Medicare for All

Even Democrats Are Divided Over Medicare For All

The single-payer fight is pitting moderate Democrats against progressives, partly because of Obamacare.

|

Bill Clark/CQ Roll Call/Newscom

In some ways, Medicare for All is on a roll. Polls show increasing public support for the idea, if not a clear sense of what it means, and Democrats in Congress—especially the expected presidential frontrunners—are increasingly willing to endorse the idea. It's likely that it will figure prominently into the 2020 presidential campaign. As one recent article in Health Affairs, a kind of Bible for health policy wonks, stated, "Medicare for All, though difficult, is now within the realm of political possibility."

I wouldn't be quite so sure, at least not in the very near future, because despite surging enthusiasm for the slogan, the practical and political problems with single-payer health care haven't changed. It's expensive, but there's no agreement among proponents about how, or even whether, to finance it. Transitioning millions of Americans from employer plans to a government-run system would be, at best, a massive administrative challenge, and more likely a bureaucratic nightmare—think Brexit, but for health care. Well-funded industry groups would vehemently oppose it. And even Democrats in Congress aren't all on board.

As Politico reported earlier this week, Medicare for All is an issue that divides congressional Democrats, and some of the same advocacy groups that funded defenses of Obamacare, some of which employ or have close ties with Democratic political operatives, are now pushing back on single-payer. And part of the reason, it turns out, is Obamacare.

That's because Obamacare funneled a signficant amount of money to hospitals and insurers, while a single-payer system like the one proposed by Sen. Bernie Sanders (I-V.T.) would cut provider payments and largely put private health insurers out of business. Taxing the rich won't provide nearly enough money to fund $32 trillion in new government spending, and the most straightforward potential financing mechanism—requiring employers to fund Medicare for All—would still be a difficult political lift.

So it's not exactly a surprise that even single-payer proponents like Rep. Frank Pallone (D-N.J.), the incoming chair of the House Energy and Commerce Committee, have been upfront about the fact that, at the moment, the votes simply don't exist.

That's why I basically agree with The Washington Examiner's Philip Klein when he warns single-payer opponents against focusing too much on the phantom threat of Medicare for All. Putting too much energy into fighting an idea that has little chance of becoming reality, he argues, is likely to make less drastic (but still substantial) expansions of government into the health care sector come across as more politically palatable.

The Medicare for All push may not be realistic in the short term, but it's not too hard to imagine Democrats coalescing around something like a Medicare buy-in program or a public option, in which government would offer an insurance plan alongside regulated private coverage. In this scenario, Medicare for All would play the too-radical, too-progressive foil to some sort of still-significant expansion of the health care state, allowing it to appear to be a middle-ground compromise.

The problem, at least for Republicans and their backers, is that opposing Medicare for All and its various congressional apostles makes for easy politics, and, just as crucially, it allows GOP lawmakers to pretend they have something that they don't — a health care policy vision of their own.

Ask a typical Republican about health policy right now, and you're likely to hear essentially empty catchphrases like "patient-centered" and "preserving the doctor-patient relationship" that have little in the way of policy substance behind them, and certainly don't contain a holistic vision for how American health care should be financed and regulated. Behind the scenes, meanwhile, conservative health care wonks spend a lot of time squabbling amongst themselves over both policy particulars and messaging; yes, there are real points of agreement, but they are united most strongly by what they are against. It doesn't help that President Trump has effectively declared Medicare, the nation's largest health care entitlement, off limits to reform.

Which means that the fight will inevitably come down to the forces on the left that support single-payer, or something closer to it, and forces on the right that basically support doing more or less what we are doing now, with all the frustrations and follies that entails.

Maybe that's a sustainable political equilibrium, in which the health policy status quo remains widely disliked but wins by virtue of being too big and too complex to overhaul. But more likely, I think, is that the single-payer forces win a game of inches, not in a year or two or even four, but perhaps in 10 or 20, when less-divided Democrats have either worked through their issues or just collectively agreed to ignore them—and Republicans are as clueless and flat-footed as ever. Medicare for All's moment has (probably) not arrived. But if its opponents don't offer an alternative, it might well be on its way.

NEXT: Environmental Protection Agency Gives $45,000 Grant to Help Non-Profit Build Sea Turtle-Shaped Trash Can

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  1. Start by asking all current Medicare recipients how happy they are with the quality of care – – – – – – –
    If that doesn’t settle it for you , ask the veterans.
    Then the Indians.

    1. Vets Admin for all who opt in, no govt plan for all who opt out.

      Next problem.

    2. People living outside These States can tell Medicare to shove it!

      1. Statistics don’t lie.

        Good one!

        If you are a male between the ages of 15 and 59, your chances of dying are higher in the U.S. (140 per thousand) than in Canada, 95, Costa Rica 127, Chile 134, and Cuba, 138.

        How is this an indication of the quality of medical care one may expect to receive in each of these countries? How many fatal car accidents are there in Cuba or Costa Rica? Suicides in Chile? Gang violence in Canada, etc.?

        Why has our vaunted free enterprise system…

        Ok, I’ve been trolled. Nice one.

        1. Statistics don’t lie, progressives do.

      2. That is one heck of a whopper.

        There are lies, damned lies, and statistics. – Mark Twain

        Much of our early death statistics are due to obesity, only possible in a prosperous nation. What you are proposing is that starvation is the “cure” to our medical system. Dolt. If you love starvation, why don’t you just pick up and move to Venezuela, or Cuba since you love it so much? Really, no one will miss you.

        1. Not to mention that in the US we count every child born in those statistics, from the moment the pop out. In most of the rest of the world, children are not counted in the statistics until they are over 1 year old. That certainly give a nice “pop” to the lifespan statistics doesn’t it?

          Add that to Johnny’s observation, and you see the talent for lying with statistics that progressives exhibit.

      3. Yeah, the Cuban Ministry of Propaganda would never lie.

    1. Eviscerate our economy for several generations?

      I suppose we can.

      1. We already have.

  2. This is workable. Congress need only adopt the solution Germany enacted n 1923. Everybody can have collectivized transfer payments from producers to non-producers by simply printing up trillions of legal-tender Deutchmarks dollars. Some Nixonstyle wage and price controls may be needed, but if the motives are altruistic, I’m sure everything will work out fine in the end–just like in Germany.

    1. No need to do that. Just declare that Monopoly money is now legal tender.

        1. “Do people want fire that can be inserted nasally?”

  3. If we all go on single-payer Medicare with the current reimbursement rates, health care facilities will close beds and doctors will find some other way to make money because they won’t be able to balance revenue and expenditures.

    And forget about getting an ambulance to come to your house. Medicare pays less than half the rate the average EMS company needs to keep staff ready to respond 24-7. And you can’t balance bill the patient. Our company only survives because of private insurance payments, a local tax, and subscriptions. If single payer comes, those three will probably go away.

    What’s the use of having everybody covered by insurance if there are less ambulances, doctors and hospital beds to care for them?


    1. If we all go on single-payer Medicare with the current reimbursement rates, health care facilities will close beds and doctors will find some other way to make money because they won’t be able to balance revenue and expenditures.

      That’s underselling the extent of this issue. Every medical provider in the United States would go out of business overnight.

      Medicare and Medicaid are propped up because you can fleece private insurance to make up the difference. Apparently, everyone forgot some of the reasons why healthcare expenses are spiking, and are doubling down on the things that caused the original problem.

      1. Every medical provider in the United States would go out of business overnight.

        Would they, though? How often do you see an itemized bill for the medical care you receive? How often are the charges explained? How easy is it to find out how much a procedure is going to cost?

        I keep going back to the childbirth well because it provides such a stark contrast. 60 years ago, you could get a normal live birth procedure done and two days in a private room for about $1000, inflation-adjusted. For our last two kids, the hospital charged $25,000 and $27,000, respectively, for those same services. Insurance paid about $17,000 of that, and the rest was waived.

        So what’s the real cost? Was it $25,000, or $17,000? Or was the actual cost far lower than that, and the hospital merely played the same game that retailers like Kohl’s play, where they jacked up the price and then offered a “discount” that was still far higher than the actual cost of the service, but made it seem like we were getting a deal?

        I don’t know about anyone else here, but I’d rather save up $1,000 than pay out the jacked-up rates that healthcare providers are charging, with little to no transparency on what the actual charges are. At least the Surgery Center of Oklahoma gives you an up-front price, along with cash-only doctors.


        1. Would they, though? How often do you see an itemized bill for the medical care you receive?

          Me, personally? I work for a hospital system in the finance department. I don’t know what the patient see’s nor does that matter to me whatsoever. If we had to survive on medicare and medicaid patients we’d be out of business, and there is no doubt about that whatsoever.

          1. “” If we had to survive on medicare and medicaid patients we’d be out of business, and there is no doubt about that whatsoever.”‘

            No doubt in my mind either. There’s a lot of money poured into clinics and hospitals that isn’t accounted for when we talk what is being spent for health care. Grant money from places like HRSA. FQHCs and CHCs around the country would fold without it.

          2. I don’t know what the patient see’s nor does that matter to me whatsoever.

            it matters to the customer if they want to get a competitive price on a service. You may not give a shit that the hospital is charging $25K for something that cost 1/25 of that 60 years ago.

            But it matters to the customers. One of the reasons that Truman’s universal healthcare policy in the Square Deal was able to get killed was because people could still get treated at a reasonable cost, and often know what they were being charged for. “Medicare for All” wouldn’t even be getting a sniff if that was still the case.

            And if people think going to Medicare for All is going to give them that $1000 cost back, as opposed to just letting things stay the way they are, guess what they’re probably going to support?


            1. it matters to the customer if they want to get a competitive price on a service.

              I don’t think you have any idea what you’re talking about. Government policy surrounding medical systems can have only one theoretical effect and that is to drive up prices.

              Transparent pricing practices are impossible in medical, and you can thank insurance companies and the government for that. Not that groups like the AMA don’t have their own culpability, but frankly the last person to know anything is going to be you because you have virtually no part to play in the payment process.

              1. I don’t think you have any idea what you’re talking about. Government policy surrounding medical systems can have only one theoretical effect and that is to drive up prices.

                Fine. Enjoy your single payer, because you clearly want the industry to avoid the responsibility of providing something that would enable the market to actually lower prices.

                Transparent pricing practices are impossible in medical, and you can thank insurance companies and the government for that.

                Bull.
                Fucking.
                Shit.

                Look up the Oklahoma Surgery Center. Notice something? *They provide prices on all their services.*

                Don’t tell me that shit is impossible when I can pull up real-world examples of why you’re making excuses for a deliberately opaque industry.

              2. “frankly the last person to know anything is going to be you because you have virtually no part to play in the payment process”

                And this is the key issue. You don’t chose a doctor on price, or negotiate the price. You DO get to chose the doctor, the hospital, and whether to get the procedure done, but have no significant part in paying for it.

        2. The rise in the cost of childbirth is largely linked to insurance costs for said services. You can thank Democrats and their lawyer lobby for 5hisnincreased cost. Compare insurance premiums for OBGYN in Florida with Canada. Democrats wont let medical lawsuit reforms happen.

          1. That still doesn’t excuse the lack of price transparency, and if that’s where the money is going, then hospitals need to be upfront about that.

            1. Hospitals get audited often. You can can even ask for a pricing list before electing for a procedure. Pregnancies are weird in that you have 9 months to look at your options. What was your actual complaint?

              1. Hospitals get audited often. You can can even ask for a pricing list before electing for a procedure.

                Huh–and yet somehow, those same hospitals can’t put up those prices on a website to provide market-based solutions. Well, some do, but apparently they’ve figured out the basic market principles that giant medical institutions haven’t.

                Pregnancies are weird in that you have 9 months to look at your options. What was your actual complaint?

                “Geez, something that cost $1K inflation adjusted now costs $25K? Why are people so upset about this?”

                Fuck, for people that worship the market as much as you all do, it’s pretty shocking that you act as surprised as progressives that people would actually want to price-shop.

                1. Why do you want the prices on a website? Do you know how insurance and hospitals even work? Each insurer will negotiate for a different price. This includes the government in Medicaid and Medicare (both at losses to the hospital). This isn’t like lasik because the markets are different. Driving ACA and coverage mandates obscures prices due to network migrations to various insurers. It’s why out of network and in network prices vary. If you want to know the cost call up by hospital billing department, give them your insurer and they will provide and estimated out of pocket with payments to the insurer. Government is exactly why this is complicated.

                  I do have to ask… do you actually know anything about how the hospital system works?

                  1. Why do you want the prices on a website? Do you know how insurance and hospitals even work?

                    “Gee, putting up prices on a website is SOOO FUCKING HARD , it just can’t be done!”

                    I do have to ask… do you actually know anything about how the hospital system works?

                    Perhaps I should be asking why you actually think this is a valid excuse.

                    1. Red Rocks in the head,

                      Each insurer has negotiated different pricing. Part of the contract for each insurer is to keep the prices negotiated confidential. The hospital will therefore, tell you what your out of pocket is expected to be once you have confirmed you are insured by a particular company. But will not tell you want that cost would be if you had a different insurance company.

                      In short, the hospital doesn’t put in on a website because they are not allowed to.

                    2. Part of the contract for each insurer is to keep the prices negotiated confidential

                      You seem to be missing the point (shocker).

                      If the charged price is $25K, and the “negotiated” price is $17K for one, and $19K for another, what’s the actual price?

                    3. I tell you how the pricing system works… and you ignore it. How fucking ignorant do you really choose to be? Just like with lost phones you only set the pricing from whatever carrier you choose, certain exceptions exist. This works the same way. The hospital even does the leg work for you to ask your insurer the estimates costs. Do you or do you not understand how insurance works? Because you seem pretty damn ignorant t.

            2. The lack of transparency is due to federal regulations. The provider has multiple prices for each service, depending on the particular insurance plan, government program reimbursement, or lack thereof. If you must have federal interference, make it be that the providers must charge everyone the same price, and post that price.
              This will eliminate ‘networks’, and the multiple payment amounts for the same service.

              1. The lack of transparency is due to federal regulations.

                Wrong. The lack of transparency is due to a lack of will on the part of healthcare providers. There’s no law dictating that hospitals can’t post prices. None. Anyone saying there is, is either ignorant, lying their ass off, or enabling a dysfunctional system.

                If you must have federal interference, make it be that the providers must charge everyone the same price, and post that price.

                That’s the whole point of it.

                1. Dude. You be proven you’re ignorant. Even when told how the system works… you ignore it. If you want prices up front go join one of the ACA co ops. Oh wait. They went bankrupt. If you want individual procedure prices, advocate for ending the insurance system instead of expanding it dumbass. Again, lasik is different as it is not mandated in coverages. For fuck sake you are dumb.

        3. “So what’s the real cost? Was it $25,000, or $17,000?”‘

          It may be something like this. The $25,000 is what the hospital charges. The $17,000 is based on what’s known as the contractual amount which is what the hospital agrees to be paid when they contracted with the insurance company.

          But you have a point I bring up often. When we talk about health care costs are we using the charge amount from the doctor office or hospital, or the amount that actually gets paid by the insurance company.

          1. Next he’s going to ask for an itemized bill for what apples true costs on iPhones are.

            1. Watching you resort to the the “fuck you, that’s why” argument for maintaining a lack of transparency on healthcare costs and pricing is so deliciously ironic that it should be poured over pancakes.

              1. Red Rocks in the head,

                Each insurer has negotiated different pricing. Part of the contract for each insurer is to keep the prices negotiated confidential. The insurer considers it proprietary as does the hospital. The hospital will therefore, tell you what your out of pocket is expected to be once you have confirmed you are insured by a particular company. But will not tell you want that cost would be if you had a different insurance company.

                In short, the hospital doesn’t put in on a website because they are not allowed to.

                1. Each insurer has negotiated different pricing. Part of the contract for each insurer is to keep the prices negotiated confidential.

                  You seem to be missing the point (shocker).

                  If the charged price is $25K, and the “negotiated” price is $17K for one, and $19K for another, what’s the actual price?

              2. I literally explained to you how insurance markets work dumbfuck. You ignored it.

    2. What’s the use of having everybody covered by insurance if there are less ambulances, doctors and hospital beds to care for them?

      Those dastardly rich people will also suffer?

      1. Of course not! Nor will our selfless government leaders who will provide a loophole to allow the special care they deserve!

    3. If we all go on single-payer Medicare with the current reimbursement rates, health care facilities will close beds and doctors will find some other way to make money because they won’t be able to balance revenue and expenditures.

      As it is, that is already happening now, with consolidation of hospitals to major metropolitan areas and divertment becoming too common as most ERs are run with skeleton crews. Even EMS is consolidating, so the only emergency response is often from the firestation.

      And the trend in public health is to operate with far less doctors, an explosion of mid-levels, and more technological monitoring in an effort to reduce costs.

      Even without the specter of single-payer on the horizon, the cost-benefit of healthcare has been abysmal, with the suspicion of graft to major health providers drawing ire.

      Regardless, you’re doomed.

      1. Anyone who knew anything mentioned during the ACA debates that it would drive market consolidation. Gee, why is anyone shocked about this development?

        1. Except consolidation had started a decade prior to the ACA, although the ACA undoubtedly accelerated the rate.

          So, care to explain the ten years prior?

          1. I apologize if it seemed as if I was stating that the ACA was the only source of consolidation, I usually make it clearer that the issue started around a hundred years ago. The ACA just accelerated the process and it was already pretty late stage.

            Most of the growth in this sector is administrative, which should terrify people. This is how the government ‘creates jobs’ and it’s killing us. Literally, in some cases.

            1. Century ago you say? Prior to even widespread use of penicillin or even the start of Medicare. Well now, that certainly is interesting.

              And while administrative costs have certainly risen, that has absolutely no bearing on consolidation. In fact, consolidation is often given as a means to reduce administrative costs.

              1. Yes about a century ago, Blue Cross came into being. 1930s or thereabouts. Some teachers in Dallas agreed with someone at Baylor and paid a monthly fee in exchange for no additional bills.

                Took off more after WWII when employer based insurance became a norm. Economic growth pumped a lot of money into the medical system. The boom created many things. Some of them in wealth some of them in miracles and wonders to paraphrase Paul Simon.

                Now that norm is barely functional. There is a transition coming.

                Not a box of cornflakes.

                1. Just few more thoughts.

                  What we think of as basic supply and demand does not work.

                  The consumer is not informed. We are talking about something that the consumer relies on expert advice for. If the doc says you need a CT scan. You can say no but you will not. The doc does not care much about the cost of the scan and you are not thinking about it.

                  The demand curve is inelastic. You want the best you can get. You are not shopping for the cheapest doctor, or angioplasty, actually as BYOB who is in this on the financial level pointed out, doctors and other providers have little to do with it.

                  The government is not going away.

                  Medicine will take all the resources it is given.

    4. US has been closing hospitals and hospital beds for 60+ years. I can easily see online stats with 1.5 million beds in 1975 and 900k now. But I know that trend goes back to the early 50’s.

      There was a bit of growth when the burbs first started – but basically the last time the US significantly expanded hospital bed capacity was in the 1920’s/1930’s when municipalities opened many hospitals in response to the disaster of how ‘charity’ hospitals responded to the 1918 flu.

      1. One, however, has to factor in that many more procedures are now outpatient procedures (and should be) and that even those that are still inpatient often result in shorter stays in the hospital than in the past. Thus, a substantial reduction in hospital beds per capita would not be surprising over the past 40 years.

        Every hospital I’m familiar with (admittedly a fairly small number) which is building a new hospital to replace the existing one (to comply with California seismic safety laws) has less beds (but they tend to all be private rooms) in the new hospital than the old one. This is explained as being because of the increase in outpatient procedures and shorter stays — there are fewer beds needed but those beds are occupied by “sicker” people on the average.

        1. Sure. Back then, quarantine length stays were needed for contagious diseases and recuperation was a lot longer.

          But it’s also true that muni’s/etc – not private/nonprofit – are the ones who will tend to build low-tech just-in-case capacity because they have lower capital costs and can, reasonably, view that as community infrastructure recoverable via prop taxes rather than daily fees in case of epidemic, natural disaster, terrorist attack, power outages/heatwaves, etc. Current hosp bed space is massively capital-intense – excessively so for anything short of heroically aggressive type intervention – and can’t at all deal with fluctuating demand. Having both types of capacity is what can keep costs down.

          1. Rehab facilities and home directed post hospital care are much better than in the past.

            Surgical techniques have decreased recovery times with endoscopic and less invasive procedures.

            The orthos have got things to the point where things like joint replacements are routine and quick out of the hospital. Good work orthos! Really it is far better than a few decades ago.

    5. Cheaper options will enter the market.

    6. Single payer advocates want us to believe that providers will save on administrative costs that they now have due to insurance company claim procedures. When pointing to cheaper systems in Europe and Japan – I don’t see many single payer advocates talking about other big differences: malpractice insurance and med school debt. I’m pretty sure doctors in France, Germany, etc. don’t get out of medical school with lots of debt as is common for American med school graduates. I suspect surgeons in Europe don’t have the high malpractice insurance costs their American counterparts do. I live in Florida and the doctors and hospitals are generally doing just fine financially – and Florida has a very high percentage of Medicare “customers”. I don’t know how to best reform our system, but what we have now is a mess. Our system hasn’t been exposed to free market forces since WWII. Employer provided health insurance has both done damage (by muting free market forces and helped finance the best medical care (if one is lucky enough to have good insurance) in the world. Medicare is a single-payer hybrid with financing challenges coming in the not-too-distant future. Insurance companies serving the individual market would – if allowed, stop offering coverage to unprofitable customers (like they did before the ACA). I used to be an insurance agent. Anybody who thinks only people with serious conditions like type 1 diabetes or cancer had trouble getting individual policies is wrong.

  4. Transitioning millions of Americans from employer plans to a government-run system would be, at best, a massive administrative challenge, and more likely a bureaucratic nightmare

    That just means the ‘challenge’ disappears in the next recession – when tens of millions of Americans will be kicked off employer plans – by their employers. And employers will lose all interest in defending some uniqueness of ‘their plan’ – since they will be busy at that point trying to extract more themselves and will be perfectly happy to throw the whole thing over to govt in exchange for a fixed payroll tax.

    1. But the glory of single payer is that there will not be a need for administration. Everyone gets care, no id cards or payment records required. The providers have to take whatever the feds pay them, and the patients have to take whatever level of service will be provided. Simple. The administrative savings alone will pay for the increased care.

      1. That’s just BS. The main problem with govt care – in the US – is precisely the total lack of administration. Administration is what allows one to think long-term and implement preventive care or train geriatricians as the GP’s for the elderly when you know that boomers will get older over time. That is what lowers costs over time. It’s what allows one to provide case mgmt for expensive care that makes it possible to contain the costs that are gonna be paid by the healthy and eliminate the entitlement teat-sucking ‘it’s all free’ mentality by the sick that drives up costs. We already spend more in PUBLIC money on healthcare than any other country – and can’t even cover most of our population.

        There is no reason anyone should be optimistic about what the US govt will do re medical care when they take over the whole thing. Our fed govt is uniquely corrupt and venal and incompetent – and giving them more money will not make that better.

  5. I imagine if Medicare for All ever comes to fruition, the result would be a lot like what we see with public education-those who can afford to will go to private clinics, while everybody else will take their chances with the public system, and of course you will even more wailing from progs about INEQUALITY!

    1. It really will be like our blue cities–the white UMC liberals will go to private clinics in the suburbs with the best doctors and gleaming facilities, while the Hispanic and black residents will be forced to deal with the squalor and low-resource hell of public clinics.


      1. …while the Hispanic and black residents entire middle class will be forced to deal with the squalor and low-resource hell of public clinics.

        Fixed that for you.

        1. The middle class will find ways to avoid the ghetto public clinics, the same way they’ve avoided sending their kids to ghetto schools. They always do.

    2. That’s the beauty of the Bernie Sanders plan. He outlaws private healthcare coverage that overlaps with public. You all must suffer. Huzzah!

      1. The easy fix is to insist all these progressives GTFO, or else. Then fix things without Marxist interference.

        At least I see that as a far better outcome than any of their lame ideas.

    3. Just like Russia actually. Where supplies in the public hospitals are short, cleanliness is lacking, the doctors are so poorly paid tips are expected.

      And the private hospitals are just a modern as in the US … and open to anyone who can pay for it, or who has private insurance.

  6. I wouldn’t be quite so sure, at least not in the very near future, because despite surging enthusiasm for the slogan, the practical and political problems with single-payer health care haven’t changed.

    Yeah, remember when concerns like those stopped the ACA becoming law? Oh, wait, that didn’t happen!

    The strategy is simple: lie and pass a program that no one understands, tell people you saved them all, then lose power and blame all the failures on the opposition party.

    In the meantime, if the nation goes broke or hyperinflation kicks in don’t worry about it. Remember: You’re making an omelette!

    1. Blame the collapse on capitalism then.

      1. Indeed, ‘Market Failure’!

      2. Superstitious antichoice prohibitionists with legal claws around the throat of every physician is may be 18th century Mercantilism, but it is nothing at all like a libertarian free market. Look at George Waffen Bush dumbfounded by the collapse attending his faith-based asset-forfeiture collapse–or Herbert Quaker Hoover’s for that matter! Republican National Socialism is not freedom.

        1. George W. Bush is certainly not a conservative, “compassionate conservative” labeling asside. GWB is not a libertarians either. GWB is a progressive Republican. Don’t act surprised, there are a bunch of them.

  7. I suppose this is because the moderate Democrats have some notion of how the economics of MediCare actually works and the Progressives just do not care about logistics if they are even aware of the concept.

    To the extent that MediCare works it is because the payers are mostly not the same group as the payees and are a considerably larger demographic.

    1. ‘moderate democrat’ LOL

  8. Medicare is so good that if you have it, you need to buy more insurance.

  9. If you are on Medicare , unless you can self insure, you still need a supplemental plan to cover expenses not covered by Medicare.

    If you want Medicaid for all, easy, just quit your job and go on welfare. Or join the armed services and get VA benefits for life.

    1. If you want Medicaid for all, easy, just quit your job and go on welfare. Or join the armed services and get VA benefits for life.

      Wouldn’t surprise me in the least if these same progs who want Medicare for all also want guaranteed government jobs for all for life-which would include serving in the military. Of course, these progs don’t like the military or anything having to do with guns, so instead they will create jobs like “non-binary health navigator” or “climate change compliance specialist”

      1. Don’t sell them short, they’ll also need Brown shirts to enforce everyone’s altruism.

        1. They contract that out to antifa; so actually, they are pretty capitalist after all – – – – – – – –

      2. They will have no problem with the military. The will just want Posse Comitatus Act gone so they can use them for “Domestic Security”. Not on the borders of course, on rebellious citizens.

  10. The progressive wings of both major political parties in the USA must win this noble fight.
    Only through government healthcare can the masses be assured they will be submissive to the enlightened few.
    Ensuring the little people will obey the prudent, humane and vicious diktats of our obvious betters is one of the best way to ensure our ruling elitists can justifiably enrich themselves through the miracle of redistribution of wealth.
    Just think.
    Any doubters or counter-revolutionary actions or words will be met with the decline of government healthcare, the only healthcare available, will reduce the populace to willing participants in the new Union of Soviet Socialist Slave States of America. Any deviation from the politically correct norms, rules, regulations, laws, etc. will result in the refusal of providing necessary medicines and surgeries not only for those foolish enough to question our ruling elitists commands, but also the refusal of medical care for the counter-revolutionary’s immediate and secondary family members.
    After all, you have to break a few eggs to make an omelet, said a kind, humane and forgiving person.

    1. Careful, Rev. Kirkland will sue you for stealing his schtick.

    2. OBL level quality. A

  11. when you can control peoples health care you can control people

  12. Please stop saying how it expensive it would be…we are already paying for health insurance for 95% of Americans so we can obviously pay for it. Also Medicare for All is the rule and we are the exception…so make the case for the status quo don’t make arguments against the system that makes the most sense.


    1. Please stop saying how it expensive it would be…we are already paying for health insurance for 95% of Americans so we can obviously pay for it.

      Wow. That’s an impressive amount of ignorance. You might want to read…anything on the subject about how much single-payer costs. As broken as our current system is, it’s at least running on a few cylinders. You appear to want to remove the engine and see how well that works.


      so make the case for the status quo don’t make arguments against the system that makes the most sense.

      Wrong argument, chuckle head, because the status quo was manufactured lock, stock, and barrel by the very government that is now crying about market failure. If you dislike the status quo, congratulations you just made an argument against central planning out of one side of your face while claiming central planning can fix everything.

      1. I support the status quo but I acknowledge that it is overpriced in light of lifestyle being more important than actual health care. That said the reason it is overpriced is because we actually have a robust free market aspect of our health insurance system. So ironically the New Deal Democrats and UAW created the extremely business friendly group market that makes private health insurance even possible. So without the government created group market we would have single payer. Single payer would be crappy but it would be cheaper than private health insurance. Crappier health insurance could make people lead healthier lifestyles which would make people healthier.

        1. “Crappier health insurance could make people lead healthier lifestyles which would make people healthier.”

          Genius! Kill all the doctors and everyone will stay healthy out of fear!

          1. Europeans are healthier than Americans in large part because they have crappier health care. Public health advances are baked into the cake in America so a country like Haiti could have the best doctors in the world and it wouldn’t make much of a difference with respect to the health of individuals in Haiti. By contrast Cuba has focused on public health and has a relatively healthy population.

  13. I once subscribed to a purely market-driven healthcare system as described in the essay by Roderick Long.

    The problem is that we now have big pharma and other medical oligopolies that distort the market, and there is no political will to do the above, without it being subverted by powerful interest groups. I have a particularly nasty pre-existing condition that makes a good test case, so I surveyed fellow sufferers in different countries. It turns out that the best care is delivered in places like the UK with the NHS (you will never convince the Brits to give it up – they love it and know that they have it good). But other nations, supposedly with “single-payer” health care, drop the ball. The devil is in the details of a plan – catch phrases don’t cut it.

    1. NHS (you will never convince the Brits to give it up – they love it and know that they have it good).

      Gee, one of my best friends is a former Brit. He describes the NHS as rubbish that nobody in their right mind uses if they have any alternative.

    2. Concern troll is concerned.

  14. Any proper single-payer system has an important market component which keeps prices under control: competitive bidding by providers. Contrast this with Obamacare which has NO price controls, and allows big pharma to laugh all the way to the bank as they sell a $1 bag of saline to a hospital for $800. This is not sustainable, and a well designed single-payer system should actually result in a much higher benefit to price ratio.

    “Well-funded industry groups would vehemently oppose it” – these are the oligopolies that don’t care when middle class people have to declare bankruptcy due to illness, or the lack of orphan drugs. Perhaps they would prefer to allow “people to die and reduce the surplus population.” But they must not be allowed to dictate the terms of our health. They are entitled to a profit, but not at the expense of health or quality of life.

    So I will potentially support a single-payer system if it mirrors one of those that have worked well so far. But the devil is definitely in the details. The GOP had its chance and blew it.

    Keep in mind that conservatives were early campaigners for the current NHS, and Libertarian economist such as Hayek proposed that any prosperous nation ought to be able to care for the health and welfare of its people without breaking a sweat.

    1. Haha, yeah. Price controls, that’ll do the trick. Hey, remind me again but weren’t wage controls step one of the collapse of the American healthcare system?

      The governement, after being empowered to pick winners and losers, started picking winners and losers. 100 years later, and here we are. If you don’t reform government, any attempt to impose single-payer is doomed. I mean, frankly economically speaking it will be doomed no matter what but if you don’t mind lines and rationing I guess it’s not so bad.

      1. You shut your mouth. Price controls worked in Venezuela. Everyone is losing weight, going on long walks and overall seem to be in good non obese health.

        1. True. I keep seeing video of the public workouts where everyone is walking up and down the streets throwing tear gas canisters back at the police.

        2. Also, their problem with rats, stray cats and dogs have been solved too.

          1. Yep, now that they catch and eat them.

  15. It is clear form the democrats rhetoric that the democrats are not interested in increasing employment or increasing opportunity people to start new business. Just the medicare for all would increase the budget of the US by $3.2 billion a year and that is with the US running near a trillion deficit and before they add the other things they want to add such as infrastructure and a national basic living income and for good measure of free college for all who want it. The democrats (some of them are anyway) are also interested in increasing the taxes on high income earners and businesses. Some have proposed an increase to what it was back when President Truman was president. That is a top tax rate of 90+%. But with the 90+% income tax rate they could not have done it then and they could not do it now. That tax rate would also cost jobs which would lower the number of people paying taxes and more people drawing entitlements such as the above mentioned. To do even most of these items the military would have to become only a national defense organization with no over seas unites other than a few marines to guard US embassies. But without the means to protect and rescue these diplomats and the marine guards the embassies most of our embassies would have to close.

    1. “Just the medicare for all would increase the budget of the US by $3.2 billion a year”

      Just the Medicare for all would increase the budget of the US by $4.2 trillion a year”

      There fixed it for you.

  16. The Medicare for All push may not be realistic in the short term [blah blah blah bullshit]

    It’s not realistic in any term. The broken nation in the history of the world. 20 Trillion debt. Spends more than $1.50 for every $1 it collects in revenue, and anyone thinks it can provide “Medicare for all?” Let’s promise everyone a fucking unicorn and a “free” flying car, too, while we’re at it. What utter horseshit.

    1. ^brokest

  17. “But if its opponents don’t offer an alternative” — The “alternative” plan IS REPEAL, REPEAL, REPEAL

    It wasn’t that long ago healthcare WAS affordable.. The opponents PLAN IS to do what has been PROVEN TIME AND AGAIN in every market TO WORK (i.e. FREE MARKETS)!!!! Instead of drafting more of the same “plans” and getting WORSE, WORSE and WORSE.

    Just because its not a communist plan doesn’t mean its not a plan at all!!!

  18. A Medicare buy-in program or a public option would, once it became concrete, likely result in strong resistance from those already on Medicare. Seniors would realize that it would become that much harder to find a good doctor (esp. primary care physicians) who would take Medicare patients due to the increase in the numbers of people seeking the fixed pool of doctors who are willing to lose money on some of their patients in exchange for making it up by overcharging the rest.

  19. Now we pay all our lives so Medicare will pay 80 % of our health care when we retire and have to purchase a supplemental policy to go with Medicare. While paying Medicare tax all our life we have to have health insurance too. So how can the US provide Medicare to everyone unless it cost people of younger age much more money since they have not been paying the tax all their life? These people that want this thnk it could cover then all their life at the same cost as us older people pay it seems, funny huh? Ain’t gonna happen.

    1. It just won’t fuckng work. Basically we either resign ourselves to the destruction of America, or get rid of the progressives one way or the other.

      To be clear, I just want them gone. To quote a friend of mine, I don’t really give a shit if they leave town riding their horse, or slung over the back of it. Their choice.

  20. The false assertions about a single payer system are nothing more than a con job. People pushing the notion always point to Canada, Sweden which are the few countries that make it work. First, Canada has a population of 37 million and Sweden only 3 million. It is much easier to make such a system work when you are talking about 1/10th and 1/100th the population of the US. However, all you have to do is look at all the recent problems in the UK to see the actual dangers of single payer medicine. In addition, we have a very good example of how efficiently a single payer system would work in this country already. It is called the VA. How many stories have bee reported about veterans dying waiting for care while administrators cooked the books to get bonuses they did not earn? The only reason progressives want a single payer system is when you control a person’s healthcare, you control the person. All this aside, there is one major problem with the proposal, we cannot afford it. We cannot afford it with the population we have now and we certainly will not be able to afford it if Democrats have their way and we continue to have a porous border letting in millions more illegally every year.

  21. I essentially started three weeks past and that i makes $385 benefit $135 to $a hundred and fifty consistently simply by working at the internet from domestic. I made ina long term! “a great deal obliged to you for giving American explicit this remarkable opportunity to earn more money from domestic. This in addition coins has adjusted my lifestyles in such quite a few manners by which, supply you!”. go to this website online domestic media tech tab for extra element thank you .
    http://www.geosalary.com

Please to post comments

Comments are closed.