# 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:** 22
**Author:** ![Dacien](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dacien/32/5663_2.png) [@Dacien](https://boards.straightdope.com/u/Dacien)\ **Post date:** [January 10, 2019, 12:29am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/421 "2019-01-10T00:29:26Z")
All I’m saying is if they ever get around to proposing a tax plan to pay for it sometime soon (an actual, real tax plan that satisfies the revenue requirement), people will balk. America’s not ready. That’s my prognostication. ---
**Author:** ![SlackerInc](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slackerinc/32/275_2.png) [@SlackerInc](https://boards.straightdope.com/u/SlackerInc)\ **Post date:** [January 10, 2019, 12:33am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/422 "2019-01-10T00:33:33Z")
> [@Railer13](#): > > First of all, in the 5 posts since you first brought up this so-called argument, nobody ‘asserted that many other countries have done this’. > > Secondly, as Elvis and Economist have tried to explain to you, the other countries implemented a more economical and efficient system years ago, and thus have never spent as much as the US does on health care. Thus, they’ve never had the exorbitant costs that they need to cut. > > This is a bizarre point you’re trying to make. It’s not a bizarre point at all. And are you really serious, that you haven’t seen all the posts insisting that plenty of other countries have done this? It’s pretty clear that Shodan and I occupy different sectors of the political spectrum. And I haven’t heard him weigh in on what I am proposing: we could probably have a good debate about that. But we agree on the point that we can’t just say “all these other countries have spent decades getting to this point while we have been doing something completely different (and pretty stupid IMO), so now we can just turn on a dime and make our system exactly like theirs”. Think about an area where the U.S. is actually the envy of the world: our postsecondary universities, especially the major research institutions. Do you think Indonesia, or Brazil, or whatever country you want to name, can just decide “okay, we want to have the same thing” and just instantly create it? The many decades of development weren’t really important—you can play “catch up” whenever you want? No. > [@septimus](#): > > So … You’re appointed legislative healthcare czar for the {you-pick-it} Party. What’s your plan? What are the baby steps for the first few years? It would be the Democratic Party, because I am a Democrat. And I already stated it several times upthread: I would push for a universal HDHP/HSA entitlement. People could get supplementary plans from their employers, or buy them themselves. But at the very least, you’d have something that would pay for preventative care and, in the case of a serious injury or illness, would limit your own financial liability to something manageable. If you rack up some medical debt that way, you could pay it off over time via an income-based repayment plan, similar to how direct federal student loans are handled. Ideally I’d also like to end the tax exemption for health plans, but that’s probably not feasible due to the power of the top 20 percent, as I also noted upthread. ---
**Author:** ![Railer13](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/railer13/32/9742_2.png) [@Railer13](https://boards.straightdope.com/u/Railer13)\ **Post date:** [January 10, 2019, 1:10am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/423 "2019-01-10T01:10:10Z")
> [@SlackerInc](#): > > It’s not a bizarre point at all. And are you really serious, that you haven’t seen all the posts insisting that plenty of other countries have done this? I was responding to Shodan asking for proof that other countries have drastically cut healthcare costs. Nobody has ever claimed that. Everybody has stated that under each country’s current system, they pay far less per capita than the US. The point that other countries had expensive health care and then reduced costs is bizarre, because it hasn’t happened that way. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [January 10, 2019, 1:27am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/424 "2019-01-10T01:27:03Z")
Just to note in passing, it isn’t all about money anyway, even though that argument makes itself quite well. It’s also about simple human decency. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [January 10, 2019, 1:28am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/425 "2019-01-10T01:28:44Z")
> [@Dacien](#): > > America’s not ready. That’s my prognostication. You have the Republican propaganda machine to thank for that, to whatever extent it exists (you might want to check the poll numbers). Rather, it seems Pelosi was right in pointing out that when people “find out what’s in it”, they support it. ---
**Author:** ![Snowboarder\_Bo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/snowboarder_bo/32/229_2.png) [@Snowboarder\_Bo](https://boards.straightdope.com/u/Snowboarder_Bo)\ **Post date:** [January 10, 2019, 1:37am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/426 "2019-01-10T01:37:03Z")
> [@Dacien](#): > > All I’m saying is if they ever get around to proposing a tax plan to pay for it sometime soon (an actual, real tax plan that satisfies the revenue requirement), people will balk. America’s not ready. That’s my prognostication. Yeah, but you’re a fucking idiot. ---
**Author:** ![SlackerInc](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slackerinc/32/275_2.png) [@SlackerInc](https://boards.straightdope.com/u/SlackerInc)\ **Post date:** [January 10, 2019, 1:45am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/427 "2019-01-10T01:45:15Z")
> [@Railer13](#): > > The point that other countries had expensive health care and then reduced costs is bizarre, because it hasn’t happened that way. :smack: That was his exact point, and mine: that you can’t put the toothpaste back in the tube. We shouldn’t have foolishly squirted all that toothpaste all over the place all these years, but we did. Now our path is necessarily different from that of a country that has not gotten so much of its GDP tied up in the health care sector. ([https://goo.gl/images/2ddLyG](https://goo.gl/images/2ddLyG)) You think 2008 was bad, try pulling the rug out from under all those companies (and the people in them) who are feeding at this trough. There needs to be a slow weaning process. ---
**Author:** ![asahi](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/asahi/32/8693_2.png) [@asahi](https://boards.straightdope.com/u/asahi)\ **Post date:** [January 10, 2019, 1:49am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/428 "2019-01-10T01:49:46Z")
> [@Snowboarder\_Bo](#): > > Yeah, but you’re a fucking idiot. No, he might be right, Snowboarder. He might be right. It’s all in the timing. Right now? Economy chugging along and unemployment at 3.9%…maybe he’s right. Wait until the house of cards, with our trillion dollar deficits and giveways to the billion dollar class, comes crashing down. We, the middle class, will be expected to pay the bill, just like we did - and we did it without questioning anything - in 2009. There’s going to come a point - it’s inevitable - when we’re going to have to prepare for battle. Peasants will have to strike fear in the hearts of their lords. My prophecies are correct. I guarantee it. ---
**Author:** ![Monty](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/monty/32/47_2.png) [@Monty](https://boards.straightdope.com/u/Monty)\ **Post date:** [January 10, 2019, 2:42am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/429 "2019-01-10T02:42:22Z")
> [@Evil\_Economist](#): > > Your knowledge of the thing you are discussing has reset to zero, Memento-style. Dacien? Nah; more like _Groundhog Day_ style, but without the personal improvement. ---
**Author:** ![Dacien](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dacien/32/5663_2.png) [@Dacien](https://boards.straightdope.com/u/Dacien)\ **Post date:** [January 10, 2019, 3:52am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/430 "2019-01-10T03:52:16Z")
> [@Evil\_Economist](#): > > Your knowledge of the thing you are discussing has reset to zero, Memento-style. Great movie, by the way. In my top three. ---
**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:** [January 10, 2019, 11:10am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/431 "2019-01-10T11:10:53Z")
This argument is at cross-purposes. I think **Dacien** et al understand that _total_ health-care spending could decline, perhaps very steeply, if the U.S. switched to a more rational system, but there would be massive disruption; there’d be financial winners and losers. For example, the health-insurance industry siphons off many scores of billions of dollars annually. Is that where cost savings is to come from? Laying off hundreds of thousands of health insurer employees will be disruptive. Kicking down the profits of insurance companies will be viewed as an act of sabotage against the stock market or people’s 401Ks. Many employers provide insurance for employees; a sudden shift of those funds to higher salaries would be uncertain and disruptive. And obviously taxpayer funding for the uninsured poor would necessitate tax increases on the higher-income brackets. Everyone making more than $X in salary — no, nobody knows the exact value of X — would suffer financially under UHC. Other countries happily accept this as part of the (Christian?) duty of charity. Paradoxically, such charitable instincts are absent in this, the most “Christian” of the developed democracies — our brand of Christianity often disdains love and instead teaches hatreds, esp. for government. > [@SlackerInc](#): > > :smack: That was his exact point, and mine: that you can’t put the toothpaste back in the tube. We shouldn’t have foolishly squirted all that toothpaste all over the place all these years, but we did. Now our path is necessarily different from that of a country that has not gotten so much of its GDP tied up in the health care sector. ([https://goo.gl/images/2ddLyG](https://goo.gl/images/2ddLyG)) You think 2008 was bad, try pulling the rug out from under all those companies (and the people in them) who are feeding at this trough. There needs to be a slow weaning process. I asked **SlackerInc** for details but AFAIK he hasn’t replied to me. Those who’ve studied the topic more than we have agreed that ACA was the best first step in the gradual way forward. But the hatreds and stupidities are so rampant in the U.S.A. that even ACA is being sabotaged. Recall that ACA was almost designed by the Republican Party! Is the best step now to re-install ACA but to rename it Trumpcare so the haters can stop hating it? ---
**Author:** ![Gyrate](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gyrate/32/3588_2.png) [@Gyrate](https://boards.straightdope.com/u/Gyrate)\ **Post date:** [January 10, 2019, 11:55am UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/432 "2019-01-10T11:55:24Z")
> [@Dacien](#): > > All I’m saying is if they ever get around to proposing a tax plan to pay for it sometime soon (an actual, real tax plan that satisfies the revenue requirement), people will balk. America’s not ready. That’s my prognostication. But that’s a presentation issue, not a financial one. And the combination of saving a considerable amount of money, removing an enormous amount of paperwork and generally not having to worry about access to healthcare overall is a big selling point. I live in the UK, I’m solidly middle class and got my tax statement yesterday. Turns out I pay about 8.8% of my annual income for “National Insurance” (and overall I pay about 27% of my income in tax including NI), and my employer kicks in a like amount. But in return that covers _everything_ - GP visits, emergency room and other hospital stays, consultants, mental health, subsidies for medicines (prescriptions in England are currently £8.80 per prescription - _any_ prescription) and assorted other medical services. No out-of-pocket fees (apart from the £8.80), no eligibility requirements, no extensive insurance paperwork, and treatment only refused in highly extreme cases. Some years I’ve used the NHS a lot, some years I’ve barely used it at all, but overall I’m getting a freaking bargain here. Once (if ever) we get past the first hurdle of getting people to understand that UHC will not lead to Soviet Union-style breadlines, there are indeed significant obstacles to getting from where the US is now to where it needs to be. Nye Bevan’s comment about having to stuff the mouths of hospital consultants with gold to bring them around is a likely harbinger of how difficult it would be to get the US, which is both far more entrenched in its ways and with far more money sloshing around than 1940’s Britain, to change. But as we can’t even get over the first hurdle it remains an academic exercise. ---
**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:** [January 10, 2019, 1:31pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/433 "2019-01-10T13:31:43Z")
> [@septimus](#): > > obviously taxpayer funding for the uninsured poor would necessitate tax increases on the higher-income brackets. 2/3 of the cost of your current system is already raised via taxes - > **[The Current and Projected Taxpayer Shares of US Health Costs](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4880216/)** > > Objectives. We estimated taxpayers’ current and projected share of US health expenditures, including government payments for public employees’ health benefits as well as tax subsidies to private health spending.Methods. We tabulated official ... You do not need to raise taxes. You just need to use these massive chunks of revenue in a vaguely sensible manner, using the sheer market power that a single purchaser has to enforce consistent and reasonable prices and achieve scale savings. Then, if people are still concerned that the wait for non-essential treatment might be too long, you can use the money you’re currently obliged to use for insurance to buy a skip the queue policy (which tend to be a a lot cheaper, when an insurer knows they’re not going to be on the hook for medication for chronic ailments, etc) just to make sure you can still feel superior to poor people…which seems to be a primary concern for the US health system. So, no new taxes, overall lower costs, everyone whose ill gets treatment, and you can still lord it over the unwashed should you so wish. ---
**Author:** ![SlackerInc](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slackerinc/32/275_2.png) [@SlackerInc](https://boards.straightdope.com/u/SlackerInc)\ **Post date:** [January 10, 2019, 1:37pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/434 "2019-01-10T13:37:38Z")
> [@Gyrate](#): > > But that’s a presentation issue, not a financial one. And the combination of saving a considerable amount of money, removing an enormous amount of paperwork and generally not having to worry about access to healthcare overall is a big selling point. The problem is that people aren’t going to believe promises like that even if they might turn out to be true. As much as I generally stick up for Obama, and I still feel he was one of the best presidents in American history, he kind of screwed the pooch with his “you can keep your health plan” promises. This is not a right wing talking point: the Pulitzer Prize-winning Politifact rated this promise the Lie of the Year in 2013 ([PolitiFact | Lie of the Year: 'If you like your health care plan, you can keep it'](https://www.politifact.com/truth-o-meter/article/2013/dec/12/lie-year-if-you-like-your-health-care-plan-keep-it/)). So people are going to be understandably wary of promises that a subsequent and much more radical change to the health system will be win-win. Something I haven’t seen addressed here is the question of supply. The randomized Oregon experiment showed that people who get Medicaid after previously being uninsured use significantly more medical services than they did before. How do we add tens of millions of patients to the system while simultaneously slashing payments to doctors, hospitals, clinics, and medical technology firms? Thinking of doctors in particular, we’ll need an influx of new doctors to meet demand. How’s that going to happen at the same time we’re saying they need to take a big pay cut? Isn’t that going to reduce, rather than increase, the number of people who choose to go to medical school instead of getting an MBA or an engineering or law degree? OTOH, if we find that it’s just untenable to try to radically “bend the cost curve” to make it like other countries, then the cost of single payer will be far greater than the optimistic estimates, which will then necessitate a much bigger hike in taxes to pay for it. > [@septimus](#): > > This argument is at cross-purposes. I think **Dacien** et al understand that _total_ health-care spending could decline, perhaps very steeply, if the U.S. switched to a more rational system, but there would be massive disruption; there’d be financial winners and losers. > > For example, the health-insurance industry siphons off many scores of billions of dollars annually. Is that where cost savings is to come from? Laying off hundreds of thousands of health insurer employees will be disruptive. Kicking down the profits of insurance companies will be viewed as an act of sabotage against the stock market or people’s 401Ks. Many employers provide insurance for employees; a sudden shift of those funds to higher salaries would be uncertain and disruptive. > > And obviously taxpayer funding for the uninsured poor would necessitate tax increases on the higher-income brackets. Everyone making more than $X in salary — no, nobody knows the exact value of X — would suffer financially under UHC. Other countries happily accept this as part of the (Christian?) duty of charity. Paradoxically, such charitable instincts are absent in this, the most “Christian” of the developed democracies — our brand of Christianity often disdains love and instead teaches hatreds, esp. for government. > > I asked **SlackerInc** for details but AFAIK he hasn’t replied to me. Say what? I didn’t intentionally avoid answering anything. What details? I agree with the rest of what you said there, BTW. ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [January 10, 2019, 1:57pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/435 "2019-01-10T13:57:46Z")
> [@Railer13](#): > > I was responding to Shodan asking for proof that other countries have drastically cut healthcare costs. Nobody has ever claimed that. Everybody has stated that under each country’s current system, they pay far less per capita than the US. > > The point that other countries had expensive health care and then reduced costs is bizarre, because it hasn’t happened that way. As **SlackerInc** mentions, that’s the point. The claim is that if the US implements single payer/UHC, we will reduce costs substantially, and no other country has ever done that. > [@Airbeck](#): > > Shodan, why is America so hapless? Why are we unable to do something that has already been done to great success in many other countries. America is being asked to do something that has never been done with any success in any country - namely, cut health care spending very substantially. > [@CarnalK](#): > > I’ve joked that you seem to be drunk on Liberal tears but I’m now starting to wonder if you’re just drunk. > > Politicians who don’t want universal care have to make obtuse arguments about the costs to argue against it. You don’t. No one is voting for you, so you don’t have to pretend the current system is more cost efficient. Why not just admit you don’t want people getting free healthcare because it offends your capitalist sensibilities? Is it your argument that, if the US implements M4A/UHC/single payer, that the US will be able to reduce health care costs and save money? If so, can you cite an example of another country that implemented single payer/UHC/M4A or its equivalent, and reduced health care costs to less than what they were before they implemented single payer/UHC? If it’s not your argument that M4A will reduce costs, then fine. But “it won’t save us any money” isn’t an obtuse argument. Regards, Shodan ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [January 10, 2019, 2:12pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/436 "2019-01-10T14:12:45Z")
> [@Gary\_Kumquat](#): > > 2/3 of the cost of your current system is already raised via taxes - > [The Current and Projected Taxpayer Shares of US Health Costs - PMC](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4880216/) > > You do not need to raise taxes. According to the report, a doubling of the personal and corporate federal income tax would not cover the increased cost, even if [ol][li]We make dramatic cuts to payments to health care providers [_]We dramatically cut drug prices [_]We include in our calculation any projected savings on administrative costs, and [\*]We assume that there is no increased utilization of the health care system by the newly covered.[/ol]Keeping in mind that acute care hospitals currently lose money on something like [three quarters of their Medicare patients](https://hbr.org/2017/11/5-ways-u-s-hospitals-can-respond-to-medicares-mounting-costs). So if we implement M4A, either we raise taxes, cut spending, or that three-quarters approaches 100%.[/li] Regards, Shodan ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [January 10, 2019, 2:50pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/437 "2019-01-10T14:50:59Z")
> [@Shodan](#): > > Keeping in mind that acute care hospitals currently lose money on something like [three quarters of their Medicare patients](https://hbr.org/2017/11/5-ways-u-s-hospitals-can-respond-to-medicares-mounting-costs). You complain that Medicare doesn’t spend enough money because of those poor, poor struggling doctors and hospitals… then in the next breath talk you will surely blather on about how Medicare costs too much and we should cut it. How about you determine how much Medicare should pay doctors, and we’ll adjust taxes to pay those bills? ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [January 10, 2019, 2:53pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/438 "2019-01-10T14:53:59Z")
> [@Shodan](#): > > As **SlackerInc** mentions, that’s the point. The claim is that if the US implements single payer/UHC, we will reduce costs substantially, and no other country has ever done that. What other countries do you suggest we compare ourselves to as a data point? As already explained, any others you might list did it generations ago and wouldn’t consider going back. Your claim that no other country has been shown to reduce costs by implementing the change is disingenuous - you might as well say no other country has increased them, either. > [@](#): > > But “it won’t save us any money” isn’t an obtuse argument. > > Regards, > Shodan Given the complete lack of substantiation for it, yes, it is. ---
**Author:** ![SlackerInc](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slackerinc/32/275_2.png) [@SlackerInc](https://boards.straightdope.com/u/SlackerInc)\ **Post date:** [January 10, 2019, 3:19pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/439 "2019-01-10T15:19:19Z")
> [@ElvisL1ves](#): > > What other countries do you suggest we compare ourselves to as a data point? As already explained, any others you might list did it generations ago and wouldn’t consider going back. Your claim that no other country has been shown to reduce costs by implementing the change is disingenuous - you might as well say no other country has increased them, either. What’s disingenuous is to take statistics from countries who adopted UHC long before expensive modern medicine developed anywhere, and say “look: we just have to swtitch to their system, and our costs wil be just like theirs”. We have no evidence that we can simply put the toothpaste back in the tube. If you want to say that skeptics don’t know what will happen either, that’s entirely fair. But for anyone who is reasonably satisfied with the status quo for their own health care, “we don’t know what will happen, but we want to try it and find out” is not enticing. (Yes, that’s selfish. Welcome to politics in America. Complaining about it isn’t going to change it or do any good for anyone.) So on the pro-MFA side, there are surely many people who haven’t fully thought it through and don’t realize that you can’t just Xerox another country’s health system without having a major plan for the transition. But I think there are others who do understand this, but also understand that voters will balk if they are really frank about the difficulties that may arise in a transition. These people believe (with justification) that the end result will be more just. So they are willing to be disingenuous, just as Obama was, to try to push it through, and then plan to deal with any backlash when the time comes and hopefully the die is cast. But that’s a very dangerous game to play. ---
**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:** [January 10, 2019, 3:27pm UTC](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514/440 "2019-01-10T15:27:41Z")
> [@Shodan](#): > > Keeping in mind that acute care hospitals currently lose money on something like [three quarters of their Medicare patients](https://hbr.org/2017/11/5-ways-u-s-hospitals-can-respond-to-medicares-mounting-costs). You know, constantly pointing out the failings in the current US healthcare market is not a good reason against changing it. You might want to ask yourself why hospitals in countries with state insurance schemes, such as France, manage to make it work and still achieve higher care rankings than the US. You might want to ask why pharmaceutical companies in the US routinely charge 2 - 3 times what they do in other countries, for starters [Previous page](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514.md?page=21) [Next page](https://boards.straightdope.com/t/ms-ocasio-cortez-on-how-to-pay-for-medicare-for-all/825514.md?page=23)