So is M4A still "Rainbows and Unicorns"?

[LiberalLovinLug]

https://www.theguardian.com/commentisfree/2020/mar/21/medicare-for-all-coronavirus-covid-19-single-payer

America's extreme neoliberal healthcare system is putting the country at risk

At the final debate of the Democratic presidential primary on Sunday, Senator Bernie Sanders and Joe Biden clashed on the coronavirus. Sanders contended the pandemic laid bare “the incredible weakness and dysfunctionality” of the US healthcare system, and called for single-payer reform. Biden countered that Italy’s universal system had failed to protect the Mediterranean nation, and asserted that Covid-19 “has nothing to do with Bernie’s Medicare for All”. At first glance, the ex-vice-president seems right: of course single-payer can’t close the door to a novel virus, any more than it can forestall a deadly earthquake or fend off a zombie apocalypse. Nonetheless, a national health program with unified financing and governance – basically the opposite of what we have in America today – is a powerful tool in a health crisis.

https://time.com/5807383/medicare-for-all-coronavirus/

Bernie Sanders May Be Losing, But COVID-19 Is Keeping Medicare for All Alive and Well

“Everybody’s seeing that it’s in the interest of all Americans that everyone gets the health care they need when they need it,” says Kelly Coogan-Gehr of National Nurses United, the country’s largest nurses union and one of the most prominent groups campaigning for Medicare for All.

As the number of diagnosed COVID-19 cases in the U.S. shoots up and stories of high hospital bills proliferate, more than two in five Americans say the epidemic has increased their likelihood of supporting universal health care proposals that involve the government providing all Americans with health insurance, according to a recent Morning Consult poll. In exit polls in nearly every state that has held a presidential primary contest so far, a majority of Democratic primary voters have said they support a single government health plan, which is what Medicare for All would bring about.


But but but........... the cost!


Besides the fact that M4A candidates painstakenly detailed how they would pay for it, the cry from Republicans to "moderate" Democrats was how outrageously expensive it would be to implememt, even if later it would save trillions. Not to mention cover everyone their whole lives no matter where they work or if they work

But now the US government somehow can quickly pass 2.4 trillion* in spending....so far.....to combat this pandemic. Mostly for corporate bailouts. Somehow when those in power have their and their big donors businesses threatened to lose profits or go under, there are TRILLIONS available, with nary at thought about it crippling the country or worrying about how they will pay for it.

*https://www.usatoday.com/in-depth/news/2020/05/08/national-debt-how-much-could-coronavirus-cost-america/3051559001/

[BComplex]

1. When people look at the cost of M4A, why don't they consider huge premiums to insurance behemoths

the same as tax dollars, but with part of those tax dollars going to HUGE profits for insurance executives, instead of health care for a poor penniless bloke who can pass on his untreated illness to the next person?

Families pay $1000 per month ($12,000) per year, plus co-pays, plus deductibles for insurance.

A whole helluvalot of that goes to pay, sure, for insurance company workers, and doctor's office help that has to work with the insurance company.

But one helluvalot of that ALSO goes to pay for huge bonuses and, in many cases, stockholder dividends or profits; money that is uselessly wasted toward good health care.

[LiberalLovinLug]

3. There is such a strong disconnect with many Americans about how they pay for services

That is a huge hurdle. Especially when there is a whole industry dedicated to misinformation and scare mongering about TAXES TAXES TAXES!

When for many, they cannot even get to a place where they see that not only will it cover themselves and their families, and relieve all that stress in life, but they will end up paying half as much as they do now. And no more losing homes nightmare stories. They are prevented from getting to that point in thinking because they are conditioned to think in terms of anything the government implements is wasteful and its like throwing your hard earned money down a black hole. And maybe they have good reason. There is a lot of waste. Especially in the MIC spending.

I think there has not been a concerted enough effort to promote it and explain it. Sanders first proposed it 48 freakin years ago! And has had little support for it while watching every other western democracy adopt it and have long ago enjoyed its benefits and cost savings.

[JustABozoOnThisBus]

5. Republicans have successfully kept the focus on TAX.

They divert from everything else. If a "D" tries to talk about "total cost, including tax, premiums, co-pays, etc", a "R" will cut them off, yelling "won't this increase TAXEX?", which, of course, it will.

Under M4A, insurance company workers would mostly get hired by the National Health Service (or whatever we call it on this side of the pond) to administer the government payments to doctor and hospital cost centers.

Insurance company executives, of course, would have to find real jobs, poor them.

[csziggy]

8. Didn't the ACA allow insurance companies a 18-20% profit?

So if we go to a government run system, that is 20% savings off the top immediately.

[BComplex]

10. Bingo! And that would decrease the overall tax on the population.

That is why we need Elizabeth Warren to be the next president (after Biden, of course), and why I want her to be the VP pick. She could structure a tax schedule so that M4A would be totally covered, and the middle (upper middle, middle, and lower middle) classes wouldn't have to end up paying more, and the poor would be covered.

Her financial plans were totally covered, and well thought-out. If people only knew what an incredibly brilliant financial mind she has, we wouldn't be in this mess. Three years of implementing her plan, and this country would NEVER go back. They'd fight to keep it like they protect Obamacare now.

PLUS, she would figure a way to hold the MIC accountable, and free up more money for an actual MILITARY, instead of a "complex".

[ismnotwasm]

2. M4A is not a workable plan in its current iterations

Just look at the “hospitals are overwhelmed” thing that just happened?

Personally, “how to pay for it” is the least of my concerns.

You need providers, you need enough healthcare workers, you need enough clinics, enough hospitals; you need proper processing OF payment, I think using current HCCPS and bundling will have to be reworked. You need to control pharmaceutical companies, and one way is looking where pharmaceuticals are manufactured. We have shortages all the time. We have a PCP shortage, less people are being called to medicine, and there are many areas people don’t want to work. We have H1B Visa driven providers in rural areas, or we did, I don’t know what’s Trumps immigration bullshit has done to that. I think he fucked it up

You would need to greatly expand government Medicare offices, hopefully with up to date software to process claims

I don’t have time to go into all my concerns, but I agree we need universal healthcare, but nothing has been offered that covers enough bases to make the legislation 1) passable 2) workable.

I hope Biden is able to change this if he’s elected

[LiberalLovinLug]

4. You are right. The logistics are challenging

But on the other side of it, the system at present is simply not sustainable.

Of course hindsight is 20/20, but the US should have started implementing it last century when every other country was starting it up. The only thing missing from FDR's New Deal.

Because now, and understandably, whole private industries have been built up around the concept of a private for-profit medical system. And have had decades upon decades to establish their monopolies, and influence. Not to mention the psychological messaging encouraging anti-government sentiment.

Yet almost everyone can understand and support how the government organizes and pays for the armed forces, as an example. Each army base, when needing new uniforms, doesn't find a factory and order and bill the tax payer for them. You can say the same thing about guns, tanks, planes. Because overall, it would cost taxpayers more. Coordination on a national scale is done, I'm sure, when ordering new uniforms for all of one style at once from one or two large manufacturers, with large orders, to save costs over all. (waste in the MIC is for another thread). Would MAGAs want to abandon that nationalized socialist way to pay for their armed forces, especially if it were to cost them twice as much?

Why is there no effort to link the idea of pooling citizens money, in order to get the best deal, when it comes to their own healthcare? It just takes a concerted effort by who we regard as our leaders to honestly explain and promote it. But IMO many are now also enmeshed into having big industry donors, but even have investments and family involved in those private industries. Making the problem go even above the logistic problems.

[ismnotwasm]

7. That's why slogans don't work

Just expanding Medicare isn’t enough. We have to have places for people to go, equipment to help diagnostics, people who can run the equipment for instance. Hospital and clinics need to communicate better with each other. The logistics are staggering because the infrastructure isn’t there.

However, we need to start somewhere. The ACA was a start, and for the life of I’ll never understand why Republicans are so against it. Or against a public option. It’s been shown over and over that preventative care saves money.

An interesting history, is the Medicare expansion done for kidney dialysis. Medicare covers chronic renal disease in a “Medicare for all” fashion

The original idea sold, was that dialysis was a “cure” for kidney disease. Also, it was thought patients could do hemodialysis at home. Instead for-profit Dialysis centers popped up all over the place, and a different kind of dialysis, peritoneal dialysis, is grossly under under utilized in the US.

[LiberalLovinLug]

9. I would disagree that slogans don't work. I would put it more that slogans are not enough.

In fact I would say that Republcians are waaaaaay ahead of Democrats in realizing that slogans work.

No child left behind
No New Taxes
Contract with America
Right to Work
just off the top of my head. Why do they stick in there?

The wording of a slogan does not have to encapsulate all the nuances of its implementation. All it has to do is convey a feel good statement to get folks on board. In Republicans case, it can even mean the opposite of what they plan to do with it.

Of course it would not be simply expanding the Medicare program. The first step is simply to introduce the concept of having a medical system where no one has to worry about being covered, losing their house etc......the closest example to that is those who now are old enough to be on Medicare. Hence using the same language to frame it with.

Politics is a different animal than the day to day logistics of providing a service. Its about changing a mindset. And the beginning of this is to find a slogan that is catchy and that polls favourably. "Socialized medicine" does not poll well. But "Medicare For All". Latest polling has it at 69% across the board support.

https://thehill.com/hilltv/what-americas-thinking/494602-poll-69-percent-of-voters-support-medicare-for-all

Why are Democrats so afraid of using slogans? "Hope and Change" worked pretty well.

[ismnotwasm]

12. Probably should have expanded a bit

In something as complex as healthcare ‘Medicare for All” is little more THAN a slogan. We need implementable policy. None of the proposed legislation addresses what needs to be addressed, instead, it’s a shell without substance.

Democrats differ wildly from Republicans despite the “they’re all the same idiots” as far as what works and what doesn’t

[I_UndergroundPanther]

14. Neoliberalism is why the republicans don't help

The citizens of this country. To a neo libral all public spending that does not feed the rich more or help private corporations and restrains free market capitalism must be stopped. Neoliberalism has nothing to do with true liberals.

[BComplex]

11. No. Elizabeth Warren had a plan. If you studied her plan, it was totally workable, and

we would never have ended up without PPE, etc, with Obama, Biden, Warren, or any other real democrat in office.

[ismnotwasm]

13. I saw that. She started out with a public option

Perfectly reasonable.

[Hoyt]

6. M4A is probably less likely now because of the cost; however, a Public Option with expanded Medicaid

and substantial premium subsidies and reduced deductibles/coinsurance may be more likely.

Those in the 40th Percentile, or so, and the un/underemployed will need subsidized or low-cost healthcare. Those who can pay some, will likely need to for the foreseeable future. Just don't see the government taking on the whole "for all," right now. However, still believe a PO will get us to universal coverage, very close to M4A, the quickest.

[Kid Berwyn]

15. Sure would be useful about now.

And into the foreseeable future.