What is Medicare for All?

I think my concern was what the difference between current premiums and new taxes would be.

This is more what I was looking for:

• A 6.2 percent income-based health care "premium" (tax) paid by employers
• A 2.2 percent income-based "premium" (tax) paid by households
• Progressive income tax rates

Under this plan,the marginal income tax rate would be:

• 37 percent on income between $250,000 and $500,000.
• 43 percent on income between $500,000 and $2 million.
• 48 percent on income between $2 million and $10 million.
• 52 percent on income above $10 million.

This is a good summary:

- People insured through work would have new taxes, but no more premiums.
- People with Medicaid would have more choices, but possibly higher taxes.
- People currently with Medicare would have more generous coverage.
- The uninsured would all get health care.
- People who buy their own insurance would have new taxes, but less out-of-pocket spending.
- Doctors and hospitals would likely face pay cuts, but would no longer face unpaid bills.
- Drug companies would likely have less profits.
- Health insurance companies would mostly be eliminated.

Got this info from here:

https://www.politifact.com/wisconsin/article/2018/oct/11/would-medicare-all-really-double-every-americans-t/

Can someone confirm that this is still the case?

Medicare for America is good for health insurers, not so much for regular people.

Medicare for America helps commercial health insurers

https://justcareusa.org/medicare-for-america-helps-commercial-health-insurers/

Dylan Dusseault, Executive Director of Business Initiative for Health Policy, explains that presidential candidates Beto O’Rourke and Kirsten Gillibrand are helping out commercial health insurers in their support of Medicare for America. Unlike Medicare for All, Medicare for America is a health reform proposal that would allow people to keep their commercial insurance if they wanted to. By so doing, it would fail to rein in health care costs and to guarantee Americans access to care. 

Medicare for America, introduced in the House by Congresswomen Jan Schakowsky and Rosa DeLauro, is a health care reform proposal that delivers universal health care. It leaves commercial insurers in place, while giving people the option to have traditional Medicare or a Medicare Advantage plan. And, it automatically enrolls everyone who is uninsured and newborns in Medicare. But, so long as commercial insurers can “compete” with Medicare, they will continue to game the health care system and undermine people’s access to care.

O’Rourke and Gillibrand see Medicare for America as an incremental step towards Medicare for All that they mistakenly claim is more feasible politically than Medicare for All. But, Medicare for America introduces additional health care spending and more government involvement in people’s health care. For these reasons, it is no more feasible politically than Medicare for All.

Medicare for America could also be a step backward from Medicare for All. It does not take on the lobbying power and political influence of the health care industry. Instead, it allows this power and influence to grow. Medicare for America would enable Medicare Advantage plans to expand their business at government expense. It also would further empower the health care industry, allowing providers to drive health care prices higher.

Medicare for America, unlike Medicare for All, does nothing to rationalize health care prices. Rather, it increases national health care spending. Not only would we continue to pay high prices for our care, we would also continue to pay the hundreds of billions of dollars in administrative costs and profits that come with commercial health insurance. Millions of Americans would still not be able to afford their health care.

Moreover, simply giving people who are uninsured Medicare might not be enough to get them access to care. Medicare for America would pay doctors Medicare rates, which are lower than commercial rates. But, it would not require doctors and hospitals to take Medicare patients. As a result, Medicare for America could make it a lot harder for people with Medicare to find doctors who will see them.

It’s not rocket science. It should be a simple system: Everyone pays for Medicare, everyone has Medicare, and if you want private health insurance on top of that, just buy it.

ridski said:
It’s not rocket science. It should be a simple system: Everyone pays for Medicare, everyone has Medicare, and if you want private health insurance on top of that, just buy it.

 It should be a simple system, paid through taxes.  Everyone is covered and you just go to any doctor or hospital and don't worry about bills.  There is no use for private insurance, except perhaps for elective procedures. 

nan said:
 It should be a simple system, paid through taxes.  Everyone is covered and you just go to any doctor or hospital and don't worry about bills.  There is no use for private insurance, except perhaps for elective procedures. 

Damn near every country with a nationalized insurance plan also has private insurance. While others are fighting to get what other countries have, you’re fighting to get what other countries don’t. What’s the reason behind that?

ridski said:
Damn near every country with a nationalized insurance plan also has private insurance. While others are fighting to get what other countries have, you’re fighting to get what other countries don’t. What’s the reason behind that?

 No country is starting from where we are starting.  You can't just look at what they have and say that proves we need to keep insurance companies.  When countries install new infrastructure, they don't look at the ones with the old infrastructure and say, "We must install 2G instead of 5G cause all those other countries have it."   

Also, there are bound to be some compromises, so you have to start out strong and try to get rid of the greedy, profit-sucking insurance companies, cause they are powerful and will do anything to survive.  I would not be surprised to see us end up like the countries that still have some private insurance, but we need to start negotiations from a strong position. 

nan said:
I would not be surprised to see us end up like the countries that still have some private insurance, but we need to start negotiations from a strong position. 

If you admit that, does that mean that you're no longer a progressive?  I only ask because the people who admit that up front are labeled "not Progressive" by you.

nohero said:
If you admit that, does that mean that you're no longer a progressive?  I only ask because the people who admit that up front are labeled "not Progressive" by you.

 No, I would like to see the insurance companies eliminated.  That would be my first choice.  I want a system where we just go to the doctor and don't worry about premiums, bills or co-pays.   If they end up somehow surviving, I want them to have minor influence. 

So the Medicare for All crowd wants systems like they have in Canada and England - but they don't want them to work the same way?

Nan - can you at least tell us what current system out there is most like Medicare for All?

jamie said:
So the Medicare for All crowd wants systems like they have in Canada and England - but they don't want them to work the same way?
Nan - can you at least tell us what current system out there is most like Medicare for All?

Countries with single-payer systems

• Canada.
• Taiwan.
• South Korea.
• Scandinavia.
• United Kingdom.
• Australia.
• Spain.

I don't mind co-pays, etc. And Medicare currently DOES have premiums and bills (not sure about co-pays since I'm not yet eligible.)  What I mind is not having everyone covered and pre-existing conditions and the high cost of having insurance being a for-profit industry.  I'm sure that there are many ways to implement "Medicare for All" or some other Universal Healthcare.  But first we have to forge agreement with the basic premise that everyone should have healthcare as a universal right.  The rest is details that can be worked out, in many different ways, but as long as that philosophy hasn't been firmly adopted, we haven't gotten past square one.

sac said:
I don't mind co-pays, etc. And Medicare currently DOES have premiums and bills (not sure about co-pays since I'm not yet eligible.)  What I mind is not having everyone covered and pre-existing conditions and the high cost of having insurance being a for-profit industry.  I'm sure that there are many ways to implement "Medicare for All" or some other Universal Healthcare.  But first we have to forge agreement with the basic premise that everyone should have healthcare as a universal right.  The rest is details that can be worked out, in many different ways, but as long as that philosophy hasn't been firmly adopted, we haven't gotten past square one.

 Single-payer is the best way to get everyone covered with the ability to have and use healthcare  Currently, we have access to healthcare, but it may not be affordable.  Many people live paycheck to paycheck.  Premiums, co-pays and deductibles make it impossible for them to afford to see doctors. Plans like "Medicare for America" are not going to change that.  No one should go bankrupt over healthcare.

nan said:
Countries with single-payer systems

• Canada.
• Taiwan.
• South Korea.
• Scandinavia.
• United Kingdom.
• Australia.
• Spain.

These place don’t have private healthcare options?  The likes of which Bernie wants to get rid of?

I wanted to know which countries were most similar to Medicare for All.

nan said:
 Single-payer is the best way to get everyone covered with the ability to have and use healthcare  Currently, we have access to healthcare, but it may not be affordable.  Many people live paycheck to paycheck.  Premiums, co-pays and deductibles make it impossible for them to afford to see doctors. Plans like "Medicare for America" are not going to change that.  No one should go bankrupt over healthcare.

That's an opinion, not a fact.  I don't necessarily disagree.  But the biggest problem here in the USA is that we still haven't gotten general agreement that universal healthcare is desireable and necessary - a basic human right.  And that is the biggest problem and also a prerequisite to working on this issue effectively.

sac said:
That's an opinion, not a fact.  I don't necessarily disagree.  But the biggest problem here in the USA is that we still haven't gotten general agreement that universal healthcare is desireable and necessary - a basic human right.  And that is the biggest problem and also a prerequisite to working on this issue effectively.

 Recent studies have shown that Medicare-for-All is the cheapest way to get everyone covered.  The insurance companies will fight like hell to combat it and support candidates who offer more insurance company friendly alternatives.  I think pigs will fly before many Republicans consider healthcare a right, so I don't see the sense in waiting for that. I do know Medicare for All polls well even with Republican voters--everyone knows someone who has had to set up a Go Fund Me or worse. 

Health Care and Insurance Industries Mobilize to Kill ‘Medicare for All’

https://www.nytimes.com/2019/02/23/us/politics/medicare-for-all-lobbyists.html?login=email&auth=login-email

So Nan ,

Say hypothetically Bernie squeaks out a win and the Dems get both houses of Congress and a filibuster-proof majority in the Senate -you can dream, right?!

They propose Medicare-for-All as you understand it. Insurance companies are gone. Everyone can see any doctor, anytime.

The Republicans demonize the plan - death panels, rationing, 9 months to see your doctor, drug companies will go out of business, etc. Some lies, some plausible arguments, at least in the near term. 

The proposal as a result enjoys weak support.

Do you push it through anyway? How do you deal with those against? What is the plan for the rollout?

jimmurphy said:
So Nan ,
Say hypothetically Bernie squeaks out a win and the Dems get both houses of Congress and a filibuster-proof majority in the Senate -you can dream, right?!


They propose Medicare-for-All as you understand it. Insurance companies are gone. Everyone can see any doctor, anytime.
The Republicans demonize the plan - death panels, rationing, 9 months to see your doctor, drug companies will go out of business, etc. Some lies, some plausible arguments, at least in the near term. 
The proposal as a result enjoys weak support.
Do you push it through anyway? How do you deal with those against? What is the plan for the rollout?

 I'm not a politician, so I'm not sure what the exact strategy will be, but any proposal put forth by the Democrats will be treated this way.  Did you see the video I posted where Obama was trying to be partisan with the Republicans to listen to them and he made lots of concessions and they still all voted "NO" on that version of Obamacare.  You need to go in with the strongest plan possible and work from there. Going in with a watered down version will just get watered down even more.  Obamacare was helpful and great for some, but it still left many people without insurance and  offered many others unaffordable premiums that kept going up. It was also supposed to have a public option for Medicare and that got taken off at the end.  Now it's 2020 and candidates like Beto are running on the pubic option like it's the newest idea since sliced bread.  By the time that goes through the wringer it will probably be worse than Obamacare.  We really need to get over incrementalism cause some of us have been waiting for decades and there is little progress.

Medicare for All wll cover everyone and save lots of money, so we should go in and demand that and see what we get.  It's not going to be an easy fight because the insurance companies have bottomless pockets.  People may have to take to the streets and have big protests like they do in other countries. That would help. Listening to CNN telling you that Medicare for America is just as good and more practical does not help--unless you are an insurance company. 

So you don't know.  OK Thanks.

jimmurphy said:
So Nan ,
Say hypothetically Bernie squeaks out a win and the Dems get both houses of Congress and a filibuster-proof majority in the Senate -you can dream, right?!


They propose Medicare-for-All as you understand it. Insurance companies are gone. Everyone can see any doctor, anytime.
The Republicans demonize the plan - death panels, rationing, 9 months to see your doctor, drug companies will go out of business, etc. Some lies, some plausible arguments, at least in the near term. 
The proposal as a result enjoys weak support.
Do you push it through anyway? How do you deal with those against? What is the plan for the rollout?

 "Hypothetically," if Sanders won the nomination, it would be w/HR 1384 as his main campaign commitment, meaning support for it will have continued strong among likely Democratic voters over the incremental plans.  Despite primary attacks by right liberals.

Then - before the election, not after - there'd be the giant right wing scare campaign, with the right trying to red bait Sanders, making up lies about HR 1384, and, at the same time, declaring Republicans had to take back the House and keep the Senate to block a potential Sanders presidency.

See where this is going?  If Sanders nonetheless won, and, in the same election, voters shifted support to Democratic candidates - candidates who would unavoidably have had to weigh in on healthcare for all - to the extent that there was an actually "filibuster-proof" Senate majority, as you hypothesize?  Well that would mean the right wing campaign had failed to win over Republican and 'swing' voters.  And that outcome would be fairly understood as a mandate - a strong mandate at that - to pass and implement HR 1384.

So to answer your questions, yes, as a matter of basic democracy and fulfilling electoral promises, Democrats would "push through" the bill, keeping it as intact as possible, despite large parts of the right wing being against it.  Wouldn't be the first time - implacable, red baiting opposition to the New Deal, e.g.  (Though not necessarily all of the right - polls show low income Republican support for government run healthcare spiked in recent years.)  How "deal" with "those against?"  What to say, it would be a contested piece of legislation that either would or would get support as it was implemented.  "Plan for the rollout?"  If you look up HR 1384, it details two years - not clear what your point is...

My point is that the devil is in the details. 

My belief and opinion is that people could vote for Bernie despite his support of M4A as they might just maybe be voting against Trump. A fact is that a millions of people, R’s and D’s alike, like their doctors and current access to those doctors and their insurance plan. 

I suspect that when the details come out, there will be much greater resistance to M4A than support.

jimmurphy said:

"...people could vote for Bernie despite his support of M4A as they might just maybe be voting against Trump."

No doubt true for many in terms of their 'druthers.'  But - accepting your hypothetical scenario - only after a majority had secured the nomination for Sanders; that is, even after right liberal primary candidates (plus probably HRC and Obama) unsuccessfully 'pledged' their support for a 'lone right liberal standing.'

So yea, 1) a Sanders candidacy could put the typically dominant right liberal bloc of the Democratic party in the position progressive liberals typically find themselves in when they are a significant minority that votes for a 'lesser of two evils,' though they don't like a lot the nominee will do.  But 2) only after his nomination campaign had persuaded a majority through argument - vs. a poll - to go for  the M4A candidate.

"A fact is that...millions of people, R’s and D’s alike, like their doctors and current access to those doctors and their insurance plan....I suspect that when the details come out, there will be much greater resistance to M4A than support."

Well, a few polls are often cited to argue as much.  But, again, your scenario requires Sanders' ideas to have been popular enough to get the nomination anyway (probably saying people can keep their docs) - despite right wing attacks and right liberal attacks and coalitions.

As I see it, jim - following your reasoning - Sanders cannot 'flip' the 2016 HRC-Sanders numbers unless he persuades a majority, during the primaries, that healthcare for all is the way to go.

That is - it's the primaries/nomination that will determine your 'but what about when people learn more' question with right liberals and swing voters; and the election period that will determine whether the M4A idea can prevail against the hardcore right.

jimmurphy said:
My point is that the devil is in the details. 


My belief and opinion is that people could vote for Bernie despite his support of M4A as they might just maybe be voting against Trump. A fact is that a millions of people, R’s and D’s alike, like their doctors and current access to those doctors and their insurance plan. 


I suspect that when the details come out, there will be much greater resistance to M4A than support.

The  same be said for any of the healthcare plans, like Medicare for America.  When Beto was announcing it to a crowd, he said it would be "expensive" and just a better alternative to not getting healthcare at all.  I'm sure he's phrasing it better now, but that's really the truth - and it's going to be even worse. 

Obamacare left something like 30 million people without healthcare.   And it was considered a big success, although lots of people hated it.  So, we have to do something and this is a chance to really put in a plan that will cover everyone  the cheapest.  And the blueprint for the rollout is already there--just expand Medicare to everyone.  There will be one network and no bills or co-pays.  This is an opportunity to finally get the healthcare the richest country in the world should be enjoying.

Edited to add:  I just watched this video and the guy explains the rational for why we need to start bargaining at the Medicare for All level, not the Medicare Buy in level.  He talks about how the politics will go and the negotiations needed to get it passed--the kind of stuff you were asking about:

nan said:

jimmurphy said:
My point is that the devil is in the details. 


My belief and opinion is that people could vote for Bernie despite his support of M4A as they might just maybe be voting against Trump. A fact is that a millions of people, R’s and D’s alike, like their doctors and current access to those doctors and their insurance plan. 


I suspect that when the details come out, there will be much greater resistance to M4A than support.

The  same be said for any of the healthcare plans, like Medicare for America.  When Beto was announcing it to a crowd, he said it would be "expensive" and just a better alternative to not getting healthcare at all.  I'm sure he's phrasing it better now, but that's really the truth - and it's going to be even worse. 
Obamacare left something like 30 million people without healthcare.   And it was considered a big success, although lots of people hated it.  So, we have to do something and this is a chance to really put in a plan that will cover everyone  the cheapest.  And the blueprint for the rollout is already there--just expand Medicare to everyone.  There will be one network and no bills or co-pays.  This is an opportunity to finally get the healthcare the richest country in the world should be enjoying.
Edited to add:  I just watched this video and the guy explains the rational for why we need to start bargaining at the Medicare for All level, not the Medicare Buy in level.  He talks about how the politics will go and the negotiations needed to get it passed--the kind of stuff you were asking about:

 gaah, how do you listen to these people nan? Your time is not well served spending it with this guy. It's just a bunch of pronouncements, based on practically nothing, assuming tons of facts not in evidence.

I'm in a nationalized health care system in Hong Kong and there's a private system that runs in parallel to it.  If you have a very serious issue, you get to a government run hospital asap simply because they have seen more cases and have all the proper protocols locked down (and the latest tech).   US$15 for an overnight stay in hospital, no extra charges for meds. I pay with the same shared value card I use for taking the bus or MTR.   Ambulance rides are free.  And there's no paperwork because I have a Hong Kong ID, which when they key it in gives them access to my entire medical history.  If you have a non emergency issue, you may have to wait anywhere from 2 weeks to 18 months to get an appointment.  That's when the private system becomes useful. I don't see the same doctor every time in the public system when I go, but quite often I do; and they're all trained at HKU, Asia's top university (maybe tied with Singapore), with residencies in the US, UK or Canada.  

The medical profession in the US has been viewed as a path to wealth whereas in Asia it's more of a way to be of service.  And HK govt negotiates drug prices on behalf of its citizens, which Cory Booker doesn't like.

This is a pretty good overview:

https://www.nytimes.com/interactive/2019/04/10/upshot/medicare-for-all-bernie-sanders-cost-estimates.html

But what will it cost me?

All of these estimates looked at the potential health care bill under a Sanders-style Medicare for all plan. In some estimates, the country would not pay more for health care, but there would still be a drastic shift in who is doing the paying. Individuals and their employers now pay nearly half of the total cost of medical care, but that percentage would fall close to zero, and the percentage paid by the federal government would rise to compensate. Even under Mr. Blahous’s lower estimate, which assumes a reduction in overall health care spending, federal spending on health care would still increase by 10 percent of G.D.P., or more than triple what the government spends on the military.

How that transfer takes place is one of the least well explained parts of the reform proposals. Taxation is the most obvious way to collect that extra revenue, but so far none of the current Medicare for all proposals have included a detailed tax plan. Even if total medical spending stayed flat over all, some taxpayers could come out ahead and pay less; others could find themselves paying more.

Democrats need to get over their fear of disrupting private health insurance

https://theweek.com/articles/833491/democrats-need-over-fear-disrupting-private-health-insurance

While ObamaCare was being discussed and negotiated, Democrats twisted themselves into knots trying not to fuss with the private insurance system too much. Thus during the 2008 campaign and afterwards, Barack Obama said some version of "if you like your insurance, you can keep it" dozens and dozens of times.

This line blew up in his face spectacularly. One of the objectives of ObamaCare was to clean up employer-based insurance. This made perfect sense, in the context of the ObamaCare approach — before the law, there was a substantial market in absolute garbage policies that didn't really cover anything (which are coming back thanks to Trump, by the way), and lot more with gaps in their coverage. New regulations on guaranteed coverage standards, the medical loss ratio, and so on made employer-based insurance considerably better — but also required substantial restructuring of the market, which destroyed a lot of policies.

Conservatives and the mainstream media had a screaming fit — especially so-called fact-checkers, who are always on the lookout for liberal flubs to give them nonpartisan cred (PolitiFact labeled Obama's claim as "lie of the year" in 2013).

But critically, the freakout was given major strength by the background condition of people being constantly kicked off their insurance. People switch jobs often, and employers routinely shop around for different or cheaper coverage. As Matt Bruenig details, a Michigan study shows that fully 28 percent of people on an employer-sponsored plan were not on the same plan a year later. About half of the population — or 160 million people — is on private insurance. If that's a representative study (and it's surely in the right ballpark), that means about 45 million insurance loss events annually, or 3.7 million per month.

Obama didn't get in trouble over his broken promise because people are deeply in love with their (increasingly crummy and expensive) private insurance. He got in trouble because it was a stupid promise that was logically impossible to fulfill, and he couldn't have avoided sounding like an outright liar. No matter what health-care reform passes, so long as private insurance exists conservatives will always be able to point to millions of people losing their existing coverage and blame it on the reform.

As an aside, it's also worth noting that the ObamaCare exchanges also require people to shop for new insurance every year as a matter of design — and anytime an insurer withdraws from the exchange, which happens all the time, everyone on its plans gets kicked off. Bit of an odd choice from people who are supposedly obsessed with the backlash problem.

At any rate, all this demonstrates the only way around the backlash hurdle — be honest with the public, and hold out the promise of good coverage that is actually permanent, like Medicare-for-all. Yes, if you have private coverage, you will lose it — but in return you'll get something really good that will stay with you for life. No more worrying that losing your job means your whole family losing their coverage, and possibly being driven into bankruptcy, or staying in a lousy job just because you need the insurance. (Medicare also has the advantage of being widely understood already, so fear of the unknown is reduced.)

Speaker Pelosi, in an interview on 60 minutes said the problem with Medicare for All is that Medicare doesn't cover a lot of things and that the ACA actually covers more. I do not know if this is accurate.

As for private insurance people are afraid of change. So even those who have lousy insurance might be afraid of getting something worse. I think that's why the "Public Option" is a good idea. If it actually offers something superior to peoples' private insurance they will gradually switch over time.

STANV said:
Speaker Pelosi, in an interview on 60 minutes said the problem with Medicare for All is that Medicare doesn't cover a lot of things and that the ACA actually covers more. I do not know if this is accurate.
As for private insurance people are afraid of change. So even those who have lousy insurance might be afraid of getting something worse. I think that's why the "Public Option" is a good idea. If it actually offers something superior to peoples' private insurance they will gradually switch over time.

 That's total BS.  Medicare for All, as proposed, covers everything including vision, hearing and dental.  The ACA is an unsustainable model, often with huge deductibles and co-pays.  I don't agree that people are afraid of losing their insurance because most people I know are struggling to pay for it. It just keeps going up and it can be lost in an instant if you lose your job or get divorced or your spouse who is the policy holder dies. And many employers do what they can to avoid paying for it so you have so many part-time workers.  It's a total mess.  There are a minority of people who have a secure situation with affordable comprehensive insurance.  I think were most people well informed about the real choices (not lied to as Pelosi does here) they would be wholeheartedly for Medicare for All.  But the insurance companies have deep pockets that extend to most of the candidates and they will do what they can to suppress information about Medicare for All and to confuse people and make them think we need to keep them. 

I happen to be on Medicare. I have found it pretty good. But there is much it does not cover.

Do the advocates want to expand it to cover everything?

What does m4a cover for chiropractic care?