Democratic Primaries
Related: About this forumIf Warren were to drop Medicare for all
...for a public option within the ACA, she would run away with the nomination. I see Medicare for all as a serious problem in a general election. The public option is the better bet because you are leaving the choice with the consumer and not making claims about eliminating private insurance. Don't drink the Bernie koolaide Elizabeth!
primary today, I would vote for: Joe Biden
Gothmog
(143,999 posts)Against my better instincts, I am slowly beginning to like Mayor Pete.
Link to tweet
Nevertheless, Buttigieg has a compelling argument: Candidates are obligated to offer bold ideas that are doable. He argues, Rather than flipping a switch and kicking almost 160 million Americans off their private insurance, including 20 million seniors already choosing private plans within Medicare, my plan lets Americans keep a private plan if they want to. The latter is a reference to Medicare
Advantage, which would go away under a strictly single-payer system.
The approach favored by Buttigieg, Biden, Sen. Amy Klobuchar (D-Minn.) and other moderates would be cheaper and allow people to gradually migrate to Medicare (if that is what they want). Moreover, if Democrats want to accomplish anything, it likely will require a Democratic majority in the Senate and use of reconciliation; they would at least need a majority. There is not, as we speak, a majority of Democrats in both houses who support Medicare-for-all.
Part of the problem with this discussion is that the Medicare-for-all advocates are adept at deflecting pesky questions about cost, logistics and political feasibility. They shouldnt be allowed to skate by on ad hominem attacks (Thats a Republican talking point!) or non sequiturs (Let me tell you how great Medicare-for-all is!) or platitudes (Were going to fight!).
primary today, I would vote for: Joe Biden
GeorgeGist
(25,294 posts)primary today, I would vote for: Joe Biden
Gothmog
(143,999 posts)Such a plan in theory may generate societal savings but such savings would not pay for a program. Governments can only spend tax revenues and/or borrowings. This study does not say how one would pay for such a program in the real world. I note that Prof. Krugman like the concepts of such a plan in theory but notes that taxes will have to be raised a great deal to pay for such a plan
Back in 2016, here is his position Prof. Krugman compares Sanders hoped for health care savings to the GOP tax cuts. http://krugman.blogs.nytimes.com/2016/01/19/weakened-at-bernies/?_r=0
To be harsh but accurate: the Sanders health plan looks a little bit like a standard Republican tax-cut plan, which relies on fantasies about huge supply-side effects to make the numbers supposedly add up. Only a little bit: after all, this is a plan seeking to provide health care, not lavish windfalls on the rich and single-payer really does save money, whereas theres no evidence that tax cuts deliver growth. Still, its not the kind of brave truth-telling the Sanders campaign pitch might have led you to expect.
Today, Prof. Krugman says that such a plan is feasible if you are willing to pay a great deal more in taxes
https://www.alternet.org/news-amp-politics/paul-krugman-explains-why-single-payer-health-care-entirely-achievable-us-and-how
The amount of higher taxes are not quantified in this article by Krugman. To pay for any such plan will require massive tax hikes
Again sanders has utterly failed in his attempts to get Vermont to adopt his magical single payer plan because the state of Vermont cannot use hypothetical societal saving to pay for this plan. Even Krugman admits that much higher taxes are needed
primary today, I would vote for: Joe Biden
Hortensis
(58,785 posts)primary today, I would vote for: Joe Biden
rurallib
(62,346 posts)That was a republican plan written by the Heritage Foundation.
I am guessing many of us hoped it would be a place holder until a real universal health care package could be passed.
M4A is the closest I have seen to universal care in this country.
The insurance companies will not give up their incredibly profitable business without fighting with every lie they have, that is for sure.
primary today, I would vote for: Joe Biden
Hortensis
(58,785 posts)coverages always planned were added to it. Frankly, I have real trouble believing Sanders himself doesn't feel real contempt for his plan. It's based on for-profit medicine just like the ACA.
And the insurance companies already see the writing on the wall. That's because "insurance" is for unforeseen emergencies, not for lifetime health maintenance. The ACA did away with underwriting and that is the future for all. The only need they can fulfill is clerical, and computers will be handling more and more of that also. Right now ACA insurers are required to devote 80% of premium dollars to patient care. That percentage will increase under any plan.
I believe it's something like 3% under the VA, but that's socialized medicine, and neither the ACA nor MfA are even slightly socialized.
primary today, I would vote for: Joe Biden
JI7
(89,175 posts)of being defender of ACA.
but for Warren that is probably not the same since she is trying to get Sanders people on her side.
primary today, I would vote for: Undecided
BeckyDem
(8,361 posts)She isn't drinking anything, she can read and knows why Medicare for All is best.
The majority of Americans support improved Medicare for all. Learn about legislation in the House (H.R. 1384) and Senate (S. 1129) that would establish this badly needed reform.
https://pnhp.org/
primary today, I would vote for: Joe Biden
themaguffin
(3,805 posts)Pete stated in the last debate.
primary today, I would vote for: Joe Biden
Sherman A1
(38,958 posts)MEDICARE FOR ALL
Access to quality healthcare is one of the most important factors in overall well being, and yet America is one of the few industrialized nations not to provide healthcare for all of its citizens. Instead, we have a private healthcare system that leaves millions uninsured and bankrupts even some of those who do have health insurance. At the same time, our cost of care is higher than in almost any other industrialized country while providing worse outcomes. The Affordable Care Act was a step in the right direction, providing funds to states to innovate while expanding Medicaid substantially. However, it didnt address the fundamental issues plaguing our healthcare system:
Access to medicine isnt guaranteed to all citizens
The incentives for healthcare providers dont align with providing quality, efficient care
This must change.
Through a Medicare for All system, we can ensure that all Americans receive the healthcare they deserve. Not only will this raise the quality of life for all Americans, but, by increasing access to preventive care, it will also bring overall healthcare costs down.
With a shift to a Medicare for All system, costs can also be controlled directly by setting prices provided for medical services. The best approach is highlighted by the top-ranked Cleveland Clinic. There, doctors are paid a flat salary instead of by a price-for-service model. This shift has led to a hospital where costs are visible and under control. Redundant tests are at a minimum, and physician turnover is much lower than at comparable hospitals.
Doctors also report being more involved with their patients. Since theyre salaried, theres no need to churn through patient after patient. Instead, they can spend the proper amount of time to ensure that each patient receives their undivided attention and empathy.
Outside of a shift to a Medicare for All system, we can look to the Southcentral Foundation for another important shift necessary in the way we treat patients: holistic approaches. At this treatment center for native Alaskans, mental and physical problems are both investigated, and, unsurprisingly, the two are often linked. By referring patients to psychologists during routine physicals, doctors are able to treat, for example, both the symptoms of obesity and the underlying mental health issue that often is related to the issue. The referral also leads people with issues they may otherwise try to bury sexual abuse, addictions, or domestic violence issues to bring them up with a doctor so that they can be addressed.
By providing holistic healthcare to all our citizens, well drastically increase the average quality of life, extend life expectancy, and treat issues that often go untreated. Well also be able to bring costs under control and outcomes up, as most other industrialized nations have.
Finally, being tied to an employer so that you dont lose your healthcare prevents economic mobility. Its important that people feel free to seek out new opportunities, and our current employer-provided healthcare system prevents that.
PROBLEMS TO BE SOLVED
Millions of Americans live without healthcare.
Even those with healthcare are often bankrupted by healthcare costs.
Many Americans who have healthcare have policies that dont afford them the opportunity to receive proper care.
Healthcare costs in this country are relatively high, and outcomes are relatively poor.
Doctors are incentivized to act as factory workers, churning through patients and prescribing redundant tests, rather than doing what theyd preferspending extra time with each patient to ensure overall health.
Many health issues fall through the cracks because doctors rely on patients to bring up issues rather than treating each one holistically.
Employees are tied to their employers because they receive the healthcare benefits through them.
Healthcare should be a basic right for all Americans. Right now, if you get sick you have two things to worry about how to get better and how to pay for it. Too many Americans are making terrible, impossible choices between paying for healthcare and other needs. We need to provide high-quality healthcare to all Americans and a Medicare for All system is the most efficient way to accomplish that. It will be a massive boost to our economy as people will be able to start businesses and change jobs without fear of losing their health insurance.
GOALS
Holistic healthcare for all Americans
Bend the cost curve of healthcare down
Focus on preventive and holistic care
Change the incentive structure for doctors
Allow doctors and hospitals to innovate in treatment
As President, I will
Work with Congress to create a Medicare for All system to provide healthcare to all Americans.
Shift the way doctors are compensated to promote holistic and empathic care.
Create incentives for and invest in innovative treatment methods and methodologies.
https://www.yang2020.com/policies/medicare-for-all/
primary today, I would vote for: Undecided
DURHAM D
(32,595 posts)Every time a voter over 65 hears how wonderful Medicare for All is going to be they think to themselves:
"Don't they know it is not a particularly good program? It does not pay a dime for prescriptions and only pays 80% on claims. Also, we paid into it all of our work years and when we reached 65 got an invite to join Medicare and keep paying in for the rest of our lives as they take it every month from our Social Security check. Can't they come up with something better than Medicare - it just ain't all that great?"
Edit: Looks like the number of voters over 65 is a little less than 50 million.
primary today, I would vote for: Undecided
The Velveteen Ocelot
(115,280 posts)that it covers everything, and it doesn't. There are copays and exclusions and you do have to keep paying premiums which are deducted from your SS check every month. If you want more complete coverage you have to buy a supplemental policy from a private insurer (and pay premiums for that, too).
primary today, I would vote for: Joe Biden
DURHAM D
(32,595 posts)voters under 65 think it is free for seniors. They have no idea that we paid into the fund for decades and that we keep on paying for a mediocre plan.
primary today, I would vote for: Undecided
The Velveteen Ocelot
(115,280 posts)for decades, and I'm still paying premiums now. Where is the money for MfA going to come from to cover the people who haven't been paying in advance for 40+ years?
primary today, I would vote for: Joe Biden
sheshe2
(83,341 posts)Last edited Thu Sep 19, 2019, 07:25 PM - Edit history (1)
Build on ACA and make that single payer.
primary today, I would vote for: Joe Biden
Funtatlaguy
(10,856 posts)And huddle with her staff and any economic advisers.
Then come out with a revised health care plan.
primary today, I would vote for: Joe Biden
primary today, I would vote for: Joe Biden
Hoyt
(54,770 posts)will cost in taxes or premiums.
Until then, people are going to prefer a Public Option so they can compare the PO cost against current health plans.
primary today, I would vote for: Joe Biden
MontanaFarmer
(630 posts)It's all about the politics, and in my opinion, and that of the OP, it's politically untenable. No chance. Restoring ALL of the affordable care act, with a Medicare buy- in or some other hyper-competitive public option, gets us there in 15 years anyway. I'm with Elizabeth on many things but with Joe Pop and The Mayor on this one.
primary today, I would vote for: Joe Biden
crazytown
(7,277 posts)there's a greek chorus here that will always tell you that ONLY Biden can beat trump.
M4A is just an excuse for pushing their guy - come hell or high-water.
primary today, I would vote for: Undecided
Bettie
(15,998 posts)if you start negotiations at "public option for the ACA", we'll walk away with the status quo or losing ground.
If you start at MFA, a public option is MUCH more likely to happen, as a starting point toward universal health care.
primary today, I would vote for: Undecided
highplainsdem
(48,730 posts)supporters who want MFA.
And she'd also likely come under attack by the Sanders campaign, who'd question her commitment to other progressive goals.
I agree with what Michael Tomasky wrote recently about her campaign probably looking for some way for her to "inch away" from MFA.
https://www.democraticunderground.com/1287285882
It's extremely odd for a candidate who always has "a plan for that" to not have her own very detailed health care plan out yet, with a detailed explanation of how to pay for it.
I don't believe she and her staff haven't done a lot of research on this.
My best guess is they know the details don't look very good.
And unlike Bernie Sanders, Warren isn't willing to admit MFA will mean raising taxes on the midddle class as well as the rich.
So she talks about agreeing with the Sanders plan.
But she dodges the question, every time she's asked, about whether taxes on the middle class will go up to pay for MFA.
This has been getting harder for her to do, and I don't expect the questions to let up.
I suppose her campaign might be considering announcing a "Eureka" moment in the future where she suddenly discovers that MFA will raise taxes too much, and so she's now considering a public option instead. (I don't know what other excuse she could use. Saying she's switching out of political expediency might bother even people like Frank Bruni who applaud her for her slipperiness when she dodges the tax question.)
But that change in position would still alienate a lot of progressives.
And people who aren't already her fans might be more than a little skeptical about the conversion and suspect that she'd known all along that there were problems with MFA, but didn't see any way of picking up more support from progressives than Sanders has without saying she's for it.
primary today, I would vote for: Joe Biden
Tennessee Tuxedo
(36 posts)Have awesome insurance, very little cost to me and do not want to give that up. My wife had severe cancer and had no problems with treatment, anything she needed it was approved and did not paying much out of pocket, saved her life.
I am sorry but MfA is the last thing I want because it would be a massive step down from what I have. Most other union members I know feel the same way. MfA is going to be a huge looser in the general.
Somebody needs to come up with a plan that gets people insurance that need it but not at the cost of the rest of us to make it work.
Does anyone understand my point?
primary today, I would vote for: Undecided
Blue_true
(31,261 posts)Where I think democrats will end up is having people like you keep your current plan if you like it (which you do), but provide an option for working people that are not as lucky as you or former workers who were struck by ageism on the job and are in the hard to find another good job 50-65 age range.
primary today, I would vote for: Joe Biden
athena
(4,187 posts)I understand what you're saying, but I believe you're mistaken about what Medicare for All would really mean. You're assuming that the health care you receive would be inferior under Medicare for All. You're assuming that it would somehow be like having inferior health insurance. But those are false assumptions.
Under Medicare for All, there would be no paperwork. Nothing would have to be approved. Your doctor would tell you what is needed; you would have it done; and you wouldn't have to pay anything. That's how it works in Canada. People have operations all the time without paying anything or having to file any paperwork. And, when your procedure is urgent, you go to the head of the line. People get cancer all the time in Canada, and they are treated for it.
Please see:
https://www.webmd.com/cancer/news/20180601/cancer-care-twice-as-costly-in-us-versus-canada#1
What's more, the extra money Americans paid didn't buy them any more time on Earth. Average survival was roughly similar on either side of the border.
"You don't necessarily see that patients in Canada are faring much worse, or worse at all, which is sometimes the impression that we have in this country -- that our outcomes are far better than in places with single-payer health care," said principal investigator Dr. Veena Shankaran.
primary today, I would vote for: Undecided
Blue_true
(31,261 posts)That is workable and builds on two structures that are in place now. It also won't require a long overhaul and costly political fight.
I think the key things is covering two groups with affordable, low deductible, no cap health insurance, the unemployed and middleclass workers that currently can't afford quality health insurance.
I believe the ACA or MFATWI should also allow small companies to buy into a cumulative group insurance pool (dramatically lowers their costs and allows them to provide high quality plans to their employees).
primary today, I would vote for: Joe Biden
BlueMississippi
(776 posts)primary today, I would vote for: Joe Biden
Owl
(3,629 posts)primary today, I would vote for: Joe Biden
elocs
(22,474 posts)but it makes for a great pie-in-the-sky promise to fix the healthcare problem.
And why call it "Medicare" for All when it is not the Medicare that millions of people already know about?
primary today, I would vote for: Joe Biden
Joe941
(2,848 posts)Now is not the time to retreat.
primary today, I would vote for: Undecided
guillaumeb
(42,641 posts)Rather than start with a weak position, demand the public option. Let the insurance companies compete if they can, but lower premiums and more coverage for the public option is something that private insurance cannot compete against.
primary today, I would vote for: Joe Biden
Florida Bull
(103 posts)If Elizabeth Warren switched to opposing Medicare for All, I would lose my trust in her. It would look two-faced, and I would feel betrayed.
There are other factors, but I think the appearance of being indecisive on Medicare for All hurt Kamala Harriss poll numbers.
It would be one thing to admit you think you will have to compromise on healthcare in the 2020s, while still endorsing Medicare for All in the longer-term future. This would apply to Kirsten Gillibrand.
But, I think it is now probably too late for a candidate to flip-flop on healthcare policy and denounce ones position from the first few debates. The candidate would appear unsure and become vulnerable to criticism from both the more Centrist and more Liberal candidates. It would also alienate supporters. Imagine Ted Cruz suddenly switching to supporting Obergefell v. Hodges or an assault weapons ban in the 2016 Republican Primary.
primary today, I would vote for: Undecided
NCLefty
(3,678 posts)tor or will somehow have a worse experience if they have an issue. They can't imagine something better because it's very complicated and even theoretical to most of us. If we can demonstrate that things are going to be BETTER, we might be able to bring people on board.
I'm not sure how she drops such a major thing without looking waffley, but if it can't be made popular, she might have to.
primary today, I would vote for: Undecided
Gothmog
(143,999 posts)primary today, I would vote for: Joe Biden
BlueWI
(1,736 posts)Agree or disagree, Warren's stance is clear. It's refreshing to move away from focus-grouping every stance in your platform. Triangulation costs Democrats election wins in the new political notmal. Warren's straightforward style is why she's appealing in this climate.
primary today, I would vote for: Undecided
athena
(4,187 posts)And giving up on it because it appears politically difficult is a losing strategy. Americans respect someone who has strong opinions, articulates them, and sticks to them. I believe Elizabeth Warren will win because she speaks the truth about health care.
primary today, I would vote for: Undecided
BlueWI
(1,736 posts)Private health insurance is an increasingly rare commodity. It's time to meet this vast need head on.
primary today, I would vote for: Undecided
brooklynite
(93,862 posts)primary today, I would vote for: Joe Biden
Tarc
(10,472 posts)primary today, I would vote for: Joe Biden
Thanks!
primary today, I would vote for: Undecided
Response to DIVINEprividence (Original post)
elocs This message was self-deleted by its author.
Gothmog
(143,999 posts)primary today, I would vote for: Joe Biden
Gothmog
(143,999 posts)Getting rid of Obamacare is a bad move https://politicalwire.com/2019/09/30/obamacare-has-made-people-healthier/
Such findings are part of an emerging mosaic of evidence that, nearly a decade after it became one of the most polarizing health-care laws in U.S. history, the ACA is making some Americans healthier and less likely to die.
primary today, I would vote for: Joe Biden