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The Heartland Institute’s Very Stupid New Medicare for All Report

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https://jacobinmag.com/2019/08/medicare-for-all-justin-haskins-heartland

A right-wing think tank just released a study slamming Medicare for All. It brings us no pleasure to inform you that its analysis is amateurish and riddled with errors.

The Heartland Institute’s Justin Haskins put out a paper purporting to be a distributional analysis of Medicare for All. The paper is one of the shoddiest think tank reports I’ve ever seen, raising the usual question about conservative think tank output: intentionally deceptive or merely incompetent? I will not answer that question in this post, but I will break down just how bad Haskins’s paper is.
 
To save you all some reading, the think tank report fails to account for most of the savings of expenses from individuals, employers and the government that the writer says would be realized under a medicare for all system done right.
 
It's worth reading because it gives some idea of why and how Sander's plan would likely work.
When we make only these (conservatively estimated) modifications to Haskins’s spreadsheet, we get a very different result.
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With the $1.4 trillion allocated back to households, the breakeven point for singles is around $90,000 while the breakeven point for families is around $140,000. Meanwhile middle-class families see dramatically higher savings than Haskins lets on. Under Haskins’s approach, a family making around $50,000 saves about $2,200. But when you reallocate the saved money like I do here, it shoots to $10,000.
 
To save you all some reading, the think tank report fails to account for most of the savings of expenses from individuals, employers and the government that the writer says would be realized under a medicare for all system done right.

Why would we assume it's going to be "done right"? I've floated the idea of having "medicare for all" with a constitutional cap on per capita spending set at top European country levels and there are never any takers.
 
Why does anyone think its hard to figure out how to do it? Just copy a system already doing it. Canada is right next door.
 
To save you all some reading, the think tank report fails to account for most of the savings of expenses from individuals, employers and the government that the writer says would be realized under a medicare for all system done right.

"Done right". That's a loophole big enough to drive a truck through.

Why does anyone think its hard to figure out how to do it? Just copy a system already doing it. Canada is right next door.

We'd have to cut military spending. That's a good thing, but not something those in power would ever agree to do. Most of the first world countries that have some variant of UHC also outsource their defense to the USA. And they don't even pay us to defend them, because they know we're stupid enough to do it for free. Or in the case of South Korea, stupid enough to pay them to let us defend them.
 
To save you all some reading, the think tank report fails to account for most of the savings of expenses from individuals, employers and the government that the writer says would be realized under a medicare for all system done right.

Why would we assume it's going to be "done right"? I've floated the idea of having "medicare for all" with a constitutional cap on per capita spending set at top European country levels and there are never any takers.

Why have a cap, and what happens when the cap is reached? What would your system look like?

Also, if it winds up costing more than the current system (and it very well may cost less), why would that be a problem? I don't think health care should be considered based on cost and with a profit in mind. It should be considered based on need and with efficiency in mind. If it winds up being a big net financial loss for the system, but is delivered with maximal efficiency, I'm more than fine with that. Public health is worth it.
 
We'd have to cut military spending. That's a good thing, but not something those in power would ever agree to do. Most of the first world countries that have some variant of UHC also outsource their defense to the USA. And they don't even pay us to defend them, because they know we're stupid enough to do it for free. Or in the case of South Korea, stupid enough to pay them to let us defend them.

It would mean giving up US hegemony and no longer being able to bully the rest of the world. I agree, unlikely may powers that be in the US would be willing to give that up. I don't agree you'd need to in order to bring in universal health care though. It isn't as expensive as people there seem to think. You could scale back the military by enough to still be dominant. US spending on military today is ridiculous and way more than needed to bully the world.
 
To save you all some reading, the think tank report fails to account for most of the savings of expenses from individuals, employers and the government that the writer says would be realized under a medicare for all system done right.

Why would we assume it's going to be "done right"? I've floated the idea of having "medicare for all" with a constitutional cap on per capita spending set at top European country levels and there are never any takers.

Why have a cap, and what happens when the cap is reached? What would your system look like?

Also, if it winds up costing more than the current system (and it very well may cost less), why would that be a problem? I don't think health care should be considered based on cost and with a profit in mind. It should be considered based on need and with efficiency in mind. If it winds up being a big net financial loss for the system, but is delivered with maximal efficiency, I'm more than fine with that. Public health is worth it.

Have a cap to ensure we achieve the promised savings. They would need to design a system that does not exceed the cap. They obviously could not legally spend money that violated the Constitution. They'd have to prioritize.
 
Have a cap to ensure we achieve the promised savings. They would need to design a system that does not exceed the cap. They obviously could not legally spend money that violated the Constitution. They'd have to prioritize.

That sounds like a really shitty healthcare system that would abandon those who need it the most and kind of be the exact opposite of what a health care system should be doing.

I should have known Americans would be able to find a way to fuck up UHC and make it as useless and inefficient as possible solely for the sake of then being able to point out how useless and inefficient it is.
 
To save you all some reading, the think tank report fails to account for most of the savings of expenses from individuals, employers and the government that the writer says would be realized under a medicare for all system done right.

Why would we assume it's going to be "done right"? I've floated the idea of having "medicare for all" with a constitutional cap on per capita spending set at top European country levels and there are never any takers.
You have?
 
Why have a cap, and what happens when the cap is reached? What would your system look like?

Also, if it winds up costing more than the current system (and it very well may cost less), why would that be a problem? I don't think health care should be considered based on cost and with a profit in mind. It should be considered based on need and with efficiency in mind. If it winds up being a big net financial loss for the system, but is delivered with maximal efficiency, I'm more than fine with that. Public health is worth it.

Have a cap to ensure we achieve the promised savings. They would need to design a system that does not exceed the cap. They obviously could not legally spend money that violated the Constitution. They'd have to prioritize.

But why promise savings? Why is cost relevant aside from for maximizing efficiency? If there is a massive loss, but its efficient, that just means you've been taking really bad care of your populace and need to do better. Health care probably SHOULD be a net loss. Imagine if you treated the military this way. Does it have to make a profit or avoid certain spending caps in time of invasion of the mainland USA? Both military and health care are matters of life and death after all.
 
Have a cap to ensure we achieve the promised savings. They would need to design a system that does not exceed the cap. They obviously could not legally spend money that violated the Constitution. They'd have to prioritize.

That sounds like a really shitty healthcare system that would abandon those who need it the most and kind of be the exact opposite of what a health care system should be doing.

I should have known Americans would be able to find a way to fuck up UHC and make it as useless and inefficient as possible solely for the sake of then being able to point out how useless and inefficient it is.

Why? Is that how you think of European national healthcare systems? Suppose we set the per capita spending cap at 10% above what France spends now. How can you argue it's not more generous than French healthcare?
 
Why have a cap, and what happens when the cap is reached? What would your system look like?

Also, if it winds up costing more than the current system (and it very well may cost less), why would that be a problem? I don't think health care should be considered based on cost and with a profit in mind. It should be considered based on need and with efficiency in mind. If it winds up being a big net financial loss for the system, but is delivered with maximal efficiency, I'm more than fine with that. Public health is worth it.

Have a cap to ensure we achieve the promised savings. They would need to design a system that does not exceed the cap. They obviously could not legally spend money that violated the Constitution. They'd have to prioritize.

But why promise savings?

Why not?

I won't support it otherwise. I simply do not believe you or anyone else who says it will cut costs if there is not something to force them to do it.

The reaction people have to the idea of a cap tells me they don't believe it either.
 
Have a cap to ensure we achieve the promised savings. They would need to design a system that does not exceed the cap. They obviously could not legally spend money that violated the Constitution. They'd have to prioritize.

That sounds like a really shitty healthcare system that would abandon those who need it the most and kind of be the exact opposite of what a health care system should be doing.

I should have known Americans would be able to find a way to fuck up UHC and make it as useless and inefficient as possible solely for the sake of then being able to point out how useless and inefficient it is.

Why? Is that how you think of European national healthcare systems? Suppose we set the per capita spending cap at 10% above what France spends now. How can you argue it's not more generous than French healthcare?

It doesn’t matter how much more it is in a general sense if you cut it off for the people who need it the most when they need it the most. The vast majority of people are going to be well below the per capita rate and a few will be well above it.

If a kid is born with a heart defect, he’s going to need a lifetime of medical care and that should be provided on account of his being a citizen with no other considerations. He shouldn’t have his medical treatments cut off and his parents forced to choose between paying their mortgage or having their son die over the concern that some healthy people might also get into an accident and drive the median rate up.
 
Why? Is that how you think of European national healthcare systems? Suppose we set the per capita spending cap at 10% above what France spends now. How can you argue it's not more generous than French healthcare?

It doesn’t matter how much more it is in a general sense if you cut it off for the people who need it the most when they need it the most. The vast majority of people are going to be well below the per capita rate and a few will be well above it.

If a kid is born with a heart defect, he’s going to need a lifetime of medical care and that should be provided on account of his being a citizen with no other considerations. He shouldn’t have his medical treatments cut off and his parents forced to choose between paying their mortgage or having their son die over the concern that some healthy people might also get into an accident and drive the median rate up.

I don't think dismal means that healthcare spending is capped per person, but that it is budgeted at a certain per capita rate per year.
 
Why? Is that how you think of European national healthcare systems? Suppose we set the per capita spending cap at 10% above what France spends now. How can you argue it's not more generous than French healthcare?

It doesn’t matter how much more it is in a general sense if you cut it off for the people who need it the most when they need it the most. The vast majority of people are going to be well below the per capita rate and a few will be well above it.

If a kid is born with a heart defect, he’s going to need a lifetime of medical care and that should be provided on account of his being a citizen with no other considerations. He shouldn’t have his medical treatments cut off and his parents forced to choose between paying their mortgage or having their son die over the concern that some healthy people might also get into an accident and drive the median rate up.

Do you know what the average spending per capita is? You take all the money you spent and divide it by all the people you covered. Nothing prevents you from spending all of the nation's budgeted money on one kid if that's how you prioritize things.

I'm guessing France and other European countries with universal healthcare are dealing with problems like this now. I think they have kids there and everything.
 
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