Tag: Medicare for All

Socialized Medicine

What really gets me is that the US has socialized health care. Your insurance company isn’t logging all of the excess income they make from you to a large medical expense you incur in the future. The whole point of insurance is that the million (or whatever) ‘customers’ all pay in their their, say, thirteen grand a year. Many people get their annual checkup, and that’s it. Insurance company pays out a couple hundred bucks from that thirteen grand. Someone gets heart surgery – the excess all those only-checkup people paid covers it, and the insurance company pays out fifty grand for that stranger’s medical care.

The American insurance system is just socialized in small, less efficient islands. Those islands are making money off of us all. And you get voted off the island when you lose your job.

Oh, and people still go bankrupt from medical expenses. Or resort to airing their sad story on GoFundMe hoping for donations. I guess we all get to feel benevolent when we donate to their fundraiser, and just paying taxes doesn’t get to make you feel like you’re personally helping someone. But do we really need a profit-driven and inefficient solution just so we can feel good about ourselves? Maybe we could switch to a more efficient system where everyone is the customer pool and the insurance company is looking to more or less break even. And you can donate the money you save on heath care to some other charity — homeless people, bail projects, food kitchens, abused animals, etc.

The problem with Medicare for all who want it

Well, there’s more than one problem since real ‘everyone’ creates more efficiencies that ‘some subset of everyone’ fail to create. But the biggest problem is that ‘all who want it’ is a false alternative to employer provided healthcare just like the ACA marketplace options creates an illusion of choice for anyone who doesn’t qualify for a subsidy.

My employer pays a lot of money for my health insurance plan. Like 14,000$ a lot. I pay another 3k. If the ‘all who want it’ platform wins and opens Medicare enrollment to everyone, do I want it? I can take my three grand and look at Medicare, just like I could take my three grand and look at the 750$ a month plans on the marketplace. Oh, or the 1000$ a month plan. My cheapest ACA option was six grand a year more than I’m paying today. And when the company increases their contribution next year and therefore doesn’t increase our salary? I still get nothing, even though they’re not paying anything for my insurance.

So am I a “who want it”? Either the Medicare plan — health insurance, emergency, and prescription drugs — is going to cost less than three grand {and my employer still gets to pocket fourteen grand and call my raise an increase in their contribution to healthcare premiums} or I have the “choice” of paying thousands more for my healthcare. I’d happily pay a couple hundred bucks extra for better insurance. I’d happily take the seventeen grand that’s being paid for my healthcare today and buy a Medicare plan. But there’s no way Medicare is going to compete with employer subsidized coverage.

And I think the “all who want it” proponents know this — set the Medicare for All system up for failure, and the for-profit insurance industry can continue unchanged.

Bankrupting the Country

There are some argumentative political statements that I can never decide if it’s deliberately obtuse or an actual misunderstanding. Joe the Plumber comes to mind — a lot of people have no understanding of business taxes (or know the difference between gross and net). Maybe he really thought a million dollar gross plumbing business would throw him into the wealth tax level. Or he’s making a disingenuous argument — either bemoaning that a plumbing business netting a million dollars would pay increased taxes or deliberately failing to mention that a million dollar gross business isn’t anywhere near wealth-tax levels and letting people hear “million dollar” and assume as they assume.

“Won’t Medicare for All bankrupt the country” has become this year’s Joe the Plumber for me. Won’t private insurance bankrupt individuals and businesses? I pay around 3k a year for my family’s insurance. If universal health care meant my taxes went up 10k, not having to pay that 3k wouldn’t make me feel much better. But what I pay isn’t the sum of what my health insurance costs. My employer paid about 14,000USD for my medical and dental insurance. Legislation can ensure what employers currently contribute to wasteful private insurance becomes funding for Medicare for All.

If the entirety of my 3k went to Medicare for all, and the remaining 7k came from my employer … they would be saving 7,000USD on a single employee. Maybe all 10k comes from the employer. My taxes go down 3k, the company still saves 4k. Or maybe universal heath care costs 17k and the entirety of what both my employer and I pay gets redirected toward Medicare. The worst case in any of these scenarios is that we’ve broken even, I’ve got better coverage, people who change jobs don’t have lapses in coverage, and people who need to see a doctor or get medicine do so.

Yes, it’s possible implementing universal health care would be a net cost increase. While there’s logical consistency that removing profit, executive salaries, and general overhead would yield a lot of savings … having more people actually use their health care might yield a lot of additional expense. But the gross cost of universal healthcare is offset by what we currently pay — just like the plumbing company with a million dollars in gross receipts isn’t forking over 40% of that million dollars in taxes.