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-   -   Elizabeth Warren's 52 Trillion dollar health plan (http://www.internationalskeptics.com/forums/showthread.php?t=340038)

applecorped 1st November 2019 06:19 AM

Elizabeth Warren's 52 Trillion dollar health plan
 
https://www.cnbc.com/amp/2019/11/01/...e-for-all.html
Edited by zooterkin:  Quote box added.
Quote:

Sen. Elizabeth Warren pledged Friday not to raise middle class taxes to fund her "Medicare for All" plan, responding to pressure she faced as she emerged as one of the frontrunners for the 2020 Democratic presidential nomination.

In a new outline, Warren's campaign said her single-payer health care plan would cost the country "just under" $52 trillion over a decade, which includes $20.5 trillion in new federal spending. It estimates the proposal would cost just less than the estimated $52 trillion in spending for the current system over 10 years.

TragicMonkey 1st November 2019 06:28 AM

Oooh, such scary numbers. And you say it'll still cost less than the current system, while covering the entire population? Is that supposed to sound like a bad deal?

Upchurch 1st November 2019 07:12 AM

Quote:

Originally Posted by applecorped (Post 12877456)
https://www.cnbc.com/amp/2019/11/01/...e-for-all.html

Sen. Elizabeth Warren pledged Friday not to raise middle class taxes to fund her "Medicare for All" plan, responding to pressure she faced as she emerged as one of the frontrunners for the 2020 Democratic presidential nomination.

In a new outline, Warren's campaign said her single-payer health care plan would cost the country "just under" $52 trillion over a decade, which includes $20.5 trillion in new federal spending. It estimates the proposal would cost just less than the estimated $52 trillion in spending for the current system over 10 years.

It's customary to quote things you are quoting. Makes it look less like plagiarism. Just sayin'.

Belz... 1st November 2019 07:17 AM

Quote:

Originally Posted by applecorped (Post 12877456)
https://www.cnbc.com/amp/2019/11/01/...e-for-all.html

Sen. Elizabeth Warren pledged Friday not to raise middle class taxes to fund her "Medicare for All" plan, responding to pressure she faced as she emerged as one of the frontrunners for the 2020 Democratic presidential nomination.

In a new outline, Warren's campaign said her single-payer health care plan would cost the country "just under" $52 trillion over a decade, which includes $20.5 trillion in new federal spending. It estimates the proposal would cost just less than the estimated $52 trillion in spending for the current system over 10 years.

Sounds like it's time to cut down on military spending a bit.

crescent 1st November 2019 07:25 AM

Quote:

Originally Posted by applecorped (Post 12877456)
https://www.cnbc.com/amp/2019/11/01/...e-for-all.html

Sen. Elizabeth Warren pledged Friday not to raise middle class taxes to fund her "Medicare for All" plan, responding to pressure she faced as she emerged as one of the frontrunners for the 2020 Democratic presidential nomination.

In a new outline, Warren's campaign said her single-payer health care plan would cost the country "just under" $52 trillion over a decade, which includes $20.5 trillion in new federal spending. It estimates the proposal would cost just less than the estimated $52 trillion in spending for the current system over 10 years.

You are describing a plan that will cost less, and which will probably provide better health care overall.

Can you explain the downside to this? I don't see one.

Distracted1 1st November 2019 07:30 AM

Quote:

Originally Posted by applecorped (Post 12877456)
https://www.cnbc.com/amp/2019/11/01/...e-for-all.html

Sen. Elizabeth Warren pledged Friday not to raise middle class taxes to fund her "Medicare for All" plan, responding to pressure she faced as she emerged as one of the frontrunners for the 2020 Democratic presidential nomination.

In a new outline, Warren's campaign said her single-payer health care plan would cost the country "just under" $52 trillion over a decade, which includes $20.5 trillion in new federal spending. It estimates the proposal would cost just less than the estimated $52 trillion in spending for the current system over 10 years.

That would be awesome if she can get it done!!!
Kudos to Warren!

Trebuchet 1st November 2019 08:36 AM

Quote:

Originally Posted by crescent (Post 12877551)
You are describing a plan that will cost less, and which will probably provide better health care overall.

Can you explain the downside to this? I don't see one.

A Democrat proposed it, and it would help poor and working people. That's always a downside to the Republican Party.

BobTheCoward 1st November 2019 08:44 AM

Quote:

Originally Posted by crescent (Post 12877551)
You are describing a plan that will cost less, and which will probably provide better health care overall.

Can you explain the downside to this? I don't see one.

It probably costs more than she estimates, though. Vox had a good piece this morning comparing her estimates to the Urban Institute. Obviously each individual assumption is justifiable. She is smart and has a very smart team. But probably not a good sign when your five assumptions are all more optimistic just to reach your target.

Arcade22 1st November 2019 08:52 AM

Quote:

Originally Posted by Belz... (Post 12877534)
Sounds like it's time to cut down on military spending a bit.

Maybe it's time Americans actually paid for public spending instead of pushing it further and further into the future.

theprestige 1st November 2019 08:52 AM

Quote:

Originally Posted by Distracted1 (Post 12877561)
That would be awesome if she can get it done!!!
Kudos to Warren!

It would be even more awesome if she can include some kind of metric or criteria for determining whether its working, and how well it's working; and if the plan includes some kind of rollback option if it turns out it isn't working.

rdwight 1st November 2019 09:32 AM

I guess it's not possible since her claim is 'no middle class tax increase' but I'd be more interested in what the back up funding plan is when inevitably her projected funding sources run lower than what is needed. No matter how well planned, this will be a messy transition. There will be shortfalls in funding and borrowing to cover.

I just don't believe any Medicare-for-all plan that doesn't include tax hikes for the middle class. And they should still be able to sell it with that eventuality.

CORed 1st November 2019 10:04 AM

Although I'm firmly convinced that single payer is the best option, I'm skeptical of the claim of no middle class tax increase, and cynical enough about politicians in general to think that the real plan is to get it passed, and push for the tax increases later (maybe in her second term, if any) as deficits mount. Even with a tax increase, increased taxes should be offset by reduced out-of-pocket costs for health insurance, co-pays, deductibles, etc.

I still think Warren's or Sanders' single payer or "medicare for all" is ultimately better than Biden's plan of "Make the ACA work", as I strongly suspect that the latter option is impossible.

CORed 1st November 2019 10:11 AM

Quote:

Originally Posted by Trebuchet (Post 12877679)
A Democrat proposed it, and it would help poor and working people. That's always a downside to the Republican Party.

It's also going to deprive insurance companies of huge revenue stream, and likely reduce revenue for doctors and hospitals as well, so expect a massive propaganda campaign to convince people that the government's going to kill Grandma, while "destroying the best healthcare system in the world" (unless you can't afford insurance, or can't get it at all due to a pre-existing condition or whatever).

CORed 1st November 2019 10:13 AM

Quote:

Originally Posted by Arcade22 (Post 12877717)
Maybe it's time Americans actually paid for public spending instead of pushing it further and further into the future.

That's crazy talk. Why raise taxes when we can just tack a few more digits onto the national debt? The Chinese will never stop buying our bonds, right?

fishbob 1st November 2019 12:11 PM

Quote:

Originally Posted by rdwight (Post 12877789)
I guess it's not possible since her claim is 'no middle class tax increase' but I'd be more interested in what the back up funding plan is when inevitably her projected funding sources run lower than what is needed. No matter how well planned, this will be a messy transition. There will be shortfalls in funding and borrowing to cover.

I just don't believe any Medicare-for-all plan that doesn't include tax hikes for the middle class. And they should still be able to sell it with that eventuality.

Between me and my employer, we pay somewhere around $8000 / year for my health insurance premiums. Plus I have several thousand in deductible and additional in co-pays. If all that went to Medicare for all, I have no change in overall costs and a bunch of other people also get coverage. Not a bad deal.

Distracted1 1st November 2019 12:20 PM

Quote:

Originally Posted by fishbob (Post 12877966)
Between me and my employer, we pay somewhere around $8000 / year for my health insurance premiums. Plus I have several thousand in deductible and additional in co-pays. If all that went to Medicare for all, I have no change in overall costs and a bunch of other people also get coverage. Not a bad deal.

My SO's employer pays nearly $14000 per year for hers- and she still has copays and deductibles (albeit low ones- her plan is a good one)
"Policies" available to me cost in excess of $6000 per year, with copays and deductibles that are laughable.
It would take some pretty serious ineptitude ,IMO, to not be able to run the healthcare system better than "we" already do.

Venom 1st November 2019 12:22 PM

Quote:

Originally Posted by fishbob (Post 12877966)
Between me and my employer, we pay somewhere around $8000 / year for my health insurance premiums. Plus I have several thousand in deductible and additional in co-pays. If all that went to Medicare for all, I have no change in overall costs and a bunch of other people also get coverage. Not a bad deal.

I think this is the sticking point for many conservatives.

Maybe add programs for combating obesity or educating people about minor illnesses that contribute to needless or preventable hospital visits.

Skeptic Ginger 1st November 2019 12:23 PM

CMS.gov

2018:
Quote:

U.S. health care spending grew 3.9 percent in 2017, reaching $3.5 trillion or $10,739 per person. As a share of the nation's Gross Domestic Product, health spending accounted for 17.9 percent.
Just for perspective, mind you. :rolleyes:

52 trillion over a decade is a BS number since it predicts increased costs and that is uncertain data. In addition, that 3.5 trillion from last year would be growing every year as well.

Trebuchet 1st November 2019 12:24 PM

Quote:

Originally Posted by CORed (Post 12877830)
It's also going to deprive insurance companies of huge revenue stream, and likely reduce revenue for doctors and hospitals as well, so expect a massive propaganda campaign to convince people that the government's going to kill Grandma, while "destroying the best healthcare system in the world" (unless you can't afford insurance, or can't get it at all due to a pre-existing condition or whatever).

I don't know that that's true. Insurance companies LOVE Medicare. The government takes on most of the risk and they get to sell supplementals and Medicare Advantage plans. I'd expect many employers will provide supplementals as a benefit to employees.

What really concerns me is that a new Democratic President will push for a health plan too rapidly. That happened in 1993 and 2009 and resulted in the disastrous elections of 1994 and 2010; handing the government over to the likes of Newt Gingrich and Mitch McConnell. I see no sign that the party has learned from those mistakes.

Bob001 1st November 2019 12:31 PM

The key problem with Warren's plan is that it would require people to give up what they have now in exchange for an unknown. The plan proposed by Klobuchar, Buttigieg and others is basically "Medicare for All Who Want It." If you don't have or don't like your employee or other private plan, you could buy into an expanded Medicare, which is already well-established and familiar. Over time, more and more people might go that way. Employers might decide to get out of the insurance business and just subsidize their employees to join Medicare. We might move to single-payer over time. But it wouldn't be an abrupt, "stop that, start this" transition that would disrupt a major part of the entire economy and doubtless leave some people worse off.

Norman Alexander 1st November 2019 12:33 PM

Quote:

Originally Posted by fishbob (Post 12877966)
Between me and my employer, we pay somewhere around $8000 / year for my health insurance premiums. Plus I have several thousand in deductible and additional in co-pays. If all that went to Medicare for all, I have no change in overall costs and a bunch of other people also get coverage. Not a bad deal.

Quote:

Originally Posted by Distracted1 (Post 12877985)
My SO's employer pays nearly $14000 per year for hers- and she still has copays and deductibles (albeit low ones- her plan is a good one)
"Policies" available to me cost in excess of $6000 per year, with copays and deductibles that are laughable.
It would take some pretty serious ineptitude ,IMO, to not be able to run the healthcare system better than "we" already do.

Can I ask you both: How much would your insurance cost if you were in low-paying or part-time work?

And if you were not employed / between jobs?

Also, would you need to renegotiate health insurance if you changed jobs?

Distracted1 1st November 2019 12:46 PM

Quote:

Originally Posted by Norman Alexander (Post 12878000)
Can I ask you both: How much would your insurance cost if you were in low-paying or part-time work?

And if you were not employed / between jobs?

Also, would you need to renegotiate health insurance if you changed jobs?

My SO does not pay for her insurance out-of-pocket, it is employer provided.

I am currently un-insured. I had a policy with Aetna that I paid for out of pocket up until the end of last year when they- as their letter read- "no longer offered individual policies in my area". The policy was not all that great, costing over $500 per month. And Aetna had replaced it many times over the years that I had it with a new plan (each time accompanied by a letter telling me that the one I had was "no longer being offered").

When I went looking at the beginning of the year, what I found that was calling itself "insurance" was- as far as I can discern- little better than a scam. The "policies" cost so much that they negate my ability to come up with the deductible when needed, so the things that are recommended by my doctor (on the partially covered visits), like Colonoscopies, would only be affordable if I were not paying for the "insurance"

Sorry. Rant.

On the plus side, If I have a stroke, you all can pay for my E.R. visit. Thanks in advance!

Bob001 1st November 2019 01:03 PM

Quote:

Originally Posted by Distracted1 (Post 12878017)
...
When I went looking at the beginning of the year, what I found that was calling itself "insurance" was- as far as I can discern- little better than a scam. The "policies" cost so much that they negate my ability to come up with the deductible when needed, so the things that are recommended by my doctor (on the partially covered visits), like Colonoscopies, would only be affordable if I were not paying for the "insurance"

Sorry. Rant.

On the plus side, If I have a stroke, you all can pay for my E.R. visit. Thanks in advance!

Did you shop on the exchange? Going uninsured is not a great idea. Even if the high deductibles would discourage you from getting routine care, you would be protected from financial catastrophe if you develop a health catastrophe. Those deductibles would start to look trivial if you develop cancer or get run over by a bus. (Forgive the sermon.)

ETA:
Plugging in a downtown Philadelphia zip code, exchange plans start around $350 a month with a $6,000 deductible, before subsidies.
https://www.healthcare.gov/see-plans/#/household

ServiceSoon 1st November 2019 01:36 PM

Quote:

Originally Posted by Skeptic Ginger (Post 12877991)
CMS.gov

2018:

Just for perspective, mind you. :rolleyes:

52 trillion over a decade is a BS number since it predicts increased costs and that is uncertain data. In addition, that 3.5 trillion from last year would be growing every year as well.

I believe that this is a perspective fail.

If health care continued to increase by 4% every year for the next 10 years it would increase from 3.5 Tril to 5.18 Tril. That increase over a 10 year period would total 1.68 Tril.

Adding a total of 52 Tril spread out over the next 10 years is a very big deal. An almost 31 times big deal, or 3100% if you prefer that metric.

Tsukasa Buddha 1st November 2019 02:26 PM

From first impressions, it seems like an American twist on single payer. The way I see it, there are two options.

A) Pay by taxing everyone. Everyone pays some, but overall pay less. Companies no longer have to deal with paying for healthcare for their employees.

One criticism I've seen of this is that there is no guarantee that companies will pass on their savings in not paying premiums to workers in the form of increased wages.

B) Use taxation to keep costs on employers, and additionally have a stricter progressive tax for the highest earners.

No tax increase on the "middle class", but companies still have to deal with paying for healthcare, which puts us at a competitive disadvantage. Also, the rich are quite good at dodging taxes.

People, like Bernie, are usually suggesting A. Warren's plan B fits the "no middle class tax raise" talking point without trying to explain tax vs total cost, but it keeps our traditional American system of the cost burden, which is IMO generally less effective.

I didn't see mention of it, but I think part of the problem in the US is doctor pay. There's a weird spiral where doctors have to take extreme amounts of debt, and the AMA restricts the number of doctors trained to keep salaries extremely high, and doctors shift to specialty and leave GP so now we have NPs trying to fill the gap, that I think needs to be addressed. And staff shortages leads to overworking and burnout which leads to staff shortages and so on.

angrysoba 1st November 2019 02:39 PM

Quote:

Originally Posted by crescent (Post 12877551)
You are describing a plan that will cost less, and which will probably provide better health care overall.

Can you explain the downside to this? I don't see one.

Because itís gonna cost 52 million dollars!!!!!!!!1!!!!!!

catsmate 1st November 2019 02:46 PM

Quote:

Originally Posted by TragicMonkey (Post 12877467)
Oooh, such scary numbers. And you say it'll still cost less than the current system, while covering the entire population? Is that supposed to sound like a bad deal?

Bah humbug, socialism.

Tsukasa Buddha 1st November 2019 03:37 PM

A left critique focusing on head vs payroll tax:

Quote:

What Warren is proposing here, in ordinary fiscal language, is a Medicare head tax. This is a departure from the normal Medicare payroll tax proposals. The distributive difference between them is that the Medicare payroll tax charges a specific percentage of each worker’s earnings, while the Medicare head tax charges a specific dollar amount per worker.

...

Needless to say, the Medicare payroll tax is far superior to the Medicare head tax distributively speaking. Specifically, the Medicare head tax charges middle and low earners massively more than the Medicare payroll tax does.

Elizabeth Warren’s team realizes this. The reason they are using the head tax is because they think they can trick journalists into declaring that this is not a tax, since it is expressed in dollar terms rather than percent terms. On first glance, this might seem like a stretch that probably won’t work. But it is a more plausible strategy once you consider that journalists are mostly very stupid and cannot evaluate policy claims on their own, relying instead on trusted sources and names (Warren being one of those names).

Separate from the distributive problems of Warren’s head tax, the two exclusions also make the proposal clearly unworkable and easily gamed. All companies have to do to avoid rather large head tax charges is spin off workers into independent contractor status or spin them off into firms with less than fifty employees that they then contract with for services.

Once some employers start doing this, the average Medicare employer contribution will have to go up to keep revenue stable, which will push even more employers to restructure their labor into independent contracting or outsourcing to small firms. And, at that point, the death spiral is off to the races.

The genius of the payroll tax, of course, is that it is unable to be evaded like this. Every dollar of labor income — even independent contractor income — is charged the same. No restructuring can save you from it.
Linky.

Roger Ramjets 1st November 2019 05:07 PM

Quote:

Originally Posted by theprestige (Post 12877718)
It would be even more awesome if she can include some kind of metric or criteria for determining whether its working, and how well it's working; and if the plan includes some kind of rollback option if it turns out it isn't working.

Nah, that would just be embarrassing when the 'metric' shows that it is working. Better to sabotage it at every opportunity, then complain that it's not working!

And besides, we know it won't work - because a Democrat proposed it. No need to look any closer...

Quote:

Originally Posted by Venom
I think this is the sticking point for many conservatives.

Indeed, people getting something for nothing is abhorrent to us - unless they are rich of course.

PhantomWolf 1st November 2019 05:12 PM

Quote:

Originally Posted by ServiceSoon (Post 12878058)
I believe that this is a perspective fail.

If health care continued to increase by 4% every year for the next 10 years it would increase from 3.5 Tril to 5.18 Tril. That increase over a 10 year period would total 1.68 Tril.

Adding a total of 52 Tril spread out over the next 10 years is a very big deal. An almost 31 times big deal, or 3100% if you prefer that metric.

I think you misread the article in the OP. Warren's plan estimated cost would be just under $52 Trillion over 10 years, it wouldn't add $52 Trillion to the current costs. In fact it stated that the current system would be more expensive coming out at just over $52 Trillion.

This means that the current system would be more expensive and serve less people.

Craig4 1st November 2019 05:30 PM

This is a "we're not ready for it" fail. Let a candidate who advocates for "keep your private insurance but here's Medicare if you need it" proceed and let people gradually conclude Medicare for all is better. Maybe we will adopt a system like most of Western Europe. Just don't risk four more years of Trump over it.

varwoche 1st November 2019 06:15 PM

Quote:

Originally Posted by Craig4 (Post 12878253)
This is a "we're not ready for it" fail. Let a candidate who advocates for "keep your private insurance but here's Medicare if you need it" proceed and let people gradually conclude Medicare for all is better. Maybe we will adopt a system like most of Western Europe. Just don't risk four more years of Trump over it.

This seems like a wise approach, just in terms of logistics and ease of implementation.

casebro 1st November 2019 06:25 PM

Splain the math: Currently Medicare covers about 1/3 of the population. Warren is going to cover 3 times as many people for the same cost? I call Pie-in-the-sky.

tyr_13 1st November 2019 06:25 PM

Quote:

Originally Posted by varwoche (Post 12878292)
This seems like a wise approach, just in terms of logistics and ease of implementation.

But not cost. It still has the inefficiency of private insurance. If it is actually popular it will have to cost more than single payer because of this inefficiency and need to cover almost as many people. If it doesn't have to cover almost as many people, then it's because it isn't actually better. Either it works and a ton of people use it, costing money, or it doesn't and then what did you even accomplish?

There is something to be said for just pulling the bandaid. The other also risks becoming an inefficient mess that stays for decades like subsidized flood insurance. In that state, the GOP can beat the Dems over the head with how much it 'proves' government can't work while the Dems have to try to keep it afloat because the Dems aren't immoral asshats who don't care if people die. As an entitlement the GOP can still try to sabotage it, but then it costs them politically like when they keep trying to break social security and Obamacare.

Beeyon 1st November 2019 06:30 PM

Seems like a political ploy to get elected, and retreat to the more sensible tax-the-middle-class-but-they're-better-off approach after the office is in hand.

The proposal seems to include an increase of her proposed wealth tax to... 6%! I'm very open to a wealth tax, but this is an absurdly high number.

varwoche 1st November 2019 06:37 PM

Quote:

Originally Posted by tyr_13 (Post 12878305)
But not cost. It still has the inefficiency of private insurance. If it is actually popular it will have to cost more than single payer because of this inefficiency and need to cover almost as many people. If it doesn't have to cover almost as many people, then it's because it isn't actually better. Either it works and a ton of people use it, costing money, or it doesn't and then what did you even accomplish?

There is something to be said for just pulling the bandaid. The other also risks becoming an inefficient mess that stays for decades like subsidized flood insurance. In that state, the GOP can beat the Dems over the head with how much it 'proves' government can't work while the Dems have to try to keep it afloat because the Dems aren't immoral asshats who don't care if people die. As an entitlement the GOP can still try to sabotage it, but then it costs them politically like when they keep trying to break social security and Obamacare.

I hear you. But with Medicare for all who want it (could someone please place an order at the acronym store) why would employers keep providing insurance? Maybe it would quickly predominate the market.

Stacyhs 1st November 2019 06:41 PM

At least Warren has a plan which is more than can be said of the Republicans. Remember when it was going to be fantastic and cheaper and so easy? Here we are 3.5 years later and they still haven't produced a plan. Quelle surprise.

crescent 1st November 2019 06:47 PM

Quote:

Originally Posted by casebro (Post 12878304)
Splain the math: Currently Medicare covers about 1/3 of the population. Warren is going to cover 3 times as many people for the same cost? I call Pie-in-the-sky.

With medicare for all, the government would have much more power to set prices. No more 10x increases in medicine price just to give the shareholders a better dividend. No more getting sent to a specialist who charges crazy amounts to look at an X-ray. This would cut an enormous amount of profit out of the system. Nobody would go to the poor house, but a few Yachts might not get purchased by CEO's who know nothing about health or medicine anyway.

This would be single payer. They would not be covering everyone for the same as Medicare currently costs. They would be covering everyone at the same overall cost as what Medicare, employer-related health insurance, and uninsured people already pay as a whole - except this way the uninsured and under-insured would get much better care than currently. No more yachts for the CEO of the Health Insurance company any more than the CEO of the hospital company.

It's pretty socialist, but our current health system is a cash cow for people who are already wealthy, and we only get poor service in return. We've tried full private enterprise health care and its the worst in the developed world. So then lets try a nice mix, with single payer and government regulation of the costs charged by the private providers.

Tsukasa Buddha 1st November 2019 07:14 PM

Quote:

Originally Posted by casebro (Post 12878304)
Splain the math: Currently Medicare covers about 1/3 of the population. Warren is going to cover 3 times as many people for the same cost? I call Pie-in-the-sky.

That's not the plan, regardless of the validity of the math. It is the same cost, or a little less, as total health care spending, not current Medicare spending. Hence, the taxes.

BobTheCoward 1st November 2019 08:54 PM

Quote:

Originally Posted by crescent (Post 12878335)
With medicare for all, the government would have much more power to set prices.

Medicare cannot negotiate drug prices even with the power they have now. If we are offering this Medicare to all, then that same Medicare doesn't have price negotiation.

Unless that is another in the long list of things that are part of Medicare that isn't going to be part of Medicare. Medicare 4 All is the ship of Theseus of Medicare.


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