Health Insurance Companies Make Big Profits - Medicare for All!

[MineralMan]

We all know that. So, a properly designed and launched Medicare for All program would be self-supporting, and could lower premiums in a major way, since it would not be allowed to show a profit.

Medicare for All would also have a pool that encompassed the entire population. Premiums would be paid, in part, by employers and in part by direct deductions from paychecks. The self-employed would, as they do now, pay the entire premium.

Premiums would be reduced because of that larger pool and by the fact that everyone with a Social Security number would be automatically enrolled. Further, because Medicare for All would be a single-payer system, it could set payments for all care, as it does now for the elderly, like myself. Premiums could take into account age, but nothing else, I recommend.

Private insurance companies could still profit by offering supplemental policies to cover the standard 20% deductible. That is a profitable thing, as demonstrated by the annual push by all insurers to get seniors to sign up for their plans. They would not do that if it were not profitable.

Medicare for All could easily be means-tested, allowing people below a set income to join the program via subsidies.

There is really no good argument to be made against Medicare for All. The only argument comes from insurers, who do not want to lose their very profitable businesses.

We should all be demanding Medicare for All. I highly recommend doing exactly that.

[Adrahil]

1. Disagree.

I favor a public option and whatever insurance companies want to offer to compete. If the public option is better, it will win out. I want to maintain options because I am not convinced that a "Medicare for All" will have sufficient quality of coverage and acceptance by providers. Also, I'd want some LONG TERM guarantees of coverage. All you need to do is see what Thatcher did to the British NHS to see what would happen if the GrOPers had their way with such a plan.

[MineralMan]

3. And I disagree with you. That's OK.

However, one thing I would favor that would be much more difficult to do would be a Constitutional Amendment declaring that the right to receive healthcare that meets the current state-of-the-art in medicine is a right of the people than cannot be abridged. Since it is a right, the amendment would also include language that required the federal government to provide a tax-funded system that ensures that the people's right to receive healthcare be implemented and adequately funded to provide such healthcare.

Now, there's a challenge. However, that would answer your question about a guarantee of coverage.

[Adrahil]

5. Can't imagine that EVER getting passed, but I agree with it in principle.

I've been watching singe-payer systems for a while now, and some have a disturbing trends, like requiring certain procedures before allowing others (such as requiring bariatric surgery before funding diabetes treatment.) I don;t like the idea of having all those eggs in one basket.

As it is, my old insurance refuse to approve knee replacement surgery becuase they sais I was too fat, though my surgeon said the risk for weight/age is only slightly elevated, and that outcomes are MUCH better for patients who have the surgery.

Fortunately, my company had an alternative plan which I switched to and is in the process of approving the surgery. A little higher deductible, but better coverage overall.

[Hoyt]

6. Medicare for all would be better, but the Public Option is the only thing possible in this country

unless we cram "single payer" down the throats of people who, for whatever stupid reason, are opposed to it. I think the natural progression to single payer will work better as more and more people gravitate to the Public Option, assuming it is actually as good as we think (gonna have to avoid monumental snafus like the early Exchange issues).

Plus, Medicare-for-All, will not be a whole lot cheaper than what we have now unless we make some major changes in the health system. Somewhat cheaper, but probably no more than 10% less. Not saying that isn't significant, but someone griping about a $400 monthly premium isn't going to stop griping when it $360 a month. Besides that, 30% of Medicare beneficiaries currently choose Medicare Advantage Plans offered by insurance companies and every provider check is written by an insurance company, provider and beneficiary questions are answered by insurance companies, etc. They will remain involved for decades.

[Adrahil]

7. Unless I have some coverage options...

... I'm not comfortable with a single choice. See my reply above.

[PoindexterOglethorpe]

2. Well that's entirely too sensible!

(Irony glyph here)

I do sincerely hope that the repeal debacle does finally move us to some sort of single payer system. I can recall reading decades ago that doctors' offices said that filling out all the myriad of different insurance forms was their biggest headache. It was an important reason why so many practitioners accept only some insurance policies. That and the need to negotiate separate agreements with each and every insurance provider.

I will suggest that a Medicare for all system needs to be phased in: start by covering all children up to a certain age. Then lower the age at the upper end by five years every year until everyone is covered. Something like that.

Or start by having rock-bottom basic care covered, such as Emergency Room visits, vaccinations, well-baby check-ups, pre-natal care. Then expand what's covered. Maybe allow for people who can afford it to puchase a buy-up plan that gives them more coverage, or faster access to a doctor. There are lots of models out there. It doesn't seem as if anyone has seriously examined any of them to see what might be a good example for this country to build from.

[MineralMan]

4. I'm sure you're right about that.

How it would be implemented would have to be decided, of course. I'm not really talking about details, as much about principles.