Medicare for All

Medicare for All Would Actually Be a Government Takeover of Health Care

House Democrats' new single-payer bill would legally prohibit today's private health insurance and determine financing for doctors and hospitals.

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ARON P. BERNSTEIN/REUTERS/Newscom

A decade ago, as the legislation that would become Obamacare was making its way through Congress, Republicans frequently blasted the Democrats' health plan as a "government takeover of health care." That phrase, introduced into circulation by GOP messaging guru Frank Luntz, was eventually awarded Politifact's Lie of the Year.

One could argue about whether the GOP's attack was the most significant lie of 2010, but it was, at minimum, an exaggeration. Although the Affordable Care Act increased regulation on individual health insurance to the point where it became something resembling a public utility, it left the bulk of the market for private health coverage intact, and even provided subsidies so that people could obtain (heavily regulated) private coverage. Today, an estimated 177 million Americans have private coverage.

The single-payer health care plans now being put forth by Democrats under the label "Medicare for All," however, would eliminate that coverage. As Rep. Pramila Jayapal (D–Wash.) said this week when announcing House Democrats' new Medicare for All bill, the plan would "mean a system where there are no private insurance companies that provide these core comprehensive benefits that will be covered through the government." Unlike Obamacare, then, Medicare for All can legitimately be described as a government takeover of health care.

Although Jayapal's plan would allow for the creation of a secondary market for supplementary coverage in addition to the government-run plan and direct cash payments to doctors, the market for the private health coverage that tens of millions of Americans currently have would be eliminated. Employers and insurers would be prohibited by law from providing the same benefits as the the government plan, a prohibition that goes further than some other countries with national health care systems. Private insurance as we know it today would be illegal.

And while the federal government would neither own hospitals nor employ doctors directly, it would be in charge of the vast majority of the nation's health care financing. That would include setting a "national health budget"—essentially, a federally imposed cap on total health care spending—and divvying up those funds by region. The federal government would also determine the budgets for capital improvements at medical facilities and set up a fee schedule imposing rates paid to doctors in private. In addition, the government would also specify staffing levels for physicians, and determine the preferred ratio of nurses to patients at any given facility.

It's true that the government already sets rates for Medicare in its current form, and those rates exert a significant influence on the administration of health care throughout the country. But today's Medicare exists alongside multiple private payers that would be eliminated under single-payer, leaving the government as the sole payer for most services.

So while doctors and hospitals would not technically be state owned under Medicare for All, the federal government would determine how the vast majority of the nation's health care dollars would be spent, making providers even more reliant on federal funds—and more susceptible to the influence and incentives of federal payment schemes—than they are today. Some practitioners might avoid this by accepting only cash payments, but it's reasonable to assume most would not. As a consequence, doctors and others in the health industry would become de facto federal employees, with significant staffing and payment decisions made by the federal government, according to formulas set by federal agencies.

Medicare for All, as envisioned by single-payer proponents like Jayapal and Sen. Bernie Sanders (I–Vt.), would thus bring about an explicit nationalization of health care financing and a tacit nationalization of health care delivery. This is not an incidental byproduct of single-payer health care, but the defining feature: Medicare for All is designed to give politicians and federal bureaucrats dramatically increased control over the nation's health care system. Republicans were mistaken to dub Obamacare a government takeover, but when it comes to single-payer, the description applies: Putting the federal government in charge is the heart of the plan.

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  1. Although Jayapal’s plan would allow for the creation of a secondary market for supplementary coverage…

    Which will eventually have premiums comparable to today’s insurance rates. That would be on top of the increased taxes.

  2. So while doctors and hospitals would not technically be state owned under Medicare for All, the federal government would determine how the vast majority of the nation’s health care dollars would be spent, making providers even more reliant on federal funds?and more susceptible to the influence and incentives of federal payment schemes?than they are today.

    The 2020 races are going to be fun!

    1. There is a word for that…

      1. And I’d argue that it isn’t “crony capitalism”.

        Socialism in my book = government ownership, prices set by something other than markets, redistribution as the goal.

        If this wouldn’t technically be pure socialism because of the lack of government ownership, let’s not forget that some 70% of the hospitals out there are already non-profits. They may not be owned by the government, but they aren’t about distributing dividends to shareholders either.

        1. The other “C” word: Corporatism.

          1. It think it’s just plain old socialism.

            Maximizing profits sure as hell isn’t the goal of a non–profit hospital.

            Prices set by bureaucrats.

            The purpose is to maximize access (aka redistribution of wealth).

            That’s just plain ol’ socialism.

            1. Worse! It’ll swiftly lead to authoritarianism! Think the Democrats are bad now with their thought police actions and the banking cartel and Silicon Valley backing them up with penalties on offenders? Imagine what they’ll be like when you have to rely on their government for health care.
              Say something out of line? No healthcare for Deplorables! Need surgery for your appendix? Whoops! Looks like you made a derisive post about Obama on Facebook in 2010. Back of the line, sucker! Next surgery date in 3 months… if you’re still alive by then. Pelosi needs her 15th facelift far more!

              1. But isn’t this what many of the pro-progressive Libertarians are for? We are screwed if we don’t line up in opposition to Dem’s . I don’t give a damn for purists who won’t back Trump yet swoon over Weld.. We need to stop these turds from gaining more of a foot hold.

        2. Communism – state owns everything. Fascism – state controls everything.

          Cronyism to the max. Corporatism. Distinctions without a difference.

        3. I was wrong about 70% of hospitals being non-profit.

          It’s actually closer to 80%.

          Number of Hospitals in the USA: 6,210

          Number of Investor-Owned (For-Profit) Hospitals: 1,322

          http://www.aha.org/statistics/…..-hospitals

          6,210 – 1,322 = 4,888 Non Investor Owned (Non-Profit) Hospitals

          4,888 / 6,210 = 78.7%

          The next time some idiot progressive tells you that the problem with our healthcare system is people seeking profits, don’t tell them that some 80% of the hospitals in this country are non-profit . . . not at first, anyway.

          First, tell them that the difference between revenues and cost is the definition of profit, and, thus, that the maximization of profit incentivizes cost cutting like nothing else can, and, hence, why capitalist system do a better job of pricing important things like healthcare to as wide a consumer base as possible. It helps if you say it while you’re in a Starbucks while some homeless guy is fumbling around looking for a place to charge up his smartphone.

          Once that’s accomplished, then we should hit them with the fact that since 80% of the hospitals in this country are non-profit, profit seeking in the industry probably isn’t a big cause of the problem.

          1. Explain to the left, too, that non-profit hardly means non-revenue. They’re classified as non-profit because revenues after expenses go into the latest hardware or a new thing for some disease or more staff or higher pay for existing staff. That the profits don’t go to shareholders does not mean they don’t exist.

            1. They’re classified as non-profit because they don’t distribute dividends.

              1. I get the classification. I’m just saying people treat “non-profit” as though no money flows in or goes out.

                1. I don’t understand why that should matter to anybody.

                  The problem (this part of it anyway) is that they don’t distribute profits to shareholders.

                  Complaining that money is still coming out and going is something people on the socialist left complain about. Were they expecting the nurses to work for free?

                  1. Are we saying that the problem isn’t that hospitals aren’t pursing profits–in the name of libertarian capitalism?

                    To whatever extent the lack of cost controls at non-profit hospitals is a problem, it is in no small part due to the fact that they are not distributing dividends to shareholders.

                    Who here thinks that McDonald’s pursuit of profit is the reason their hamburgers are so damn expensive that hardly anybody can afford to buy them?

                    They’re not expensive, and just about everybody can afford to buy them.

                    1. I’m not arguing with your explanation, just saying that a fair segment of the left treats “non-profit” as though it means something else. The term describes exactly what you said and from the administration’s standpoint, profit is very much desired because equipment costs money and so does quality help. That the money is not dispersed to shareholders via dividends does not mean that at year’s end, hospitals don’t have money that is then spent on people and equipment.

                    2. You seem to have internalized arguments from the left as if they were from the right.

                      Left = socialism.

                      Right = capitalism.

                      The argument that sans profits hospitals would spend more money on providing better patient care gets it all wrong. There is nothing worthwhile to the pro-capitalist argument in pointing out that non-profits still have revenue. That observation is good for nothing and actually harmful to the cause of capitalism.

                      If these hospitals were distributing dividends to shareholders and maximizing profits, the prices they charge for services would be lower and their services more affordable to more people. The fact that 80% of the hospitals are non-profit is a big problem.

                    3. You seem to have internalized arguments from the left as if they were from the right.
                      No, mostly I’ve just listened to the argument. Jesus, dude. Didn’t say a word about capitalism or about socialism.

                      Much of the left treats ‘non-profit’ as though it means something other than what it actually means. That’s the sum total of what I said from the start.

                    4. “You seem to have internalized arguments from the left as if they were from the right.
                      Left = socialism.
                      Right = capitalism”

                      Dude, in America, it’s more like:

                      Left= mostly capitalism, with a few things socialized
                      Right=mostly capitalism, with slightly fewer things socialized, but a lot more cronyism

                      “If these hospitals were distributing dividends to shareholders and maximizing profits, the prices they charge for services would be lower and their services more affordable to more people.”

                      That’s an interesting theory. If they were taking in less money (because their prices were lower), they’d have more money available, to distribute to shareholders?

                      There definitely ARE some inefficiencies in the healthcare business… all that money pharmaceutical companies pay for advertising, for example, and personal injury lawyers, and defensive medicine practiced to ward off medmal lawyers. But approximately one of them are related to the nonprofit status of hospitals, and it’s this… nonprofits take people who need lifesaving treatment, and treat them to save their lives, whether or not they can pay for the treatment.

                    5. So, basically your premise is that if we converted these non-profit hospitals to profit, our healthcare and prices would improve? I mean that sounds relatively logical and I do believe it may lead to lower prices and such. Many have talked about allowing hospitals and such to compete in order to lower prices of drugs and services. In my opinion I think thats the best option. Allowing government to take over and set their ridiculous mandates and their spending system would crush our economy. Also I appreciate the info, I had no idea 80% of hospitals were non-profit and what that actually meant.

            2. The fact that they’re 80% non profits is probably half the problem… With no profit motive, they’re likely more lax about keeping costs contained. If they were 100% for profit, I suspect we’d see a LOT of cost cutting and efficiency measures taken.

              1. “The fact that they’re 80% non profits is probably half the problem… With no profit motive, they’re likely more lax about keeping costs contained.”

                This would be true, if profits came about solely by cutting costs. But they don’t.

                In any case, your thesis is easily demonstrated to be incorrect. Most HMOs are non-profit. What are HMOs best known for? That’s right, pissing their customers off by nickel-and-diming them and denying coverage.

              2. “The fact that they’re 80% non profits is probably half the problem…”

                It is a big part of the problem, but it’s also a symptom of the bigger problem.

                The question to ask is, “Why do 80% of America’s hospitals choose to be non-profit?”

                The answer to that question is more complicated, and a lot of it has to do with a huge portion of the system’s resources being dominated by Medicare and Medicaid patients. You can’t have price signals and competition when the federal government is setting prices nationwide for the overwhelming majority of services being sold.

                Like I wrote above, if profit is the difference between revenue and cost and revenue is fixed at rates below costs to hospitals, then why would they choose to be for-profit? And the fact is that both Medicare and Medicaid pay below the cost of care and leave hospitals to gouge private pay patients to make up for the difference, and in inner city and poor areas with few private pay patients in their demographic to make up for the losses, you need a church, a government, or a charitable organization to make up for the difference between what it costs to care for patients and what Medicaid, especially, will pay.

                1. That 80% of the hospitals in this country are non-profit is an important observation. Why they choose to be non-profits tells us what’s wrong with the system, and it shouldn’t surprise any libertarians to learn that the problem is government instead of markets setting prices and socialist redistribution schemes that only serve to keep the shelves of the grocery store bare and items on the menu that are far exceed the costs that average people can afford to pay on their own.

                2. “The question to ask is, “Why do 80% of America’s hospitals choose to be non-profit?””

                  Because in the past, most hospitals were run by religious organizations, which were themselves non-profit.

          2. Incidentally, non-profit hospitals have a higher average profit margin than for-profit hospitals.
            Last I looked, 12%-8%
            (And medical insurance industry average profit margin was like 4%)

            So, to qualify as non-profit, a hospital must provide like 25% of its services pro bono. The trick is, things like throwing fundraisers and hosting conferences counts as pro bono toward that 25%.
            Clever little scheme.

            I looked this up like 2-3 years ago, so it might have changed

            1. “So, to qualify as non-profit, a hospital must provide like 25% of its services pro bono. The trick is, things like throwing fundraisers and hosting conferences counts as pro bono toward that 25%.
              Clever little scheme.”

              In SF, Kaiser sponsors an ‘eat local’ farmer’s market at their largest campus, meaning the patients can’t find parking.
              Natch, this is touted as ‘healthier for the humans and the environment’; I’ve never seen one shred of evidence for either claim.

              1. Evidence is oppression

        4. There’s historical precedent for socialists, instead of claiming outright ownership of an industry, leaving it in nominal hands while subjecting it to such detailed regulation that it effectively becomes government property.

          The term is “fascism”, that’s how the National Socialists in Germany did it.

  3. I’m sure there’s some brinkmanship going on here, much like the Republicans passing bills to repeal ObamaCare–right up until the moment they had control of both chambers in Congress. When they could really do it, suddenly they got cold feet.

    I said, “I’m sure”, but maybe it’s more like I want to believe that’s the case. I hope we never find out. I haven’t voted for a Republican since I voted for George W. Bush* against Al Gore, and I ended up regretting voting for him, but if the Democratic party is all about nationalizing healthcare completely and the Green New Deal, then this libertarian is moving towards the Republican party.

    If the Democrats are all about a kinder, gentler authoritarian socialism now, how can an unapologetic libertarian capitalist not get dragged into supporting the Republican party?

    *He was going to privatize social security and move from a welfare model to private charity!

    1. “”He was going to privatize social security and move from a welfare model to private charity!””

      Then he got the most minor of push back on that so he completely caved. Didn’t even give it enough time for a conversation. Absolutely spineless.

      1. I saw Reagan end the oil crisis with a stroke of his pen.

        I saw the USSR come crashing to the ground.

        I thought anything was possible.

        1. W. always seemed like a bit of a doofus, but he did have some good talking points in 2000. He’d already made an ass of himself by the time I could vote, so I’ve only voted L my whole life… But will vote for Trump in 2020 unless he really does something super stupid.

          1. “will vote for Trump in 2020 unless he really does something super stupid.”

            So, have you already picked out who you’ll be voting for?

            1. LOLz, good one! Because voting for a LUNATIC like Sanders or whoever would be a WAY better idea, right? Trump’s personality is dodgy, but his policies have been decent enough. He’s no Ron Paul, but he’s better than anything else on offer by a country mile.

    2. The basic difference here is that the Republicans lie about being conservative, they aren’t really, but they claim to be.

      While the Democrats lie about being communists: They are really, but they claim NOT to be.

      So you get that bait and switch from both parties, but the Republicans do less than they advertised, while the Democrats do MORE.

      1. Shorter version: Both parties pretend to be further to the Right than they are.

        1. Shorter but also more accurate versions:

          Both parties will pretend to be whatever is in their interests to pretend to be at that exact moment for that exact group.

          The Democrats want to take away YOUR money, and give it to people who are poorer than you are.
          The Republicans want to take away YOUR money, and give it to people who are richer than you are.

          1. Right, and it’s in the interests of both parties to pretend to be further to the Right than they are, because the American population is to the right of our political class.

            The Democrats want to take away everybody’s money, and give it to the government, which is to say, themselves. Look at Bernie, a socialist with multiple mansions, who flies private jets.

            Giving it to the poor is just a pretext for taking it from everybody else.

            I’ve observed that when people on the left start talking about Republicans taking my money and giving it to people who are richer than me, they usually mean by that not ripping the wealthy off as much as they’d like.

            1. ” because the American population is to the right of our political class.”

              If you’re delusional, and/or interact with a limited subset of Americans.

              “The Democrats want to take away everybody’s money, and give it to the government, which is to say, themselves. Look at Bernie”

              Bernie isn’t a Democrat. Don’t let this fact spoil your narrative.

              “I’ve observed that when people on the left start talking about Republicans taking my money and giving it to people[…]”

              When D’s run the government, the government gets bigger. Whereas when the R’s run the government, the government gets bigger. The only thing that’s different is who is getting the money.

              1. ALL of this chatter is BS — The GOP platform is about “limited government”. Granite there are far too many RINO’S in the mix (they end up being further left than claimed) but make no mistake there is NO SUCH thing as “crony capitalism” it’s ALL “crony socialism”. Without socialism the government was never granted the power to be “crony”.

  4. Medicare for All is designed to give politicians and federal bureaucrats dramatically increased control over the nation’s health care system.

    *And* over your medical records. Don’t forget that part.

    1. Your medical records? Try their medical records about you.

      1. “I see that your mandatory blood test came back positive for drugs, sorry sir but hospital police are on their way to arrest you.”

        It’s all about the control, but they could see that scenario as a way to limit usage since `free` just means there’s less of it to go around.

  5. When I read or hear Suderman’s Trump takes, he usually has fire in his belly. Like the wall, guy can’t help but get fired up. Why not? 40 billion is a lot of money.

    When he talks about healthcare, he calls it out, but in a very calm way. Which is interesting, because it will cost 1000 times more than a wall, especially when you add in all the healthcare we hand out to illegal immigrants. Seems like something worth getting fired up about.

    Why the difference?

    1. *** scratches head ***

      Because his stroke will be covered by Medicare For All only when caused by appropriate outrages?

    2. Could it be a matter of your own perception?

      1. Listen to one podcast episode and you’ll know what I’m talking about. Loses his shit about anything Trump does

    3. Because he’s a stupid prog at heart like all the other writers at Reason? At best they’re all just leftists who kind of understand economics.

      1. So, the reason you’re here is… because you read all the articles by people you don’t like or respect?

        1. As a generic news source, Reason is LESS awful than reading CNN or Fox News or WaPo or whatever.

          They cover most of the big stories. They EVEN sometimes cover cool stories of interest to actual libertarians. Even on the generic coverage front, they’re usually slightly more fair/balanced than reading MSM pieces. But they’re still pretty awful.

          One eyed man is king in the land of the blind and all that. I read a lot of other alternative media for stuff that Reason doesn’t cover. It works well enough for me.

  6. The rest of the civilized world can manage to provide affordable healthcare for their people. Capitalism has failed spectacularly in the US in this regard. Either you care about the people of a country or you care about how much money you can suck out of them when they are sick and vulnerable. We all know which of these two possibilities Libertarians favor.

    1. TDHawkes|2.28.19 @ 5:01PM|#
      “The rest of the civilized world can manage to provide affordable healthcare for their people. Capitalism has failed spectacularly in the US in this regard. Either you care about the people of a country or you care about how much money you can suck out of them when they are sick and vulnerable. We all know which of these two possibilities Libertarians favor.”

      These threads always attract fucking lefty ignoramuses.

      1. hey look – you failed to make any sort of substantive rejoinder. Libertarianism’s biggest problem is with you conservative types who have an irrational hatred of the left, which is ironic, considering libertarianism was originally a leftist movement.

        1. “hey look – you failed to make any sort of substantive rejoinder. Libertarianism’s biggest problem is with you conservative types who have an irrational hatred of the left, which is ironic, considering libertarianism was originally a leftist movement.”

          Fuck off Hihn: You and the other ignoramus got exactly what you are due. Any more and I’d have to turn it into single syllables, you scumbag.

          1. so angry. but then again, if my uncle touched me there all the time as a kid, i would be bitter too. there is help #metoo4sevo

        2. There is no such thing as an “irrational hatred of the left,” ALL hatred of the left is rational! The left has mass murdered more people in the last 100 years than all others combined, several times over.

          1. Death to the left-handed! Death, he says! There’s a REASON that left-handed people care called “sinister”… it’s literally the definition of the word!

    2. When faced with an either/or choice framed in this manner I always choose to say: “Fuck off, slaver”

    3. The “rest of the civilized world” pays taxes at a rate that would make people like choke. The rest of the civilized world also pays stiff national sales taxes. The rest of the civilized world, at least most of it, cannot tolerate a permanent welfare class. And the rest of the civilized world leans to culturally homogeneous, some places more or less than others, but all were more that way when their systems were implemented.

      1. nope: Canada. a nation of immigrants ancestry. One province basically bans the main language of all the other provinces (tangent: we should invade quebec, take the maple syrup, and enslave the francophones), and even today more than 1/5 people is an immigrant. Canada’s taxes are also modest compared to, say, Norway or Switzerland. They have universal health care and it works despite that. So, you’re fcking wrong, Karen.

        1. Bullshit! As stated, Canada was pretty homogenous UNTIL the last couple decades. Yeah, the had some random Europeans who mixed in with little problem. But were mostly British and French even then.

          Canadas taxes are not modest compared to the US, for many people. There are some decent things about how they do things in Canada, but I wouldn’t trade our system for their for the world.

          1. ” Canada was pretty homogenous UNTIL the last couple decades. Yeah, the had some random Europeans who mixed in with little problem. But were mostly British and French even then.”

            You’ve never been to Vancouver.

            1. You’ve never been to Vancouver.

              Vancouver didn’t start getting an influx of Asian residents until around the mid-1980s, either.

              1. This will come as a surprise to the people who were in Vancouver before the mid 1980’s.

                1. No where near the influx you have now. There was a “noticeable” Asian population before the handover of Hong Kong, then you had a boom, and now you have illegal Asian as well as legal Asian immigration that have made for “Hongcouver”

            2. LOLz

              I live in Washington moron, I’ve been to BC a ton of times.

              History didn’t START a couple decades ago.

              Canada was almost entirely British and French until a few decades ago.

              Just as it is completely proper to say America was a WHITE country, it is proper to say that about Canada too. Blacks, and Indians were the only minorities of ANY note in the USA until 1965 immigration act kicked in. Everybody else was such a small percentage of the population it didn’t even factor in. Canada was FAR whiter than the USA too, I might add.

              You are the one who doesn’t know history apparently.

        2. “Works”, you’ve clearly never seen under the curtain of Canadian healthcare, it “works” but man is it a massive mess.

    4. Civilized world? That’s a stretch. Free world? Definitely not.

      It’s affordable healthcare if you ignore the exorbitant taxes. It’s not effective, since you may die in the months spent waiting before you see a doctor.

    5. Why the fuck stop with health care? That same evil capitalism has been sucking money from people when they are hungry, cold or hot, need to get somewhere else, or just crave some sexual release.

      The US must be a terrible place given that the vast majority of people get these needs more than met in the private market, while a dysfunctional minority needs goverenment provision. We all know which option retards like you prefer.

      1. Why the fuck stop with health care? That same evil capitalism has been sucking money from people when they are hungry, cold or hot, need to get somewhere else, or just crave some sexual release.

        Indeed, one might argue that meeting *these* needs is even more of a “basic human right” than health care.

        And we haven’t yet surfaced the *true* fundamentals like relief of boredom and freedom from being offended.

        1. Medical care is an important right, but even more importently, don’t we all have a right to basic food provided under government supervision, planning, and production?

          Obesity problem solved!

          1. “Medical care is an important right”

            Medical care isn’t a right.

            But you still have the problem that some people who need care to survive can’t pay for it. Do you choose to resolve this problem by forcing other people to pay for it, or by letting people die because they can’t afford the life-saving care they need?

            Then, once you’ve gotten past that, you have the same question only for suffering and surviving instead of dying. Do you choose to force people to pay for it, or to let the suffering continue to suffer?

            You can make whichever choice you like, but you own your choice.

      2. They don’t intend to stop with health care. They just figure that, once they can cut off your health care with a phone call, you’ll be in a worse position to fight back when they come for everything else.

    6. I get whatever health care I want. How is that a failure?

      1. Because you don’t get the healthcare he wants.

      2. People do not often want health care.

        They sometimes need medical care.

        When they need medical care there is no shopping.

        Not a box of cornflakes.

    7. It’s not affordable and it’s not consistent. Do some research.

      Healthcare has never been a free-market commodity?it has always been gov’t regulated in the U.S.?so it’s flat out wrong to say that capitalism has failed spectacularly in this regard.

      That is the ONLY thing, in fact, that has never been tried: Full deregulation of the medical industry, including the insurance companies. You want to shift the paradigm, well there you go.

      And the first principle of libertarianism is not money money money. It’s self-agency.

  7. “One could argue about whether the GOP’s attack was the most significant lie of 2010, but it was, at minimum, an exaggeration. Although the Affordable Care Act increased regulation on individual health insurance to the point where it became something resembling a public utility, it left the bulk of the market for private health coverage intact, and even provided subsidies so that people could obtain (heavily regulated) private coverage. Today, an estimated 177 million Americans have private coverage.”

    “Fascism isn’t real socialism!”

    1. Obamacare wasn’t either fascism OR socialism.

      If you didn’t like it, self-insure and pay the tax.

  8. do the “Medicare for all” people understand how Medicare actually works? What they’re really advocating is the VA for all. Medicare turns down a large number of claims, almost everyone on it has a supplemental policy of some type, and it’s not ‘free.’

    1. And the payment per unit of service sucks. MC is at best a break even for providers. You aren’t going to attract the best and the brightest with the kind of salary structure MC-dependent institutions can offer

      1. Actually, many (most?) providers who accept lower Medicare rates make ends meet by charging other payers more. What happens when there are no other payers?

        1. They have to fire the billing departments and medical billing gets reformed as a lot more simple and direct.

          So win-win, no?

      2. Every hospital is Medicare dependant.

        1. and Medicare sets the tone for how everything else is billed.

          1. Every hospital takes responsibilty and is liable for every patient who gets in the door of the emergency department. Payment or not happens after the fact.

            True or false.

            Hill-Burton aside. If you do not accept Medicare you can not exist in general practice.

            There are institutions and practices who do not accept Medicare. By hospital I am excluding those without an emergency department, basic surgery, intensive care, and related services.

            A medical office is not expected to provide that level of coverage. If you want JCAHO as a hospital just try that.

            1. “Hill-Burton aside. If you do not accept Medicare you can not exist in general practice.”

              Actually, you can. There’s a formal process for opting out of the system, and a whole ecosystem of doctors who have done so. What basically doesn’t exist is the “non-participating” category, because Medicare rules still apply to those doctors if a patient happens to be on it.

              The problem is, Medicare isn’t opt in, it’s opt out. The doctor is controlled by the system unless they jump through the hoops to get out, which can take a while.

              1. A fairly substantial number of doctors make a quite comfortable living by conducting practices which do not include any Medicare patients. The don’t have to sing to the tune of any insurers, including but not limited to Medicare, because they run a cash business. Cosmetic surgeons. Michael Jackson’s Propofol doctor. etc.

                1. And they’re more economical, too, because they can spend their time actually being doctors, without the enormous regulatory overhead. That, I understand, is the main attraction for doctors: They get to spend their time being doctors instead of bureaucrats.

                2. Yes but to have a hospital based practice you need to accept Medicare.

                  You can see outpatients without accepting any insurance at all, few even attempt it but can be done.

                  Say you are a general surgeon at St. Elswhere. You have to take call, if you know what that is. It is in your agreement with the hospital. You cannot do that without Medicare and other provider IDs. The hospital will not grant you privileges without it.

                  A doctors office and a hospital are not the same thing.

      3. Ha. Ha. Yup, no bright docs at Mass General.

        1. totally what he said

        2. “Ha. Ha. Yup, no bright docs at Mass General.”

          Ha. Ha. No intelligent comments from you.

    2. give it up you conservative, nut job, fcking rtrds. Literally every country in western Europe has socialized medicine, similar health outcomes to the US, and spends way less money. The evidence is not on your side. Even Hayek supported universal, government provided healthcare – see the road to serfdom.

      1. Grapefruit Juice + cardboard box = hard drive!!!

      2. Every one of those countries has an income tax system that hits ALL levels hard.
        Every one of those countries has a VAT in the 20-25% range.
        Every one has far higher gas taxes than we do.
        Every one has a far more homogeneous population than we do.

        If you want the US to be Finland or Denmark, then 1) explain how you’ll impose their tax systems here and 2) how you’ll make the US look like either.

        1. yeah, and? they somehow are still really nice places to live with high standards of living.

          “Every one of those countries has an income tax system that hits ALL levels hard.
          Every one of those countries has a VAT in the 20-25% range.
          Every one has far higher gas taxes than we do.
          Every one has a far more homogeneous population than we do.” – [multiple citations missing]

          again, even Friedrich freaking Hayek advocated government run healthcare in the freaking Road to Serfdom.

          “If you want the US to be Finland or Denmark, then 1) explain how you’ll impose their tax systems here and 2) how you’ll make the US look like either.” – 1.) vote for leaders who will impose said tax systemes, and 2.) why would we want to look like finland? what does that even mean? Like, should our people should look more Finnish? We should all have saunas and nordic ski in our free time?

          You seem to think that universal healthcare won’t work in non homogeneous countries. While it’s unclear what you mean by homogeneity, i think you mean ethnicity.

          As such, i present to you, Canada. A nation also made up of immigrants, where an entire province speaks french and despises english speakers. A nation that was 20% immigrants 10 years ago, and will be close to 30% in the near future. Despite this, universal health care is working there from what i’m told, and they like it.

          1. Try again retard!

            With the except of a couple small countries like Norway (the Saudi Arabia of Europe!), their average income both PRE and ESPECIALLY POST tax are shit compared to in America.

            Their houses are about half the size. They either can’t afford cars, or have to drive tiny shit boxes out of pure necessity. They cannot afford nearly as much of ANYTHING… Because their government takes it all, and makes their economies smaller and weaker for it.

            Did you know your average white American makes about double (or more!) what the average income is in most of Europe? Poor minority groups drag down the US average so it looks like we ONLY make about 50% more.

            SO if you want to convince Americans we should cut our TAKE HOME income by something like 1/2 to 2/3rds, so we can have “free” healthcare… Have at it buddy. Americans have far better lives than Europeans. A large part of that is because of our free-er market system and lower taxes.

            1. “Poor minority groups drag down the US average so it looks like we ONLY make about 50% more.”

              Imagine how the statistics would look if we took in refugees in comparable ratios to, say, France or Germany.

              1. Huh?

                You do know ALL those countries in Europe are still whiter than America has EVER been since the founding of the country right?

                So if you’re trying to imply their very troublesome, but still statistically small, influx of shitty refugees explains away our being 40%+ minority in the USA, the math just don’t jive.

                White and Asian Americans make about twice as much money as anybody in a major European nation. We have 40% of people who fall into “poor” ethnic groups in the USA. IIRC the UK is the least white country in Asia at around 85-88% white or so (too lazy to look up), but many of their immigrants ARE successful Indians and other Asians.

                Their socialism drags them down relative to us.

          2. Have you ever lived in Canada? I have a work permit, and it wasn’t easy to get. Canada has really stringent requirements to immigrate.

            You have to show that you will not be a drain on the economy. I had to show I had employment, submit to a full background check, provide info on my dependents, siblings and in-laws as well as their dependents so they know that if I bring in any family that they won’t be a drain either.

            Sure, the Greater Toronto Area is incredibly diverse ethnically but culturally it’s tech-savvy college grads working in tech who form a lot of the center of gravity. A pretty healthy bunch from what I saw. They still bitched about access to care and high taxes. And they didn’t work all that hard.

      3. This is one of the hihn-crowd’s hinhsane socks.
        Fuck off, Hihn.

        1. idk who hihn is, but it’s clear you have the hots for him like whoah. don’t try to hide it.

      4. And why do you think the US government would spend less money? They already can’t manage Medicare as it is now, and the VA is even worse. Our government has shown time and again they are incapable of managing healthcare, so giving them more people’s healthcare to manage doesn’t seem like a good idea at all

        “Medicare for All” is hilarious because I know of literally no one who thinks Medicare is a good system, the only people on it are the people who have no other choice, and even most of them have to supplement it with a private plan anyway

        1. “I know of literally no one who thinks Medicare is a good system”

          It gets higher reviews from its “customers” than any private insurance system.

          ” the only people on it are the people who have no other choice”

          Are you confusing Medicaid with Medicare, by any chance? “The only people on Medicare” are everybody old enough to qualify. Medicaid, on the other hand, is for younger people who can’t obtain private insurance.

  9. One could argue about whether the GOP’s attack was the most significant lie of 2010,

    No, idiot, that would be “if you like your doctor you can keep your doctor”.

    1. Different year.

  10. Going from a ruinously expensive system to a worse system with no stops in between. Good luck. And why not just pass and enact the GND while you are at it?

  11. It’s not a takeover of medical care. It’s a takeover of medical insurance. And it presumably allows for a secondary private insurance market for things not covered by “Medicare for all”.

    The fact that the government pays for all the highways is not a “takeover of the automotive industry”, either.

    1. Builds and “maintains” highways. I pay for it.

      1. Well, then Joe Contractor builds and maintains them, and you pay for it.

    2. “The fact that the government pays for all the highways is not a “takeover of the automotive industry”, either.”

      Pretty sure this is Hihn. If not, it’s some idiot equally as imbecilic.
      Your ‘equivalence’ pretty much covers apples, orange and octopi.

      1. make a substantive argument, or don’t talk. comments such as the one above are both really dumb, and not effective at changing anyone’s mind.

        1. Now I’m convinced it’s Hihn.

          1. It is.
            Fuck off, Hihn.

            1. no, but i like watching adult videos. you guys are just angry conservatives that make terrible arguments. Like many conservatives who mistake themselves for libertarians, you probably have a myopic reading list, have preconceived conclusions such that any evidence to the contrary is necessarily rejected (like people in flat earth societies), and surprisingly, a lot of you guys are really bad at basic econ, which usually is a strength for libertarians. At least, people buzzing around Cato and Mises have a stronger grasp than you rtrds.

              1. Fuck off, Hihn.

                1. the earth is round, trashley. i’m sorry, but it is.

                  1. Fuck off, Hihn.

      2. He displays some of the Hihn traits, but until he goes berserk I’m going to give him the benefit of the doubt.

        1. Even worse if there’s another person that stupid… I prefer to think there’s only ONE Hihn level retard in the world, Hihn Himself!

      3. “Pretty sure this is Hihn”

        Because you see him everywhere. Isn’t that him, hiding under your desk?

        1. Fuck off, Hihn

          1. Oh, no. He’s INSIDE THE COMPUTER?

            Better step back, and unplug it at the wall.

      4. “If not, it’s some idiot equally as imbecilic.”

        I’ll concede that your knowledge of imbecilic idiots is second to none, but, based on how accurate the first part of that comment was, why should anyone take the second half seriously, either?

        1. who is this Hihn person? It would be more insulting to be called Hihn if anyone else knew who hihn was.

          1. Fuck off, Hihn.

          2. Lots of people know who Hihn is Hihn. HIHN IS LEGEND!

            Just not in a good way.

            1. ” HIHN IS LEGEND!”

              He also seems to be anyone who disagrees with this “Sevo” person.

    3. He who pays the piper calls the tune. It’s not an old principle, why ignore it?

      And, why can’t you buy station wagons anymore? Because, yeah, there basically was a “takeover of the automotive industry”, they get fined for selling cars the government doesn’t approve of.

      1. “He who pays the piper calls the tune. It’s not an old principle, why ignore it?”

        Because it denies agency to the piper?

        “And, why can’t you buy station wagons anymore?”

        Well, *I* can’t for the same reason as always… I don’t want a station wagon. For you, I’m torn between guessing that it’s because you’re broke, or because the old folks home you live in keeps taking the keys. Give me a hint.

        ” there basically was a “takeover of the automotive industry”, they get fined for selling cars the government doesn’t approve of.”

        Oh, we’re just making shit up, now? Or is that your highly-distorted view of “cars have to have emissions control systems now”? Or what the fuck are you babbling about?

        1. There you go, you do know why they can’t sell station wagons: Because they get fined for each one they sell.

          The excuse is “pollution”, but station wagons got replaced by SUVs that pollute more, so that excuse is kind of hollow.

          But, the bottom line is, they’re in a business that can’t sell what the customer wants, just what the government will give them permission to sell. And more and more of the economy is running on that basis.

          That’s why the economy had been slowing down, why we were suffering under “the new normal”, because the weight of all that regulation was killing economic growth. That’s why the internet became such a big thing, because it was one area of the economy that was still free.

          1. “There you go, you do know why they can’t sell station wagons”

            The thrust of my statement was that “They DO sell station wagons”. You didn’t bother to incorporate what I actually said into your response to what I said. This is because you want to tell your fantasy, and your fantasy doesn’t need any confirmation from anyone else.

    4. The gov’t doesn’t build highways. They collect taxes and distribute them to private industry, which builds the highways.

      Stop conflating socialism with the government acting as a middle man to achieve basic infrastructure because it’s easier than us all individually paying private industry. Which, BTW, is not something I believe, but that’s the argument of even the most limited government advocates?that there are some things that gov’t can do that private industry can’t. Police, a judiciary, military defense.

      That’s not socialism. That’s just the government protecting our rights/civil liberties.

      And health care is not a right.

      1. And, as far as I can tell, the government’s role in almost all building projects they are involved in, including roads, is to maintain a regulatory bureaucracy over the entire process from pre-planning, to design, to construction.

        The end result of which is that the project takes about 3 times longer to complete and costs twice as much as it should have.

        Outside consultants must perform studies. Those studies are reviewed by government bureaucrats and additional consultants. Recommendations are made, and the studies must be completed again.

        Designs are submitted by design professionals. Those designs are reviewed by government bureaucrats and more additional consultants. Recommendations are made, and the designs must be revised.

        Cost estimates are completed. Those estimates are reviewed by government bureaucrats and outside auditors and construction consultants. ‘Value engineering’ suggestions are made, and the designs must be revised again, and the cost estimates as well. New studies may be required to take into account the new designs. Those studies are then reviewed once again by the state and their outside consultants, which usually result in additional recommendations . . .

  12. The Democrats would turn the health care system into the DMV, with blood and bandages.

    1. So like the DMV when they have long lines.

      1. First you have to fill out the 567218FYTW form and then wait 6-8 weeks for your bandages to arrive by mail

  13. I am not yet sold on Medicare for all. How about we do a trial run just with the politicians who are in favor of it. They go on Medicare for, say, 5 years. If they are still enthusiastic after the trial is up, then I will consider it.

    1. lap83, politicians have awarded themselves super-uber tippy-top insurance plans that nobody else can match. So that’s not a useful test.

      How’s this for an alternative: you go on the small group plan offered to its faculty by the small private school of your choice. Then after one year of that, you try Medicare. I’ve already been through that one. I can tell you its advantange Medicare, all the way. It’s not close. That’s why it only takes one year to find out.

  14. Hayek supported universal healthcare. Every country in western Europe has it, has healthcare outcomes at least as good as the US or better, and they all spend less. The empirical evidence is clear. Their system works better than ours because it produces the same or better results with less resources. It’s that simple.

    Government has socialized the roads, national defense, retirement, our monetary system, schools, etc. Unless your a pure, white as snow anarcho cap, you believe in some degree of socialism. Acting like adding healthcare to the above list would be tantamount to ushering in soviet style communism is really disingenuous or really dumb. Libertarians don’t need either of those perceptions.

    1. Medical care should be limited to treatment modalities available in 1789.

      Coffee mug – peanut butter crackers = Tylenol!!

      /Full Hihn

      1. hi, trashley.

        1. Fuck off, Hihn.

          1. no. i don’t want to, trashley. No means no, that is, unless uncle billy bob takes you behind the barn again.

            1. Fuck off, Hihn

    2. You suppose those “healthcare outcomes” have anything, anything at all, to do with lifestyle? Never mind that Europeans walk more, usually by necessity living in far more densely populated areas where cars are often a hindrance. Never mind that, on average, they’re neither as fat or as stressed as the typical American. Never mind their vacation policies vs those here.

      Their system works, to the extent that it works, because it relies most if not all of the population to kick in; it works because people live healthier than many Americans who believe decades of bad habits are for doctors to cure; and it works by necessarily saying ‘no’ to things Americans believe can only be answered with ‘yes.’

      1. do you realize that when they do statistical studies that they control for all sorts of variables. Did you never take a class on regression analysis or econometrics?

        Europeans walk more, but they also drink and smoke cigarettes more. etc etc. these are all relevant variables to control for in a statistical model. So when we say that europeans have about the same outcomes, we say that controlling for said variables.

        The system in Europe works because socialism is often better than a mixed solution of both capitalism and socialism. Free market health care is not today, nor will ever be an option on the table. The choice is between smarter socialism or dumber socialism.

        1. “The system in Europe works because socialism is often better than a mixed solution of both capitalism and socialism.”
          It never is.
          Fuck off Hihn.

          1. Trashley: thought experiment for you. If fannie mae and freddie mac hadn’t been backed by the government, ceteris paribus, they would have been way more risk averse because they would know, that, while their profits would still be private, so too would be their losses. If fannie mae and freddie mac had been completely government run, they would not have had profit incentives to take large risks, and thus wouldn’t have had huge losses in the last crash.

            But because they were both private and public, they had the worst of both: an incentive to take wild risks knowing that if they bet wrong, they could socialize the losses. In other words, it would have been bette for them to be either completely private, or completely government run. It was precisely because they were neither that caused the excessive risk taking and losses that the public had to cover as tax payers.

            1. Point us at the success stories of socialism, if you can.

              1. Western Europe – largely socially democratic. Most of their countries have large welfare states, universal healthcare and education through college etc. Universal mass transportation etc. Last time i visited, i noticed they all drove nice cars, had high standards of living, and seemed to be having a good time.

                the United States: We socialize national defense – seem to be doing well there, in fact, without the pentagon, we might not have the internet as we know it today. We have socialized our monetary system, and somehow are the world reserve currency. Our socialized freeway system was once the envy of the world. Our socialized space program landed a man on the moon, a feat that has not been matched by anyone else, private or public.

                If you think that socialism only comes in the form of soviet style communism where they abolish the price system and the state literally owns all factors of production, you are really fcking dumb.

                1. Last time i visited, i noticed they all drove nice cars, had high standards of living, and seemed to be having a good time.

                  You’re dreaming. They do not all have nice cars. Hell, half of them on the continent don’t own a car. Pretty much the people who can afford to own and operate cars are the people who can afford nice(ish) cars.

                  List of countries by vehicles per capita

                  Here we see that there are way fewer cars per capita in Europe with the exception of stupid rich places like Monaco and Liechtenstein. Or Iceland where there’s a bunch of wide open space. The highest number in a largish European country is Italy and it’s 69.5% vs 91.0% in the US.

                  And wrt to the standard of living, just about everything tends to be more expensive and housing is way more expensive and smaller. I don’t know if I’d particularly enjoy that standard of living.

                  It appears that you view life in Europe through rose tinted glasses.

                  1. oh that’s right, many of them don’t need a car because of how convenient and cheap the mass transit is. my mistake.

                    “And wrt to the standard of living, just about everything tends to be more expensive and housing is way more expensive and smaller.” – [citation missing]

                    Are you really using cars owned per capita as a proxy for standard of living? Really? I’m giggling. Because, i can think of plenty of white trash losers who apparently own way more cars than i do, judging by their front lawns and driveways.

            2. If fannie mae and freddie mac had been completely government run, they would not have had profit incentives to take large risks

              They would have never invested in Solyndra or Cash for Clunkers or the stimulus package etc. etc. if they were pure government.

              1. hey – apparently you don’t know what Fannie and Freddie are.

                1. hey – apparently you missed my point

                  I did not miss yours, which was to say that entities with no profit motive (governments) don’t make risky “investments”. I guess that’s actually true since there’s not really any risk to them at all. It’s not their money they’re throwing away. But they do tend to throw money away on crap that is just a complete waste. The profit/loss mechanism tends to keep that sort of thing in check within private enterprise. There is no such incentive structure with government. Waste can continue unabated as long as politics will allow it. So you’ve got it completely backward.

                  1. no, i got it. it was just dumb. a stimulus package isn’t an investment. neither is cash for clunkers. At least, not in the same sense as buying mortgages.

                    ” But they do tend to throw money away on crap that is just a complete waste. ” – you mean, you identified a few anecdotes of this, but don’t have any aggregate data to compare. Other anecdotes exist, such as, wall collective investing in sub prime mortgages without really looking at the underwriting – 40 year loans, zero downpyaments, ficos below 600, etc. Then there was enron. The dot com bubble. the S and L crisis etc. Without quantifiable aggregate data, all you have is anecdotes.

                    “There is no such incentive structure with government. ” – Wrong. There’s an entire field of economics that studies the incentives that public actors face.. It’s called public choice economics. it’s founder won the nobel prize. teaches at GMU still, i believe. James Buchanan. Actually, i was wrong, he died in 2013, but still is the father of public choice theory.

                    “Waste can continue unabated as long as politics will allow it.” – waste can continue in the private sector unabated as long as the market will allow it. See, i can make vague, practically meaningless assertions too! Do you even have an objective definition of waste. For example, i would consider buying a nickelback ticket a complete waste of money and possibly a crime against humanity, yet, nickelback still fills up concert venues.

                    1. “A stimulus package isn’t an investment”

                      Ho
                      ly
                      Shit,
                      You’re as dumb as chemjeff.

                    2. is a stimulus package the purchase of an asset to be saved over a period of time with the intent of selling it later for a higher price or collecting rent on said asset? It’s not? what? i guess it’s not an investment in the same sense as buying mortgage backed securities.

                      i’m not 100% sure, but i’m gonna go ahead and guess that you are a degree-less, white trash conservative who annoys his family at thanksgiving, and is slightly Aspergery.

                    3. Fuck off, Hihn

                    4. Yep – as stupid as chemjeff.
                      Resorting to progressive tropes is just sad – a sign of deep seeded insecurity.
                      Please, explain the entire concept of “stimulus” that excludes as a purpose growing value over time.
                      If you say it’s just straight up theft to be given to cronies, I can agree on that. But the same people who sold the stimulus as something other than that are the same people selling single payer healthcare. Were they lying then or are they lying now?

                      I’d suggest that you invest in some bodyguards, if you can afford them. Otherwise, I see your throat being slit sooner rather than later.

                    5. If Fannie and Freddie were private, they never would have made those bad investments… But if they were fully public, they STILL would have, because it was POLITICIANS forcing them to issue loans to unqualified poor people and minorities who shouldn’t have been getting loans, because they wanted to increase home ownership rates for blow it cases… That would have happened just the same if it had been 100% government run.

                    6. ” I see your throat being slit sooner rather than later.”

                      Keep your sexual fantasies to yourself, next time.

        2. So when we say that europeans have about the same outcomes, we say that controlling for said variables.
          No, you’re not. You’re putting out what amounts to propaganda that treats a 90% white nation just like this one. No place does better than the US in terms of cancer survival rates.

          The system in Europe works because socialism is often better than a mixed solution of both capitalism and socialism.
          It works, to the extent it works, because:
          –people are taxed at far higher rates than Americans would tolerate
          –it necessarily says ‘no’ to certain things, especially for older people
          –it’s geared toward cultures that are far more monolithic than us
          –it does not tolerate a massive welfare dependency class

          1. [citations missing]

            “You’re putting out what amounts to propaganda that treats a 90%…” – christ on a bike. how do you expect to be taken seriously with comments like that

            “It works, to the extent it works, because:
            –people are taxed at far higher rates than Americans would tolerate – [citation missing]

            “-it necessarily says ‘no’ to certain things, especially for older people” – and? this isn’t possible in america somehow?

            “it’s geared toward cultures that are far more monolithic than us” – [citation missing] I believe britain is pretty diverse compared to say, Norway. And again, age and race etc are all variables that can be factored into a statistical model.

            I would suggest you take a primer on Econometrics. You wouldn’t be saying all this nonsense if you understood how regression modeling works.

            1. [citations missing]
              You wouldn’t understand them; they have too many syllables.
              Fuck off, Hihn.

              1. whoah. white trash tries to make a zing.

                1. Fuck off, Hihn

    3. “Government has socialized the roads, national defense, retirement, our monetary system, schools, etc. Unless your a pure, white as snow anarcho cap, you believe in some degree of socialism. Acting like adding healthcare to the above list would be tantamount to ushering in soviet style communism is really disingenuous or really dumb. Libertarians don’t need either of those perceptions.”

      This is what passes for logic among the hihnsane:
      ‘We’ve decided to tolerate gov’t disasters in some cases since it’s real hard to run an army otherwise. Therefore, we should turn over EVERYTHING to the state!!!!’
      Fuck off, Hihn.

      1. Cute strawman, cletus. I thought we were talking about the narrow provision of healthcare goods and services, not the entire economy. You conservatives and your stupid fallacies.
        I pointed out that you and I must accept socialism to some degree unless you’re an anarcho capitalist. Or do you think national defense should be privatized? How bout the freeway system? And adjudicative services – do you want that privatized – as in, do you want multiple competing systems of law/courts? Most libertarians are not Rothbardians, so most accept some degree of a centralized state that socializes the provision of certain goods/services.

        As such, when talking about universal healthcare, it’s not a question of capitalism vs socialism, because a.) what i mentioned above, and b.) health care in the US has not been a free market affair since pre WWII at the latest. We’ve regulated, subsidized, nationalized etc the shit out of it already. Pre Obamacare it was not even close to a free market. So really the question is, given that we have and will continue to have socialized medicine, which socialization schemes are likely to work out the best? The status quo? Single payer? The German model?

        When you act like people who want universal healthcare want to government to take over things to cause disaster, the only thing you do is guarantee that anyone who isn’t part of your little circle jerk here will relegate you to the margin of serious conversation. Please stop.

        1. Fuck off, Hihn.

          1. hi, Trashley. I’m sorry about your childhood. It must be hard facing your uncle at family reunions.

            1. Fuck off, Hihn

            2. Shitlibs sure do have an incest fetish.

    4. Thing is there are lots of different ways to do “universal healthcare”. Technically, we have that now. It just costs way too much for mediocre results.

      And while nationalized healthcare is seen as a fix for this, it doesn’t address the underlying problems that make healthcare so much more expensive here. This is also basic Hayek- let markets work. Adopting a European model is an anathema to markets. Nationalizing the system we have now would be a recipe for abuse and graft. Even more than we have now.

      I’d even be willing to consider nationalized healthcare IF more was done to address the corruption within the current system and results were still unsatisfactory.

      But nationalized healthcare is jumping the gun. There has to be a better way to organize it than simply let’s do what Europe does.

    5. Government has socialized the roads, national defense, retirement, our monetary system, schools, etc. Unless your a pure, white as snow anarcho cap, you believe in some degree of socialism. Acting like adding healthcare to the above list would be tantamount to ushering in soviet style communism is really disingenuous or really dumb.

      The slippery slope fallacy works both ways. If I can’t argue against your incremental imposition of socialism because “This will start us down the road to hell”, then you can’t use the fact that we’re already on that path to argue for going further.

      That isn’t the light at the end of the tunnel. It’s the glow of the ovens.

  15. Seems like one recurring feature in these health insurance threads is comparison between on-the-job insurance at big corporate employers, and what you could expect otherwise. Problem with that is it’s a giant cherry pick of what is certainly the most subsidized part of the industry. Nothing else can match it, so it’s hardly the right standard of comparison.

    How many big-company insurance boosters have ever compared their rates and coverages to what people get offered in small business markets? How many big corporate workforces “look like America,” especially with regard to age distribution among the insured? From an insurer’s point of view there are so many advantages to insuring big corps that they profitably offer far more generous coverage than anyone else can get. Big corporate insurers can even rely on corporate human resources managers to weed out workers before they become actuarially too risky.

    Whatever insurance plan the nation adopts, it has to cover everyone, all the time, throughout every stage of life. Comparisons to plans which don’t begin to do that?like big corporate plans?are never useful. One political problem with fixing health insurance is going to be weaning the nation’s most privileged insurance consumers off their sense of personal entitlement to bargain insurance deals which everyone else is in fact subsidizing.

    1. “Whatever insurance plan the nation adopts, it has to cover everyone, all the time, throughout every stage of life.”

      Why do lefties assume any random assertion is equal to an argument?
      OK, here’s the reply: No, it doesn’t.

      1. so you criticized the op for arguing by assertion and then argued by assertion?

        1. Fuck off, Hihn.

          1. it almost seems like you don’t have any rational, substantive thing to say so you’ve regressed to acting like a child, but i must be mistaken. Someone like you, trashley, would never do such a thing!

            1. Fuck off, Hihn.

    2. One thing “medicare for all” would do is cut down on the wasted legal expense of fighting over who has to pay when someone is sick or injured. Yes, this means trouble for local broadcasters, who’ll have to find new advertisers now that the personal injury and medmal lawyers aren’t advertising, but for everyone else, that’s a net win.

      Of course, if you can afford it, you can always pay cash for your medical services… if you’re willing to pay cash on the barrel, you can get whatever you want, whether it be laser eye surgery or another script for opiates.

      1. So you’d have to pay cash on top of your VAT for far less, assuming you weren’t denied care due to your social credit score.

        1. tin foil is on sale at costco – better stock up for your hats!

          1. “tin foil is on sale at costco – better stock up for your hats!”

            You bought out the entire supply.
            Fuck off Hihn

            1. Get a room!

        2. You seem to have inserted rather a large number of things in your one sentence that I didn’t suggest in my whole paragraph.

    3. Stephen you have no clue. My last 3 employers were all less than 50 employees, one was a Canadian company. My wife worked for a rather large Canadian company with over 200 employees at just her facility. The rates her company paid as well as the benefits were not significantly different. Same carrier, same deductible, and less than $50/month difference.

      1. Greg F, to make sense of your comment, I have to assume you are classing the 200 employee company as a big corporate account, and comparing that to the smaller firms you mention. The big company, on the basis of that population, would not be a big corporate account of the sort I mentioned.

        I do have a clue?more than a clue. Our family used to get its insurance through a small group plan from my wife’s employer. For years, it was an okay deal. Then, over about a 5-year span, it escalated. We ended up with insurance which?taking the employer’s share into account, along with our payroll contribution, deductibles, co-pays, and “shared participation” (whatever that is), was costing us more than $23,000 a year before it reimbursed the first nickel. Naturally, the employer shopped around vigorously. They never found even one company that wanted the business, at any price. Compared to that, Medicare has been a tremendous relief?and we now get our care from among the highest ranked providers in the nation. No group restrictions.

        Anyone who is getting a better deal in the private market than we get from Medicare is getting a subsidy from regulations rigged to let the corporate insurance market cherry pick the insured population. And Medicare could be notably less costly than it is, if it were managed to lower costs, especially for pharmaceuticals.

  16. Between the green new deal, the government takeover of health care, and reparations, the democrat/progressive/socialist/communist party is looking at a huge defeat.

    1. yeah, people who want to combat global warming, ensure everyone has access to education and healthcare etc, are just liars who secretly want to usher in soviet style communism. You know their intent better than they do, because that’s a reasonable thing to think.

      1. You’re weak ass, sickly bitches who keep whining for other people to take care of them.

        1. yup, all of us west coasters with our expensive homes, net tax contributions to the federal government. If it wasn’t for the true patriots in the bible belt, how would we be able to make such a large net payment to the federal government to subsidize your flyover shitholes?

          1. Fuck off, Hihn

          2. Then why all the crying for you to be collectively taken care of?
            You’re impotent

      2. “yeah, people who want to combat global warming, ensure everyone has access to education and healthcare etc, are just liars who secretly want to usher in soviet style communism. You know their intent better than they do, because that’s a reasonable thing to think.”

        Pretty much, Hihn. Fuck off.

      3. Fight global warming with a massive transformative effort

        Collectively provided education and health services for people who otherwise could not afford high quality options

        A healthy economy

        If you would Pick any two I’d take you seriously.

        If you really wanted to fight global warming as an existential threat, you’d build nuke plants and re-direct spending to invest in efforts to develop technology that would capture or alter greenhouse gasses. A lot of “the little people” would get kicked to the curb because of resource allocation, with a rueful “Sorry, I feel for ya, but we have a war to win.”

        That’s what resolve looks like.

  17. So is Pramila Jayapal one of the kind of immigrant success story Reason is always touting?

  18. The most amusing thing about this topic is that there never seems to be any discussion about the primary constraint — supply. Supply of hospitals, doctors, drugs, etc. How is shifting how you pay from the market to a fixed price bureaucracy going to bring in more supply? If it isn’t then you’re just setting up a queue.

    The largest problem they have is that they are essentially trying to enslave the existing suppliers to work at 1/3 the price for twice as long. For every right there is a corresponding obligation. Everyone will have a right to health care and, apparently, doctors will be obligated to provide it whether they like it or not. I foresee a massive health tourism industry popping up in Mexico and a lot of supply leaving the US, the best part of the supply (high level experts and surgeons) creating a free market for the wealthy and upper middle class who can afford it.

    In other words, this will just turn the middle and lower classes into medicaid recipients. Perhaps the voters are sufficiently stupid to sign up for this but I have my doubts. I don’t even think Pelosi would go for this because the insurance companies, doctors, hospitals, drug makers are all going to have their heads explode if it becomes more than a talking point.

    1. “How is shifting how you pay from the market to a fixed price bureaucracy going to bring in more supply? If it isn’t then you’re just setting up a queue.”

      See Monopsony: “In the microeconomic theory of monopsony, a single entity is assumed to have market power over sellers as the only purchaser of a good or service, much in the same manner that a monopolist can influence the price for its buyers in a monopoly, in which only one seller faces many buyers.”

      “The largest problem they have is that they are essentially trying to enslave the existing suppliers to work at 1/3 the price for twice as long.” – lol. enslave? wtf, dude. also, [citation missing]

      “Everyone will have a right to health care and, apparently, doctors will be obligated to provide it whether they like it or not.” – yup, just like we enslaved teachers to public schools here. They can’t quit, call in sick etc. Have you been to europe? They keep their doctors locked up after hours so they can’t run away. They set up fugitive doctor laws around the EU.

      “In other words, this will just turn the middle and lower classes into medicaid recipients. Perhaps the voters are sufficiently stupid to sign up for this but I have my doubts. ” – there’s a effing entire continent that has socialized medicine. None of the sky is falling predictions you make about government provided health care happen there.

      1. “yup, just like we enslaved teachers to public schools here.”

        If you listen to public school teacher’s unions, this is precisely what we do.

        1. oh really? they’re in chains? they don’t have ownership of the product of their labor? Do we pluck them from their homes and force them to teach? Are they not able to leave their jobs if they wish? Do we whip our teachers when they misbehave? Do we trade them between school districts when we please? When they try to escape their schools, do we send packs of dogs after them to hunt them down? When did we pass the fugitive teacher law?

          Seriously, stop equating socialism with slavery. it’s not a convincing argument, and definitely makes libertarians seem like sensationalist idiots who are incapable of even basic distinctive nuance.

          1. hayek > friedman|2.28.19 @ 8:08PM|#
            “…they don’t have ownership of the product of their labor?…”

            No, they don’t Hihn, fuck off.

      2. What do you call someone who you have a human right to the fruits of their labor? How many perfect altruists do you think are intellectually capable of becoming an M.D.? Why do you assume the best and brightest won’t go into petroleum engineering instead of med school? How many PCP do you think there are vs. how many you’d need to supply everyone? How would rural residents get to a provider without a right to transportation?

        It’s a total remake of society based on caste servitude to the state. They will pretend to pay us, and we will pretend to work.

        1. “What do you call someone who you have a human right to the fruits of their labor?” – i would need a lot more context to accurately define this.

          “How many perfect altruists do you think are intellectually capable of becoming an M.D.?” – exactly elevendy twelveteen

          “Why do you assume the best and brightest won’t go into petroleum engineering instead of med school? ” – idk, because countries with universal healthcare still have skies. I checked, Canada’s sky is definitely still in the sky today. Totally hasn’t fallen.

          “It’s a total remake of society based on caste servitude to the state. They will pretend to pay us, and we will pretend to work.” – here comes the conspiratoid nonsense. And 9/11 was an inside job, right? We definitely didn’t land on the moon, right?

          1. As expected, you haven’t thought about it.

            1. Also bonus points for having economists as a name but recognizing zero of the economic underpinnings of my questions. Or, perhaps, you did notice which caused reflexive diversion.

              1. exactly, elevendy twelveteen. The multiverse is calling to you via ultra-sentient particles. Can you hear it? Although you may not realize it, you are karmic. Turbulence is the antithesis of guidance. Where there is materialism, karma cannot thrive. You may be ruled by greed without realizing it. Do not let it exterminate the healing of your myth.

                Or in other words, i suspect you at most made it through highschool, possibly did some time at suffolk nights, but aren’t what i consider educated enough to take seriously.

                1. Fuck off, Hihn

            2. Yup. In all the countries with socialized medicine, being a doctor is NOT a very sought after profession. Many people with brains go into other, higher paying fields instead. So they DO get doctors… But they tend to be more mediocre than in a system like we have in the USA.

              1. Right. You get the brightest from third-world countries where the middle class opportunity is a ticket out of hell.

                Maybe that’s why we need to stop the spread of free markets: we’re going to run out of shitholes to import smart people to do hard work for below-market remuneration.

          2. Yeah teachers and all schools are all run by a giant bureaucracy in DC which sets and pays tuition for each student forbids any competition. /sarc
            This is obviously not the case. 100% different from what Democrats are proposing for mediocre, I mean, Medicare.

    2. ” How is shifting how you pay from the market to a fixed price bureaucracy going to bring in more supply?”

      So, you’re arguing that the government should get involved in the creation of more doctors and nurses? Maybe start subsidizing the schools, or paying people directly to go to school? Or do you want a more restrained approach, where the government just loans people money to earn a medical degree, and then demands repayment for a decade or two once they actually become doctors, with serving underserved medical markets earning a discount on repayment. Is that what they should be doing?

  19. Obamacare was as far as the Democrats felt they could go in 2010. It was always intended to be an incremental step towards a government take over of health care, which is itself an incremental step towards a government takeover of the whole economy.

    Trump is so icky, though, we’d better elect Democrat supermajorities and a Socialist President to take away his Twitter account.

    1. when you make your hat, do you fold the tin foil with three or four corners?

      1. Shiny side in.

        1. i don’t understand the libertarians who are convinced that people on the left (which btw, is where classical liberalism originates) have malicious intent.

          As an argument, it will always fail, because most people don’t have malicious intent, and when you insist otherwise, people will assume you and your associated political view points are not to be taken seriously. If your justification of libertarianism relies upon showing that the state is this nefarious, malicious actor, you will never convince anyone but loose change 9/11 truther types. As a communication strategy for the movement, it’s worse than ineffective. It backfires.

          1. “i don’t understand the libertarians who are convinced that people on the left (which btw, is where classical liberalism originates) have malicious intent.”

            That’s because you’re a fucking ignoramus, Hihn.
            Fuck off.

  20. My answer to thins, as in so many things is, “You sorry bastards can’t even maintain the highway system. We put up with sky high gasoline taxes for that, and you piss it all away on personal obsessions like bike lanes and raiding trails and light rail. Fix the goddamned roads and bridges, and keep them fixed for a decade. One decade. Then, MAYBE, we’ll talk about letting you try something new that’s more complicated.”

    1. roads are fine where i live. in Canada, they seem to be even nicer. They pay about the same taxes and get so much more quality government services for it (except for that third-world shithole called quebec).

      1. “roads are fine where i live. in Canada, they seem to be even nicer. They pay about the same taxes and get so much more quality government services for it (except for that third-world shithole called quebec).”

        You’re full of shit, Hihn, fuck off.

      2. Isn’t it easier for you to just move to Canada rather than arguing for the whole economy and healthcare system to be changed to your liking? What hubris…

  21. I think we can all agree that there are only two real factors that will move healthcare in the right direction here:
    1) technological advancements (which are slowly happening, but could use some regulatory breathing room).
    2) healthier lifestyle shifts to decrease overall costs (not happening as quickly as I’d like to see, but I eat right, exercise, and am a rich white man. So I’m covered).

    1. Agree. But those aren’t popular solutions to those committed to playing SIM city with our lives.

  22. Hihnfected by hihnsane asshole.
    Fuck off, Hihn.

  23. “One could argue about whether the GOP’s attack was the most significant lie of 2010, but it was, at minimum, an exaggeration.”

    “Although the Affordable Care Act increased regulation on individual health insurance to the point where it became something resembling a public utility, it left the bulk of the market for private health coverage intact, and even provided subsidies so that people could obtain (heavily regulated) private coverage.”

    And I’m betting you don’t even realize that you contradicted yourself right there.

  24. So, as I’ve said before, if bleeding hearts REALLY wanted to give health care to the poor, AND actually improve the system… There is one Deal With The Devil that might actually work. But that isn’t their real goal, they just want to take it over and go commie style because they like being commies.

    The compromise that might actually be doable would be:

    Deregulate the health industry almost completely. This would create market efficiencies, which are currently strangled by regulations out the ass.

    Then… JUST PAY FOR POOR PEOPLES SHIT.

    Cons and libertarians might make the deal with the devil because the bulk of the system would be improved by going more free market. Poor people get their shit paid for. Funny thing is, costs might come down so much almost nobody would end up using the government shit system.

    This is probably why they would NEVER suggest doing this.

    1. Very well said. Deregulate heavily and just give people money to shop around. Let them keep the savings.

    2. No. Then the costs of that shit would just go up.

    3. I don’t know about paying for people’s care but the cost of healthcare is a point that I wish would get discussed more in these articles. Seems that the answer is always how much we should subsidize instead of what we can do to make it cost less.

    4. Unsustainable.

      Even if we assume that complete deregulation would lead to cheaper medical drugs and services in the short-term?, the government simply accepting whatever bill comes along means that providers are incentivized to keep raising prices. After all, no matter how high they raise them, the government will just pay it, right?

      That said, look at the history of welfare in this country. We used to be a lot more “deregulated” about it. Someone was super poor and needed help? Write them a check, and let them decide whether to spend it on food, medicine, rent, or utilities. But politicians don’t really trust poor people (or any people for that matter, but they have more control over poor people) to make the “right” decisions, and over time split the money into different piles that had to be spent on specific things in specific ways, giving us the current mess.

      So given that history, there’s no real reason to suspect that even if you could do your “Deal with the Devil” initially, that the deal would hold. DC would have too many incentives to be more discerning, and it would never trust that poor people are getting the “right” services.
      ________
      ?Unlikely, but lets run with it.

      1. You could have pull it off with UBI. It would have required traveling back in time to when progressives were more willing to negotiate instead gambling an eventual flush of all three branches to force their agenda, especially given a gritted teeth arrangement is more approachable than dismantling a clusterfuck program later on. You probably could have gotten a hard cap of a percentage of GDP for social spending with piecemeal reforms to healthcare after the fact.

        Now it is facing down the prospects of a black hole to shovel money into on top of the other underfunded programs driving us to oblivion.

        And even with that, you still have the short, short bus crew pontificating endlessly that if they could only happenstance upon the right measure of snark and bile the world would rejoice at their genius which would render all political compromise superfluous, and we could all usher in a golden age of peace and prosperity, lauding their brilliance that all that was needed was to tell leftist to get fucked just one. more. time.

        Brilliant strategizing guys.

      2. Yeah, it would all be in the structuring.

        Let us say that anyone under a certain income level gets money to buy insurance privately, a la Obamacare style crap. Then they’re just buying into the market like anybody else. Alternatively, it could be some Medicare like system. Maybe have people at in between income levels only get partially subsidized, or have to but into the Medicare system. These levels should be pretty damn poor people only too, to make most people who have the means have to buy into the private system.

        They key thing here is that 90% of the healthcare spending would still be PRIVATE, so the hospitals etc wouldn’t realistically be able to simply charge $200K to check your blood pressure, because private insurers wouldn’t stand for it, and the government isn’t going to let themselves get gauged that much worse than private insurers.

        I’m positive the deregulation would kick the industry into a massive efficiency gaining period… Because there is sooooo much obvious fat to trim, if they were unshackled there’s no way it wouldn’t happen.


  25. Medicare for All Would Actually Be a Government Takeover of Health Care

    A feature, not a bug.

    That’s what they want.

  26. Some questions I’d like a statist to answer:
    1. Why haven’t liberal states already implemented universal healthcare? Several deep blue states with willing populations such as Vermont and Hawaii, have looked into this, why no success? Why not try this on a state level first?
    2. How do you intend to pay for any of this when our debt is already in the trillions, our deficit is in the billions? Do you care about debasing our currency with printing, borrowing and spending and stealing the value of present and future ordinary hard working individual’s savings and property?

  27. The rest of the world enjoys our drug innovation and military umbrella. What would happen to them if we recouped development costs more equally? Is there anything the government can do to lower costs it imposes on the system through regulations? We don’t know the true costs of their socialism OR ours. This isn’t a simple fix and I don’t see any honesty as to how we got here coming from the left, fresh off of Obamacare, promising that would fix things. Where is your accountability?

  28. “The federal government would also determine the budgets for capital improvements at medical facilities and set up a fee schedule imposing rates paid to doctors in private. In addition, the government would also specify staffing levels for physicians, and determine the preferred ratio of nurses to patients at any given facility.”

    So, basically no different from the current system. CMS already does all this and more.

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  30. There does need to be major gov’t intervention and the private insurance companies need to go. But of course their shareholders aren’t crazy about that idea, so it will probably never happen. But it would be the best thing for 99% of the country.

  31. Can’t wait for “Dentistry for All”… Say goodbye to tooth surgery at $80/pop, say hello to loosing the house over it.

    Seriously; Is there even ONE STINK-EN thing the Democrats paint on the face of their policy that doesn’t end up being the EXACT opposite after implementation.

    “Affordable Care Act” LOL!!!!..

    Its became so darn affordable no one could pay for it anymore except the government who coincidentally doesn’t create ONE single element of consumer value. Awe; but the government can WITH BIG GUNS force “those people” to pay for it (i.e. Slavery).

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