# The dangerous politics of Medicare For All **URL:** \ **Category:** Politics & Elections\ **Created:** [July 31, 2019, 11:19am UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922 "2019-07-31T11:19:12Z")\ **Posts on this page:** 20\ **Page:** 11
**Author:** ![Muffin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/muffin/32/4341_2.png) [@Muffin](https://boards.straightdope.com/u/Muffin)\ **Post date:** [August 26, 2019, 5:36pm UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/201 "2019-08-26T17:36:58Z")
> [@survinga](#): > > People with private health insurance have better outcomes in the US than people who are uninsured or people with Medicaid. Studies have shown this ad nauseum. Then insure every single person in top tier private health care entirely paid for out of the government’s pocket. But of course you will not do that. Instead you will simply let people suffer and die for lack of top health care. ---
**Author:** ![Muffin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/muffin/32/4341_2.png) [@Muffin](https://boards.straightdope.com/u/Muffin)\ **Post date:** [August 26, 2019, 6:23pm UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/202 "2019-08-26T18:23:09Z")
> [@SlackerInc](#): > > Selfish, stupid, whatever you want to say: their vote counts just as much regardless. And if you follow American politics at all, you should not be surprised that it is not the most rationally presented, wonky argument that wins out. That’s where proponents of single payor health care need to spread the gospel on how people will live longer and live in a healthier condition longer (as pointed out by wolfpup up thread), while paying less for it out of their own pockets and less for it through their tax dollars, while being entirely free to go to which ever doctor or doctors that they chose. For the most part, Americans are big on belief, such as belief in god, guns and anti-socialism. Deeply held beliefs tend to be impervious to fact and reason. Change will be generational. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [August 26, 2019, 6:55pm UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/203 "2019-08-26T18:55:54Z")
> [@wolfpup](#): > > … In fact you yourself seemed to be buying in to some of this by citing how well Medicare Advantage works with the aid of private insurers, when the fact is that MA works just because capitation and outcome-based management are good ideas, and the insurers are strictly held in line by their contractual obligations … Perhaps I did not make myself clear if that was your takeaway. The point was that those good ideas can and do work in an environment that uses insurance companies. Those good ideas are perhaps even more important than whether or not the system is single payer or a competitive marketplace. And I’d quibble with a can’t get there assessment. I think public option will demonstrate its superiority and the move to single payer will be inexorable. But not overnight and gradually enough that many of the job losses will be by attrition. And by proving itself first. But glad to see that agree on the current practical politics of it. ---
**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\ **Post date:** [August 27, 2019, 12:05am UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/204 "2019-08-27T00:05:10Z")
> [@Muffin](#): > > Then insure every single person in top tier private health care entirely paid for out of the government’s pocket. > > But of course you will not do that. Instead you will simply let people suffer and die for lack of top health care. I’m all for increasing the level of subsidies in the exchanges, and for letting people with good employer coverage (that they overwhelmingly like) keep it. I’m also for expanding Medicaid, even though it’s not as good as private, because Medicaid offers a good way out for people who are uninsured. That’s not letting people “suffer and die”, and you’re misrepresenting what I’m saying. ---
**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\ **Post date:** [August 27, 2019, 12:16am UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/205 "2019-08-27T00:16:21Z")
> [@wolfpup](#): > > 1. Re: insured vs uninsured outcomes: so you’re surprised that having access to health care results in better outcomes than not having access to health care. Duly noted, but most of us aren’t surprised by the bleeding obvious. > > 2. Re: insurance vs Medicaid: so you’re surprised that funding top-tier ongoing health care including preventative services results in better outcomes than the care from an artificially limited substandard tier, the patients of which have typically had spotty to non-existent health care for much of their lives due to poverty. Duly noted, but again, most of us aren’t surprised at all. > > 3. Re: all of the above, including the claim that “children in Southern California have better access to care if they have private insurance vs government-funded insurance”: be prepared to be surprised again, because residents of Canada on average [live longer healthier lives than Americans](https://www.reuters.com/article/us-health/canadians-live-longer-healthier-than-americans-study-idUSTRE63R6B520100429) despite living under the yoke of evil “government-funded insurance”! In point of serious fact, better health outcomes in Canada are largely _ **because of** _ a lifetime of guaranteed access to health care with no monetary obstacles to such access. The same results generally hold for most European countries, too. > > I have no doubt that you “can post these kinds of studies day and night” but without the proper comparative context your implied conclusions are worthless. Well, Bernie and Warren want a plan that has no co-pays and deductibles and no premiums, but pays much less than Private. It sounds an awful lot like Medicaid for All, even though it’s named (incorrectly) “Medicare for All”. And in this election environment, I think we need to point out that private insurance in the US is superior in outcomes to Medicaid, hence my links, which are just a few among many. This is not worthless. This is true. And the reason I originally posted that is Muffin’s point about private insurance burning money for no good cause, which flies in the face of the superior outcomes in the US for people with private insurance. You can call it worthless, but that’s just nonsense. Americans need health insurance, not self-righteous points that attack what the majority of us have, who like what we have, who are doing better than those that don’t have it. ---
**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\ **Post date:** [August 27, 2019, 12:30am UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/206 "2019-08-27T00:30:05Z")
> [@CarnalK](#): > > Well, get back to me when you do. People actually providing care are unlikely to lose their jobs so that number means nothing without knowing the breakdown. How do you know people who provide care are unlikely to lose their jobs? And how do you know healthcare employment numbers mean nothing? And how do you know that no one will care if an entire industry is wiped out by Sanders/Warren version of M4A? I think in the political campaigns, this will be far more problematic than you will admit. This Kaiser link says that 2 million jobs could get killed, even though it says, “that’s OK”… [Analysis: A Health Care Overhaul Could Kill 2 Million Jobs, And That’s OK - KFF Health News](https://khn.org/news/analysis-a-health-care-overhaul-could-kill-2-million-jobs-and-thats-ok/) Let’s see how that holds up in an election against Republicans, and in the face of a country where 80% of Americans like their own healthcare, and 70% like their own insurance. ---
**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\ **Post date:** [August 27, 2019, 12:35am UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/207 "2019-08-27T00:35:07Z")
> [@CarnalK](#): > > People with insurance have better outcomes than people without insurance. I stand amazed. …and better than people with Medicaid… ---
**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\ **Post date:** [August 27, 2019, 12:39am UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/208 "2019-08-27T00:39:30Z")
> [@wolfpup](#): > > I’m not lamenting the fact that they’re selfish, I’m lamenting the fact that they’re stupid Those kinds of attacks generally don’t work in politics, and aren’t persuasive. Attacking voters or attacking people who don’t agree with you… I sure hope the Dems don’t do that in 2020, as it sort of reminds me of Hillary’s Deplorables comment. Didn’t work out for her at all - even though I voted for her - and it won’t work in 2020 either. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [August 27, 2019, 1:02am UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/209 "2019-08-27T01:02:15Z")
**survinga** , no, Medicaid for All would also not be at all apt and making a compare and contrast with private insurance is specious at best. [Here](https://www.kff.org/medicaid/issue-brief/10-things-to-know-about-medicaid-setting-the-facts-straight/) are some facts. 1. Medi_care_ is administered by contracted private plans now for about a third of all enrollees; Medic_aid_ is up to about two thirds, using risk-based models. This is not the model of the proposal. 2. Medicaid is not a universal program taken by all providers. _Many_ providers refuse to play in the space. Access to care, even to basic primary care services, is sometimes so poor as to be as unto nonexistent. Hellavu lot better than no insurance but still an issue. The Canadian-style system proposed would not have that problem. Provider access (referral for specialty care required) would be better in the proposed Canadian-style system that under the current American private insurance model. 3. Medicaid specifically takes care of population inherently different from the general pool. Poor, with all the structural challenges associated with poverty, but also sicker. It provides > [@](#): > > … health and long-term care for millions of America’s poorest and most vulnerable people, acting as a high risk pool for the private insurance market. … 83% of poor children; 48% of children with special health care needs and 45% of nonelderly adults with disabilities (such as physical disabilities, developmental disabilities such as autism, traumatic brain injury, serious mental illness, and Alzheimer’s disease); and more than six in ten nursing home residents … To be fair Medicaid as a plan performs _amazingly_ well given its role as a high risk pool buffer taking care of very vulnerable patients not infrequently with disabilities and complex chronic illnesses who often have very limited resources. But it usually pays crap for the work involved and many I know will only participate as a function of civic responsibility, and then only if they can limit their panel size, as they often effectively lose money in the process. Really though, what is proposed is a Canadian-style system for All. Not Medicare for All, not Medicaid for all, at all. ---
**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\ **Post date:** [August 27, 2019, 1:27am UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/210 "2019-08-27T01:27:49Z")
> [@DSeid](#): > > **survinga** , no, Medicaid for All would also not be at all apt and making a compare and contrast with private insurance is specious at best. > > [Here](https://www.kff.org/medicaid/issue-brief/10-things-to-know-about-medicaid-setting-the-facts-straight/) are some facts. > > 1. Medi_care_ is administered by contracted private plans now for about a third of all enrollees; Medic_aid_ is up to about two thirds, using risk-based models. This is not the model of the proposal. > > 2. Medicaid is not a universal program taken by all providers. _Many_ providers refuse to play in the space. Access to care, even to basic primary care services, is sometimes so poor as to be as unto nonexistent. Hellavu lot better than no insurance but still an issue. The Canadian-style system proposed would not have that problem. Provider access (referral for specialty care required) would be better in the proposed Canadian-style system that under the current American private insurance model. > > 3. Medicaid specifically takes care of population inherently different from the general pool. Poor, with all the structural challenges associated with poverty, but also sicker. It provides > > To be fair Medicaid as a plan performs _amazingly_ well given its role as a high risk pool buffer taking care of very vulnerable patients not infrequently with disabilities and complex chronic illnesses who often have very limited resources. But it usually pays crap for the work involved and many I know will only participate as a function of civic responsibility, and then only if they can limit their panel size, as they often effectively lose money in the process. > > Really though, what is proposed is a Canadian-style system for All. Not Medicare for All, not Medicaid for all, at all. Look, I know that Sanders plan isn’t Medicaid or Medicare for All. I was just taking his comments about no premiums, deductibles, co-pays, and lower reimbursement into account in my post. I’m not against Medicaid, by the way. Many doctors don’t take it. I know people in my extended family who have Medicaid, and they are limited in the doctors that will see them or treat them. But I know that it’s helped millions of people, and I wish the rest of the red states in the US would finally accept the Medicaid expansion. But in this country, the best outcomes are associated with private insurance. I think that should be pointed out to people who post wtte that private insurance is a waste that burns money while people die, etc. In this country, the best path to UHC is to expand on what we have - which does include more government involvement - instead of throwing it out, and completely replacing it with something very different. ---
**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\ **Post date:** [August 27, 2019, 9:32am UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/211 "2019-08-27T09:32:19Z")
> [@survinga](#): > > Well, Bernie and Warren want a plan that has no co-pays and deductibles and no premiums, but pays much less than Private. It sounds an awful lot like Medicaid for All, even though it’s named (incorrectly) “Medicare for All”. It also sounds _ **exactly** _ like the foundational principles of health care in Canada, which is Bernie’s point. It also sounds very much like UHC in most of the civilized world, which is also Bernie’s point, except for the minor aspect that in many systems there is a nominal co-pay. That part is just an implementation detail – the important thing is that public UHC systems eliminate the interference and gross inefficiencies of a useless middleman trying to profit by mediating access to something that is a basic human right. > [@survinga](#): > > And in this election environment, I think we need to point out that private insurance in the US is superior in outcomes to Medicaid, hence my links, which are just a few among many. This is not worthless. This is true. Well, pointing that out is certainly a job that you’re trying to do, and Republicans along with the lobbyists at America’s Health Insurance Plans™ thank you. But you’re wrong, for the reasons I itemized, which you’ve chosen to just ignore so you can plow ahead with the same talking points again and again. Private insurance is definitely the best thing to have in the US at this time, but only because that’s how skewed and broken the system has become: all forms of public insurance are relegated to being a second-rate poor cousin, and that’s by design. _ **That’s not how it is in other countries, where that is NOT the design** _. You can go ahead and ignore that, too. > [@survinga](#): > > Americans need health insurance, not self-righteous points that attack what the majority of us have, who like what we have, who are doing better than those that don’t have it. No, in the final analysis Americans don’t “need” health insurance, Americans need _ **health care** _. If you confuse the unnecessary and meddlesome middleman with the final product, then the next step is to argue that if Americans “need” health insurance, then what better way to provide a wide variety of “choice” than through the wonderful mechanism of the “competitive free market”? Those words would warm the heart of any free-market ideologue, and certainly bring in donations from the health insurers and their lobbyists. But as other countries have discovered – and they discovered this a long time ago – what people actually need is unimpeded and guaranteed access to health care. The irony of it all, of course, is that in the name of “choice” and free-market “competition”, Americans actually have far less choice in the real end product – actual health care – than the people of other advanced nations, because access to actual health care in America is controlled by health insurers and limited by their fiduciary duty to minimize claims, control medical payouts, and herding patients into their own provider networks. As I’ve often said, quoting the late health care economist Uwe Reinhardt, physicians in other countries would be horrified at the degree to which American health insurers meddle between patients and their caregivers. How can anyone “need” health insurance when I’ve never had health insurance in my life, and that’s just the way I and all my fellow citizens like it? I simply have lifetime access to any needed health care from any provider at any time, at no cost to me. > [@survinga](#): > > Those kinds of attacks generally don’t work in politics, and aren’t persuasive. Attacking voters or attacking people who don’t agree with you… I sure hope the Dems don’t do that in 2020, as it sort of reminds me of Hillary’s Deplorables comment. Didn’t work out for her at all - even though I voted for her - and it won’t work in 2020 either. Good thing I’m not a politician running for office. ---
**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:** [August 27, 2019, 11:02am UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/212 "2019-08-27T11:02:50Z")
Abruptly abolishing private health insurance in the early 2020s is a stupid idea, whether viewed as a matter of policy, or as a matter of electability. And Elizabeth Warren is anything but a stupid person. We bought into Obamacare as the first step in a _gradual_ process: increase subsidies, impose patient-friendly rules, add a public option; the problems of private health insurance would gradually wither away. I hope Elizabeth Warren clarifies that her plan is something along those lines. Instead of “Medicare for All” I propose “VA Healthcare for Some”! Contrary to right-wing propaganda, the VA provides good health care efficiently for 9 million-plus people. How hard would it be for VA to serve 10 million-plus? With the extra million being ordinary people who volunteer to hire the VA as their insurer, at a price set by VA to make a profit. It might be impractical to expand VA Healthcare to serve a large portion of the population, but if it served a few million it could provide a useful comparison on services and prices charged by the private sector. ---
**Author:** ![Ludovic](https://avatars.discourse-cdn.com/v4/letter/l/7ab992/32.png) [@Ludovic](https://boards.straightdope.com/u/Ludovic)\ **Post date:** [August 27, 2019, 1:35pm UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/213 "2019-08-27T13:35:01Z")
> [@wolfpup](#): > > The irony of it all, of course, is that in the name of “choice” and free-market “competition”, Americans actually have far less choice in the real end product – actual health care – than the people of other advanced nations, because access to actual health care in America is controlled by health insurers and limited by their fiduciary duty to minimize claims, control medical payouts, and herding patients into their own provider networks. And furthermore, the free market is efficient when people make informed decisions based on an analysis of the costs and benefits. The costs for health care are completely opaque, whether with insurance or not, and ironically, the system for government-run health care is more transparent. ---
**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\ **Post date:** [August 27, 2019, 9:04pm UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/214 "2019-08-27T21:04:35Z")
> [@wolfpup](#): > > No, in the final analysis Americans don’t “need” health insurance, Americans need _ **health care** _. If you confuse the unnecessary and meddlesome middleman with the final product, then the next step is to argue that if Americans “need” health insurance, then what better way to provide a wide variety of “choice” than through the wonderful mechanism of the “competitive free market”? Those words would warm the heart of any free-market ideologue, and certainly bring in donations from the health insurers and their lobbyists. But as other countries have discovered – and they discovered this a long time ago – what people actually need is unimpeded and guaranteed access to health care. In terms of health outcomes, insured Americans and Canadians are very similar. [https://www.healthaffairs.org/doi/full/10.1377/hlthaff.25.4.1133](https://www.healthaffairs.org/doi/full/10.1377/hlthaff.25.4.1133) Our main problem is people who aren’t insured. If we could get them signed up via Medicaid, that would be good. If we could subsidize a private policy for them, even better… ---
**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:** [August 27, 2019, 10:43pm UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/215 "2019-08-27T22:43:43Z")
> [@survinga](#): > > Our main problem is people who aren’t insured. If we could get them signed up via Medicaid, that would be good. If we could subsidize a private policy for them, even better… If you ignore costs and knew these private policies wouldn’t require substantial personal costs for healthcare, yes. But those are respectively wrong and unlikely assumptions. To put this thread back on track, the unlikelihood of private insurance not being a bankruptcy trap houkd be emphasized. The “pencil pushing middleman” should be emphasized as the major source of job losses, regardless of how precisely accurate that is. ---
**Author:** ![Muffin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/muffin/32/4341_2.png) [@Muffin](https://boards.straightdope.com/u/Muffin)\ **Post date:** [August 27, 2019, 11:43pm UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/216 "2019-08-27T23:43:26Z")
“Higher levels of inequality” in the USA? Here’s how to solve it: Put everyone, rich or poor, of every ethnic group and geographic location, into the same pool with the same medical resources and the same access to those resources. ---
**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:** [August 28, 2019, 12:39am UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/217 "2019-08-28T00:39:03Z")
H > [@Muffin](#): > > “Higher levels of inequality” in the USA? Here’s how to solve it: > > Put everyone, rich or poor, of every ethnic group and geographic location, into the same pool with the same medical resources and the same access to those resources. Wtf is wrong with you and wolfpup? Why the hell do you think this is an “argue how awesome UHC is” thread? ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [August 28, 2019, 12:41am UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/218 "2019-08-28T00:41:03Z")
> [@CarnalK](#): > > If you ignore costs and knew these private policies wouldn’t require substantial personal costs for healthcare, yes. But those are respectively wrong and unlikely assumptions. To put this thread back on track, the unlikelihood of private insurance not being a bankruptcy trap houkd be emphasized. The “pencil pushing middleman” should be emphasized as the major source of job losses, regardless of how precisely accurate that is. IOW you propose lying? To the first part … as has been pointed out in this thread already to very significant degrees current Medicare and more so current Medicaid are in fact functionally subsidized “private policies” in which the terms of the policy coverage are standardized and very explicitly laid out by the government. They (because of the specifics of those terms) are delivering on costs and quality, value, over what the FFS model administered by government itself does. **wolfpup** , you really had a point that the Canadian model has been the victim of disinformation in the United States. It is a shame that you couple that with so many falsehoods about the American one. Your doing that really weakens your position tremendously. ---
**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\ **Post date:** [August 28, 2019, 1:35am UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/219 "2019-08-28T01:35:21Z")
> [@CarnalK](#): > > To put this thread back on track, the unlikelihood of private insurance not being a bankruptcy trap houkd be emphasized. I guess a candidate could emphasize that, and get plenty of attaboys from the Sanders wing. The problem is that the number of “medical bankruptcies” is GREATLY exaggerated, and that private insurance is in fact not a bankruptcy trap. > **[Myth and Measurement: The Case of Medical Bankruptcies](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865642/)** “_We calculated this estimate as follows: the graph shows that, on average, a hospitalization increases the annual probability of going bankrupt in the following 4 years by 0.004. Multiplying this figure by the annual hospitalization rate of 7.8% for our population (which we calculated using the 1999–2010 Medical Expenditure Panel Survey) reveals that 0.031% (0.004 × 7.8%) of the population goes bankrupt each year as the result of a hospitalization. Given that the annual household bankruptcy rate is 0.8% among the nonelderly,4 **hospitalizations cause about 4% (0.031/0.8) of bankruptcies among nonelderly adults**. A similar calculation for a subsample of uninsured adults reveals that even in that population, hospitalizations are responsible for only 6% of bankruptcies4; for this population, the effect of a hospitalization on the likelihood of bankruptcy is (not surprisingly) larger, but the hospitalization rate is lower than in the overall nonelderly population._” So, while I agree that the prescribed talking point would probably be a popular talking point in a primary, it will be shredded in an election where everyone isn’t trying to “out-Bernie” each other on healthcare. ---
**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:** [August 28, 2019, 4:16am UTC](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922/220 "2019-08-28T04:16:58Z")
Right. When I first heard Bernie talking about medical bankruptcies, I actually naïvely believed that he meant cases where people had a car accident or serious illness that bankrupted them all by itself. But the reality is that he counts every case where someone declared bankruptcy and listed medical bills as one of the many things on the pile of debt. That’s not honest. > [@Muffin](#): > > Then insure every single person in top tier private health care entirely paid for out of the government’s pocket. > > But of course you will not do that. Instead you will simply let people suffer and die for lack of top health care. Whoa, talk about fallacy of the excluded middle! How about giving poor and low income people health plans that are much better than what they have now, but not quite as good as the coverage a wealthy or upper-middle-class person has? > [@Ludovic](#): > > And furthermore, the free market is efficient when people make informed decisions based on an analysis of the costs and benefits. The costs for health care are completely opaque, whether with insurance or not, and ironically, the system for government-run health care is more transparent. Yes, and if we were having that wonky policy debate, I would make a strong pitch for my preference, which is an entitlement of an HDHP/HSA plan along with transparent medical pricing and consumer choice. But no politician is proposing that, and furthermore people probably wouldn’t like it very well. The dislike is actually a necessary component, because the idea is to get people to “bend the cost curve” by shopping around and fretting a bit over their healthcare costs, but without being vulnerable to a massive financial wipeout. Therefore it is sadly a political nonstarter. > [@survinga](#): > > In terms of health outcomes, insured Americans and Canadians are very similar. > > [https://www.healthaffairs.org/doi/full/10.1377/hlthaff.25.4.1133](https://www.healthaffairs.org/doi/full/10.1377/hlthaff.25.4.1133) > > Our main problem is people who aren’t insured. If we could get them signed up via Medicaid, that would be good. If we could subsidize a private policy for them, even better… Nice. Notice that in that study, Canadians in the fourth and fifth quintiles, 40% of the population, were slightly _more_ likely to have an unmet healthcare need than were comparable Americans. That’s the group I have been talking about, who cannot lose even an iota of the health coverage they have now or they will freak out. And they vote and contribute to candidates in huge numbers. > [@Muffin](#): > > Put everyone, rich or poor, of every ethnic group and geographic location, into the same pool with the same medical resources and the same access to those resources. _ **SlackerInc** rings in first, and Alex Trebek calls on him:_ “How do you get wealthy and upper middle class people to freak out and ensure a GOP landslide in the next election?” > [@DSeid](#): > > So you think American voters are stupid. Well, looking at who our president is that is a hard thesis to argue against. LOL, sad but true. :smack: > [@DSeid](#): > > _Politically_ the GOP has weakness on healthcare with the unforced error of continuing to try to repeal the ACA. The ACA in fact has delivered quite a lot. Politically a Democratic candidate should be leveraging that GOP weakness, not arguing that they agree the ACA is so horrible that it should be scrapped and replaced. Politically you leverage their weakness by pointing out how many of the current issues with the ACA are a result of intentional GOP kneecapping trying to sabotage it with voters’ healthcare problems as cynical political civilian casualties. Politically you remind voters that the ACA was a compromise that could pass at the time and that it should be improved upon with specific ideas of how … ideas that are less disruptive and ones that allow them to have choices about it. This, 1,000%. > [@wolfpup](#): > > I do believe that Democrats should put forward a cautious transitionary approach mainly built around introducing a public option to the ACA. I understand that people are fearful of revolutionary changes, and I think Sanders’ all-or-nothing proposal that would ban private insurance is a serious mistake. Well, blow me down! We do agree. Now please tell this to the millions of people supporting Sanders and Warren. [Previous page](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922.md?page=10) [Next page](https://boards.straightdope.com/t/the-dangerous-politics-of-medicare-for-all/837922.md?page=12)