Question for the "Medicare for all" folks...

[damonm]

..which, BTW, I think is a GOOD idea...

Has anyone run any cost estimates as to how much that would cost/yr and what if any effect it would have on the deficit? If so, could you point me to those links? Thanks.

[damonm]

1. C'mon! 20 views and no one has an answer?

[stray cat]

2. If people were willing to pay 5-10,000 per person which is dirt cheap insurance

and it were mandatory it would completely stabilize Medicare I would guess. We could leave it at its current lower level for those on a fixed income and over 60. This way we have a mandate but people don't pay the evil insurance company

[DFLforever]

4. I'm on Medicare and still need to purchase supplemental

insurance because Medicare doesn't cover all costs. I supposed I could do without insurance but then I would have the uncertainty of out of pocket expenses.

[last1standing]

3. It looks like the CBO hasn't scored it but would lead to savings.

http://en.wikipedia.org/wiki/United_States_National_Health_Care_Act#Cost_analysis_of_the_bill

[Dr.Phool]

5. According to HR 676, the House version,

And Conyers numbers, Medicare for all, that eliminates co-pays, deductibles, and supplemental insurance could be completely funded by an additional 3-3.5% payroll tax on employees and employers.

The numbers and methodology used to be posted at www.healthcare-now.org , but I haven't been there for a while.

[jtrockville]

6. CBO was never asked to score it.

Here's a commentary on why it was never scored, by Phil E. Benjamin (senior editor of Public Affairs magazine):

...

HR 676 closely mirrors the current Medicare program and is sometimes referred to as a "Medical For All" proposal. This is a "Public Option" that would cover everyone and be the cheapest national health care program. The Congressional Budget Office was not asked to "score" HR 676 for good reason. The Democrats would not allow the bill to be seriously considered, for it knew, it would receive a very low-cost score. After all, Single Payer would have eliminated the insurance industry as a major player. That is where much of the high cost lies in the House and Senate bills.

The leadership of the Democratic Party determined that it could not or would not eliminate the insurance industry from running our national health program. The term used was it would be too "disruptive" to the insurance industry to do that. Left out of the reasoning are the 50 million who have no health insurance and 60 million who have poor coverage will continue to have their lives disrupted every minutes of every day.

...
http://paeditorsblog.blogspot.com/2009/10/struggle-for-health-rights.html

[Festivito]

8. Note: "and be the cheapest national health care program" Try 3K/y v. 7K/y.

PBS Moyers did a piece showing other country's costs of universal /public option /single payer /medicare part E for everyone -- whatever or whichever you would want to call it.

He showed it at about $3,000 per year per capita. England slightly under. Canada at about $3,500.

We, the US, are paying over $7,000 per year per capita, over 2-trillion dollars per year or one-sixth our GDP.

We could be paying (at 3K) under one-trillion per year and put health care at about one-twelfth of GDP where the other countries are.

So, the idea of Congress is to offer some aspects of universal by regulation without completely dismantling the Health Insurance Industry campaign-money cash cow. This leaves some people not covered, but fewer which brings down the cost and saves a little. Thus, $7,120 per year comes down to say $6,800 per year, and the billions of dollars is paraded as a great gain.

If M$M waked America, the M$M would not get those expensive pill ad, hospital ad, insurance ad revenues.

So, Congress refuses to let the CBO determine the cost of Single payer and make it clear. Because it's the "cheapest national health care program" as the article said.

[bornskeptic]

15. No, he's not the senior editor of Public Affairs magazine.

He's the senior editor of Political Affairs magazine (Marxist thought online).

http://www.politicalaffairs.net/

He's also lying egregiosly. The reason the CBO never scored HR676 is because the CBO gave the sponsors a heads up on what it would look like, and it would have been really ugly. The first item in the CBO score is the increase it would cause in Government expenditure. Even providing everyone with the coverage Medicare enrollees have now couldn't be done for less than $5000 per person per year. That is only half of what the Federal Government spends now on each Medicare enrollee. But HR676 proposes to eliminate out-of-pocket expenses as well, and also to provide full dental and vision coverage. That would easily come to an additional $1.5 trillion annually. The proposed taxes in HR676 wouldn't come close to covering that.

[nannah]

7. medicare is not free

people pay for medicare.

currently people pay large amounts to insurance companies for health insurance; they will continue to pay but they will pay less and it will go to medicare.

people who haven't been able to afford access to health care will be able to pay income sensitive amounts for their medicare.

all medical care will be compensated; doctors and providers will bill medicare; they will need less overhead to cover collections. they can negotiate fees with medicare and medicare can negotiate with all providers. Currently medicare passes 97% of their collections through to health care providers; insurance co's pass 70 to 75% of the money they collect to health care providers.

there will be job creation for people to work within the new structure. those with past billing experience will have access to medicare jobs (this was in the last single payer legislation). more health care dollars will go to hands on care, less to collections and administration.

this seems consistent with the current structure of medicare and federal cost setting apparatus for collecting payments, setting costs, and making payments to vendors.

[busymom]

9. OK...so here's my question...

It will be unpopular, but I accept that.

In the UK, the wait list for CT/MRI/PET scanners can be up to 6 months. Wait times to see specialists even longer. Though costs are lower, people don't even get semi-private rooms ... it's more like 4-6 people per room. Forget any nice amenities. In Germany, for example, they don't even stock towels in most hospitals. As they told me when I was hospitalized and didn't bring a towel (who would think to do that?) "Hey, this isn't a hotel".

Medicare pays providers next-to-nothing. What does this mean? With the medicare cuts coming from the CMS that were effective Jan 1, it means that it costs more to see a complicated medicare patient than is brought into a clinic. Our hospital system will have to close their free outreach clinic and inpatient psych beds because they use any surplus income to fund these programs that are always in the red.

I know that no one here wants to pay doctors as much as ... plumbers make. Hell, the man who is fixing my stairs today and is a master carpenter lives in a house twice the size of mine and twice as nice. Should I start lobbying to have his rates cut because I don't think it's fair?

A friend of ours who is a home inspector in Texas and owns his business earns more than my husband who will come in at all hours of the day and night to see you whether you have health insurance or not. 8 years of college and then med school ... 8 years of residency and specialty training....we have very little retirement, no savings for our kids for college ...

With the new cuts to medicare, my husband's partner has decided he's tired of getting bent and is retiring. My husband is considering simply finding a different career. At this point, what does he have to lose?

If we adopt a medicare for all policy, what will stop the government from continuing to prop up big pharma and making deeper cuts in terms of reimbursement?

You also have to know that govt. sponsored health care for all will not be the same level of care across the board. The nice hospital facilities and MRI scanners on every corner are a product of the private insurance industry...so are the nurses salaries. In Germany, nurses earn a pittance. The system can't afford highly skilled nurses.

Unpopular opinion, but I have lived in europe and the uk and have worked in the health systems in all countries.

[CTyankee]

12. If the people don't see to it that the program is funded, what you describe happens.

If and when the people decide it's worth it to pay for it, the funding will be provided. That funding is always at risk so the populace must be vigilant eternally and politically attuned to what is going on.

I do not hear of this happening in France or Italy so I have to presume that their populations are more active politically...

[slipslidingaway]

13. The per capita spending in the UK is about a third of what the US spends ...

and as you know their system is not what is proposed under a Medicare for All system.

Not sure exactly what is your question, but IMO it is not helpful to throw out the following numbers.

"In the UK, the wait list for CT/MRI/PET scanners can be up to 6 months. Wait times to see specialists even longer. Though costs are lower, people don't even get semi-private rooms ... it's more like 4-6 people per room. Forget any nice amenities..."

[Lars39]

16. Are all the MRI machines in government hospitals only?

In the US, there are private healthcare businesses who also have MRI machines, etc...this is in addition to the machines in hospitals.

[walldude]

22. And here is my answer:

Although your post was filled with mostly republican talking points and not a "question" I will answer what I think was your question.

No one is talking about giving away free medical care to all, the Medicare for all discussion is you pay your premiums to medicare instead of to a for profit company, and by eliminating the need for massive profits you automatically reduce costs to consumers. Negotiations with hospital can then become serious. Instead of the $89 dollars charged for a "Mucas Removal System" you pay 10 cents for a fucking tissue.

And the costs for doctors are figured into operation costs not profits so doctors will still be able to make the big bucks.

[slipslidingaway]

10. Sadly the Democrats never bothered to gather the information...

that might have led to a real discussion about HC reform.

:(

There are some older estimates at the link below, this time it was just completely ignored ... progress.

:shrug:


http://www.pnhp.org/facts/single_payer_system_cost.php?page=all

[eridani]

11. Washington Health Security Trust estimates that WA State can cover everyone--

--for $100/month/adult and an 8% payroll tax on businesses that have more than a $150,000 payroll. That assumes that Medicare and Medicaid funds go into the system.

http://www.healthcareforallwa.org/health-security-trust/

[MISSDem]

14. I know that I will sound like a Republican but "free" HC will

break the country. They tried it in Tennessee and it almost bankrupted the State. When people don't have to pay for it they over use it.

[CTyankee]

17. Do you have data to back this up, specifically with regard to your state?

nt

[walldude]

19. No one is talking "free"

what is being discussed is paying premiums into Medicare instead of for profit insurance companies. Your premiums would automatically drop 20-30% at least. It would not cost anything, deficit neutral.

[walldude]

18. Thom Hartmann has a bunch of info on this.. It's deficit neutral

there are no "costs" per se. It would be supported by premiums paid in which would be at least 20-30% cheaper than for profit insurance, and subsidies for the poor could be covered with slightly higher premiums for high income families.

I have been over and over this, I can't find a flaw anywhere and I can't find a single thing that the Republicans could use as an attack except the old "we don't want the government running anything" crap. They can all keep their crappy for profit insurance, right up until they realize they're getting screwed and they all start signing up for Medicare for all, then we have the opening for universal single payer...

[damonm]

23. Do you have a link?

Or am I gonna have to do this all myself? :P

[LatteLibertine]

20. Not sure

and medicare does have extremely low overhead.

The bottomline is costs must be contained in some way and access must be increased.

IMO Health care should not first be about big profits. It really should not be an optional consumer product.

On the practical side, sick people aren't going to be very productive, and may put other healthy citizens at risk of also becoming ill.

Having a health populous is win/win. On another note, physicians should focus more on keeping folks well than fixing them after they break down.

[Juche]

21. About a trillion dollars a year

It would require about a trillion dollars in new revenue, I believe.

We spend 2.5 trillion on health care, with about 50% being public funds. So you keep those public funds (current payroll, sin and income taxes that fund health care), then add in a tax on high income earners and a payroll tax.

However updated info shows it would save $1.4 trillion in private spending because it would be more efficient and have negotiation powers and lower overhead.

So basically you'd pay $4 in taxes to save $6 in private spending.

http://www.healthcare-now.org/hr-676/

HR 676 Would Reduce Overall Healthcare Costs
Families Pay Less

A study by nationally recognized economist, Dean Baker, of the Center for Economic Research and Policy concluded that under H.R. 676, a family of three making $40,000 per year would spend approximately $1900 per year for healthcare coverage. Currently, (in 2007) the average annual premium for families covered under an employee health plan is $11,000. (National Coalition on Health Care.)
Businesses Pays Less

In 2005, without reform, the average employer that offers coverage was contributing $2,600 to healthcare per employee (for much skimpier benefits), or 217.00 per month. Under HR 676, the average costs to employers for an employee making $30,000 per year will be reduced to $1,425 per year; or about $119.00 per month.

Baker’s study reported that HR 676 would reduce health spending in 2005 from $1 trillion, 918 billion dollars to 1 trillion, 861.3 billion dollars, which translates into a saving of $56 billion in overall healthcare spending while covering all of the uninsured. This is a 3% reduction in over-all healthcare spending.
Proposed Funding For HR 676 Program

Maintain current federal and state funding for existing healthcare programs; employer payroll tax of 4.5%, an employee payroll tax of 3.3%, in addition to the already existing 1.45% for Medicare; establish a 5% health tax on the top 5% of income earners; 10% tax on top 1% of wage earners, 1/3rd of 1% stock transaction tax, closing corporate tax loop-holes; repeal the Bush tax cut for the highest income earners.

[anakie]

24. We pay 1.5% of our taxable income

in Australia as a medicare levy. For those who earn over 150,000 dollars it is compulsory to buy additional private health insurance, or be penalised an additional 1% of their salary. These high earners are also able to use medicare.

I have recently had back surgery for a prolapsed disc in my lower back. I went to my GP on a Tuesday - gap payment $20 to get a referral for a CT. I had the CT that afternoon - cost $0. I went back to my GP on the next Thursday to get the CT results - I needed surgery. Cost for this visit $0. I was referred to a specialist who I managed to see the next day; I have to say this was a lucky break. I went outside the medicare system on this visit and paid his fee - $200 of which approx $100 was refunded through medicare.

He managed to get me on to the public surgery list for the next week. I was operated on the following Monday week - 14 days from GP visit to operation. 2 days in hospital and I walked (hobbled really) out of the hospital with a bill for $0.

As an Australian, I really don't get what the opposition to affordable healthcare in America is. Present company (mostly) excluded. And the ones who seem to be crying loudest are those most in need.
Obama is doing his best for these people who just don't seem to get it. IMHO.


Peace