Good questions brother.
First, I'll address Medicare for All and your good argument about costs .. in the words of a Nobel economist ..
"A system in which the government provides universal health insurance is often referred to as "single payer," but I like Ted Kennedy's slogan "Medicare for all." It reminds voters that America already has a highly successful, popular single-payer program, albeit only for the elderly. It shows that we're talking about government insurance, not government-provided health care. And it makes it clear that like Medicare (but unlike Canada's system), a U.S. national health insurance system would allow individuals with the means and inclination to buy their own medical care.
The great advantage of universal, government-provided health insurance is lower costs. Canada's government-run insurance system has much less bureaucracy and much lower administrative costs than our largely private system. Medicare has much lower administrative costs than private insurance. The reason is that single-payer systems don't devote large resources to screening out high-risk clients or charging them higher fees. The savings from a single-payer system would probably exceed $200 billion a year, far more than the cost of covering all of those now uninsured."
http://www.nytimes.com/2005/06/13/opinion/13krugman.html?hp
If costs are your main objection to Medicare for All, that's an argument you will lose guaranteed if you choose to go there. Guaranteed.
Medicare for All would save an estimated $300 billion. Even though 50 million of us have no health coverage at all and another 50 million are poorly insured, we spend almost twice as much as the other countries that cover every one. We waste hundreds of billions on insurance companies which do not provide any healthcare at all. In fact, one third of that money is wasted on salaries, lobbying, stock holder profits, and marketing.
Would you call these benfits worth considering? ..
"1. Comprehensive Health Coverage for everyone "
No problem with this.
"2. Greater choice of provider "
No problem with this
"3.Health decisions made by patient and provider instead of HMO/Insurance Companies "
As long as this doesn't revert to the government coming between the doctor and patient, then definitely no problem with this.
"4. Improved Health Planning"
On this, this can occur with or without the public option or Medicare E as you call it.
"5. Health coverage would be portable, not tied to employment. "
Also part of my suggestions, so obviously I agree with this.
"6. Eliminates the high (up to 33 percent) overhead cost of multiple private, for-profit insurances by including coverage for everyone in a single-risk pool reducing administrative costs to that of Medicare: 1-5%. "
I will have to look into this one. Given that the private insurance subsidizes Medicare today, those additional costs are going to come back into the picture if you have Medicare E.
"7. Instead of hundreds of insurances with differing requirements (requiring increased office staff), providers would deal with only one form. "
You could accomplish the same thing by eliminating the widely varying regulations of the 50 states. Also, almost every state has 90-95% of its business with 2-3 providers. Not hundreds.
"8. The plan would be financed with a progressive payroll tax, at less per-capita cost. "
If I am forced to stay with the current insanity that is our tax code, then the above doesn't bother me. That said, as you may be aware, I am a HUGE proponent of the flat tax with standard deduction only. You want to eliminate costs.... reduce the tax code from 67,000+ pages down to one.
"9, Businesses would avoid hassles of managing health care, and become more competitive without annual inflationary health costs. "
I agree with removing the burden from companies. That is also a part of my plan. Note... whether people pay for it with a payroll tax or pay for it directly... they are still paying for it. So if you are going to subsidize the low income anyway, why not just add them to the Medicare system and not screw with it all??? This is a point others have brought up that I am in agreement with.
"10. Consumers would pay less for goods and services that are inflated by businesses’ high health costs - e.g., currently $1,500 is added to the cost of each U.S.-made automobile due to health costs. "
Again, I agree health care should cease coming from the corporations. I simply have a different way of charging the consumer.
"11. US Consumers , who now spend twice as much per capita as consumers in other developed countries (with poorer outcomes), would save because administrative health costs would be greatly reduced. "
Here we break apart. I do not believe the government is any more/less efficient at running this than the insurance companies. Given the vast underfunded liabilities that Medicare currently faces, coupled with the 'fixes' Congress keeps passing... I don't see the saving you do in this area.
"12. Single-risk-pool coverage would permit negotiation of lower, bulk rates for medications and durable medical equipment."
This is the same line they used with getting companies to go with the HMO plans etc... that larger groups would be 'cheaper'. For those that are high risk... it is indeed cheaper. For the healthier individuals, it most certainly is a much higher cost to go with a group plan. The US drug companies currently subsidize other lower income countries with higher priced drugs here in the US. Given that roughly 85-90% of drugs never even make it in front of the FDA, the costs of the trial and error must be recaptured. The same holds true for medical equipment/devices. Otherwise you take away the incentive to develop new drugs/technologies. So on this point we strongly disagree with each other. I think one of the main problems in this country is that every time something new comes out, we get the sense of entitlement that we should have immediate access to it.
To divert slightly to something that isn't about health care... when big screen tv's came out... should we have forced the price down so that everyone could afford one when they first came out? No, of course we wouldn't. Because if we did, then there would be no incentive for those manufacturers to create the next generation of tvs. Because you wouldn't be allowing them to profit from their innovation. So why would we try to do that to drug and medical device companies?
"13. Increased US life expectancy: Similar socioeconomic single-payer European countries enjoy average two-year longer life expectancies. "
I would have to look this up again, but I believe the above is due to how we count "births"
"14. The over-45 million uninsured Americans and 50 million more underinsured would have access to preventative care, without having to resort to and pay for emergency care at costing 4 to 5 times more. "
The uninsured certainly cost us by going to emergency care. I agree that we need to do something for this segment of the population. Though it is nowhere near 45 million uninsured, at least not 45 million that cannot afford it. Many choose not to be insured due to their health. Another large chuck of that 45mm is illegal immigrants. I in no way support paying for anything other than emergency care for them.
"15. Emergency rooms would be used as emergency rooms, not for primary care. "
See above
"16. Retirees would not face loss of health coverage by employers. "
I can't speak for all plans, but many allow retirees to continue with the plan. Those that don't the individual has the current Medicare system.
"17. Eliminates the profit motive that places priority on stockholders’ profits, and creates a perverse incentive to deny health coverage to the ill or high-risk."
A valid point.
18. Eliminates co-pays and deductibles and long waits for coverage -- sometimes waiting until death.
http://medicareforall.net/faqs.html
The program is deeply underfunded, but it has high ratings from those who use it .. no long delays for treatment .. excellent doctors .. doctors get paid .. none of the arguiments that have been used by those against real reform .. and that's the problem I have with your ideas. Some of them are good ideas, but none on them creates competition to the healthcare industry. That's not reform, that's tweaking. Portability is a good idea .. but those who have Medicare don't have that problem.
On the merits, this is not an argument those who stand against real healthcare refom can win. It's a battle they will have to fight on emotion, not merit.
Guaranteed .. and if you like I'll start a thread on it and prove it.
