try2b_comprehensive/32/65_2.png) [@Try2B\_Comprehensive](https://boards.straightdope.com/u/Try2B_Comprehensive)\ **Post date:** [December 8, 2018, 12:30am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/230 "2018-12-08T00:30:12Z")
> [@eschereal](#): > > There was a guy a couple decades ago who got the deficit down to nil (perhaps even into positive territory) and managed to do it while getting head. He did it with an assist in the form of a tax hike by H W. Who then got creamed in the next election, teaching the GOP a valuable lesson: the best interests of the country are for suckers. Better to team up with our adversaries to cheat at elections. ---
**Author:** ![SteveG1](https://avatars.discourse-cdn.com/v4/letter/s/bb73d2/32.png) [@SteveG1](https://boards.straightdope.com/u/SteveG1)\ **Post date:** [December 10, 2018, 3:57am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/231 "2018-12-10T03:57:36Z")
> [@Shodan](#): > > You asked about the effect on the deficit. > > Do the math for me: if we double federal income tax, and it doesn’t cover the cost of M4A, does the deficit go up, or down? > > And my cite said rather clearly Which is what I said it said. > > Regards, > Shodan After this past year, and looking at how Trump and the Republicans deliberately blew up “the deficit” (which is bullshit anyway) with their own personal tax give-away to themselves, and then tried to use that as an excuse to gut everything that doesn’t line their pockets, all I can say is Fuck them and their deficit hawk bullshit. ---
**Author:** ![jz78817](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jz78817/32/1028_2.png) [@jz78817](https://boards.straightdope.com/u/jz78817)\ **Post date:** [December 10, 2018, 4:27am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/232 "2018-12-10T04:27:22Z")
> [@Shodan](#): > > Just saying “well somebody will pay for it anyway” is [AOC thinking](https://dailycaller.com/2018/11/06/ocasio-cortez-medicare-for-all-pay/). > > Regards, > Shodan it is also apparently Trump thinking, because apparently “somebody will pay for it anyway” is why he signed the massive tax gift to corporations and the wealthy. you miserable piece of shit. ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [December 10, 2018, 9:58am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/233 "2018-12-10T09:58:19Z")
> [@bump](#): > > [https://www.nytimes.com/2018/06/08/business/would-a-single-payer-system-require-painful-sacrifices-from-doctors.html](https://www.nytimes.com/2018/06/08/business/would-a-single-payer-system-require-painful-sacrifices-from-doctors.html) > > Somewhere between 11-13% and 40% less. Is that a “through the bank” conversion, or localized? US salaries are higher in a direct exchange rate than those in most other countries, but that’s for every profession and like I said, direct exchange. Once you take cost of living into account, or look at “after taxes and other unescapable expenses” (such as the amount paid monthly for healthcare insurance, which depending on the country is a tax or not), the difference isn’t anywhere near as large. ---
**Author:** ![bump](https://avatars.discourse-cdn.com/v4/letter/b/7c8e57/32.png) [@bump](https://boards.straightdope.com/u/bump)\ **Post date:** [December 10, 2018, 3:24pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/234 "2018-12-10T15:24:21Z")
> [@Nava](#): > > Is that a “through the bank” conversion, or localized? US salaries are higher in a direct exchange rate than those in most other countries, but that’s for every profession and like I said, direct exchange. Once you take cost of living into account, or look at “after taxes and other unescapable expenses” (such as the amount paid monthly for healthcare insurance, which depending on the country is a tax or not), the difference isn’t anywhere near as large. Don’t know- the article doesn’t say. ---
**Author:** ![CarnalK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnalk/32/486_2.png) [@CarnalK](https://boards.straightdope.com/u/CarnalK)\ **Post date:** [December 10, 2018, 3:32pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/235 "2018-12-10T15:32:23Z")
Another benefit of universal healthcare not usually discussed is that it could take away the need for a lot of litigation. If there’s no medical costs to recover, there’s a lot less reason to sue someone for an injury. ---
**Author:** ![Gary\_Kumquat](https://avatars.discourse-cdn.com/v4/letter/g/4491bb/32.png) [@Gary\_Kumquat](https://boards.straightdope.com/u/Gary_Kumquat)\ **Post date:** [December 11, 2018, 7:13am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/236 "2018-12-11T07:13:43Z")
> [@Shodan](#): > > If we cut dramatically what we spend on drugs, which we would have to do if M4A is going to work, then we would be giving something up - namely, expensive drugs that may or may not work better than a cheaper version. Hence my example of statin drugs. This is completely untrue. You are paying far more for the SAME drugs; the exact same drug, from the exact same manufacturer. Have a look at insulin, where in the US prices for the latest slow release versions have gone up by a factor of 6 in 12 years. Monthly supply of Lantis in the US - $3300\* Monthly supply of Lantis in the UK - $460\*\* Same drug. Same manufacturer. 9 times the cost. Or to use your example, statins:\*\*\*: “The cost of statins in the US is radically higher than the costs paid for the same brands in the UK, and many more insured Americans are prescribed statins, raising the overall costs in that country [1]. According to Dr Hershel Jick (Boston University School of Medicine, MA) and colleagues, who used 2005 numbers for their analysis, statin costs were as much as 400% higher in the US than in the UK” You have decided to take a politician to task for not being able to properly check their sums, and then done the very same thing yourself. There is no challenge for the US to pay for universal health care. As I’ve pointed out repeatedly, as a nation you are already paying far more, for a lower grade of service. Please would you stop making demonstrably untrue claims (that you would get worse drugs, or somehow a lower cost to the country would increase your deficit) purely because your ideology finds the idea of UHC repugnant. \*[https://www.goodrx.com/blog/why-is-lantus-so-expensive-and-how-can-you-save/](https://www.goodrx.com/blog/why-is-lantus-so-expensive-and-how-can-you-save/) \*\*[http://gmmmg.nhs.uk/docs/cost\_comparison\_charts.pdf](http://gmmmg.nhs.uk/docs/cost_comparison_charts.pdf) \*\*\*[https://www.medscape.com/viewarticle/756771](https://www.medscape.com/viewarticle/756771) ---
**Author:** ![CarnalK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnalk/32/486_2.png) [@CarnalK](https://boards.straightdope.com/u/CarnalK)\ **Post date:** [December 11, 2018, 7:45am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/237 "2018-12-11T07:45:12Z")
I suspect the weed that Shodan is smoking is the “If the U.S. wasn’t paying high prices for these drugs, pharmaceutical R&D would grind to a halt. Therefore the US is subsidizing the rest of the world’s cheaper drugs.” type. ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [December 11, 2018, 1:47pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/238 "2018-12-11T13:47:06Z")
> [@CarnalK](#): > > I suspect the weed that Shodan is smoking is the “If the U.S. wasn’t paying high prices for these drugs, pharmaceutical R&D would grind to a halt. Therefore the US is subsidizing the rest of the world’s cheaper drugs.” type. Perhaps he should try [smoking this article](http://truecostofhealthcare.org/the_pharmaceutical_industry/). According to it, only 17% of the pharmaceutical dollar goes to Research. Larger shares go to ‘Marketing,’ ‘Profit’ and ‘Other.’ (AFAICT truecostofhealthcare is a respected, frequently-cited site.) And, as the article points out, Research is defined broadly. Pay a doctor to prescribe a drug to his patients as part of a s’study’ and the fees paid to doctor are counted as ‘research.’ And of course some of the ‘research’ is to find patentable replacements for nearly-equivalent off-patent drugs. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [December 11, 2018, 2:22pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/239 "2018-12-11T14:22:12Z")
> [@Airbeck](#): > > Dude the entire OP was discredited due to basic misunderstandings of his own cite. Her detractors remind me of haters of a certain other politician as well. Now that that politician is out of the spotlight they need to aim their ire at someone else. No. No it wasn’t. The OP correctly points out a pretty mind numbing error by AOC. Shodan’s error was perhaps misreading a sentence. AOC’s error was having such a lack of familiarity with the budget that she could make a statement like that. She needs to spend a little more time familiarizing herself with the guts of governing, I’m sure she’ll get there. She is going to keep putting her foot in her mouth but ultimately her point is that we can afford medicare for all if we are willing to reduce other spending (or heaven forbid, increase taxes). With that said, I am rooting for her. I particularly liked how she called out the establishment Democrats for letting Wall Street and the Chamber of commerce effectively run their freshman orientation. The cozy relationship between wall street and the democrats should have ended in 2008. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [December 11, 2018, 2:37pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/240 "2018-12-11T14:37:39Z")
> [@Grim\_Render](#): > > The notion that US military spending is bigger than US healthcare spending is actually one I’ve run across several times on forums and social media. It seems to be a natural fit to the narrative that destruction is prioritized by the establishment over social spending. A lot of people simply don’t seem to grok how large US healthcare spending is. Defense spending is more than medicare OR Medicaid but not as large as medicare and medicaid combined. > [@](#): > > I am assuming the 21 T number is over 10 years. It sounds roughly accurate that way. Which does mean that the statement from Vox “_That means 66% of Medicare for All could have been funded already by the Pentagon._” is, strictly speaking, accurate. Sure, I suppose if we got rid of all defense spending we could afford all the nice shit that European countries have like universal health care and free college tuition but SOMEBODY’S got to defend Europe. > [@](#): > > Current Medicare spending is 0,7 T, with current military spending being 0,7 T that is 1,4 T or 66 % of Medicare for all. > > The catch is that to do this, the entire military would have to be decommissioned and shut down, which is very far from being any kind of good thing. But yes, you could get up to 66 % that way. If we reduced our military to the same percentage of our GDP as China, we would save over 300 billion per year. Go back to a Clinton tax regime and you end up with enough money for European style socialism. [Previous page](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514.md?page=11) [Next page](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514.md?page=13)