Discussions about healthcare options by Democratic Presidentical Candidates

[MineralMan]

need to include consideration for employer contributions to their employees' current health insurance plans. Most American households have part of their health insurance paid by employers. In many cases, people don't know how much the employer contribution is. In many cases, it is higher than those households realize. Over time, there has been a serious erosion of those employer subsidies, shifting healthcare costs more and more onto employees.

Whatever plan is created needs to assess employers for those contributions, in similar amounts to what they are paying now or at an equitable level to be determined. If that is done, costs to individuals through taxation for those plans will be higher than many are discussion. Often employer contributions are not even mentioned as part of the funding for whatever plan is proposed.

Self-employed people and people working for below average pay usually do not benefit from employer contributions, raising their out-of-pocket costs for health insurance or healthcare. That is partly offset, under ACA, by subsidies and tax credits, but those benefit successful self-employed people more than people who are employed by companies who do not contribute very much or who contribute very little toward health insurance costs.

Whatever system is implemented needs to be funded, in large part, by employer taxes that are similar to or greater than current contributions by employers to employee health insurance premiums. Any system that doesn't include such taxation will be untenable. We cannot let employers skate away from their responsibility to fund their employees' health care programs. If that happens, it will amount to a tax reduction for employers, at no benefit to workers.

[The Velveteen Ocelot]

1. If you ask me (and you didn't), all of these complex, detailed plans

for reforming health insurance (it's not health care) should be viewed with the understanding that they are only aspirational, and once they go through the Congressional meat grinder they will come out the other end almost unrecognizable. For that reason I'm pretty much ignoring them, except to the extent that I am trying to evaluate whether even the broad outlines of any of them will be (a) appealing to voters, and (b) able to survive Congress. I am deeply skeptical when any candidate promises that if he/she is elected we will have "free" health care, because that's not gonna happen.

[MineralMan]

2. There is no such thing as "free healthcare."

It does not exist. There is healthcare that is financed by individuals and corporations, and there is healthcare that is financed through taxation. There is no "free healthcare." There cannot be, because healthcare requires people, products, and facilities. People must be paid, Products must be created, manufactured, and distributed, and facilities must be built, equipped, and maintained.

In the simplest possible tax-based healthcare system, the costs of healthcare are calculated and divided by the number of people who will receive it. That establishes a number that can be worked with, cost per individual.

All savings, via reductions in administrative costs, price controls on healthcare services, and other measures, can reduce the cost per individual.

Then, a progressive tax system collects the required funding based on ability to pay.

It's quite simple, really. But, that's not how any of the plans actually work.

[The Velveteen Ocelot]

3. Exactly right. There is no free anything.

So I don't want to see any of our candidates claiming or suggesting that any of their proposals will deliver free health care or free college or free anything else because everything has to be paid for somehow, by someone. No doubt there are ways of delivering health care, college, etc., that are more efficient (and therefore cheaper) and more equitable than what we have now. But it won't be free.

[redqueen]

4. That's a good point. These details are important

and if they're not included some voters may not feel they can trust the proposals will be workable.

[MineralMan]

5. Well, none of the proposals are what will finally emerge anyhow.

That will be determined by whatever Congress is in place, as did the ACA.

However, proposing something that sounds free is a great campaign strategy, so it's a popular thing to promise. It annoys me, though, no matter the nature of the proposal.

[redqueen]

6. Same.

This is one of the things that Yang's supporters appreciate is the willingness to dig down into these kinds of details.

[MineralMan]

7. It's not working out that well for Yang, though.

[redqueen]

8. I disagree.

To go from 0, a total unknown, to outlasting governors, representatives, and senators?