“Medicare for All:” Where Are the Details?

Why haven’t any of the nearly two-dozen Democrat presidential candidates who are daily screaming on the campaign trail about the absolute necessity of “Medicare for All” given us a PowerPoint presentation showing exactly what we will get with their single-payer program? More importantly, why haven’t they used that same PowerPoint presentation to show us exactly what it will cost and how we will pay for it? The answers are simple: “The Government will pay!” Sure…

We found out a long time ago when a person already in office (and especially one already in office who wishes to remain in office) promises one of the myriads of government goodies we’ll all receive if they remain-in or get voted-into office never gives us any of the details because they don’t want us to know the details! That certainly is the case with Medicare for All. But guess what: we have the proof of what Medicare for All as proposed already in Congress will include. Wanna see? Straight from the horse’s mouth:

Single-Payer/Medicare for All Details

First, and probably most important is that it would wipe the healthcare payer slate clean and create an entirely new program of funding healthcare.

If it became law, Sen. Bernie Sanders’ bill would move 325 million Americans into a new health insurance program. Gone would be Medicaid, Medicare (as we know it), private coverage like Blue Cross and employer-sponsored insurance.

Currently about 74 million people on Medicaid (23 percent of people covered in the U.S.) are using healthcare, and the doctors and hospitals caring for them are losing lots of money. It’s not unusual for a medical provider to lose between 22 and 40 cents on each dollar’s worth of care they deliver to the 74 million people on Medicaid. If we moved the entire country to Medicaid payment levels, we would expect a lot of medical capacity to disappear, virtually overnight. And you can imagine the effect that would have on safety, quality and accessibility.

A Medicaid for all plan would be impossible because of cost for services to implement. Why? With reimbursement levels so low, even decent healthcare providers would run from that profession. We’d have to find another plan that might be more palatable to the industry.

Replacing these payers would require a single government entity that we would all be enrolled into (no choice about it) and is designed to replace our current healthcare experience with a risk-free, premium-free, deductible-free, copayment free, co-insurance free, out-of-pocket cost-free experience. In this proposed system referred to as “Medicare For All” you could access healthcare whenever you want without paying a dime.

So it we really wipe the healthcare cost slate clean as well except for those paid in total or in part by the government. It would mean the federal healthcare entity that would be charged with operating Medicare for All would have to find $3 trillion dollars for year one of the program and that amount would increase slightly each year going forward. Where would that $3 trillion come from? From government revenue paid to the government in taxes. So how are the current dollars spent on healthcare costs distributed between government, private insurance, and self-pay?

  • Private insurance premiums paid by individuals, families, and employers pay all the medical costs for those insured plus 31%. That 31% goes to partially fund Medicare and Medicaid costs.
  • Medicare employee and employer payroll deductions pay for 89% of providers costs.
  • Medicaid provider costs are 100% paid by federal and state governments.

It is important to note that only 9% of uninsured patient bills ever get paid, which means providers are required to underwrite 91% of those costs. These number seem pretty bleak and comprise a mighty hill that must be climbed in this healthcare finance debate. Maybe that’s why none of the candidates are talking about these details!

How Do We Pay For Medicare for All?

Know this for certain: there’s a reason none of the candidates have in any way broached on this subject during campaigning. No matter what solution is offered, its reality is horrible for American taxpayers.

If private insurance were removed, then all that money you are paying in premiums, deductibles, co- pays, coinsurance and max out-of-pocket costs would have to be converted into taxes so the federal government can keep healthcare going for all 325 million of us. All the money will become a tax — on you, on your boss and on every transaction you ever make. You could end up buying healthcare every time you buy anything else. And you can forget about the massive pre-tax benefits everyone who gets healthcare from their job enjoys today. That’s $250 billion a year that you and your employer save in taxes now that would also be converted into taxes and collected.

Who reading this today relishes the thought of us paying the federal government to not only fund but to manage our entire healthcare system? I shudder to think that would ever happen. I don’t know of a single entity on Earth more inept and more corrupt in handling tax dollars AND managing any operational processes than the federal government! As you contemplate the federal government running all of healthcare, factor into your thinking these quotes from a report by the Government Accountability Office on our existing government-funded healthcare, just so you can see how their OWN scorekeepers think they are doing today:

On Medicaid:

“With estimated improper payments totaling more than $36 billion (9% leakage) in federal dollars in fiscal year 2016, CMS needs to improve the effectiveness of its program integrity efforts to help identify and prevent improper payments, such as payments for non-covered services or services that were billed for but never provided.”

On Medicare:

“…it is clear that fraud contributes to Medicare’s fiscal problems. More broadly, in fiscal year 2013, CMS estimated that improper payments… were almost $50 billion (9% leakage).”

Summary

Here’s what NO one is talking about: we do NOT need to replace or even repair our “healthcare.” What needs to be tweaked is our “healthcare funding system,” leaving actual healthcare alone. By messing with the structure of the entire system will almost immediately destroy the amazing healthcare in the U.S.

So what can we do? What should we do?

We published a detailed plan in two parts titled “The ONLY Fix for Healthcare that will Work” in two parts on July 19 and July 20, 2017. I encourage you to take a few minutes and go back and read these.

In short, it’s certainly time now for these Democrat candidates to explain details of this concept as well as the concepts floated for the “Green New Deal” and free college tuition as well as government paying for all outstanding college debt. The candidates should never e too busy to explain details on anything and everything they promise.

There are some that will cringe when I say this: Donald Trump from his campaign promises has delivered more in his first two years in office than has any other president in U.S. history. That still gives no pass to him or any other 2020 candidate from giving Americans details of their proposals.

One thing we are slammed with by these single payer proponents is “It works in Scandinavia, so why can’t it work here?” Denmark is their “poster” system for single payer healthcare and overall socialism to which they point. While you’re considering all this, consider this about Denmark:

A school teacher in Denmark makes about $61,000 a year.  In Denmark all education is free.  Doctors and hospitals are free to use and students get paid to learn.  

Denmark’s minimum income tax rate is 40%.  National sales tax there is 25% plus there are government assessed duties and fees.  Gasoline is $10 a gallon.  The purchase of a car is taxed by the government at 180% of the selling price.  A car that sells for $20,000 in the U.S. costs $40,000 in Denmark.

Denmark is the highest taxed nation in the World — taxed an average of 80% of every dollar earned.  Danes have the highest personal debt in the World.  Few own cars or homes.  Anyone who makes over $80,000 a year pays a personal tax of 68%.  Most Danes with higher earning have either found ways to evade the tax or have left the Country, taking companies they own with them.

Denmark’s suicide rate for the past 5 decades has averaged 20.8 per 100,000 people, with a highest rate of 32.  The American suicide rate has averaged 11.1 during the same 5 decades and has never exceeded 12.7.  More than 11% of adult Danes — supposedly the happiest people in the World — are on antidepressants.  Everyone wants the American dream.  In Denmark’s Neo-communist economy, no one will ever own or accomplish anything.

”’Medicare for all’ is not Socialism. We’re just talking about healthcare now,” they respond. Honestly, one requires the other to even have a glimmer of a chance to work.

In their world, $100,000 in income from a job means you get to keep $10,000: that $800 a month.

I’m not ready for that. Are you?


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