Elizabeth Warrens - Tax and Spend Plan for Medicare for all

[Horatio Parker]

I can say with very good confidence that no one's plan for universal healthcare will be adopted with no changes. My guess is plans will be discussed and changed often in congress for six months to a year. It's way too complicated an issue to take at face value. Funding, reimbursement, qualifications, rules, so very many aspects that will all need to be mulled over.

Yes. Warren has been getting flack from the left for not being progressive enough, and flack from the right over funding. Now she has an answer.

What M4A will look like if implemented is anyone's guess.

One point, I think AOC made, is that the Supreme ruled health costs are a tax due to the mandate. If so, there will be a tax cut, not an increase.

 

[Loren Pechtel]

Stinks.

It's the usual garbage of tax the rich.

In addition there's the problem that it provides a huge incentive to outsourcing.

Ummm... outsourcing / temping became very popular about 10 years ago.

Permatemping wouldn't help with this. Outsourcing would. This just provides a huge incentive to outsource more.

 

[Loren Pechtel]

What about the Switzerland example - everyone is required to by private health insurance and can pick from a menu of options. It seems to work for the Swiss, although a small country. The early stages of the ACA tried to do this with huge push back. Perhaps trying it again?

Yeah, and if we want a UHC system simply subsidize premiums to the tune of whatever the lowest price plan you're eligible for is. No big disruptions and no foxes guarding the henhouse--I think it would be a much better approach. Perhaps we also want to lower the deductibles but that would be a separate action that I would prefer to be done in a different year.

 

[PyramidHead]

I can say with very good confidence that no one's plan for universal healthcare will be adopted with no changes. My guess is plans will be discussed and changed often in congress for six months to a year. It's way too complicated an issue to take at face value. Funding, reimbursement, qualifications, rules, so very many aspects that will all need to be mulled over.

I do think it's encouraging that we're entering point in the primary contest where a main point of contention will be how to fund a UHC program.

 

[ZiprHead]

Economist: Warren is right. Her Medicare for All plan won't raise taxes on the middle class

It's no secret that I'm not a fan of Medicare for All. That's why I'm impressed that Senator Elizabeth Warren's campaign reached out to me to independently review her proposed financing plan for the program. Her numbers add up and her plan fully finances the program without imposing any new taxes on middle-class families.

The most important source of revenue for Warren's Medicare for All plan is simply to have businesses pay their employees' health insurance premiums to Medicare instead of private insurance companies. Over time, businesses would be required to pay slightly less to Medicare for health insurance than they would otherwise have paid to private insurers. New small businesses with fewer than 50 employees would not be required to make these payments.

 

[Gun Nut]

Sen. Elizabeth Warren said that as president she would tap billionaires and large employers to pay the bulk of $20.5 trillion in new spending over a decade to finance her Medicare for All health-care plan, promising to shield most Americans from higher taxes under the proposal.

As a small business owner this alarms me. I have thus far support Warren for President, however, this may be a bridge too far. My business health care costs are outrageous and we can barely cover the basic plan with high deductibles with the employees paying for 30%. I haven't delved into her details yet, and I hardly think if she is elected that this would move forward as proposed. The current system needs reform. I'm not sure this is it. It's seems way too much tax and spendy for me. I think Warren needs to move more Center of left.

To determine if this is concerning, or relieving, I would need to see the Republican candidate's plan. Can you produce that in a comparative matrix?

 

[Gun Nut]

Is it your view that the republicans are cutting spending?

No. Trausti thinks that tax cuts with trillion dollar deficits isn't being generous with other people's money. I disagree. I think that taxcuts ARE taking money from other people. Namely, Future Me, and anyone else who plans to live more than 30 more years. The babies in the idiom I used above are literal babies.

I'm sorry, but I'm not getting it. Clearly reducing taxes will lead to higher deficits if spending isn't reduced. But how are tax cuts taking money from someone else?

Because the dept is being paid out of Social Security... which is an entitlement you have been paying into for your entire working career (assuming you have ever been employed and paid any income tax, that is). So the pennies you save today will cost you dollars tomorrow when you are old and can't (and shouldn't have to) work anymore.

 

[Horatio Parker]

I'm sorry, but I'm not getting it. Clearly reducing taxes will lead to higher deficits if spending isn't reduced. But how are tax cuts taking money from someone else?

Because the dept is being paid out of Social Security... which is an entitlement you have been paying into for your entire working career (assuming you have ever been employed and paid any income tax, that is). So the pennies you save today will cost you dollars tomorrow when you are old and can't (and shouldn't have to) work anymore.

SS doesn't fund deficits, it's financing is separate from the general budget. Today's SS payroll tax dollars pay today's recipients.

Tax cuts don't cost anyone and neither do deficits.

 

[T.G.G. Moogly]

Imo, the most sensible thing to do at first, would be to work at bringing down the cost of drugs. Sure, there are many affordable generics, but some life saving drugs like Insulin, pulmonary inhalers, and cancer drugs, to name a few, are insanely priced. If that can't be fixed, why would anyone be gullible enough to believe that we can change the entire mess that we currently have into the type of coverage that Warren or Sanders support. If you think Warren would make a good president, but don't like her idealistic goals, don't worry. She can't get anything done without the cooperation of Congress, and more than half of the Democrats are moderates, plus Republicans aren't going away.

We always talk about negotiating drug prices but that's an exercise in cost-shifting that has lead to a decent part of the problem. instead, lets ban all forms of drug price negotiation--instead, drug companies are required to sell at the same price to all customers. This will end most abuse. Since I first proposed this we have seen the new problem of sole-source suppliers jacking the price through the roof, knowing the cost of entry will allow them to rake it in. I'm not as sure what to do about this one but I think the drug price negotiation plays a role here--prices were driven too low, resulting in all but one player leaving the field. I'm not sure how practical it would be but I'm inclined to think that requiring all large entities to purchase no more than 50% of their supply from one company unless there was only one player would go a long way towards preventing this--it would pretty much ensure there would be at least two players.

And, something that nobody has even mentioned, is the enormous amount of waste, fraud and abuse in the current Medicare system. It would take an enormous amount of effort to drastically limit that problem. It can be very easy to order unnecessary tests, procedures, and over utilize care in the current system. That's just abuse, but outright fraud has also been a big problem. Quite a few doctors have been caught this year bilking Medicare for millions. Think about all the ones who haven't been caught, not to mention hospitals, and other types of providers of care. How do you change that? I'd like to see realistic plans for these problems before we pretend that we can radically overhaul our entire health care system. Just stating some of my concerns.

The left loves to pretend the fraud and abuse level is very low when in practice all that's low is the enforcement. There's a reason the medicare advantage programs can offer lots of perks above standard medicare for the same cost--they're better at controlling the nonsense.

I was advised to go with an Advantage Plan. I could not believe how inexpensive the premiums were and literally asked several times, "What's the catch?" But there isn't one. My plan is one fifth or less of the cost I'd pay for your typical Supplement, and it includes drug coverage.

 

[Loren Pechtel]

I was advised to go with an Advantage Plan. I could not believe how inexpensive the premiums were and literally asked several times, "What's the catch?" But there isn't one. My plan is one fifth or less of the cost I'd pay for your typical Supplement, and it includes drug coverage.

The "catch" is a restricted network and sometimes hoops to jump through for authorizations.

The advice I've heard is those with a lot of health problems are likely better off with traditional + supplement, the healthier end of the spectrum is better off with an advantage plan.

My wife pays nothing at all (beyond the normal part B premiums) for her plan and will get back something like $200 from incentives.

 

[T.G.G. Moogly]

I was advised to go with an Advantage Plan. I could not believe how inexpensive the premiums were and literally asked several times, "What's the catch?" But there isn't one. My plan is one fifth or less of the cost I'd pay for your typical Supplement, and it includes drug coverage.

The "catch" is a restricted network and sometimes hoops to jump through for authorizations.

In my case that's not much of a "catch" because it amounted to the same plan I've had for the last 30 years.

Yes, it pays to have good health. The advice was basically don't waste your money on a supplement if you're in good health.

 

[southernhybrid]

I was advised to go with an Advantage Plan. I could not believe how inexpensive the premiums were and literally asked several times, "What's the catch?" But there isn't one. My plan is one fifth or less of the cost I'd pay for your typical Supplement, and it includes drug coverage.

The "catch" is a restricted network and sometimes hoops to jump through for authorizations.

The advice I've heard is those with a lot of health problems are likely better off with traditional + supplement, the healthier end of the spectrum is better off with an advantage plan.

My wife pays nothing at all (beyond the normal part B premiums) for her plan and will get back something like $200 from incentives.

I'm switching to an Advantage Plan for 2020. They are getting a lot better than they were at first. I don't need prior approval to have anything done. And, the copays for things out of my network aren't that bad. I agree that in the past people with a lot of health problems should stay away from Advantage Plans, but it appears as if things are changing.

Plus, Medicare B is going up almost every year lately, at a much faster rate than the rate of inflation. It was 105, five years ago, but it will be 144 next year. People who have B, D and a supplement are often paying over 400 or 500 dollars a month, depending on age and where they live. Advantage Plans are private insurance plans, for those who don't know that, but they are heavily subsidized by the government. So far, I use very little health care, but I do take one drug that isn't covered by any Medicare plan and I have to jump through hoops to get the price down to 80 dollars a month, even single year. My husband's inhaler costs 165 a month, even with a drug plan. People who haven't gotten to Medicare age yet, have no idea how expensive it can be. Not all drugs are expensive if you have Part D or Part C, but all it takes is one expensive drug to make it difficult if you have very little savings and SS is your only source of income.
.

I wish the Congress would do something about drug prices instead of promising pie in the sky free for all health care. I've known people who travel to Mexico or Canada to buy their drugs, if they live close to those borders. There is no good reason why Americans are paying such high prices for drugs. Drug prices are what hurt a lot older adults. If we didn't have substantial savings, there is no way we could pay for our drugs. If you're very low income and get Medicaid as your supplement, the drugs are free, as long as Medicaid covers your particular drugs.

 

[PyramidHead]

This past weekend, Warren has revealed that she won't push for Medicare for All as a policy priority until her third year in office, after the midterms. Before then, it will just be a 'public option' a la ACA, which is of course doomed to fail and is a giant handout to insurance companies because it lets them offload all of their riskier clients (who are disproportionately poor and will thus go to the public option).

Warren has basically no interest in health care and is just trying to get people off her back until she wins the election, at which point she'll throw her hands up, say she tried the best possible plan and it failed, and the fight for single payer will be lost for another generation.

 

[PyramidHead]

And here we go.

https://twitter.com/ewarren/status/1195370955377446914

By the end of my third year, I’ll fight to pass legislation to complete the transition to #MedicareForAll. Once millions have experienced the full benefits of a #MedicareforAll option and compared it to the corrupt and wasteful system we have today, the people will demand it.

In other words, Warren has shifted from saying "I'm with Bernie on Medicare for All" during the first round of debates to a policy that is essentially the same as that of Pete Buttigeig's "Medicare for All who want it". Someone even did a video comparison:



ETA: here's how this will play out in a Warren administration. She rolls out the public option phase of the transition and is mercilessly tarred as a communist by the Republicans. Business owners start offering less and less insurance in retaliation, forcing more and more people onto the public program. It becomes the underfunded nightmare its critics say it is, and Republicans use it as their wedge issue for the midterms. Warren compromises on it in order to get re-elected, and Medicare for All dies forever. This is not the vision of someone who will fight for single payer universal health care, it's a doomed-to-fail approach that Warren has deployed to get everyone off her back, because she never particularly cared about the issue until recently and has no intention of making it a priority.

 

[Loren Pechtel]

This past weekend, Warren has revealed that she won't push for Medicare for All as a policy priority until her third year in office, after the midterms. Before then, it will just be a 'public option' a la ACA, which is of course doomed to fail and is a giant handout to insurance companies because it lets them offload all of their riskier clients (who are disproportionately poor and will thus go to the public option).

Warren has basically no interest in health care and is just trying to get people off her back until she wins the election, at which point she'll throw her hands up, say she tried the best possible plan and it failed, and the fight for single payer will be lost for another generation.

And how are they supposed to push them onto the public option??

 

[PyramidHead]

This past weekend, Warren has revealed that she won't push for Medicare for All as a policy priority until her third year in office, after the midterms. Before then, it will just be a 'public option' a la ACA, which is of course doomed to fail and is a giant handout to insurance companies because it lets them offload all of their riskier clients (who are disproportionately poor and will thus go to the public option).

Warren has basically no interest in health care and is just trying to get people off her back until she wins the election, at which point she'll throw her hands up, say she tried the best possible plan and it failed, and the fight for single payer will be lost for another generation.

And how are they supposed to push them onto the public option??

By raising rates to the point of pricing them out. Insurance companies make money by providing insurance to people who will use it the least because they don't need it. Otherwise, they have to pay for things like surgery and other expensive procedures, and they don't want to do that. They would like nothing more than to filter out clients whose membership is both shaky from a profit standpoint (because of their low income and uncertain employment status) and risky from a payout standpoint (because they are more likely to need expensive procedures since they have fewer regular exams, worse nutrition, more stress, and more exposure to violence and other forms of injury compared to wealthier people). This has been their project from the get-go, of course, but installing a state-consecrated mechanism to make their refusal of such clients more justifiable is a huge marketing giveaway.

Under Warren's plan, the number of low-income people who are priced out of their insurance coverage will increase, and they will head to the public option in larger numbers than it will ever be prepared to accommodate. In a couple of years, it will be a blemish, another underfunded welfare system that proves the government can't do anything right, and then there will be no more wind left in the sails for single payer. I know you don't care about that, but it's as good an illustration as any why Warren cannot be the choice for progressives who care about M4A. At this point, her plan is essentially no different from Biden's or Buttigeig's.

 

[Jimmy Higgins]

Who has ever tried to pass things in the third year?

 

[Loren Pechtel]

This past weekend, Warren has revealed that she won't push for Medicare for All as a policy priority until her third year in office, after the midterms. Before then, it will just be a 'public option' a la ACA, which is of course doomed to fail and is a giant handout to insurance companies because it lets them offload all of their riskier clients (who are disproportionately poor and will thus go to the public option).

Warren has basically no interest in health care and is just trying to get people off her back until she wins the election, at which point she'll throw her hands up, say she tried the best possible plan and it failed, and the fight for single payer will be lost for another generation.

And how are they supposed to push them onto the public option??

By raising rates to the point of pricing them out. Insurance companies make money by providing insurance to people who will use it the least because they don't need it. Otherwise, they have to pay for things like surgery and other expensive procedures, and they don't want to do that. They would like nothing more than to filter out clients whose membership is both shaky from a profit standpoint (because of their low income and uncertain employment status) and risky from a payout standpoint (because they are more likely to need expensive procedures since they have fewer regular exams, worse nutrition, more stress, and more exposure to violence and other forms of injury compared to wealthier people). This has been their project from the get-go, of course, but installing a state-consecrated mechanism to make their refusal of such clients more justifiable is a huge marketing giveaway.

Get a new calendar--this is something that the ACA put a stop to years ago.

Under Warren's plan, the number of low-income people who are priced out of their insurance coverage will increase, and they will head to the public option in larger numbers than it will ever be prepared to accommodate. In a couple of years, it will be a blemish, another underfunded welfare system that proves the government can't do anything right, and then there will be no more wind left in the sails for single payer. I know you don't care about that, but it's as good an illustration as any why Warren cannot be the choice for progressives who care about M4A. At this point, her plan is essentially no different from Biden's or Buttigeig's.

I do agree it would be an underfunded mess but that's what UHC always turns into. Warren's plan isn't anything special in that regard.

 

[zorq]

Debt will eventually need to be paid. Borrowing from future generations to give out extra wads of cash to old folks today is taking money from those future generations. What is there not to understand? Future generations will be forced to pay this debt, perhaps through some austerity by cutting back on benefits and infrastructure that present humans are enjoying right now.

The trouble is, the US budget is soon to be able 80% Medicare, Social Security, Medicaid, interest and the military. The military definitely provides avenues for some cost reductions, but the remaining slice of the pie for discretionary spending in the US is getting smaller and smaller, meaning most cuts there will not affect the bottom line.

So if there is nothing left to cut then the future generations will be asked to pay for it more directly with higher taxes ... or higher inflation, which is really just a regressive, stealth, wealth tax. Someone ALWAYS has to pay for a tax cut... just not the people who die before the repercussions kick in.

 

[T.G.G. Moogly]

Debt will eventually need to be paid. Borrowing from future generations to give out extra wads of cash to old folks today is taking money from those future generations. What is there not to understand? Future generations will be forced to pay this debt, perhaps through some austerity by cutting back on benefits and infrastructure that present humans are enjoying right now.

The trouble is, the US budget is soon to be able 80% Medicare, Social Security, Medicaid, interest and the military. The military definitely provides avenues for some cost reductions, but the remaining slice of the pie for discretionary spending in the US is getting smaller and smaller, meaning most cuts there will not affect the bottom line.

So if there is nothing left to cut then the future generations will be asked to pay for it more directly with higher taxes ... or higher inflation, which is really just a regressive, stealth, wealth tax. Someone ALWAYS has to pay for a tax cut... just not the people who die before the repercussions kick in.

Tax cuts without spending cuts are not cuts at all, just the issuance of IOUs.