Current Events > Sanders' latest single-payer plan estimated to cost an additional $36 Trillion

(+) Yeah! (+)

https://abcnews.go.com/Health/wireStory/study-medicare-bill-estimated-326-trillion-56906940

TLDR: A study done on Bernie Sanders' latest single-payer plan estimates said the plan would add about $36 Trillion to the government's health care spending. The estimate was in line with the multiple estimates done on his plan touted during the 2016 election. As then, Bernie neglected to say how much his plan would cost and how it'd be paid for.

Instead of doing that, he attacked the Koch's, because one of them chairs the board for the organization that did the study.

The study cites that there is some cost savings from administrative streamlining, but that an increase in use, insuring of 30 million uninsured people (how could there be that many uninsured still? I thought Obamacare was supposed to stop that... Oh, that's right - the OBM said beore it passed that we'd still have 30 million uninsured Americans, meaning we got worse health care for a higher cost with ZERO benefit whatsoever), and no copays or premiums mean the government pays out the ass.

Once again, single-payer is too fucking expensive.
---

darkjedilink posted...

Koch's, because one of them chairs the board for the organization that did the study.

you don't think that's even a little suspicious? of course the Koch brothers are going to produce anti-government reports.
---

Single payer will never work until Babyboomers die off. They are too great in numbers and millennials lack the numbers to pick up the slack.

Cut the damn military budget by a few zeros!!!
---

Cheater87 posted...

Cut the damn military budget by a few zeros!!!

Still wouldnt be enough.

$36 Trillion, huh? Man, so fucking close...

https://www.nytimes.com/2015/10/17/business/putting-numbers-to-a-tax-increase-for-the-rich.html

To get the most accurate picture possible, throw in all the scraps of income, from the most obvious (like wages, interest and dividends) to the least (like employer contributions to health plans, overseas earnings and growth in retirement accounts). According to that measure used by the Tax Policy Center, a joint project of the Urban Institute and the Brookings Institution the top 1 percent includes about 1.13 million households earning an average income of $2.1 million.

Raising their total tax burden to, say, 40 percent would generate about $157 billion in revenue the first year. Increasing it to 45 percent brings in a whopping $276 billion. Even taking account of state and local taxes, the average household in this group would still take home at least $1 million a year.

If the tax increase were limited to just the 115,000 households in the top 0.1 percent, with an average income of $9.4 million, a 40 percent tax rate would produce $55 billion in extra revenue in its first year.

---

The flaw in these estimates is that they assume the current costs, with all its middlemen and various other hands in the pot, are just going to shift directly to the public treasury unchanged.
The reality is that the actual public cost will be vastly less, party due to the bulk of the middlemen being eliminated, but mostly due to price controls and rationing.

$36 trillion per what? Year? Decade?

Yet health costs are cheaper in the countries that have implemented them (i.e. every developed country (it's hard to consider the US one anymore) and even some undeveloped countries).
---

s0nicfan posted...

$36 Trillion, huh? Man, so fucking close...

https://www.nytimes.com/2015/10/17/business/putting-numbers-to-a-tax-increase-for-the-rich.html

To get the most accurate picture possible, throw in all the scraps of income, from the most obvious (like wages, interest and dividends) to the least (like employer contributions to health plans, overseas earnings and growth in retirement accounts). According to that measure used by the Tax Policy Center, a joint project of the Urban Institute and the Brookings Institution the top 1 percent includes about 1.13 million households earning an average income of $2.1 million.

Raising their total tax burden to, say, 40 percent would generate about $157 billion in revenue the first year. Increasing it to 45 percent brings in a whopping $276 billion. Even taking account of state and local taxes, the average household in this group would still take home at least $1 million a year.

If the tax increase were limited to just the 115,000 households in the top 0.1 percent, with an average income of $9.4 million, a 40 percent tax rate would produce $55 billion in extra revenue in its first year.

but all the socialists on ce keep telling me it would be easy to pay for universal healthcare by taxing the 1%

is it possible they don't understand economics
---

1337toothbrush posted...

Yet health costs are cheaper in the countries that have implemented them (i.e. every developed country (it's hard to consider the US one anymore) and even some undeveloped countries).

shhh this is a fact free zone

AlephZero posted...

but all the socialists on ce keep telling me it would be easy to pay for universal healthcare by taxing the 1%

is it possible they don't understand economics

We can easily pay for healthcare by making it suck.

1337toothbrush posted...

Yet health costs are cheaper in the countries that have implemented them (i.e. every developed country (it's hard to consider the US one anymore) and even some undeveloped countries).

What's the average healthcare cost per person in your best example? We can extrapolate what the equivalent US cost would be from there. Also make sure you include whatever taxes are being taken out as part of the cost, as opposed to pretending that mending a broken bone is a dollar because it's subsidized by taxes.
---

CruelBuffalo posted...

$36 trillion per what? Year? Decade?

From the 10 year period between 2022 and 2031, or roughly 3.5 trillion a year
---

I looked at the report, the numbers seem solid to me and are roughly in-line with estimates that other organizations have made

e.g. https://www.healthcare-now.org/296831690-Kenneth-Thorpe-s-analysis-of-Bernie-Sanders-s-single-payer-proposal.pdf
---

Balrog0 posted...

CruelBuffalo posted...

$36 trillion per what? Year? Decade?

From the 10 year period between 2022 and 2031, or roughly 3.5 trillion a year

Basically doubling the current budget, which is already underfunded by abut 25%.

once again, single-payer is too f***ing expensive.

Then explain how other countries pay for it.

Metro2 posted...

once again, single-payer is too f***ing expensive.

Then explain how other countries pay for it.

They don't. Single Payer is a myth:
https://www.forbes.com/sites/timworstall/2017/03/26/its-surprising-how-few-countries-have-national-single-payer-health-care-systems/
---

Metro2 posted...

once again, single-payer is too f***ing expensive.

Then explain how other countries pay for it.

Rationing and price controls.

They would have to raise taxes of course. But if they can show that the increase in taxes is less than what people pay for health care right now, I will support single payer healthcare. I like capitalism but I'm okay with elements of socialism.
---

s0nicfan posted...

Metro2 posted...

once again, single-payer is too f***ing expensive.

Then explain how other countries pay for it.

They don't. Single Payer is a myth:
https://www.forbes.com/sites/timworstall/2017/03/26/its-surprising-how-few-countries-have-national-single-payer-health-care-systems/

that's what I was going to say, the only single payer country I can think of is Canada
---

Metro2 posted...

once again, single-payer is too f***ing expensive.

Then explain how other countries pay for it.

By taxing everyone near 50%. Until socialists in the US come up with a plan that significantly raises taxes across the board instead of hiding behind "the 1% will pay for it" it's hard to take them seriously. For some reason they don't want to run on doubling the tax rate for the middle class, I wonder why.
---

s0nicfan posted...

1337toothbrush posted...

Yet health costs are cheaper in the countries that have implemented them (i.e. every developed country (it's hard to consider the US one anymore) and even some undeveloped countries).

What's the average healthcare cost per person in your best example? We can extrapolate what the equivalent US cost would be from there. Also make sure you include whatever taxes are being taken out as part of the cost, as opposed to pretending that mending a broken bone is a dollar because it's subsidized by taxes.

Actually I did the work for you. In Germany, procedures cost roughly half of what they do in the US:
https://german-medicalgroup.com/page/for_patients/costs_of_medical_treatment/

So that $3.6 trillion a year becomes $1.8 trillion a year. Which means even if we raise the 1% tax rate to 45%, we're still about $1.5 trillion short in funds to cover it year to year.
---

s0nicfan posted...

s0nicfan posted...

1337toothbrush posted...

Yet health costs are cheaper in the countries that have implemented them (i.e. every developed country (it's hard to consider the US one anymore) and even some undeveloped countries).

What's the average healthcare cost per person in your best example? We can extrapolate what the equivalent US cost would be from there. Also make sure you include whatever taxes are being taken out as part of the cost, as opposed to pretending that mending a broken bone is a dollar because it's subsidized by taxes.

Actually I did the work for you. In Germany, procedures cost roughly half of what they do in the US:
https://german-medicalgroup.com/page/for_patients/costs_of_medical_treatment/

So that $3.6 trillion a year becomes $1.8 trillion a year. Which means even if we raise the 1% tax rate to 45%, we're still about $1.5 trillion short in funds to cover it year to year.

The 3.6 trillion isn't including the savings we get from the decrease in spending in other areas (no more medicaid) so actually if you use these numbers, that would mean spending was 1.8 trillion - about 1.1 trillion or 700b which is actually fairly modest
---

eh those numbers are pretty off because we are rounding a lot and being loose with our numbers, but my point is if you could actually negotiate payments to providers that were that low we would be pretty close to solving our problem
---

Balrog0 posted...

eh those numbers are pretty off because we are rounding a lot and being loose with our numbers, but my point is if you could actually negotiate payments to providers that were that low we would be pretty close to solving our problem

So beyond taxing the 1% we'll also need to convince or force the entire medical industry to cut their prices in half. What kind of "negotiation" are you actually imagine that ends with a provider cutting their prices in half across the board?

EDIT: and at $700B we're still at less than 50% funded by "taxing the 1%"
---

Something is better than nothing.

AlephZero posted...

By taxing everyone near 50%.

Canada has universal healthcare and the tax rate is most certainly not 50%
---

I mean you're the one who was generous enough to make the assumption we could do that when you thought it made your argument stronger, I'm just adding context to your post

I think it would be sort of easy to negotiate prices down if you got rid of private insurance subsidies actually, but not across the board. No one is going to say we should pay nurses or pediatricians less, but we might be able to get some specialists reimbursement rates down, for instance. It is the biggest problem I have with single payer advocates, their lack of seriousness about cost controls.
---

The better solution is to embrace the fact that public healthcare is generally awful.
Implement a chain of public clinics and hospitals, while leaving the private system largely intact. With the indigent and desperate in the public system, the private system no longer has to write off (thus pass along) the costs of deadbeats, bankruptcies, and medicare/aid payment tables, reducing costs for everyone else.

That's the point of a "VA for everyone" concept.

My goodness the right love to shuck and jive when the status quo is challenged.
---

_OujiDoza_ posted...

My goodness the right love to shuck and jive when the status quo is challenged.

All I see here is the "conservatrolls" running numbers.

_OujiDoza_ posted...

My goodness the right love to shuck and jive when the status quo is challenged.

my goodness socialists like to shuck and jive when it comes to talking about paying for everything they're promising
---

Cheater87 posted...

Cut the damn military budget by a few zeros!!!

That is a terrible idea. Its at what 600 billion? If it was cut to 6 billion I dont think that is enough to maintain even half the troops and existing equipment we have right now let alone to do any research, operations, new equipment acquisition/construction etc.

We can argue about how much is needed but these super drastic cuts certain people suggest are imbecilic. If Russia and China are such threats we need to maintain superiority or at the absolute minimum parity with them instead of massively shrinking and letting our existing resources rust and breakdown.

If we cut it to 600 Million we might as well just abolish the whole military because that would be fucking nothing.

Oh and 600 billion give or take a year vs 36 trillion over than ten years....even if we cut the ENTIRE military budget it would only cover 6 trillion or so out of that.

TLDR: Think before you post and learn some damn math.
---

Questionmarktarius posted...

The better solution is to embrace the fact that public healthcare is generally awful.
Implement a chain of public clinics and hospitals, while leaving the private system largely intact. With the indigent and desperate in the public system, the private system no longer has to write off (thus pass along) the costs of deadbeats, bankruptcies, and medicare/aid payment tables, reducing costs for everyone else.

That's the point of a "VA for everyone" concept.

you keep saying this despite the fact that you've been told what a stupid suggestion it is several times

what do medicaid and medicare, by far the two largest sources of public health insurance, have to do with this weird scheme you've created based on the VA? this is even more stupid than people who act like single payer is the only kind of universal coverage, because it relies on the same fallacy, but then also pretends public insurance is easily separable from private insurance as though providers that accept private insurance don't accept medicaid or medicare, or as though private insurance isn't heavily subsidied whether it's employer-sponsored or on the public exchanges
---

Our current system would cost $300 billion more to cover fewer people

http://peoplespolicyproject.org/2018/07/30/mercatus-study-finds-medicare-for-all-saves-300-billion/

The reports methods are pretty straightforward. Blahous starts with current projections about how much the country will spend on health care between 2022 and 2031. From there, he adds the costs associated with higher utilization of medical services and then subtracts the savings from lower administrative costs, lower reimbursements for medical services, and lower drug prices. After this bit of arithmetic, Blahous finds that health expenditures would be lower for every year during the first decade of implementation. The net change across the whole 10-year period is a savings of $303 billion.

You'd just rather pay premiums and co-pays than taxes.
---

If this isn't a good plan, then what's the right plan?
---

Balrog0 posted...

what do medicaid and medicare, by far the two largest sources of public health insurance, have to do with this weird scheme you've created based on the VA?

A VA for everyone would replace both, pulling them out of the private system.
As is, medicaid patients are being squeezed out anyway: http://www.slate.com/blogs/moneybox/2017/03/20/new_stats_show_more_doctors_are_taking_medicaid_belying_a_mendacious_gop.html

We have one-third of the physicians in this nation, Brian, who are not seeing Medicaid patients, Price said (the cancer survivors was Brian). And so if we want to be honest with ourselves as a society, it's important we step back and say, Why is that? Why are those doctors not seeing Medicaid patients? Let me just suggest it's because the Medicaid program itself has real problems in it. Price added that the Trump administration wants to move some patients from Medicaid to private insurance that might be much more responsive to them.

Antifar posted...

Our current system would cost $300 billion more to cover fewer people

http://peoplespolicyproject.org/2018/07/30/mercatus-study-finds-medicare-for-all-saves-300-billion/

The reports methods are pretty straightforward. Blahous starts with current projections about how much the country will spend on health care between 2022 and 2031. From there, he adds the costs associated with higher utilization of medical services and then subtracts the savings from lower administrative costs, lower reimbursements for medical services, and lower drug prices. After this bit of arithmetic, Blahous finds that health expenditures would be lower for every year during the first decade of implementation. The net change across the whole 10-year period is a savings of $303 billion.

You'd just rather pay premiums and co-pays than taxes.

well the idea is that with taxes, health care would be subsidized by everyone, as opposed to copays which are only paid by the sick/people who need coverage for something.

it's socialism. Get the healthy to help pay for the sick so the sick don't go bankrupt. some people like this idea, and others do not.

unsurprisingly, the people who are benefitting the most from it are fans, and the people who lose out don't like it.

SwordMaster13X posted...

If this isn't a good plan, then what's the right plan?

Or perhaps a more fundamental question: Is it even possible to provide adequate and even coverage to 325 million people? The best plans in the world work in extremely small, homogeneous countries that are 2% the population of the US, and among equivalent countries in terms of size and diversity, the US has by far the best healthcare.
https://en.wikipedia.org/wiki/List_of_countries_by_population_(United_Nations)

The first country you hit that isn't basically third world is Japan, which is already half the pop of the US, followed by Germany at about 1/4 our size.
---

Antifar posted...

Our current system would cost $300 billion more to cover fewer people

http://peoplespolicyproject.org/2018/07/30/mercatus-study-finds-medicare-for-all-saves-300-billion/

The reports methods are pretty straightforward. Blahous starts with current projections about how much the country will spend on health care between 2022 and 2031. From there, he adds the costs associated with higher utilization of medical services and then subtracts the savings from lower administrative costs, lower reimbursements for medical services, and lower drug prices. After this bit of arithmetic, Blahous finds that health expenditures would be lower for every year during the first decade of implementation. The net change across the whole 10-year period is a savings of $303 billion.

You'd just rather pay premiums and co-pays than taxes.

well that site won't work for me, but it is fairly straightforward that you can cover a lot more people if you slash the amount you pay for services... it isn't rocket science

if you really wanted to bring down the costs, we'd be advocating for medicaid for all which (in addition to having a more generous benefits package in general than medicare) pays about 61% of what medicare does to providers
---

s0nicfan posted...

Metro2 posted...

once again, single-payer is too f***ing expensive.

Then explain how other countries pay for it.

They don't. Single Payer is a myth:
https://www.forbes.com/sites/timworstall/2017/03/26/its-surprising-how-few-countries-have-national-single-payer-health-care-systems/

That's interesting. I always had doubts about single payer working in such a large, growing nation. Proponents I argued with didn't see why the population of a country would be an issue. I don't really know enough to argue though.
---

CruelBuffalo posted...

$36 trillion per what? Year? Decade?

Decade

Questionmarktarius posted...

The flaw in these estimates is that they assume the current costs, with all its middlemen and various other hands in the pot, are just going to shift directly to the public treasury unchanged.
The reality is that the actual public cost will be vastly less, party due to the bulk of the middlemen being eliminated, but mostly due to price controls and rationing.

The report factors that in, actually, estimating a 'savings' of a few trillion dollars, still equating $36 trillion extra cost.

Giant_Aspirin posted...

darkjedilink posted...

Koch's, because one of them chairs the board for the organization that did the study.

you don't think that's even a little suspicious? of course the Koch brothers are going to produce anti-government reports.

I would, if not for the fact that, in 2016, many grous not funded by them came to similar conclusions, that this study falls in line with.
---

darkjedilink posted...

The report factors that in, actually, estimating a 'savings' of a few trillion dollars, still equating $36 trillion extra cost.

Extra cost for the federal government

$300 billion less in total spending on health
---

Antifar posted...

darkjedilink posted...

The report factors that in, actually, estimating a 'savings' of a few trillion dollars, still equating $36 trillion extra cost.

Extra cost for the federal government

$300 billion less in total spending on health

Okay, and your point?

You do know that our government is already $18 Trillion in debt, right? Where's that extra $36 gonna come from?
---

darkjedilink posted...

The report factors that in, actually, estimating a 'savings' of a few trillion dollars, still equating $36 trillion extra cost.

Of course, $36T over ten years is roughly $11k per person, per year, or about $920 a month, which is more or less what decent insurance runs nowadays.

darkjedilink posted...

I would, if not for the fact that, in 2016, many grous not funded by them came to similar conclusions, that this study falls in line with.

got source?
---

darkjedilink posted...

Antifar posted...

darkjedilink posted...

The report factors that in, actually, estimating a 'savings' of a few trillion dollars, still equating $36 trillion extra cost.

Extra cost for the federal government

$300 billion less in total spending on health

Okay, and your point?

You do know that our government is already $18 Trillion in debt, right? Where's that extra $36 gonna come from?

I mean if you were paying attention you'd know that the 1% has lots of money and the 99% has nothing so you just take the 99% and move them into the 1% so you have 199%.
---

Why is the White House press secretary making her own health care plans?

darkjedilink posted...

You do know that our government is already $18 Trillion in debt, right? Where's that extra $36 gonna come from?

Progressive taxation that results in the average person paying less than under the current system. If you believe the money simply isn't there to be taxed, then it certainly isn't there to cover the higher costs of our existing system.
---