bearlyamazing said:
Many of the countries that have nationalized healthcare have long waiting times, too. Many Canadians come to America for healthcare.
One of the big problems paying for nationalized healthcare is that we already have a big tax burden here with income taxes, payroll/social security tax (double the tax at 15.3% for self-employed), property taxes, state taxes in most states, gas tax and sales tax. Our economy and economic growth would be crushed with the tax increases required to pay for a plan like MFA.
2/3 of the country are on employer paid/cost shared healthcare or Medicare/Medicaid. It's a noble goal to try and get to 100% but they have to come up with some other feasible way to get the other 1/3 better healthcare options without blowing up the economy. The deficit's already horrendously bad. It would explode with a MFA plan or if we bear all the burden, it will crush growth and consumer spending. No way to spin around that fact.
You do understand that under medicare today, most people (81%) have insurance supplements that pay for a substantial portion of their costs? This is a huge shift in dollars from the employer to the individual. And you do understand that the individual (unless below certain poverty lines) pays premumims for the base coverage? There seems to be some misconception that medicare if free or a give away. It isn't. And part D (meds) is high co-pays. So there is a huge cost shift from employer to a retired individual. I really think you don't know how medicare works.
What Medicare does do is provide everyone that qualifies insurance, and contain costs by being a huge provider (for example, essentially no doctor can afford to not accept Medicare's lower payments since it is such a large provider). They theory is that if is essentially the only provider, the costs will go down even further. It is not free, most everyone on Medicare pays something. It is not perfect. Drug costs can be high, certain things are not covered, there are coverage gaps - thus, you need to pay for a supplement. There are other complaints as well, but the point is there is no perfect system - at least not one than is cost-effective.
I'm on Medicare. You clearly are not. It isn't a give away or budget buster. The Supplementary Medical Insurance Trust Fund is expected to be adequately funded over the next 10 years and beyond because premium income and general revenue income for Parts B and D are reset each year to cover expected costs. Part A is still is positive, but expecting to need higher than planned premium increases starting in 2048 assuming Obamacare remains good law and some provisions in Trump's 2019 budget pass (so far there seems to be bipartisan support). If not, there will be higher than expected premiums sooner. There is more complexity, but in general, I'm not seeing where your claims come from.
Doctors and other health care providers will make less. Will that mean less doctors in the long run, maybe. What happens in most places is certain doctors, the top guys in specialities, become private doctors for the rich, who will pay above national health care prices. So for most things you see a national doctor and for the very serious stuff you may use a private doctor or health facility. That is how it works in Australia which has a system close to MFA. The Canadian system is different than Medicare, it's based on individual taxes and Canadians paying for a 30% co-pay. But provider costs are much lower due to the government monopoly, so that 30% is more manageable. Unlike Medicare, you must see you general doctor first (they are the gate keeper) and depending on the urgency of your condition you get seen by a specialist doctor or get a specialized test (this doesn't apply to emergencies obviously). So there can be less wait or more wait. That simply isn't the system under Medicare..
You need to remember that it is the individual, not the employer, who pays for medicare currently, so I don't get some of the discussion, unless Sanders is going to do a Warren and tax the wealthy, transactions, etc.. That is not my understanding. Sanders's version for financing Medicare-for-all includes raising employer-side payroll taxes by 7.5 percentage points in order to raise roughly $3.9 trillion over 10 years. On average,
this is less than what employers are currently spending on premium contributions for their employees, so workers and employers should generally come out ahead under this system. Companies with younger employees will probably lose. those not covered by an employer plan will have to pay taxes instead of premiums (this probably is to fit within the SCOTUS legal decision on Obamacare). I think the supplemental insurance will stay be paid by individuals and I'm not sure what he is doing on co-pays, etc. There is a progressive tax rate which I will not try to explain.
The point is that while the structure of Sanders's plan is broadly progressive and broadly beneficial to most households and companies, the exact calculus of who ends up ahead and who does not hinges on a complicated set of factors. There will be some losers and winners. Sorta like Trump's tax cuts.