With a Medicare for All system

[SHRED]

In the discussions surrounding Medicare-for-All I rarely, if ever, hear how beneficial it would be to the employer.
Whether it be a savings to the public employer (which we pay for) or the private sector the burden would be lifted.

Think of the economic growth potential with the outrageous cost of health insurance removed.

[genxlib]

1. In the big picture yes

But I don't think we can forego capturing that money to make the transition. Whether it is in direct premiums to Medicare or in increased taxes, the replacement costs have to be paid for with those dollars.

[brewens]

4. They talk about it like it's all extra taxes on workers and they lose their employee insurance.

One way or another, all that money employers contribute has to either help pay for Medicare for all, or be paid as extra salary or wages to employees. If the corporate assholes thought they would just get to pocket all that, I suppose they would be a little more in favor of it.

[Hoyt]

2. I cannot imagine a Medicare-for-All system that will not include a "tax" on businesses

if businesses are "relieved" form the cost of health insurance. Otherwise, they'll have to dump the entire cost of insuring the uninsured, underinsured, any coverage of what are now called coinsurance and deductibles, etc., directly onto individuals.

If M4A doesn't include a tax on businesses, I fear people are too stupid to understand that although their taxes just went up substantially to pay for health care, they are better off than before.

If the government decides not to levy a tax, they'll likely come up with some legislative attempt to force companies to pay their "healthcare savings" in increased wages/salaries which would then have to be used primarily for individual premiums.

Point is, I don't think the entire burden will be lifted. At best, employees are going to demand higher wages if businesses are relieved of $5,000 to $10,000 (or more) per employee in employee compensation.

None of that is meant to be a slam against M4A or any other universal health coverage proposal, because we have to go there, sooner or later. Personally, I think a Public Option will get us there faster in the current political environment.

[Turin_C3PO]

3. That's I'm thinking.

Incrementalism. Start with a public option and go from there to an NHS British-type system eventually.

[Autumn]

5. Tulsi brought that up last night. nt

[ismnotwasm]

6. Medicare as it is, is cumbersome and difficult to deal with from an administrative point of view

For us to move to single payer, a number of things need to happen, and they need to to happen in fairly short order. Drug companies drive a lot of costs, thus affecting policy. This is criminal wrong. Insurance companies hold the reins for reimbursement for well, everything. Those reins would simply pass to the government in M4A. Medicare reimbursement are already inadequate, hospitals have very specific guidelines. There’s what is called “bundling” a specific amount for specific procedures. HCAHPS, patient satisfaction surveys, that can effect reimbursement. There are are not enough providers as it is, as we move towards universal Healthcare, there needs to be enough providers especially in underserved and rural areas. There is also a nurses shortage—this is PRIOR to to universal healthcare.

Medicare is harder when someone needs durable Medicare equipment or has a prolonged or chronic illness. there is a transition from Medicare to Medicaid for some people

There are pathways to universal healthcare, it’s just not a simple as people make it out to be. I believe a well designed program could certainly save money, but money is never my first concern, it’s patient care. This is why I am with the “strengthen the ACA, and add a public option” opinion.

https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/hospitalqualityinits/hospitalhcahps.html

https://innovation.cms.gov/initiatives/bundled-payments/

https://www.forbes.com/sites/miriamknoll/2019/03/07/doctoring-the-doctor-shortage/#5708877576f3

https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage

https://www.medicareresources.org/faqs/how-does-medicare-reimbursement-work/

[Midnightwalk]

7. This is the kind of stuff that makes the transition hard

I’m for getting to single payer but you point out an interesting problem.

If employers get to pocket the money saved a different funding source is needed. I don’t see how we can directly tax that savings (spending varies too much), but we could raise taxes on business or more generally

Eventually single payer should help overall health care costs but initially it might just change who pays and how.

We should still start heading to universal coverage. We will never have a system that works if we don’t start fixing it.

We also need to start saving in other areas such as prescription drug pricing, over testing and gouging on procedures Drug pricing reform is popular and will save a lot. Any savings we can get makes ither reforms easier to pay for and success will make other reforms easier to pass.