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‘Medicare for all’ advocates emboldened by ObamaCare lawsuit

Greenbeard

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I've remarked before on a fascinating phenomenon that's emerged over the past decade or so: an odd alignment of the left and right on health care. Indeed, if you find yourself discussing health care with someone, you often can't tell from the conversation if that someone self-identifies as being on the far left or the far right. The rhetoric of those two groups has converged, their critiques of market-based systems mirror each other, and their immediate (if not end) goal is seemingly shared.

That's why what once would have seemed ironic now makes a strange sort of sense: the right has done (and is doing) more to advance the Medicare-for-all agenda than the left ever did. If they succeed in their efforts, I daresay some form of single-payer being implemented in the next decade almost certainly becomes inevitable.

‘Medicare for all’ advocates emboldened by ObamaCare lawsuit
Progressive groups and lawmakers plan to use a Texas judge's ruling against ObamaCare to jump-start their push for “Medicare for all” in the next Congress.

Supporters of a single-payer health system are arguing that now is the time to start moving in a new direction from the Affordable Care Act, in part because they feel the 2010 health law will never be safe from Republican attempts to destroy or sabotage it.

“In light of the Republican Party’s assault, a version of Medicare for all is necessary for the future," said Topher Spiro, vice president for health policy at the Center for American Progress. "There are just too many points of vulnerability in the current system.”

The court decision in Texas that invalidates ObamaCare in its entirety came on the heels of sweeping Democratic victories in the midterm elections, a combination that has energized advocates of Medicare for all.
The court case, brought by 20 GOP-led states, was at the center of this year's midterm campaign after Democrats attacked Republicans for supporting the lawsuit and seeking to overturn ObamaCare's protections for pre-existing conditions.
The Trump administration, in a rare move, declined to defend the law in court, arguing instead that the pre-existing condition protections should be overturned.
 

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Making it convoluted and designing it to fail was a feature, not a bug of Obamacare. Socialized medicine was the eventual goal all along.
 

Greenbeard

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Making it convoluted and designing it to fail was a feature, not a bug of Obamacare. Socialized medicine was the eventual goal all along.

Despite the GOP's best efforts, the ACA isn't failing. That's why the GOP is on to Plan D to destroy the markets: judge-shopping for sympathetic wingnuts to buy their bad arguments.

If the ACA was designed to fail, the GOP wouldn't have to work so hard to bring it down. Their years of trying to sabotage and discredit the marketplaces, though, are part of what I was getting at in the OP.
 

OrphanSlug

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We have been saying for years that Obamacare was just a stepping stone to single-payer and complete government take over of healthcare in this nation. With our aging population and how Republicans are going about this we have every expectation that the public will fear the alternative enough to end up with some form of “Medicare for all.”

This ship set sail a long way back, I would argue back in the 1980s (if not earlier) with how larger HMOs conducted themselves and ultimately turning themselves into the mess that jump started Obamacare thinking in the first place. Every step along the way and each evolution of legislation trying to regulate all this just added to the distortion of why we pay so much per capita for healthcare.

The moment business profit intentions invisioned themselves in the room between the doctor and the patient, eventually the public would cry to exchange out business profit for government inefficiency as the lesser of two evils knowing the system would never go back to doctor and patient.

Stepping stone... Medicare for all is right around the corner.
 

Dittohead not!

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I've remarked before on a fascinating phenomenon that's emerged over the past decade or so: an odd alignment of the left and right on health care. Indeed, if you find yourself discussing health care with someone, you often can't tell from the conversation if that someone self-identifies as being on the far left or the far right. The rhetoric of those two groups has converged, their critiques of market-based systems mirror each other, and their immediate (if not end) goal is seemingly shared.

That's why what once would have seemed ironic now makes a strange sort of sense: the right has done (and is doing) more to advance the Medicare-for-all agenda than the left ever did. If they succeed in their efforts, I daresay some form of single-payer being implemented in the next decade almost certainly becomes inevitable.

‘Medicare for all’ advocates emboldened by ObamaCare lawsuit

Don't you just love irony? I know I do. Conservatives, self described, that is, hurrying along the inevitable acceptance of Medicare for all, a long time goal of the left wing. Here's yet another, in light of this statement:

The Trump administration, in a rare move, declined to defend the law in court, arguing instead that the pre-existing condition protections should be overturned.
In campaign speeches, advertisements and interviews, Republican politicians are showing a zeal for protecting Americans with pre-existing health conditions.

President Trump has gone the furthest, saying not only that he will ensure protections for the previously ill, but also pledging that his party will do so more effectively than Democrats.

Of course we all know that 180 degree turnarounds by the Trump Administration are nothing new, but still, isn't that another interesting bit of irony?
 

ttwtt78640

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Many who advocate for Medicare for all actually seem to favor a program more like (expanded?) Medicaid for all. Medicare has (basically fixed - they go up only at fairly high income levels) premiums, deductibles, pays only 80% of 'covered' expenses and often requires "supplemental" private coverage to be deemed satisfactory. Medicaid has no (user) premiums, deductibles or co-pays and covers far more than Medicare does.

I favor offering (expanded?) Medicaid as a "pubic option" with the addition of premiums set at 10% of AGI (the level after which medical care costs become tax deductible).
 

ttwtt78640

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Despite the GOP's best efforts, the ACA isn't failing. That's why the GOP is on to Plan D to destroy the markets: judge-shopping for sympathetic wingnuts to buy their bad arguments.

If the ACA was designed to fail, the GOP wouldn't have to work so hard to bring it down. Their years of trying to sabotage and discredit the marketplaces, though, are part of what I was getting at in the OP.

The provision in PPACA most apt to cause collapse of 'private' (employer subsidized) insurance was the cadillac plan tax - which, oddly, was simply dropped (but called delayed?). As the cost of more and more employer subsidized 'private' insurance plans exceeded inflation they were to become taxable (at 40%?) and thus would be cancelled or their cost shifted to the employee.
 

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Well if govt.-run, single-payer insurance is good enough for well off farmer (FCIC) and better off bankers (FDIC)

then it should be good enough for the people's physical health. (FHIC ?)

I know, single-payer insurance through the govt, is soshillizm except for the same for the rich...that's a partnership, as

particular those as reflected in the OPIC Overseas private [sic] investor insurance
 

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Many who advocate for Medicare for all actually seem to favor a program more like (expanded?) Medicaid for all. Medicare has (basically fixed - they go up only at fairly high income levels) premiums, deductibles, pays only 80% of 'covered' expenses and often requires "supplemental" private coverage to be deemed satisfactory. Medicaid has no (user) premiums, deductibles or co-pays and covers far more than Medicare does.

I favor offering (expanded?) Medicaid as a "pubic option" with the addition of premiums set at 10% of AGI (the level after which medical care costs become tax deductible).

True, Medicare is not free to the user. There is a monthly cost, copays, supplemental insurance needed.

But, it's easier to find providers who will accept Medicare. I've been on Medicare for several years now, and it's actually just as good as the Blue Cross was that my erstwhile employer provided.

The thing about Blue Cross, and similar plans, is that they cost an arm and a leg and continue to get more costly.
 

ttwtt78640

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True, Medicare is not free to the user. There is a monthly cost, copays, supplemental insurance needed.

But, it's easier to find providers who will accept Medicare. I've been on Medicare for several years now, and it's actually just as good as the Blue Cross was that my erstwhile employer provided.

The thing about Blue Cross, and similar plans, is that they cost an arm and a leg and continue to get more costly.

I start Medicare in a few weeks and have yet to try to find a supplemental plan (available in my area and accepted by my clinic/doctor) that makes sense. Being expected to pay 20% of some huge medical bill is no more scary than being expected to pay 100% of it - since I can afford neither. My current medical care expenses (being uninsured and paying cash for them) are $350 to $400/year so I view Medicare as a minus since it will reduce my Social Security income by more than I will ever likely receive in benefits.

Medicare premium costs also seem to rise as fast as Social Security (SS) benefits do. The other odd part of Medicare is that its premiums cost the same regardless of income - my girlfriend gets less than half the SS that I get yet must pay the same premium amount. I assume that M4A will be an entirely different system with premiums based nearly entirely on income thus lower income folks are winners (assuming that "the poor" now getting Medicaid or expanded Medicaid would still pay nothing) and higher income folks are losers and yet everyone is alleged to get the same benefits. Without seeing a detailed breakdown of the out of pocket costs and benefits, M4A is simply a political talking point.
 

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I start Medicare in a few weeks and have yet to try to find a supplemental plan (available in my area and accepted by my clinic/doctor) that makes sense. Being expected to pay 20% of some huge medical bill is no more scary than being expected to pay 100% of it - since I can afford neither. My current medical care expenses (being uninsured and paying cash for them) are $350 to $400/year so I view Medicare as a minus since it will reduce my Social Security income by more than I will ever likely receive in benefits.

Medicare premium costs also seem to rise as fast as Social Security (SS) benefits do. The other odd part of Medicare is that its premiums cost the same regardless of income - my girlfriend gets less than half the SS that I get yet must pay the same premium amount. I assume that M4A will be an entirely different system with premiums based nearly entirely on income thus lower income folks are winners (assuming that "the poor" now getting Medicaid or expanded Medicaid would still pay nothing) and higher income folks are losers and yet everyone is alleged to get the same benefits. Without seeing a detailed breakdown of the out of pocket costs and benefits, M4A is simply a political talking point.

I'd look into HMOs. I joined one and pay only $20 a month. There are copays, but it looks like you don't go to the doctor very often. That's a good thing, as long as you go in for an annual physical.

I have a buddy who bragged about not going to the Dr. Before he was 65, he had no medical insurance. Luckily for him, his heart attack waited until he was covered by Medicare. Still, he almost died. I'm not sure what his total cost was, but I'd guess close to a million.
 

ttwtt78640

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I'd look into HMOs. I joined one and pay only $20 a month. There are copays, but it looks like you don't go to the doctor very often. That's a good thing, as long as you go in for an annual physical.

I have a buddy who bragged about not going to the Dr. Before he was 65, he had no medical insurance. Luckily for him, his heart attack waited until he was covered by Medicare. Still, he almost died. I'm not sure what his total cost was, but I'd guess close to a million.

I see a doctor once per year (including some lab tests) but go to the clinic for an INR test (done by a nurse) at least monthly to ensure that my warfarin (Coumadin) dosage is working as desired. My prescription drug costs are very low at $40/year.

That (bolded above) is my point. Whether I am responsible for a mere $200K (thanks to Medicare) or the entire $1M would make absolutely no difference to me. My Medicare coverage would obviously make a difference to the care provider(s) - they get paid something rather large from Medicare even if I could pay them essentially nothing.
 

Dittohead not!

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I see a doctor once per year (including some lab tests) but go to the clinic for an INR test (done by a nurse) at least monthly to ensure that my warfarin (Coumadin) dosage is working as desired. My prescription drug costs are very low at $40/year.

That (bolded above) is my point. Whether I am responsible for a mere $200K (thanks to Medicare) or the entire $1M would make absolutely no difference to me. My Medicare coverage would obviously make a difference to the care provider(s) - they get paid something rather large from Medicare even if I could pay them essentially nothing.

If you don't have medical insurance at all, and no way to pay high bills, the providers will be very reluctant to perform expensive procedures or take expensive tests, or prescribe expensive meds. Doing without health insurance of any sort is like playing Russian roulette with any savings you might have as well as with your health and well being.

So far, you've been lucky. You shouldn't rely on luck.
 

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Don't you just love irony? I know I do. Conservatives, self described, that is, hurrying along the inevitable acceptance of Medicare for all, a long time goal of the left wing. Here's yet another, in light of this statement:

You do know that Medicare does not pay the billed amount by any Dr. or Hospital, these bills are greatly discounted, which called, approved by Medicare. Thus no Doctor or Hospital can survive only on Medicare patience. In the end if our system was converted to Medicare for all, the cost to keep Doctors on deck and Hospitals open would require Medicare to greatly raise their pay schedule. Thus skyrocket tax increases.
 

ttwtt78640

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If you don't have medical insurance at all, and no way to pay high bills, the providers will be very reluctant to perform expensive procedures or take expensive tests, or prescribe expensive meds. Doing without health insurance of any sort is like playing Russian roulette with any savings you might have as well as with your health and well being.

So far, you've been lucky. You shouldn't rely on luck.

As I said, I will have Medicare in mid February 2019. Medicare will nearly quadruple my normal annual medical care expenses but it might offer incentives for care providers to keep me alive should I require very expensive care in the future.
 

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As I said, I will have Medicare in mid February 2019. Medicare will nearly quadruple my normal annual medical care expenses but it might offer incentives for care providers to keep me alive should I require very expensive care in the future.

Staying alive is kind of important.

 

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You do know that Medicare does not pay the billed amount by any Dr. or Hospital, these bills are greatly discounted, which called, approved by Medicare. Thus no Doctor or Hospital can survive only on Medicare patience. In the end if our system was converted to Medicare for all, the cost to keep Doctors on deck and Hospitals open would require Medicare to greatly raise their pay schedule. Thus skyrocket tax increases.

I'm aware that Medicare negotiates prices and discounts billing. I'm also aware that providers bill more than they expect to get to Medicare and to the insurers. I'm also quite sure you can't back up your opinion that private insurance is subsidizing Medicare.
 

ttwtt78640

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Staying alive is kind of important.



Yep, yet nobody ever does. Staying alive is getting much more expensive as is a K-12 public education which is already under complete government control. If you think that X is expensive now then just wait until it is "free" under a single payer system.
 

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I've remarked before on a fascinating phenomenon that's emerged over the past decade or so: an odd alignment of the left and right on health care. Indeed, if you find yourself discussing health care with someone, you often can't tell from the conversation if that someone self-identifies as being on the far left or the far right. The rhetoric of those two groups has converged, their critiques of market-based systems mirror each other, and their immediate (if not end) goal is seemingly shared.

That's why what once would have seemed ironic now makes a strange sort of sense: the right has done (and is doing) more to advance the Medicare-for-all agenda than the left ever did. If they succeed in their efforts, I daresay some form of single-payer being implemented in the next decade almost certainly becomes inevitable.

I will never cease to be amused at how you consider SP/UHC systems, which are the norm and standard in the developed world, a product of 'far left' thinking; one of many things that clearly highlights how utterly and hopelessly detached from reality the American political Overton window is at present, particularly among those who consider themselves 'centrist' who would be, in reality, firmly right wing in virtually any other wealthy, developed democracy.

Moreover, though conservatives may oppose ACA for all the wrong reasons (and progressives have only ever opposed it on the basis it does too little without actually working to undermine it as a rule), there is indeed certainly bipartisan agreement on the desirability of Medicare for All with roughly 70% popular support last I checked, including a majority of Republicans, to say nothing of the fact that both sides acknowledge the ongoing, blatant and systemic failure of market-based healthcare in America.

That having been established, despite your obvious desire to draw a false equivalency between the left and right on this issue, presumably in an attempt to vilify or discredit us as you've tirelessly worked towards in other threads, no such parallel exists; perhaps the only thing in common is that we dislike the status quo and feel it insufficient, but their direction is and has always been obviously and markedly different from ours; that we dislike ACA for likewise obviously and markedly different reasons says essentially nothing to suggest any kind of actual horseshoe, convergence or dovetailing between us.
 
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Surrealistik

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Yep, yet nobody ever does. Staying alive is getting much more expensive as is a K-12 public education which is already under complete government control. If you think that X is expensive now then just wait until it is "free" under a single payer system.

Except even the right wing Mercatus think tank suggests it will cost the country trillions less than present aggregate spending?

Pretty much the only way it will cost more on average is if lobbyists insert themselves/donors exert pressure and forbid the exercise of economy of scale, payer consolidation and bargaining power that lies at the beating heart of SP savings as they've currently done with regards to drug prices vis a vis medicare; not unlike how they killed say the public option in the case of ACA through their well paid shill Lieberman, and are more or less overwhelmingly responsible for the calcification and continuation of this unacceptable, insanely inefficient status quo.
 
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Dittohead not!

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Yep, yet nobody ever does. Staying alive is getting much more expensive as is a K-12 public education which is already under complete government control. If you think that X is expensive now then just wait until it is "free" under a single payer system.

That's what a lot of people seem to think, yet every other advanced nation in the world has a universal health care system, and they all pay less than we do. We have actually invented a health care system that is more expensive than socialism. Think about that one for a while.

What we need is a new system, one based on real market economics, not on monopoly, and not dominated by the insurance industry.

Here's what I'd do: Issue every citizen and legal resident a credit card that can only be used for medical costs. When the amount charged on that card in a given year exceeds 10% of the holder's annual income, then the government steps in and pays the rest.

That 's it. No one would know whether the individual or the government was paying. The individual would have an incentive to shop around and compare costs. No one would face medical bankruptcy. The providers wouldn't need a staff whose expertise is not medicine, but how to collect from the insurance companies and/or the government. Medical care wouldn't be "free," but would be affordable to everyone. No papers to fill out, either, just sign the little electronic box, and the provider is paid immediately. Deadbeats would be chased by the credit card company. That's their expertise, after all.
 

ttwtt78640

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Except even the right wing Mercatus think tank suggests it will cost the country trillions less than present aggregate spending?

Pretty much the only way it will cost more on average is if lobbyists insert themselves/donors exert pressure and forbid the exercise of economy of scale, payer consolidation and bargaining power that lies at the beating heart of SP savings as they've currently done with regards to drug prices vis a vis medicare; not unlike how they killed say the public option in the case of ACA through their well paid shill Lieberman, and are more or less overwhelmingly responsible for the calcification and continuation of this unacceptable, insanely inefficient status quo.

You can rest assured that (bolded above) is going to happen since that is the way of the sausage factory known as the US congress. When you cede total control of 1/6 of the US economy to a gaggle of congress critters (who will write some fill in the blanks later law - like PPACA) you are taking a huge risk. Better to have a state (or two) try these wondrous ideas of SP than to jump right in on a national scale.
 

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That's what a lot of people seem to think, yet every other advanced nation in the world has a universal health care system, and they all pay less than we do. We have actually invented a health care system that is more expensive than socialism. Think about that one for a while.

Not just more expensive, but vastly more expensive.

What we need is a new system, one based on real market economics, not on monopoly, and not dominated by the insurance industry.

Here's what I'd do: Issue every citizen and legal resident a credit card that can only be used for medical costs. When the amount charged on that card in a given year exceeds 10% of the holder's annual income, then the government steps in and pays the rest.

That 's it. No one would know whether the individual or the government was paying. The individual would have an incentive to shop around and compare costs. No one would face medical bankruptcy. The providers wouldn't need a staff whose expertise is not medicine, but how to collect from the insurance companies and/or the government. Medical care wouldn't be "free," but would be affordable to everyone. No papers to fill out, either, just sign the little electronic box, and the provider is paid immediately. Deadbeats would be chased by the credit card company. That's their expertise, after all.

Sounds like more of a UHC with a heavy govt component. I'm not sure how effective it would be in driving down costs due to considerable payer fragmentation remaining, along with all its attendant waste. If the govt was free to leverage its negotiating power to reduce payouts however, it might end up significantly better/more efficient than the status quo. That said, good luck challenging the political power and capital of the insurers, providers and suppliers though; as with MFA, they would fight this tooth and nail as it means a significant loss of market share, and in the case of providers, tempered/reduced profits.
 
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When you hear the words "government takeover of health care" you are hearing the talking points invented by Frank Luntz.
Pretty much ANYONE who uses that slogan cannot define the difference between single payer and socialized medicine.
They seem to think that single payer means government run hospitals and doctors working as government employees.

When you hear that slogan, understand that you're dealing with a low information person who probably only listens or watches far-Right information sources.
 
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