Bernie on releasing a plan to pay for MFA: "I don't think I have to do that right now."

[BeyondGeography]

From an interview today with John Harwood:

John Harwood: One of the constraints has been fiscal. Senator Warren is producing plans to pay for Medicare for All. You’ve identified revenue sources for about half of it. Do you think it’s important to identify revenue sources for the other half? Or do you believe, as those who subscribe to modern monetary theory believe, that we’ve been a little bit too constrained by concerns about the deficit?

Bernie Sanders: We’re trying to pay for the damn thing. At a time of massive income and wealth inequality, it is my view that the wealthiest people in this country, the top 1/10th of 1% should be paying substantially more than they’re paying right now. You have an insane situation. Let my Wall Street friends there tell me why it makes sense.

... John Harwood: But you still have more revenue to go to make it fully paid for, yes?

Bernie Sanders: The fight right now is to get the American people to understand that we’re spending twice as much per capita, that of course, we can pay for it. We’re paying it now in a very reactionary, regressive way. I want to pay for it in a progressive way.

You’re asking me to come up with an exact detailed plan of how every American — how much you’re going to pay more in taxes, how much I’m going to pay. I don’t think I have to do that right now.

John Harwood: You think it’s foolish that Senator Warren is trying to?

Bernie Sanders: I’m not saying it’s foolish. All that I’m saying is that we have laid out a variety of options that are progressive. We’ll have that debate. At the end of the day, we will pay for every nickel of Medicare for All, and it will save the overwhelming majority of the American people, who will no longer pay premiums.

More at https://www.cnbc.com/2019/10/28/bernie-sanders-lets-not-make-people-overly-nervous-about-socialism.html

[George II]

1. AHA! The truth comes out. Wonder now if everyone will acknowledge it's an incomplete plan?

So he doesn't know yet how he will pay for it, but it will save everyone money.

[thesquanderer]

14. But IS it really important to have that level of detail?

After all, as many people here have said (perhaps even you?) NONE of these plans will get enacted exactly as the candidate says they will, they will all ultimately be negotiated through congress, who will determine the details. In that case, arguably, the important thing is to present the broad strokes.

The other candidates who have less ambitious plans still often have plans that have costs associated with them, but no one is asking them for such detailed accounts of exactly where every dollar will come from, or to prove they will be revenue neutral.

Back to what Sanders said, I think his big point here is, as a society, we are ALREADY paying enough into the healthcare system to achieve single payer (MFA). As he says, "We’re paying it now in a very reactionary, regressive way." And more, per capita, then in other countries. So it's not like the funds aren't there, the question becomes one of how you manage the reallocation. He says he has "laid out a variety of options that are progressive." It is ultimately congress who will determine how much of which ones to use.

I'm not saying more detailed plans don't have value, and I'll be curious to see Warren's. I'm just not convinced it's essential, or that the whole argument isn't being used as little more than a political football.

[George II]

15. Sounds good to me. On April 15 next year I'll just put a check, nothing else, in an envelope...

....and send it to the IRS. Think they will accept that?

Or:

[thesquanderer]

18. That answer doesn't address anything I said. But as far as April 15 goes...

How is this any different from every candidate in every presidential election? They tell you what their plans are, they may tell you they intend to cut taxes on x or raise taxes on y, spend money on this but cut expenditures on that, but when it comes time to vote, you NEVER have enough detail to predict what your next tax return will be.

[George II]

19. He's been touring the country for more than four years talking about his plan. He's told us...

....it would be fully paid. Now he's coming out after all that time, saying he doesn't have a plan for paying for it?

One would think that during those four years he might have sat down for a few hours or a few days to at least give us an outline of how to pay for it.

One thing I've mentioned several times that he hasn't even addressed specifically who will be administering his plan. Will they be government employees? Today's existing Centers for Medicare and Medicaid Services department certainly doesn't have close to the number of people required to administer a plan that covers 325 million people. Currently there are one third that number of people on Medicare and Medicaid. The work of the CMS will be tripled.

He also hadn't addressed what will happen to the hundreds of thousands or millions of people currently working for private insurance companies, which he plans on phasing out or dramatically downsizing over four years.

Finally, he totally ignores the participation of private insurance companies (which he wants to all but eliminate) in the current administration of Medicare.

[thesquanderer]

21. Numerous points about your reply...

Yes, he has talked about how to pay for it. It's here at https://www.sanders.senate.gov/download/options-to-finance-medicare-for-all?inline=file
But it does not provide the level of detail he is now being asked for.

Funny that you essentially ask, "Since Medicare does not have enough employees to administer something of this scale, where will the employees come from" and then "What will happen to all the private insurance employees who will be put out of work?" It seems to me that the second question is the perfect answer to the first. The people with the right skills and experience will indeed be available and looking for work! Maybe not 100% of them, as the new system should require fewer total employees (eliminating redundancies, reducing paperwork), but probably the great majority of them. I don't think the new system would have any problem finding staff.

My understanding is that he does not ignore "participation of private insurance companies...in the current administration of Medicare" -- rather he says they will be unnecessary.

[George II]

24. There are 10 CMS Regional Offices right now....

Last edited Tue Oct 29, 2019, 01:36 PM - Edit history (1)

...all of them in major cities. But there are people working for private insurance companies in every state, many in rural areas. Are these people, when they lose their jobs, supposed to pick up and move to Chicago or Dallas or Atlanta, etc? Will we have hundreds of thousands or more people who have been working in the private sector displaced and forced to become Federal employees in big cities?

This is just the tip of the iceberg. There are many other details that I don't think have been considered in this vague "plan".

[W_HAMILTON]

2. You mean you didn't include that in the damn bill?

[Kahuna7]

8. I see what you did there!

[awesomerwb1]

3. I want a Bugatti Chiron

How am I going to pay for it? I don't think I have to tell you that right now.

M4A! Student debt forgiveness! Hell, let's go with mortgage forgiveness while we're at it!

How are we gonna pay for it all? Who cares! Look, squirrel!

[George II]

4. Might we be seeing this soon?

[tirebiter]

20. Hoover was a progressive, you know

Just sayin’

[Cha]

34. Awesome!

[comradebillyboy]

5. You want European style social walfare then you have to pay European

style tax rates. There aren't enough billionaires to finance Bernie's welfare state. Good luck selling America on 50% income taxes and 25% value added taxes on all sales.

[George II]

6. Personal income tax rate in Denmark, which has been touted as an example for M4A, is 55%.

[bluewater]

9. Is it a case of you get what you pay for? US ranked behind Denmark in quality of life.

Quality of Life
Through all phases of life, these countries treat their citizens well. Scandinavian countries fared well, as did Canada.

Beyond the essential ideas of broad access to food and housing, to quality education and health care, to employment that will sustain us, quality of life may also include intangibles such as job security, political stability, individual freedom and environmental quality.
What social scientists do agree on is that material wealth is not the most important factor in assessing a life lived well. The results of the Quality of Life sub-ranking survey reflect that sensibility.

The 2019 Best Countries rankings, formed in partnership with BAV Group, a unit of global marketing communications company VMLY&R, and the Wharton School of the University of Pennsylvania, are based on a study that surveyed more than 20,000 global citizens from four regions to assess perceptions of 80 countries on 75 different metrics. The Quality of Life subranking is based on an equally weighted average of scores from nine country attributes that relate to quality of life in a country: affordable, a good job market, economically stable, family friendly, income equality, politically stable, safe, well-developed public education system and well-developed public health system. The Quality of Life subranking score had a 17 percent weight in the overall Best Countries ranking.
People consistently view a small group of nations as best providing for their citizens. For the fourth consecutive year, Canada ranks No. 1 overall for providing a good quality of life. Survey respondents view the North American country as No. 1 for both being politically stable and having a well-developed public education system, and No. 2 for having a good job market, a perception supported by independent research. The North American country is seen as possessing the fifth best well-developed public health care system. In fact, Canada is rated in the top 10 in all but one of the nine attributes, affordability, where Asian countries dominate.

Seven European countries are ranked in the top 10, and 13 from the continent rank in the top 20. Sweden, Denmark and Norway immediately follow Canada, with Switzerland, Finland, Australia, the Netherlands, New Zealand and Germany also finishing in the top 10.

https://www.usnews.com/news/best-countries/quality-of-life-rankings

Denmark was ranked 3rd in overall good quality of life for its citizens, the USA ranked 17th.

[George II]

12. Denmark is a country of 16,000 square miles, the US is 3.8 million square miles.

Denmark is just slightly larger than Maryland. Maryland has a higher quality of life than 44 other states.

Geography and total population are huge factors in determining the quality of life.

[melman]

17. What the hell?

[BeyondGeography]

13. +1

Health care will be resolved (or not) in Congress. Meantime, I hope our candidates do more to raise awareness of the fact that we have one of the worst overall health care systems in the western world than attack each other on the relative merits of proposals that may or may not happen.

[redqueen]

23. +1 nt

[TidalWave46]

7. We have known this about him.

He also isn’t a nuts and bolts kind of guy.

[Me.]

16. But Don't We Need A "nuts and bolts kind of" Person?

The devil is in the details and yes, if you're running for pres. right now, you need to present real answers, right now.

[TidalWave46]

22. I don't consider him to be a serious Presidential candidate.

I consider him to be a very powerful activist.

[George II]

10. What's interesting is that there were three other OPs on this interview since 9:30 AM...

...no mention of this.

[NurseJackie]

11. Mmm... tasty!

[OilemFirchen]

25. "I want to pay for it in a progressive way."

Doubling the Medicare tax rate is not progressive. It is, in fact, the very definition of regressive.

[Autumn]

27. Do you have a link to him saying he would double the Medicare tax rate to pay for MFA?

[OilemFirchen]

28. Saying? Doubt it. Committing to writing? Sure:

4 percent income-based premium paid by households

Revenue raised: $3.5 trillion over ten years.The typical middle class family would save over $4,400 under this plan.Last year the typical working family paid an average of$5,277in premiums to private health insurance companies.Under this option, a typical family of four earning $50,000, after taking the standard deduction, would pay a 4 percent income-based premium to fund Medicare for All –just $844 a year –saving that family over $4,400 a year.Because of the standard deduction, families of four making less than $29,000 a year would not pay this premium.

https://www.sanders.senate.gov/download/options-to-finance-medicare-for-all?inline=file

My mistake, BTW. Increasing it by more than a third. Same point, though.

[Autumn]

31. " instead of $5,277 a year in premiums to private health insurance they would $844 a year

to fund MFA "saving that family over $4,400 a year"

That 4 percent income-based premium for their MFA sounds like it could be a savings for that family to me.

[OilemFirchen]

32. It's still a regressive tax.

That was my very simple point.

BTW, in Ohio a family of four earning $32,724 qualifies for Medicaid. That family would pay 4% for Medicare on $3,724 annually. It's likely worse in some other states, though I haven't researched it.

That's regressive, wouldn't you say?

[elleng]

26. We're paying it now in a very reactionary, regressive way. I want to pay for it in a progressive way

RIGHT.

[SWBTATTReg]

29. No matter what it costs etc., it still has to go through Congress, and get funding, so no matter...

what anyone says it cost, it has to go through the CBO (Congressional Budget Office), and both houses of Congress, and then be placed onto the president's desk for signature/etc.

Sure, the $billionaires have lots of money to help pay for this bill, but will they? I suspect that they won't and regardless of how much we get from them (the $billionaires), more than likely, more funds would be needed to help pay the total costs. It's all too much in the air now, being that (1) will MFA be implemented immediately (need to allow others already on ins. plans to migrate, etc.); (2) will plan be implemented over a staggered amount of time? (3) what kind of deductibles will there be; (4) will everything be covered?; (5) many other issues and ?s remain, too numerous to detail here.

So I think coming up with a specific cost is way too early. We already know what Medicare/etc. cost today. Doing for everyone is really going to pop the lid wide open. As Sanders says, the debate (I say multiple debates will occur, many debates, look at what the ACA under Obama went through).

[Buzz cook]

30. Congress writes the legislation not the candidates.

Its ridiculous to demand a full write up from the candidates.

I notice the same demands are not made for any other program or for other candidates.

[Happy Hoosier]

33. With all due respect....

.... candidates have to prove their policies are realistic. The big strike on a MFA type plan is cost. For those skeptical of its practicality, “we’ll figure it out” isn’t going to allay their fears. Both Bernie and Liz need to do better on that front. They will be asked this question MANY times, of that you can be sure.

[BeyondGeography]

36. One's working on the details, the other is looking at the big picture

[Buzz cook]

37. If that's the case then

Perhaps the medicare for some and ACA for others could explain how they're going to pay for it.

If our current system costs 10k per person per year and we have a population of 330 million and 24 million still don't have health insurance; how are you going to pay for it, who will pay for it, will taxes go up?
That's more than 33 trillion over ten years, not counting that medical insurance costs raise at a rate higher than inflation and not counting the cost of bring the non-insured into the system.

This works out to be more than the 30 trillion cost Joe Biden claimed medicare for all would cost.

How will Warren and Sanders pay for it? The monies now being paid into private insurance will instead be paid into a public insurance program. That is not a ta unless you believe our current medicare payroll withdrawals are a tax instead of insurance. That is a frequent claim).
Further the monies that corporations paid into private insurance will go to fund public insurance. A further increase in the top tax rate will give additional funding to public health insurance.

Many calculations strongly indicate savings with M4A over the current system. A public option is our current system plus other costs. It is arguably more expensive that either M4A or our current system the ACA.

[Happy Hoosier]

38. That's great... they need to put out the plan, and be ready to answer that question.

Liz is doing a better job of that (belatedly). Bernie's "I don't need to do that now" is exactly why so many of us think he'd get shredded in the GE, because the other side would zero in on that and ask him over, and over, and over again.

Just MHO, of course.

[Buzz cook]

42. I agree with Bernie though

He and the rest shouldn't "have" to explain details of a bill thats at least 3 years in the future.

No one is aking that question for any other subject and that's because its a dishonest question.

[Gothmog]

35. A dose of reality for Medicare-for-all

Link to tweet

Now we have two more data points. The quite credible think tank, Committee for a Responsible Federal Budget, comes up with some options assuming a cost of $30 trillion over the next decade (a midway point in the range of estimates):

We estimate the cost could be covered with a 32 percent payroll tax, a 25 percent income surtax, a 42 percent value-added tax, or a public premium averaging $7,500 per capita or more than $12,000 per individual who wouldn’t otherwise be enrolled in Medicare, Medicaid, or CHIP. Medicare for All could also be paid for by more than doubling individual and corporate income tax rates, reducing federal spending by 80 percent, or increasing the national debt by 108 percent of GDP. Tax increases on high earners, corporations, and the financial sector by themselves could not cover much more than one-third of the cost of Medicare for All.

But you say, none of that is remotely feasible politically and would have all sorts of negative economic consequences.

Warren actually has an even harder task since CFRB does not exempt the middle class. Therefore, Warren cannot use “a 32 percent payroll tax, a 25 percent income surtax, a 42 percent value-added tax, or a public premium averaging $7,500 per capita” if they are going to hit the middle class to such an extent that it wipes out savings from removing insurance premiums, co-pays, deductibles, etc. This is the equivalent of trying to balance on elephant on the head of a pin.

[Happy Hoosier]

39. I think it IS feasible....

After all, other major industrialized nations manage it. But I think the Candidates need to be honest about what it will take. Dodging the question is not a winning strategy.

[Gothmog]

40. Good luck in raising the funds needed for this program

This is from a non-partisan think group that is well respected http://www.crfb.org/papers/choices-financing-medicare-all-preliminary-analysis

Proposals to adopt single-payer health care in the United States have grown in popularity in recent years, as numerous lawmakers and presidential candidates have embraced Medicare for All. However, few have grappled with how to finance the new costs imposed on the federal government. By most estimates, Medicare for All would cost the federal government about $30 trillion over the next decade. How this cost is financed would have considerable distributional, economic, and policy implications.

In the coming months, the Committee for a Responsible Federal Budget will publish a detailed analysis describing numerous ways to finance Medicare for All and the consequences and trade-offs associated with each choice. This paper provides our preliminary estimates of the magnitude of each potential change and a brief discussion of the types of trade-offs policymakers will need to consider.

We find that Medicare for All could be financed with:

A 32 percent payroll tax
A 25 percent income surtax
A 42 percent value-added tax (VAT)
A mandatory public premium averaging $7,500 per capita – the equivalent of $12,000 per individual not otherwise on public insurance
More than doubling all individual and corporate income tax rates
An 80 percent reduction in non-health federal spending
A 108 percent of Gross Domestic Product (GDP) increase in the national debt
Impossibly high taxes on high earners, corporations, and the financial sector
A combination of approaches

Each of these choices would have consequences for the distribution of income, growth in the economy, and ability to raise new revenue. Some of these consequences could be balanced against each other by adopting a combination approach that includes smaller versions of several of the options as well as additional policies.

[Gothmog]

41. Biden's health care plan will be ready to go the day he's sworn into office

Link to tweet

[Cha]

43. Thanks for the tweet, Goth! Biden's plan ready NOW!

Link to tweet

[myohmy2]

44. +1

"I don't think I have to do that right now."

...Bernie's right as usual...

...plenty of time to think and talk about this later...

...no needed to give the pukes ammunition and a target...

...do the pukes ever talk about how they'll really pay for their tax giveaways to the 1%?

...never...

...this is why Bernie will be our next President...

[LongtimeAZDem]

45. I honestly cannot tell if your posts are intended to be sarcastic

[myohmy2]

46. nope...

...no sarcasm...I'm a true Bernie believer...

...Bernie's spent his entire life being a die-hard Progressive and a straight shooter...a 'Not Me, Us.' kind of guy...

...I trust Bernie to make good decisions...

…(as much as I can trust any politician)...

[Joe941]

47. This is a very smart position at this time.

In time yea, but now is not the time. Very savvy.