I don’t disagree with any of this, but even if mandatory, government-funded universal healthcare is the best way forward (a point many would debate) that doesn’t mean it’s a good 2020 campaign promise.
Right or wrong, a majority of Americans are OK with private health insurance. Promising to abolish it sounds like the kind of socialist-style overreach that will scare many undecided voters, and it plays right into the GOP’s storyline: elect Democrats, and the US becomes the next Venezuela.
Talk about a transition. Talk about competition between Medicare and private insurance. But talk about a ban on private insurance and we’ll be stuck with the same system for another generation.
I thought Republicans were more susceptible to fear mongering and propaganda from Trump than Democrats, but I guess if we take Trump at his word, then we deserve what we get.
Yes, and the contenders other than Bernie and Warren understand this. It’s typical left winger stubbornness. Get everyone healthcare, and don’t get all caught up in whether it’s a public-private patchwork.
I’m not worried about Rs or Ds being susceptible to fear mongering and propaganda – I’m worried about the few hundred thousand undecideds in the middle who will decide the election. They already have ample reason to view Trump skeptically, but if they can be scared into thinking the Dems are too far left they just might stay home. Again.
Not exactly. The report I assume you are talking about mirrored the findings of another report by the Urban Institute. Those findings were based on the following assumptions.
[ul][li]We could cut drug prices significantly. That is, I suppose, possible, but it is not the same as saying “spend the same on drugs but it would cost less”.[/ul][/li][ul][li]It assumed significant administrative savings. That is problematic, because the administrative costs of Medicare are partially done by other parts of the government. It still has to happen, and administrative costs have to be paid for, but it is important to note that having a different part of the government do the administration is not the same as saying it will automatically save costs.[/ul][/li][ul][li]It assumed no increase in utilization, and that people would get preventative care that would reduce health care costs down the line, and things like assuming they would go to their regular doctor instead of the expensive emergency room. This is also problematic. By and large, preventative care does not save money overall. And, under Obamacare, both visits to PHPs and to emergency rooms went up. Visits to regular doctors, IOW, were in addition to emergency room visits, and did not replace them.[/ul][/li][ul][li]More importantly, the report also assumed that all doctors and health care providers would be reimbursed at Medicare rates. Those rates are set by law. On average, doctors lose money treating 65-80% of their Medicare patients. They make up the difference by charging their other patients more. [/ul][/li]Based on those assumptions, and if we doubled all payroll taxes instead of paying insurance premiums, it would save around $2 trillion over ten years. It would also add to the deficit - doubling payroll taxes would not replace insurance premiums enough to be revenue neutral - it would have to be higher - i.e. we would save less than $2 trillion, but how much less was not addressed.
Obviously we can’t just say “replace all insurance premiums with taxes” because that would not save anything and there would be no particular advantage in M4A.
But the report did not find “we would save a lot of money by eliminating the middle man”. It found “we would save a lot of money by paying doctors less than it cost them to deliver health care”, and that is not at all the same thing.
In theory I suppose we could do it. Just tell doctors and clinics “it will take you a lot longer to pay off your $250,000 in medical school debt - now go figure out how to deliver the best health care possible while getting paid a lot less” but figuring out how to do it is harder than simply informing them it has to be done.
I think you have may misunderstood me. I agree with you on the issues. I put “giving free healthcare to immigrants” in quotes in the original post because it’s how the public sees it, not me. I agree that Medicare for All and healthcare for undocumented immigrants would probably be cheaper and certainly more humane. The problem is the Average Joe and Josie just hear their insurance is being taken from them and that we’re giving a “damn free ride to those Mexicans.” The Republicans would utterly destroy us on the messaging. Why? Because the reality is just too complex. The average person is simple and uninformed and just doesn’t have the capacity to see second order effects. The ultra-progressive agenda is just too big a step for the centrist voters the Democrats will desperately need to win in 2020. I’d prefer Elizabeth Warren, but if Biden polls better against Trump I’ll take him in a heartbeat. Getting Trump out of office is the single most important Democratic agenda there is.
Yes, the MFA coverage for illegal immigrants idea is the most politically moronic idea ever. And it’s not just about emergency care, but regular primary care as well. This is right up there with Bernie’s plan to let prisoners vote. :smack:
America is a country where the top three richest Americans hold as much wealth as the bottom 150 million Americans, and people have to beg for insulin money on the internet.
Don’t think of it as tax. Think of it as anti-guillotine insurance.
As for the OP, I’d like an 80-20 split between positive and negative. For the positive, I’d focus on healthcare and green jobs. For the negative, I’d steer clear of Russia and Trump’s racist tweets and focus on the appalling conditions in the border camps.
I agree it’s an abdication of moral responsibility. However, I think there’s a clear political upside. The Dem candidate can only talk about one thing at a time, and the more time they spend talking about what Trump has said, the less time they can spend talking about what he’s done.
We all know what’ll happen if the Dems spend time talking about Trump’s tweets. His idiot followers will drag the conversation down tangents about what exactly, precisely, specifically Trump meant with each tweet, and what was in his heart when the wrote them, and what even is racism anyway and blah blah blah blah blah? Then soulless cunts like Hannity will signal boost their nonsense until, once again, the whole conversation becomes about Trump, which is exactly what he wants.
Far better, in my opinion, to keep the focus on what Trump’s done like the anti-American crimes in the ICE border camps.
Put another way, what would you rather Trump’s supporters argue? That he’s not racist, or that he’s not mistreating kids?
I’m not saying to talk about his tweets all the time or even most of the time. But I took you to mean we shouldn’t say anything about them at all.
ETA: If you are worried about a muddled message, “mistreating kids” is problematic because it was the Obama administration in 2014 that started putting kids in cages.
The majority of centrist voters simply do not care about this issue - at least not to the extent that they will change their vote on it. They care about themselves. If you want to go negative on Trump then you need to focus on issues that matter to them. Talk about how the tax cuts only benefited the elites(we need to take back that word). Talk about how the Republicans are trying to take away their healthcare. Talk about how he wants to give another tax cut to the rich who own stocks while cutting programs that help the middle class. Tell them about how coal plants have closed because of his ineffective policies and how steelworkers and farmers are suffering under his needless trade war. The voters the Dems need don’t care that much about immigrants or the climate. They’re too busy trying to pay their electric and pharmacy bills.
Yes. Talk about the issues that affect Americans every day and how Trump and the GOP have not only failed to improve them, they haven’t even addressed them. Ask “What happened to replacing Obamacare with ‘something great?’” Then play the clip of Trump saying “Who knew it was so complicated?”
I didn’t see the report by the Urban Institute, but the Mercatus report, is that the one it’s mirroring?
I was reading this analysis from FactCheck.org and it brings up the same points you do. At the end it also says "Sanders’ spokesman, Miller-Lewis, argues that the initial assumptions used in the report — the ones based on Sanders’ Medicare for All Act — are legitimate. The buying power associated with a system that represents all Americans would allow the government to negotiate significant savings in payments to health care providers, as well as on drug prices.The whole point of universal health care is that you’ll get these cost-savings.
“It’s done everywhere in the world,” he said. “I don’t think we’re making any wrong assumptions.”
There is a certain amount of guesswork in estimating the cost of something as complicated as the health care system, and all of those estimates rely on a multitude of assumptions. We’re not suggesting the assumptions made in the Sanders bill are wrong, only that they aren’t Blahous’ assumptions.”
I see Slacker Inc started a thread about M4A, it looks a bit biased to me but I’ll read it later.
Yes, the Mercatus report is the one we’re talking about.
I would not characterize Sanders’ assumptions as “wrong”. The problem with them IMO is that “if” is the biggest little word in the world.
If we reimburse doctors at Medicare rates, then overall, they will lose money 65-80% of the time. Then what happens? I doubt very much they will simply carry on - they are much more likely to adjust. Delivering less health care overall, preferably more efficiently but definitely less.
Doctors will definitely take a shellacking from socialized medicine. Not sure that’s a bad thing. The arrogance of the profession in general does more damage to healthcare than the good pay attracts talent.