Medicare for America, Beto O'Rourke's health care plan

[Hortensis]

Same goal, universal healthcare, but allowing a choice of paths to suit people's varying preferences and needs.

VOX: "... Employer-based insurance, which covers half of all Americans, would be preserved, though workers would have the option of leaving their work plan to join the new Medicare program.

Over a long enough timeline, however, Medicare for America would likely cover most and maybe all Americans under a single government plan. The uninsured and people on Medicaid or Obamacare would be moved into the new public coverage right away, and newborns would be enrolled automatically in the plan as well.

O’Rourke has quickly become the bill’s most prominent proponent, citing it on the campaign trail as the best path to universal coverage despite his earlier support for single-payer health care.

From the Texas Tribune: “It responds to the fact that so many Americans have said, ‘I like my employer-based insurance. I want to keep it. I like the network I’m in. I like the doctor that I see,’” O’Rourke said. “It complements what already exists with the need that we have for millions of Americans who do not have insurance and ensures that each of them can enroll in Medicare. It then suggests additional investments in that program so it becomes the program of choice and people who have private insurance migrate over to the Medicare system.”

O’Rourke added: “Now listen, we may disagree about the best policy path forward, but for me, that affords us the greatest buy-in from the greatest number of Americans because this cannot be the policy or plan of just one person or one party. We’re going to have to get as many people as possible into this if we’re going to achieve that goal.”

VOX: Medicare for America, explained
https://www.vox.com/policy-and-politics/2019/3/18/18270857/medicare-for-all-beto-orourke-2020-policies-voxcare

Currently something like 70% of Americans get their coverage through their jobs. This is a BIG issue for voters who worry about being able to keep what they have.

[Hortensis]

1. Sanders' plan: My choice or nothing. Beto's: Your choice.

[InAbLuEsTaTe]

59. No, the choice is between letting greedy corporations continue to bilk the healthcare system

while standing by and doing nothing as people die unnecessarily, OR insure everyone through single-payer healthcare and save countless lives in the process. Think I'll choose the latter and go with Bernie's MFA plan. Several major candidates support Bernie'a plan by co-sponsoring his bill in the Senate... smart political move on their part!!


Bernie & Elizabeth 2020!!!
Welcome to the revolution!!!

[Hortensis]

62. You're completely wrong in what you imagine

are the differences. They're both based on the Medicare model, which means private industry providers. The VA is our only major socialized medicine. These would both be government regulated capitalism, like Medicare.

You're also wrong in believing several major candidates support "Bernie's plan" as you mean it. They're almost all campaigning on what are actually variations they believe are better while keeping the popular name. Also, Beto is not alone in having second thoughts at the extremism of Sanders plan and the danger that it could reelect Trump and even give control of the house back to the Republicans.

Btw, credit to Sanders in realizing that trying to destroy the VA system would probably destroy any chance of his success. For the longest time I've observed the great irony of people who, while calling for socialized medicine, were apparently so carried away by the imagined simplicity of one-system-for-all (anything BUT simple) that they wanted to roll all those hapless vets into a far less desirable single payer or MfA system.

[Politicub]

2. These VOX explainers are fantastic!

Thanks for posting the link.

[Hortensis]

68. :) Names to recognize: Reps Rosa DeLauro CT and Jan Schakowsky IL

because they wrote and introduced this plan and have been involved with healthcare legislation for years. Just throwing that in because people who care about this issue might like to know about them.

[WeekiWater]

3. This is how to get the ball rolling.

"Over a long enough timeline, however, Medicare for America would likely cover most and maybe all Americans under a single government plan. The uninsured and people on Medicaid or Obamacare would be moved into the new public coverage right away, and newborns would be enrolled automatically in the plan as well."

[brer cat]

4. A commonsense approach

that can actually succeed because more people will accept it.

[Amimnoch]

5. And unlike BS, Beto would likely pass any improvement Congress sends his way.

Let's be honest, no bill will go before any of our candidates unless we reclaim the senate + hold the house. Holding the House seems very likely, retaking the senate in 2020 still remains possible, but not a given by any stretch.

No bill improving healthcare will get to any presidents desk if the tRumpublicons maintain even a 1 seat majority in the senate.. nuclear option or not.

But if we do gain a majority, and our new Senate majority leader does invoke the nuclear option or finds a way around cloture for getting a bill passed:

If a bill passes that only gives a minor improvement to the ACA, like say puts in the government option?
-I don't doubt for a second a President Beto will pass it. Pretty much all of our candidates other than BS can be counted on to pass it.
-BS might not because it doesn't go far enough. More than enough evidence of him not supporting bills that he felt fell short of his purity testing.

Same if it's a single payer. Same if it's anything short of what BS wants.

His own past actions, positions, and speeches gives me NO CONFIDENCE at all that he will work with a Democratic Party majority unless they pass the bills that HE wants passed. Sort of like another POTUS I can think of right offhand, eh?

ANY Democratic Party Candidate BUT BS in 2020 PLEASE!

[bullwinkle428]

6. Public option is the only logical and realistic way to pursue this, so I

definitely applaud this proposal.

[BlueFlorida]

7. Beto is sensible and he listens to people

He doesn't peddle 60's socialist ideas and ram them down people's throats.

[Hassin Bin Sober]

13. You mean 60s socialist ideas like Medicare?

[BlueFlorida]

15. Medicare is not a socialist idea

Forcing everyone to have Medicare is a terrible idea.

[Hassin Bin Sober]

20. Um, everyone has Medicare. They pay for it every paycheck. You don't have a choice.

[BlueFlorida]

22. It is post retirement. nt

[tkmorris]

30. Do retired people have a choice?

[Hassin Bin Sober]

44. They can not enroll and face penalties. But no one can refuse paying for it.

This idea it is some kind of totalitarianism to make Medicare For All mandatory is laughable.

[Indygram]

48. When something is your ONLY option and choice is taken away

Then it is kind of totalitarian. I have employer provided healthcare that I like. I don't want to be forced to give up something I like. Neither will most other people who like what they have. Adding a public option people can choose if they need it is widely supported. The second you tell people who like the sound of "Medicare for All" that it means ONLY Medicare and NOTHING else you will see massive resistance. People DO want a public option but they don't want all other choices taken away.

[George II]

27. Everyone does NOT have Medicare. People have Medicare if they:

Are 65 or over
Permanently disabled (based on specific criteria)
Have end-stage renal disease
Have ALS

[Hassin Bin Sober]

64. Medicare for all is socialist but Medicare isn't.

Oy

[progressoid]

66. We all have to pay into it. Forced to, if you prefer that word.

We just don't get to use it until we are old farts.

[BlueFlorida]

67. It is still insurance.

Because the premiums become astronomical after age 65, we pay into the policy through payroll deductions earlier and we are required to have 40 quarters of contributions to become eligible.

It is not "socialism."

[George II]

56. Just because Ronald Reagan called it "socialist" means that it's socialist?

[Hortensis]

9. :) No, Bernie owns his totalitarian "no other choice" approach.

It's essentially both un-Democratic and un-democratic.

[BlueFlorida]

23. ...

[George II]

28. Beto leading the way again... no shock there!

[Indygram]

65. He is the perfect balance

Gosh he reminds me so much of Obama...makes me miss having a real president.

[WeekiWater]

12. There is a significant amount of dishonesty and deception in your post.

" It does nothing to address mounting healthcare debt, CEO profits off of the sick, nor the fact that most Americans cannot afford an emergency over 400 dollars. And yet those who were to sign up for this program will still have out of pocket expenses, capped at 5000 for a family?"

That is inaccurate from what is being presented. Nice try.

[WeekiWater]

21. Some things are clear on face value. NT

[WeekiWater]

33. " I created it like an hour ago"

What did you create an hour ago?

[WeekiWater]

35. Keep posting!

It's a fun ride!

[melman]

17. "Interesting language settings. "

That's not how twitter works. The language settings you see are your own.

[WeekiWater]

19. You are incorrect.

I don't have a login to Twitter.

Clearly you noticed the same thing. No other twitter pages I pull up show that. Nice try.

[melman]

24. I'm not

And I didn't. And I'm not logged in either.

So sorry but you are wrong on all counts.

[WeekiWater]

25. I will remove that part as to not distract from the core dishonest parts of the claims.

Thank you.

[tkmorris]

29. Good removal

Now instead, could you point out what part of the post was erroneous? I won't call it "dishonest" as I have no reason to believe it wasn't posted in good faith.

[WeekiWater]

32. Just about all of what was put forward is erroneous.

https://www.democraticunderground.com/128763701#post31

[BlueFlorida]

26. People always make money and profit off sickness of others

Doctors and nurses for example.

Insurance is a service -- they have contracted doctors and hospitals who would agree to take less money to keep the plans from going into stratosphere and they manage to handle all issues re: whether the treatment you are getting is right or if someone is overutilizing the system.

Insurance is actually a classically socialist business -- to each according to their need and from each according to their ability. This is why we buy car insurance because the premium is cheaper than liability. This is why we buy life insurance. All those companies provide a service as well and thus profit from it.

Even Medicare does not cover everything. Enter what? Insurance companies with supplemental policies.

The reason health care costs are going up is not because of the insurance companies. It is modern technology and modern biologicals which cost an astronomical sum of money. Some anti-cancer mabs (monoclonal antibodies) cost as much as $400K for the treatment.

[WeekiWater]

31. Elaboration since it seems to be needed.

"It does nothing to address mounting healthcare debt, CEO profits off of the sick, nor the fact that most Americans cannot afford an emergency over 400 dollars."

Immediately moving all people currently covered under the ACA, and all uninsured individuals over to an improved medicare system, wouldn't have an impact on the overall impact of healthcare debt? It clearly would. You are talking about millions of uninsured people.

Shifting society over to medicare wouldn't have an impact on private insurance profits? Clearly it would.

Creating a scale for premiums, out of pocket costs and copays wouldn't have an impact on affordability? Clearly it would.

Those are the core of your position. Each point you made is clearly inaccurate.

Only one of us has mentioned Sanders. It wasn't me. He has nothing to do with what I have stated.

[WeekiWater]

39. The word dishonest might be a bit rough.

But your claims were not accurate. On that we agree. There is a word for spreading inaccurate claims. It does rise to the level I stated. That said, my use of words does not foster conversation and is not welcoming.

[Hortensis]

11. Experts say Medicare for America would be economically doable,

while still assuring that people of lower means would pay little to nothing in deductibles. What you're promised is what you'd get. Very unlike Sanders' plan, which again as economists rolling their eyes.

Also, keeping freedom of choice open, in addition to being intrinsically necessary to democracy, also enables competition and would make sure citizens could continue to compare what they have through the government to what others do through private insurance. We know, of course, that over time by far most people would choose the Medicare in Medicare for America, a self-correcting situation where inadequate employment-related insurance disappeared while some that was good remained.

[melman]

18. "Experts"

Which ones? Let's see a link.

[Eliot Rosewater]

42. I am confused, I thought BS and his fans wanted Medicare for all

[Indygram]

50. Medicare for America is more of a public option without destroying private insurance in the process

Medicare for All is essentially Medicare ONLY.

[George II]

61. This is a sensible proposal. Even Sanders hasn't yet figured out a way to pay for his.....

...."Medicare for All" proposal. He didn't in his 2017 introduction of his virtually identical proposal either.

[Indygram]

14. Beto deserves way more attention than he gets here to be honest

He's an incredible candidate who has me seriously considering changing my registration from Independent to Democrat just so I can vote for him in Florida's primary.

[BlueFlorida]

51. I agree.

Supporters of one candidate flood the forum with OPs about his waking up in the morning to falling asleep at night and everything in between. Other candidates' message gets drowned out. Maybe that is the plan.

[Indygram]

54. I noticed that too, so I adjusted my settings to trash all threads with

the first and last name of that particular candidate. Now I can see all the other awesome discussions! It's beautiful!

[Nanjeanne]

36. Personally I'm sick of my tax dollars going to subsidize extremely profitable insurance companies.

I find it amazing that there are people who think it's fine to hand over their tax dollars to Aetna and other insurance companies on the exchange to subsidize the ridiculously high monthly premiums that they (and other ins cos) are charging so that Aetna can give their departing CEO $70 million in a golden parachute.

Socialism for corporate insurance companies seems to be ok. But heaven forbid we actually use tax dollars to skip the middleman and give healthCARE to people.

[Indygram]

37. I have Cigna and my employer pays for about 3/4 of my premium

My premiums for medical, vision and dental combined is under $42 a week. I do not support Medicare for All but I DO support Medicare for America or a public option. I want to have options and a choice. I think most people feel the same and resent having anyone take their choices away. A Medicare or Medicaid public option would be widely supported by the majority of America. Single payer with ONLY Medicare for all and nothing else would be vehemently opposed by the majority. When people hear "Medicare for All" they don't realize it means, "Medicare is all you get, no other choices."

[Nanjeanne]

41. You are very lucky and that's great. But as taxpayers - you, me and every one of us are still paying

for the rest of the people who receive their healthcare thru the ACA exchanges and get subsidies to pay for their premiums. That goes to the insurance company. So . . . in addition to your 1/4 premium - your tax dollars are also going to insurance companies in the form of Obamacare subisidies.

Choices? Choice to do what? With Medicare For All you go to the doctor, you get healthcare, you don't go bankrupt if you have a serious illness. What other choices do you want to have? I'm seriously asking because I simply don't understand this choice argument. When I was employed I had the choice of whatever plan my employer provided which was 2. I "chose" the more expensive plan because it at least let me see my doctor and had what back then was something called (I think) PPO which allowed me to go out of network to a specialist if I wanted . . . at an additional cost of course. When Republicans talk about choice it makes me shake my head. They say you should have the "choice" to buy the best plan you can afford. WTH? Why should your income "choose" your healthcare. Do factory workers deserve less healthcare than a vice president at a bank? Well, I think not.

It's great that you have an incredible plan. It's highly unusual as most employers that used to pay 100% of premiums for their workers over the years have offered less and less with more and more deductibles and copays. So Congratulations on having a terrific boss who is paying so much more than the $2,184 a year you say you are paying!

[Indygram]

53. Why are you so against people having Medicare if they want it WITHOUT taking away my insurance?

There is absolutely NO reason why people can't have both.

I love the idea of Medicare for America but hate and do not support the idea of Medicare for All aka Medicare ONLY.

[Nanjeanne]

57. The reason is purely cost-effective. As an option - it is quite possible that the people who will

"choose" it will be those who have been unable get to insurance or afford insurance - the sicker and the more elderly. That puts extra strain on the pool - it's why those high-risk pools that Republicans talk about thinking are the answer - don't work. For a system to actually be cost-effective and control costs the pool has to be quite large and include younger and healthier people who aren't drawing as much from it.

It's not a question of me wanting to take away YOUR insurance. I want you top have healthcare. If you could go to your doctor and have your medical needs taken care of - what are you losing? Do you really care if Aetna writes the check to your doctor - or the US government does?

[Indygram]

63. A public option Medicare can be added almost instantly and will force competition

That means private insurers would HAVE to offer something better for less that people would actually want to buy or they would go out of business. It is NEVER wise to allow a complete monopoly on something so important as healthcare. I don't feel comfortable with having ONLY one option for healthcare. Sorry, I do not and never will support single payer Medicare Only/Medicare for All. I will 100% support Medicare for America, though.

[Indygram]

58. How is Medicare for America not providing a choice?

Did you read up on it at all? It would give people who get employer insurance the option of keeping it OR transitioning to Medicare if they want to and it would be based on income. Based on what I have read about it, it takes what is good about Medicare for All but without decimating the current system. Just adding a public option is all it would take to force private insurers to become more competitive and provide a far better product than they do now.

[Hortensis]

40. The ACA has a 20% cap on insurer admin costs + profits.

The other 80% of premium dollars has to go to patient care. A huge improvement over how unregulated companies divvy what they charge us up and far, far from "subsidized." The whole health industry is overcharging for a lot of stuff, but most people would be surprised to know that healthcare in general is among the least-profitable industries to invest in. Profits are much lower than others on average.

Btw, under the ACA insurance companies aren't really insurance companies any more. Underwriting risks is almost entirely obsolete as a means of providing healthcare, and the ACA doesn't even require applicants to fill out a health history, just choose the preferred company and plan. One premium for all. They're now mere policy issuers and claims processors, and we will always need a big bureaucracy to handle administration of a program this huge.

[Nanjeanne]

43. Sorry not understanding what this has to do with the fact that our government gives subsidies

to people who can't afford the premiums on the exchange? Where do you think the government gets the money for those subsidies? Who do you think receives the money? It's our dollars going to insurance companies. It's how the ACA helps people afford their premiums.

What does that have to do with 80% going to patient care? You are confusing the help citizens receive when they buy their insurance policies each year on the exchange with how much an insurance company has to pay for patient care (which was one of the very good things that happened when the ACA went into effect).

[Hortensis]

46. Oh, you said subsidizing insurance companies, so

I thought that was what you meant. Under the ACA and Medicare, they've been cut down to clerical processors. It will always be necessary to pay for any entity, private or government, to process the clerical end.

As for who pays: Us, of course, forever. And through the nose as a nation even though modern medical care will always be extremely expensive, because living far longer and far healthier than ever before is not a luxury, it's our new reality.

I wouldn't waste my energy hating an insurance industry that's about to meet the same fate as the farrier industry. Better to be thrilled at being born into this amazing era. So our generations have to suffer through this inevitable transition to making modern healthcare available to all. Healthwise, it's still infinitely better than being born in 1919, and I'm so glad for what I'll be leaving our grandchildren.

[Nanjeanne]

49. Ah . . . no I was just thinking if my taxpayer money has to go to anyone I'd prefer it to be to pay

citizens' healthCARE - as opposed to Aetna's CEO's golden parachute.

My feelings about what I want for this country have evolved as my experiences in the healthcare system have . . . as a younger person getting insurance through my employer and needing very little care - I was quite content. As years went by I was able to see employers offering much less (hey, remember the debacle of HMO's?) and networks of physicians and hospitals becoming narrower. When I started my own business - my eyes were opened to how difficult a system it was to navigate - and afford. When the ACA was passed, I was so thrilled with the many good things that happened to now be included - but as someone a few years from Medicare I was appalled at how much my monthly premiums would be in CT (who, as opposed to some states like NY, were able to charge more based on age) and how much an 80/20 split cost me when I got breast cancer (we earned too much for any taxpayer subsidies) - and I remember the joy I finally felt when my husband and I were finally old enough to get Medicare! We chose a supplemental plan to cover the 20% rather than a cheaper Advantage plan - and then

When my husband was diagnosed with an incurable but "manageable" cancer - we saw how incredibly lucky we were that we had made those decisions - his treatments were paid for. But that "choice" was good for us. My dearest friend made another "choice" to purchase a less expensive Advantage plan -- and when she was diagnosed with a brain tumor she found out sadly how limited her ability to seek out certain doctors or go to certain hospitals was. And when she was ready for hospice - she had only one option that was covered. Her husband decided that hospice wasn't good for her - and "chose" to get her into another one. When that was approved - he then had to pay the 20% share which was quite significant by the time she passed. So much for "choices".

My husband's stem cell transplant and associated fees were paid for. We still need to get a grant from the Leukemia Association to pay the $800/month copay his chemo pills cost each month (and that's with drug insurance) - but his hospital infusions and his doctor visits are taken care of. It's really not until you have to manage a serious illness and you spend time with others who are also managing serious illnesses - that you truly understand how fortunate citizens in other countries are who never worry about whether they can see a specialist or receive their life-saving treatments without the fear of medical bankruptcy.

I wish that for all of us.

[Hortensis]

55. With you all the way on all of that.

We'd be most of the way there now if we'd gotten the power the polls for the first 2/3 of 2016 said we were headed for. We'd probably be talking about the staged roll-out of a guaranteed national income, but for sure would already have major programs up and running for training in new skills and many new jobs in infrastructure projects.

Btw, speaking of our to-do list, one big case for Medicare for America is the legal one -- I've read that it'd be much less vulnerable to court challenges than Sanders' attempt to prohibit job-related insurance and require healthcare be provided through his government program.

So, on to 2020 and getting this done.

[doompatrol39]

60. How many of these people who say they like their private employer coverage...

..have ever had to use it for anything other than routine preventative care? As someone who has always had supposedly great, cadillac employer coverage, through different corporations, and has had pretty much every insurance carrier at one point, and who has spent multiple years with a sick child and multiple years with a wife with cancer, I can say that this supposed great insurance is a nightmare and still costs us ridiculous amounts of money out of pocket. We are lucky that we have very good paying jobs and can cover those costs but 1) payment only comes after literally hours of dealing with customer service reps and fighting and filing disputes and everything else, and 2) the out of pockets would likely bankrupt most people and could have probably paid for a decent college education for most people.

I just hate being lectured by people about our great healthcare system or how much people love their private insurance by people who at most have had to deal with annual physicals or small outpatient procedures every few years.

[Hortensis]

69. "LET'S DIVE IN: Reps. DeLauro & Schakowsky's "Medicare for America"

These clips are from a very informative blog on all things healthcare reform. It's discussing DeLauro & Schakowsky's design of a healthcare program that will both deliver universal healthcare AND offer most Americans what they want and can support. Much of the backlash against the ACA was about forcing 5-6 million often poorly served people onto it. Sanders' program would force 160 million with workplace insurance to give it up! HUGE, huge problem.

... One of the trickiest parts about trying to overhaul the entire U.S. healthcare system is twofold:

* On the one hand, there's nearly 30 million Americans still uninsured, while another 20 million or so are covered via a hodge-podge of healthcare plans ranging from pretty good (subsidized individual market enrollees) to crap ... would be far better served by a more comprehensive public program with lower out of pocket costs.
* On the other hand, nearly half the population (around 160 million or so of us) are covered through our employers...and while plenty of those with employer coverage hate it, polls consistently show that a large majority of them are pretty happy with it (or at least reasonably satisfied ... they aren't willing to let it be torn away and replaced with an all-new, unknown/unproven system). ....

The thing about health insurance risk pools is that you need low-cost healthy people enrolled in order to help cover the expenses for high-cost sick people. In order to do this, you have to make participation mandatory to some degree...

On the other hand, people who are satisfied with their current system tend to hate being forced into participating in a Big Government Program (remember the massive backlash over President Obama's "If You Like It You Can Keep It" statement? The ACA only "forced" around 5-6 million people to switch policies, yet the outrage was so fierce...

The "Medicare for America" bill, along with the three previous proposals it's modeled after, neatly walks this tightrope by making a vastly improved/enhanced "Medicare" program mandatory for roughly half the country (those least likely to object) but completely optional for the other half (those most likely to object). ...

http://acasignups.net/19/02/05/updated-lets-dive-reps-delauro-schakowskys-medicare-america