Bernie Sanders: A large single-payer health system already exists in the United States.

[Playinghardball]

Bernie Sanders @SenSanders
· 2h 2 hours ago
A large single-payer health system already exists in the United States.

[shenmue]

1. I'm for it

[hifiguy]

2. GO, BERNIE, GO!!

[snpsmom]

3. Tricare

The military medical system is another one, and it works very, very well.

[Half-Century Man]

32. this is the way to go.

[Nay]

39. Can you give us an overview of how Tricare works as opposed to how

Medicare is described in the posts below? From what little I know, Tricare seems more like one-payer health care than Medicare, because Medicare makes you buy insurance for the 20% it doesn't cover.

[SickOfTheOnePct]

53. Medicare doesn't "make" anyone buy supplemental insurance

People choose to buy it or they choose to pay the 20%.

There are four different kinds of TriCare (used to be three, thus the name), and each is a bit different.

TriCare Prime - works like an HMO. No premiums for active duty or dependents, or Medicare recipients under the age of 65. No co-pay if you use a military treatment facility, low co-pay for civilian providers. ~$278 annual premium for retiree, ~$580 annual premium for retiree family.

TriCare Standard - works more like Medicare, but no premiums. $150/person $300/family annual deductible, pays 80%, patient is responsible for 20%, and supplemental policies are available. No premiums for active duty family members or military retirees. Popular with retirees to use as a free supplemental policy for the employer provided health insurance.

TriCare Extra - works like TriCare Standard, but utilizes a list of preferred providers. When using a preferred provider, TriCare Extra pays 85% v. 80%.

TriCare for Life - for use with Medicare Part B; no premiums for TriCare for Life, but you must pay Medicare Part B premiums. What it pays depends on the service. If service is covered by Medicare and TriCare, TriCare for Life acts a supplemental that pays what Medicare doesn't pay. If service is covered by TriCare but not Medicare, Medicare pays nothing, TriCare pays 80%, 20% is out of pocket.

For all of these, patients much check to see if the provider accepts TriCare. Providers that accept Medicare must also accept TriCare, but providers that accept TriCare do not have to accept Medicare.

[TheNutcracker]

4. This IS what is needed to fix everything you hear that's not great about the ACA

The first really big issue for all of our programs including Medicare, are cost controls on pharmaceuticals. Then we can get to streamlining it all to single payer.

The insurance companies and drug companies are still the main controllers for profit. That must end.

Bernie, you are the B E S T!

[saidsimplesimon]

83. I agree with TheNutcracker. n/t

[Maineman]

5. Exactly

[jeff47]

6. Yes, but needs a small tweak

Need to get rid of the uncapped 80/20 split in part B.

[BrotherIvan]

7. This made me tear up a bit

We NEED it. We are DYING without it. We must have it.

[Enthusiast]

24. We are DYING without it.

[URL=.html][IMG][/IMG][/URL] [URL=.html][IMG][/IMG][/URL]

[appalachiablue]

8. Yess! The Solution we already have! Go Bernie

[nichomachus]

9. A few facts about Medicare for those who aren't on it.

It's not free. You have to pay about $100 a months for basic coverage -- very basic.

Once you've paid your Medicare deductible, Medicare pays 80 percent of costs. You are responsible for the rest.

You then have two choices.

1. You can buy a supplement plan from an insurance company -- and these cost several hundred dollars a month.

2. You can go into a Medicare Advantage plan, which is basically an HMO. The government gives them a sum of money each month for you, and they make a profit by denying care.

Let me give you some examples. As far as cost -- I pay the government $100 a month. Then, I pay my supplemental insurance company $180 a month. I have a cheap plan because I used to be in a union (Yay). Other people pay considerably more. Then, I pay $50 a month for my prescription plan. Then, I have a $500 annual deductible. So, my annual cost under Medicare is $4,000 or $334 a month.

For those on the Medicare Advantage plan, they are subject to all the things that people experience in HMOs. I and a friend had a very similar condition. Our test results were the same. My physician recommended surgery. I had it. Problem solved. My friend's HMO physician told him that he "didn't need" surgery and that his symptoms, which continue, were "normal." He gave him a generic drug that is an off-label use. Another friend in a Medicare HMO needed chemo. They would provide it, but his copay would be $1,100 a week. He couldn't afford it because he was living SS check to SS check. In their defense, the HMO did give him nice hospice care until he died.

Medicare and its different supplement schemes still leave you in the hands of the insurance corporations.

Also, the paperwork, at least if you're in a supplement plan, is incredible. You get paperwork from Medicare, from the insurance company, from the providers, from the labs, from the xray people,and from the hospital. I can't keep track of it, even with a spreadsheet I devised. And it's time-shifted. I just got a statement from a procedure I had done in April.

OTOH, my friends in Europe go to the doctor, show their card, get treated, go home, and that's the end of it.

Be very wary of "Medicare for all." It sounds good, but it's not what we need.

[TBF]

13. It would be an improvement

Over my current 2K per month payments.

[nichomachus]

43. As long as you want insurance corporations still in charge of your healthcare

Go for it.

[TBF]

45. How would insurance cos. be more

in charge than they are now?

And what would you offer instead?

[Paper Roses]

16. I agree with you. Medicare is not the end-all-be-all.

I also pay the $100.00 a month for part A, $80.00 for part B and an additional $55.00 for RX.I admit that this is far less expensive than what may be paid by others but when these monies come out of a meager SS check each month, it is a big dent. The deductibles are large and my options are limited.
It would be nice to be able to afford something better but with limited dollars, many of us have chosen the least expensive options which, of course, have the largest deductibles.

There seems to be no way to get around the fact that the insurance companies hold the cards in all of this.

I agree, we need a much greater plan than anything now available. I will never live long enough to see it.
I just hope I die quickly, not some long illness so whatever I have I can leave to my kids, not to go into some bloated insurance company coffers.

Yes, the paperwork is a big pain in the backside. One has to be an Einstein to figure it out.

[Hatchling]

65. I am also on Medicare.

But I have Medi-cal as well. I pay a miniscule amount for my scripts and that is it. I am on SSA and SSI.

[eggplant]

18. His point wasn't that medicare is perfect...

...but rather that there exist massive single payer systems with all of the needed infrastructure today.

[h2ebits]

28. On the other hand. . . .

My insurance premium decreased from $1,300 per month to $104.90 per month when I became eligible for Medicare. I then had to make a choice between an additional MediGap (supplemental) insurance policy or a Medicare Advantage Plan (at the time all were HMO's with the exception of one PPO Plan) or no additional coverage over and above Medicare itself.

I'm glad for you that you can afford the extra several hundred dollars a month for your supplemental plan + prescription coverage. And I'm sorry that you have had health issues.

I looked through all of the Advantage plans, contacted my primary care physician to ensure that she accepted the insurance plan that I was thinking to apply for, and now have an Advantage plan with a $0.00 monthly premium that includes prescription drug coverage. This plan also has a maximum amount out-of-pocket annually (for 2015 the cap has been raised from $4,500 to $5,900). I am quite healthy, I have a primary care physician that I have had for many years, and I know that I can always get a second opinion from another doctor. Anecdotally, my annual cost under Medicare is $104.90 x 12 = $1,258.80 + a couple of co-pays & prescriptions of approximately another $250 for an annual total of $1,509 or $126 per month. My choice is to pay the insurance companies as little as possible for as long as possible and roll the dice.

We end up with the same answer. It's all a game of chance with the insurance companies and they literally have this country by the throat while they shake us down.

As with you, I am wary of "Medicare for all" if it continues to operate with its dependence on insurance companies. But even as it stands, it is a far cry better than no insurance or the gigantic premium that I was paying prior to becoming eligible. The real point here is that we need a single payer system in this country.

P.S. Your friends in Europe are paying for their medical care through taxes--really it's not free anywhere--so pick your poison. And with our greed is good society, money is always the first thought rather than caring for people.

[SheilaT]

31. My experience is nearly identical to yours, except that

because I had a high enough income last year, my Medicare Parts B & D premiums are higher, $159/month. I have an Advantage Plan my doctor participates in. Now that I get my few generic prescription meds three months at a time for no copay, I am out of pocket nothing for doctor visits, medication, lab tests, and things like flu or shingles vaccines.

So the claim that a person has to pay all of a deductible, whatever that amount may be, is either false or at least misleading. Don't know how much the ACA has affected Medicare coverage, but I know before I went on Medicare my shingles shot was free to me, no copay at all. And lots of routine things are covered under Medicare, such as routine office visits and certain tests and so on.

True, Medicare does not cover everything, but it is probably the very best thing we have going so far in this country.

[mainer]

41. In Europe they have to pay a monthly premium too.

It's not really free there, but the monthly contribution is pretty minimal. In Holland, young people pay on average a little over a hundred Euros a month.

So we shouldn't complain about having to pay a monthly Medicare premium.

[lancer78]

58. Ok, what is their deductible though?

It is co-pays and deductibles that make health insurance unaffordable.

[Doctor_J]

54. Medicare overhead - 3%. ACA/private insurance overhead - 20%.

I can't believe there are democrats bashing Medicare. Wait. Yes I can.

[IronLionZion]

72. Can you imagine people like me processing your Medicare claims?

[rickford66]

63. There is Medicare paperwork but ....

you can just ignore it. It's just statements about their payments. Some of it may be re-reimbursement checks for covered procedures that you paid directly. You can't ignore the co-pay bills from your health professionals though.

[redruddyred]

68. no problems like what you describe here.

I've been on medicare about two years and have no complaints. premiums are a little high but they're really good about capping copays. when I had regular insurance drs and hospitals would try to overbill me and stuff or suggest procedures I didn't need. there's been a lot less drama since I went on disability. honestly I'm just glad to be able to see the dr when I need to and get reasonable preventative healthcare, which saves all of us money; the way poor people are treated in this country, that's huge.

a chiropractor I saw a couple of times is also a huge fan of medicare; apparently they're pretty honorable about paying people which is not true for the insurance companies.

the european system is, I think, better, but due to cutbacks I know that people with very serious, although not life-threatening illness are having trouble getting the care they need. stilll, they can go to the doc and get the basics taken care of with nothing out of pocket, while prescriptions are affordable. I don't think this is any inherent problem of a universal health care system tho, but rather a result of the neoliberal creep of the past few dedcades.

actually the problems with medicare are, I think, entirely to do with underfunding. but at least we elect our politicians (sort of).

[1StrongBlackMan]

10. I completely agree ...

So why can't he (someone) draft legislation to allow anyone/everyone to buy into Medicare (at any age) as an alternative to the hated ACA?

[subterranean]

15. That was proposed as an alternative to the public option in the ACA.

It would have allowed people 55 and older to buy into Medicare. But the asshole Senator from Connecticut (the 60th vote) said that he'd refuse to vote for any Medicare buy-in (an idea he'd supported in the past), and that was the end of that.

And, of course, as long as the Republicans control the House and/or Senate, such a proposal would have zero chance of passing.

[1StrongBlackMan]

20. Was that before, or after Prsident Obama unilaterally caved on the P.O. ...

as a favor to the insurance industry and big pharma?



(As has been the narrative)

[rhett o rick]

66. So your point is that it isn't Obama's fault. He did the best he could. nm

[1StrongBlackMan]

85. Yes. eom.

[joshcryer]

47. He introduced S. 1782, but it will never get out of committee.

So it's a non-starter.

[1StrongBlackMan]

48. How many times did the gop introduce legislation to repeal the ACA? ...

it's non-starter only if your stop.

[JonLP24]

59. Political realities

ACA is pretty much the same health care reform Nixon proposed in 1974. Hubert Humphrey dedicated his political career to universal health care (I always wonder what life would have been life if he won instead of Nixon). He supported doing the right thing over political popularity -- he was a crucial ally for Truman's civil rights platform. See the 1948 Democratic Convention for reference.

I don't keep track of every legislation drafted and since the vast majority of them rarely pass I don't know if anyone haven't drafted legislation and doubt most people know. (It was easy to disprove the claim that Sanders hasn't sponsored an alternative infrastructure program in response to his Keystone opposition)

[geardaddy]

11. Hear, hear!

Tell 'em Bernie

[TBF]

12. Exactly. knr

Nt

[Scuba]

14. Democrats nationally should be campaigning on three issues: Medicare for All ....

... Enriching and expanding Social Security

... Raising the minimum wage.


These issues are all winners

[Enthusiast]

22. These issues would get people to the polls.

[Scuba]

29. Perhaps that explains why Democrats don't campaign on them.

[Enthusiast]

38. The big corporate donors do not want these things mentioned—verboten.

[URL=.html][IMG][/IMG][/URL]

[BrotherIvan]

35. Add something about college tuition to appeal to young people

Who have no faith in actually getting SS and are likely healthy enough not to worry about health care. But I would think the main issue facing 18-20 year olds is the idea of signing up for a lifetime of indebted servitude. So your three + college tuition + public financing for elections/ending corruption and you have a very appealing core platform upon which to build under the umbrella of fairness and equality.

[Octafish]

17. Socialist!

Which is not necessarily a bad thing.

[Enthusiast]

19. Kicked and recommended a whole bunch!

Way to go, Bernie!

[woo me with science]

21. Huge K&R

Thank you, Bernie!

[former9thward]

23. Medicare is not remotely single payer.

It should be expanded to everyone however. Medicare is a jumble of payments to doctors, hospitals, pharmacies and various supplemental plans.

[ReRe]

25. K&R

I don't remember who it was who stood up in a presser during the run-up to the ACA and said point blank that that is what should happen... said that it would amount to approximate 2-3 pages to do it. No 3-foot high bill, a 3-page bill. Voila'! Done! Was it Dennis Kucinich? Alan Grayson? Who was it? Waxman? Or was it Bernie himself?

I don't know what is wrong with us. We come up against a problem, and rather than handle the problemy/face down the monster kit-and-kaboodle once and for all, every single time we do the wrong fucking thing?

Time after time after time this country does this. Has this country made one sound decent decision in the last 50 years? Isn't it about time we did something right?

It's time for a new direction. It's time for a new idea, or time for an old idea that actually worked in this country, lifting all boats.
It's time.

[bvar22]

49. HR-676... Medicare for All, first introduced by D Kucinich in 2003,

and the several times after that. It was ONE PAGE long.

"The bill was first introduced in 2003,[7] when it had 25 cosponsors, and has been reintroduced in each Congress since. During the 2009 health care debates over the bill that became the Patient Protection and Affordable Care Act, H.R. 676 was expected to be debated and voted upon by the House in September 2009, but was never debated. Advocates who remained staunchly for single-payer health care as the ultimate vote and passage of the America's Affordable Health Choices Act of 2009 loomed tried to present HR 676 as a viable alternative to the Affordable Health Care for America Act (H.R. 3962), but were ignored, and in some cases arrested by police during various nationwide debate events, and the bill never received significant public support."

http://en.wikipedia.org/wiki/United_States_National_Health_Care_Act

The Media refused to cover this bill, and few Americans were aware of it.
Max Baucus, Democratic Senator, Montana, chaired the committee on Health Care Reforms refused
to seat ANY advocates for a Medicare for All, and even had people arrested who tried to bring it up.


For his obstruction of National Single Payer, Max Baucus was rewarded with the Ambassadorship to China, a plum that most politicos would kill for. I'm sure Max is happy with his new job,
and busy filling up his offshore accounts.

Baucus was a 3rd Way/DLC Player, and was well rewarded for his part in the Kabuki Theater.

[ReRe]

60. Thanks!

I was pretty sure it was Dennis. I seen it on C-Span. (He also knew what to do about Iraq--- just bring 'em home!)

[TheNutcracker]

26. Healthy younger people will enhance Medicare! Why not start with allowing young/healthy to sign up?

[RufusTFirefly]

64. Yes!!! This is an important argument for people who favor cost savings over quality of life

Just to be clear: I'm not dissing you, Nutcracker. I just think there are lots of ways to pitch Medicare for All to appeal to a wide audience.
Mentioning the positive impact of young people becoming part of the system is one of them. An important one.

[Raster]

79. Because the Medical-Insurance Complex prefers their profits to be free-flowing and unencumbered.

The LAST THING Corporate Medicine, big Pharma, Health Insurance for-profit, and their human sycophants want to do is to bring logic and order to the American health care system. The Last Thing. There is NO FINANCIAL MOTIVE for the Medical-Insurance Complex to ensure that everyone has decent, impartial and sustaining health care. In fact, quite the opposite.

[TheNutcracker]

27. All the ills of the ACA are there for the insurance companies and BIG PHARMA-still no cost controls

on either.

[the_sly_pig]

30. 600 Billion dollar military budget.

600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.6600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.
600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.6600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.
600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.6600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.
600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.6600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.
600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.6600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.
600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.6600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.600 Billion dollar military budget.

[Enthusiast]

40. +1

[ctsnowman]

75. + 600 Billion.

[tom_kelly]

33. The VA is the best system I've been a part of - n/t

[Comrade Grumpy]

34. Speak it, Brother Bernie!

[loyalsister]

36. Likewise, we also have a flawed and limited form of universal healthcare

The Emergency Medical Treatment and Active Labor Act (EMTALA) is an act of the United States Congress, passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospitals that accept payments from Medicare to provide emergency health care treatment to anyone needing it regardless of citizenship, legal status, or ability to pay. There are no reimbursement provisions. Participating hospitals may not transfer or discharge patients needing emergency treatment except with the informed consent or stabilization of the patient or when their condition requires transfer to a hospital better equipped to administer the treatment.


The most significant effect is that, regardless of insurance status, participating (in Medicare) hospitals cannot deny urgent medical assistance. Currently EMTALA only requires that hospitals stabilize the emergency. According to some analyses of the U.S. health care safety net, EMTALA is an incomplete and strained program.

http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act

Like I said, flawed and limited (there are all sorts of things that make it inadequate. But there does exist a legal requirement that everyone has some access to healthcare. -- Thanks to Ronald Reagan.

[stage left]

37. Bernie Sanders is a dirty socialist.

And a man after my own heart.Before I was eligible for Medicare, I had no insurance at all for ten long years. That was a pretty difficult haul for a diabetic.

[Enthusiast]

42. The General Welfare should be top priority.

[sabrina 1]

44. He sounds like FDR the more the speaks. But why is an Independent saying what the entire Democratic

Party ought to be saying?

[TheKentuckian]

46. Medicare isn't really single payer, even traditional is an 80/20 multi payer program

You account for Advantage and Part D and it isn't even close to single payer. What it is, is really a market hook that gives folks a familiar and popular anchor point but Medicaid is functionaly more single payer as is Tricare (though there are copays).

[840high]

50. kick for Bernie.

[randys1]

51. My health insurance premium or my share went from $333 a month to $667 a month as a result

of my turning a certain age PLUS the usual increases, WAY too much

We must DEMAND a single payer system, I even goy my health insurance agent to admit to me that is what we need

He says have medicare for all with baseline coverage then you can buy enhancements, etc

[loudsue]

52. Oh Gawd Yes!!! I started Medicare in September. It ROCKS. What we REALLY

need is to get price controls on the insurance companies & privatized hospitals.

[Doctor_J]

55. The 2009-2010 democrats were too corrupt or cowardly to pass Medicare for all

or even an expansion. Now it will never happen. I would love to know why the president didn't use an executive order to change the eligibility age to 60

[SickOfTheOnePct]

56. If the statutory age is 65

The President can't just re-write the law with an executive order.

[IronLionZion]

74. Why don't we just fire all of the people's representatives and have a dictator instead?

[lancer78]

57. Medicare still requires

premiums to be paid by the insured. It is NOT a true single payer system.

[HockeyMom]

77. Only Medicare Part B ($104/month)

There are no premiums for Medicare Part A. You are not required to buy additional coverage from a private insurance company.

[forthemiddle]

82. The $104.00 a month is decieving

That $104.00 a month is highly subsidized, it is subsidized by the taxes employees and employers pay out their paychecks every week. I don't have the exact figures, but I recall it is over $650.00 per person, per month unsubsidized.
That would mean the Medicare for All for a family of 4 would be, on average $2600.00 a month premium.
Of course there would be some help for people that can't afford it, but for the ones that could why would they change their insurance to Medicare if they are paying 1/2 or less than that now?
There was a DUer that did extensive work on this in the past, but I cannot remember his name and had links to proof that there is no way we could do Medicare for All at todays premiums ($104.00 a month).

Also to say that Medicare is single payer is wrong also. Medicare, right now, is administered through insurance companies. BCBS is one, WPS is another.

[ellie]

61. Yes please.

[RiverLover]

62. Sounds good!! ~nt

[imthevicar]

67. The Moment I Knew The POTUS was for the Corperations,

When he took this option OFF the table.

[True Blue Door]

70. You mean when the composition of Congress and the Supreme Court took it off the table.

Acknowledging reality - now there's the mark of a Corporatist Betrayer President. In Ralph Nader's id, maybe.

[True Blue Door]

69. Agreed. Now what's your plan to do it, Senator?

[byronius]

71. Guy says the best shit.

Love him.

[libtodeath]

73. This could have been done 30 years ago except for that bastard raygun

[ctsnowman]

76. Exactly!

[MADem]

78. Nicely argued! Of course, the GOP would like to pull that rug out, too, I'm sure. nt

[FairWinds]

80. Hey Mr. Sly & Others -

Actual military spending is nowhere close to $600 billion,
it is double that. Here is a good source.
http://www.theatlantic.com/politics/archive/2012/02/the-real-defense-budget/253327/
And yes, it is bankrupting the country.
This message brought to you by
Veterans For Peace

[Zorra]

81. The real voice of the Democratic Party is an Independent. nt

[HoosierCowboy]

84. Amen

enuf said