New Medicare for All Bill

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New Medicare for All Bill

Postby KeithE » Wed Sep 13, 2017 6:19 pm

Bernie is leading a new effort for a Medicare for All Bill this time starting in the Senate (don’t know the details yet or even the SB #). Sixteen and counting co-sponsors. There has been of course a Medicare for All Bill for a long time in the House (H.R 676). That has been posted about previously at BL here. It has 117 co-sponsors in the House.

The only things that are detailed in Bernie’s plan (in the above news story) is that there would be a $250/year deductible for prescription drugs- not bad. Not sure about hospitalization deductibles or doctor visits deductibles and the CBO scoring is not yet done. The estimated (non-CBO) cost tags are:
to be paid for in part by a proposed new 2.2% income tax on all Americans, a 6.2% levy on employers and a further round of tax hikes on the wealthy.


I suspect that is a 2.2% increase in the payroll tax (we now pay 1.45% now for our post 65 medical needs). Bernie is rightfully (imo) hitting employers and the rich harder (employers now pay 1.45%) and that will certainly be negotiated.

What is 2.2%+1.45% = 3.65% for the average American family making say $100K/year? That is $3650/year or $304/month.

What do employees (lucky enough to have family health insurance) pay a month? It is $4956/year or $413/month.

Thus it would be 25% cheaper as far as premiums go and we can cover everyone. Deductibles would probably be less as well (but that is not clear yet).

This is made possible by the lower administration costs in Medicare (<2%) than in health insurance companies (>15%), the economy of scale, and the high profits of the insurance industry.

Wrt HR 676 (which has been studied in more detail), read here. It raises payroll taxes to 5% both to employees and employers (more evenly split between employees and employers) and it appears to be about the same ($416/month vs $413/month for family with income of $100K/year) in premiums.

What are we waiting for??

It at least deserves a CBO score and due consideration (as much as any ObamaCare mod). Especially since 53% of Americans favor a single-payer (43% oppose it) even though the the media does not mention it favorably.

Image

Now that the single-payer is cast as a Medicare-for-all, I suspect the polls would show even more support. I know I love my Medicare more than any employer-based plan since about 1995 when most good companies paid all the premiums.

I start this topic knowing that there wil be many more details in the bills to be discussed. It may turn out to be less cost effective than the status quo, but I doubt it. Other countries use a variety of universal single payer health care systems that cost half as much and provides better results.
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Re: New Medicare for All Bill

Postby Sandy » Thu Sep 14, 2017 8:26 pm

I'm not completely following your numbers here, Keith, but what I see is that there will be an increase in payroll taxes, and an increase of taxes on the "wealthy," which would include most business owner-employers, that would be about 25% less than the average cost of insurance premiums currently. So this plan puts, on the average, about 25% of what most people now pay for insurance back in their pocket. I watched a couple of news reports, and read the Washington Post report, but didn't see anything about this plan having negotiated rates for medical care. I'd be in favor of that as well.
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Re: New Medicare for All Bill

Postby KeithE » Thu Sep 14, 2017 9:38 pm

Sandy wrote:I'm not completely following your numbers here, Keith, but what I see is that there will be an increase in payroll taxes, and an increase of taxes on the "wealthy," which would include most business owner-employers, that would be about 25% less than the average cost of insurance premiums currently. So this plan puts, on the average, about 25% of what most people now pay for insurance back in their pocket. I watched a couple of news reports, and read the Washington Post report, but didn't see anything about this plan having negotiated rates for medical care. I'd be in favor of that as well.

I think you caught the amount of cost reductions there would be for a family making $100K/year if the added payroll tax is 2.2% (for a total of 3.65% - we pay 1.45% now). Now that will be highly variable depending on the family income. If that family income is $50K/year, then the cost reduction would be more like a 63% cost reduction (from $413/month currently to $152/month) and if that family income is $200K/year there would be an increase of 47% and even more for higher incomes. Thus unlike today health care costs would then be “progressive” just as we have a progressive tax system now - quite a change. All of this is applicable only to replacing employer-based insurance not ACA insured.

Nor does it attempt to factor in any price negotiations for medical procedures or drugs buys. Bound to be some savings there as well.

This is not likely to even come to a vote (McConnell would have to authorize) and if it did more CBO based analysis would inform what the payroll tax would be to be self-sufficient.

I just hope this topic can follow these ideas (and numbers) and maybe some year we will join the rest of the World in having cost-effective (half our current costs) health care.

The country has been poisoned against government doing anything effectively. Much of the rest of the world is doing health care universally and affordably and they love it.

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Re: New Medicare for All Bill

Postby KeithE » Fri Sep 15, 2017 8:46 am

I have not read it yet but here is the Senate Bill offered by Bernie in case anyone here cares to study it further. I’ll expand my comments as I have time.

Meanwhile consider Dems Not Backing Medicare for All Get Twice as Much Industry Cash as Co-Sponsors and more (68%) went to Republicans. This is why it will probably not even get a hearing or even a CBO score (it would look so much better than any ACA mod). Btw, Bernie took $0 from the health insurance companies.
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Re: New Medicare for All Bill

Postby Haruo » Fri Sep 15, 2017 10:39 am

KeithE wrote:The country has been poisoned against government doing anything effectively. Much of the rest of the world is doing health care universally and affordably and they love it.

Image

Based on your pie chart, I wouldn't say "they love it", but they do like it better than we like what we've got, and by a considerable margin. Canadians are happier with theirs than the Brits. Be interesting to know what details drive the differences, or if it's just a matter of personal unpleasability in the UK.

This accords with my impressions based on sporadic conversations with people all over the world. I know Canadians who dislike their system, but I know far more who like it.

Personally, I have (as long as I work at least 16 hours a week average over the course of a four-week month) an employer-paid union plan with very low deductibles. I'm 63½ and am planning on leaving the workforce before I'm 65, and the biggest challenge I face is how to maintain affordable health coverage until Medicare kicks in. Mrs. H. has VA coverage with no deductibles for most stuff, and I'm not clear on how that will mix with Medicare when she hits 65.
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Re: New Medicare for All Bill

Postby KeithE » Thu Sep 21, 2017 8:45 am

49% approve of Medical for All, 35% oppose

17% approve of the previous GOP’s Better Care Reconciliation Act, 55% oppose
Another Poll has the GOP Better Care Reconciliation Act at 12%

This is not the new Graham- Cassidy (G-C) Plan possibly being brought to a vote next week (sans CBO analysis or discussion of amendments).
The Facts about the G-C Plan
One difference is that this plan block grants funds to states for some matters (mostly Medicaid and ability drop any of the 10 essential health care matters that OC demands). It also does not eliminate the taxes on the rich and corporations like the GOP Plan did. It allows for high rate pools for those with pre-existing conditions and maternity. It also does away with mandates (personal and corporate)/penalties and will likely lead to 30M+ losing coverage. The + comes from my belief that if corporate mandates disappear there will be companies that drop health care coverage for their employees (something the CBO did not consider when estimated 30M people losing coverage when scoring the previous Plans).

What approach do you favor? and why?
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Re: New Medicare for All Bill

Postby Sandy » Thu Sep 21, 2017 2:45 pm

Probably goes without saying, I favor medicare for all. Everything else that has been proposed from the GOP side is purely political, and doesn't take into consideration the effect it will have on people. Their only interest is the political prestige of overturning the previous President's signature legislation, not in proposing any kind of health care legislation that will do anything except make their rich contributors richer. The more days that the proposal is out there, the slimmer the chances that it gets passed.
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