I don't have the patience to read the fine details here, but my point is that M4A is just framed and argued completely wrong. I get what they are trying to argue here (Change is scary so its better politically to campaign on securing what you have vs. big structural change). The argument of M4A is about where you are from a principled perspective. Meaning ideals of private dog eat dog conservative marketplace vs. fully socialized govt. regulated market supplier that is about full coverage vs. a capitalist survival of the fittest market. The argument someone like Warren needs to be making is about capitalism in general and principles that state here's where we need a regulated market approach vs. here's where the system NEEDS a socialized approached because a private market is not affordable and sustainable (the private firefighter & police officer argument). So to answer your question "what they are really debating".... the answer is they are debating LAWS, and plans that are being presented to the American people as a zero sum choice... You vote for Warren, you get 50 Trillion in debt and economic collapse. Etc. When the debate SHOULD BE about where you are from a principled perspective, and education to the voter on what YOUR PLAN is for enacting change to the current system through the legislative process. The simple fact is the Dems lose when the voters are allowed to be ignorant and uneducated on the facts & processes of governance.
If the realistic goal is to improve on the ACA with an additional public option, why not run on that to begin with? Unless Warren really believes she can successfully implement M4A, she should pivot to the middle. Why give more ammunition to the enemy to describe you as the buggy woman and hence increase your odds against winning? Simply put, how many here, right and left wingers, would be in favor of ACA2.0 + public option? I would.
"Ahh yes...... well we need money so lets take it from the business see." "So we need more money so lets tax the business...." "Oh dear..... we need more money lets lets have the business volunteer to give it to us." "I see...... well we need more? So the business did not voluntarily give us enough so lets take more." "Okay well we can get more money by taxing the taxes the business owes." "See! No problems, we have solved 75% of the financial worries. Now we can just tax the business for the other 25%."
here's another analysis. I really am trying to understand more of the specifics here. I'll bold the part where the $9 trillion employer contribution is discussed. Still seems like a bad idea to me. https://theweek.com/articles/875812/good-bad-ugly-elizabeth-warrens-medicareforall-plan The good, the bad, and the ugly in Elizabeth Warren's Medicare-for-all plan Jeff Spross November 1, 2019 Elizabeth Warren now has a plan to pay for that. After taking a lot of incoming fire from debate moderators and rivals for the Democratic presidential primary, the 2020 contender released on Friday a plan to fully fund Medicare-for-all. It's bold, detailed, and kind of sneaky. By taking her critics super literally, Warren turns the demand to pay for Medicare-for-all into an excuse to do a whole bunch of policy tweaks — some to taxes, most to other government policies. Many of these ideas are good; a few are questionable or just plain bad. But the unifying theme is that all of them would leave the federal government with more money to spend without explicitly hiking taxes on the vast majority of Americans. The basic challenge of Medicare-for-all is straightforward: Giving every American quality health insurance without making them pay premiums would be very expensive — a little under $52 trillion over a decade. Most everyone assumes that offsetting that enormous amount of spending would require broad tax hikes across the population. Democrats worry that once voters get a look at those tax hikes, people wouldn't understand how much they would save on net and would then turn on the program. Hence the relentless demands from reporters asking Warren to explain how she'll pay for it. But Warren seems to have taken the demand that she match every dollar of Medicare-for-all spending with a dollar from elsewhere as a kind of dare. It's like she picked up every remaining lefty budget idea and just threw them into her plan. Let's go through Warren's proposal: $52 trillion over a decade is actually slightly less than the country is expected to spend in total on health care on its current path. It's just that, right now, that spending comes from lots of sources: government, private health insurers, businesses, and consumers. Medicare-for-all simply replaces all that spending with one single stream of government spending. Warren rightly notes that total spending is so high because all sorts of hiccups in the current system permit hospitals, providers, insurers, and other players to jack prices through the roof. Thus, Warren's first batch of ideas includes a bunch of fixes to bring those prices down. Warren wants to set up standardized reimbursement rates for hospitals and other providers across the system. They would be 10 percent more generous than Medicare's current rates, with extra boosts for rural hospitals and other providers in tough spots. Replacing the smorgasbord of private insurers with one government insurer will also wipe out a lot of excess administrative costs in the system. Warren wants to use federal regulators to start seriously enforcing antitrust law against big hospital chains and mergers, breaking up the consolidated power with which they ratchet up prices. Finally, she aims to use already-proposed legislation to force American drug prices to fall more in line with international prices — and if that fails, she has ready-to-go bills to start overriding pharmaceutical patents and use public funds to sponsor drug research directly. (Frankly, she ought to do both of those latter ideas regardless.) Warren's first questionable idea is to take the $6 trillion that state and local governments currently spend on Medicaid and health insurance programs and redirect it into federal coffers instead. That proposal certainly doesn't leave states and localities any worse off, but it would be even better to free their budgets from having to meet those obligations entirely. In that regard, it's a missed opportunity. Of course, the federal government already spends an enormous amount on Medicare, its share of Medicaid, and other programs. Once you throw in that, the $6 trillion from states and localities, and all the savings from the aforementioned proposals, there's roughly $20.5 trillion over the next decade left to account for. This is where Warren really starts swinging for the fences. She wants to reform Wall Street with a 0.1 percent tax on every financial trade plus a small fee on the forty or so biggest banks in the country. These two ideas would raise revenue but also come with two beneficial side effects: slowing down speculation in the financial system and encouraging big banks to downsize a bit. Warren also wants to provide undocumented immigrants a path to citizenship, which would bring new taxpayers into the country. Another way she wants to add revenue is to crack down hard on tax evasion by the wealthy by bolstering the Internal Revenue Service and passing other reforms. If all that's not enough, the senator also aims to cut a defense budget item — Overseas Contingency Operations — that's essentially served since 9/11 as a placeholder for extra spending on foreign wars. All of the above gets her another $4.4 trillion over a decade. Granted, $2.3 trillion of that comes from the tax evasion crackdown, which seems really optimistic. And the explanation Warren links to doesn't provide much detail on how that estimate was reached. Warren's next big change is to essentially take the money that businesses pay private insurers for job coverage and redirect it to the government through a specifically designed fee — read: a tax. This gets Warren $8.8 trillion over 10 years, but it's also her worst proposal. The fee/tax would charge employers a dollar amount per worker, rather than a percentage of each workers' income, like already-existing business-side payroll taxes do. You can argue over how much employer-side taxes pass through to employees' pay — it probably varies a lot depending on the state of the labor market — but to the degree it does pass through, it's the kind of broad-based tax increase Warren is ostensibly trying to avoid. It's severely regressive, and all else being equal, it will discourage hiring. In the realm of straightforward taxes, Warren suggests ratcheting up the wealth tax she's already proposed: Instead of charging two cents annually on all wealth over $50 million and three cents on all wealth over $1 billion, she'd crank the latter charge up to six cents. More interestingly, Warren wants the richest 1 percent of Americans to pay capital gains tax rates at their income tax rates (a very good idea for everyone's capital gains, actually) and charge them annually based on the market value of their capital gains, rather than just at the moment of sale. For corporations, Warren would impose a new international minimum tax to prevent American multinationals from shifting profits into foreign tax havens. She would also change the way business expenses are calculated: Instead of being able to expense investment in assets all at once, companies will have to space it out. This increases tax revenue, but there are actually strong arguments for why the alternative is preferable over Warren's approach. All of these changes would bring in roughly $7.5 trillion over the decade. Finally, all the money that people would've spent on premiums and deductibles and copays now gets freed up to go elsewhere. That will be a big boost to economic activity, which should increase the revenue already-existing taxes bring in. Warren estimates that will get her a final $1.4 trillion. And that's the ball game. A lot of these ideas — the taxes on the rich, the reforms to tax accountability, the health system changes, etc — are good ideas. The change to corporate expensing and the use of state and local health spending are both questionable. The employer-side tax is straight-up ugly. Warren would be better taking the money she gets from those latter sources and just throwing them on the national credit card instead. a bit more at the link
Obamacare has too much of a stink associated with it...IMO best to start from scratch. Once you've burned the toast you can scrape some of it off but you can never get rid of all the burned crumbs.
Regardless of what you think about MFA , it’s exceeding clear that our healthcare system is **** . A private market isn’t going to work . Not without the strictest and impossible to actually implement regulations of all time lol . The market just doesn’t function Pick your poison : aysemtric information , cost insensitivity , incentives are to proscribe treatments that make the most money not are the most cost effective . This is where the argument for a single , non-profit minded entity to bargain with providers to lower costs becomes clear . But I favor a transition to a public option (or single payer) while still letting private insurance find a niche in the market . Healthcare is a fundamentally difficult question. What do we want as a society ? Are we willing to admit that capitalism (as it has been practiced so far ) can solve this issue ? There is not a silver bullet . “Fixing” our system to give everyone better or equal healthcare and lower costs across the board is daunting . I would for sure be dead if my parents didn’t have health insurance when I was born ... or maybe my family would be in inescapable debt. So , our system isn’t totally ****ed . But as per usual , we don’t get to looking at an issue until it’s spiraling out of control. We’d probably cut 100 billion in medical expenses if everyone ate a little healthier and exercised .
I doubt that M4A, as proposed, will get through. But push for as much as you can get and pivot to the center later. Not before bringing it to the table. Bring the best and most far-reaching plan to the table, then compromise from there. That's when you pivot to the center. You don't pivot before you've brought your idea to the table. That's how we ended up with the watered-down ACA. Let's lead and bring forward a bold proposal. Then compromise what you have to. But if you compromise beforehand, you will just end up compromising on an already compromised proposal. Go bold. Show leadership. Then only when needed, pull back a little.
This plan is a trainwreck - in particular the employer contribution - and I suspect it's the beginning of the end of her campaign. It's also why Dems demanded to see the details - when she had to flesh it out, the whole thing falls apart. One of the key popular elements of M4A is that it would free up money - the money employers were spending on healthcare could be given directly to employees as raises. Now, that money is just going to the government. So not only do employees not get more money, they might also get less desirable healthcare (it's easy to say everyone will love M4A quality coverage, but the reality is lower reimbursement rates almost certainly corresponds with a drop in services as doctors and hospitals have to cut back). Unions are going to go bonkers against this proposal since one of their strongpoints is negotiating popular health care plans for their employees. The flat amount per employee that the article mentions is misleading though - the current health care costs are a flat cost per employee, and this is replacing that. It certainly won't help hiring and maintains the current discouragement of hiring, but it doesn't make that element any worse. In an ideal world, M4A was supposed to fix this problem though.
That's the opposite of how all the big social services elements of our society have come about, whether its SS, Medicare, Medicaid, CHIP, etc. All started small and grew over time. Obamacare is the foundation going forward - that was the compromise. Now you build on it. Add a public option to it and make it a PPO. Add importing of prescription drugs. Allow employees to opt out of employer plans and use those funds for the public option. Expand subsidies if needed. At that point, you've largely solved many of our healthcare woes - at least to the same extent M4A would - without imposing it by government fiat and without the hell of trying to restructure 16% of the US economy overnight. The public option can negotiate along with Medicare and have plenty of buying power. If people aren't choosing it over private insurers, that's your answer in terms of what the people want. If they are, private insurers will be forced to compete. You get the same results as M4A without any of the risk or anger.
With everyone covered with no co-pay, no deductible, no bs unnecessary layers (paperwork, ins, signup yearly, shopping for plans, doctor spending a quarter of their time on insurance). Freedom of movement (no longer tied to a crappy job just for healthcare), removal of fear of bankruptcy from medical cost, removal of fear of denial of service... All things equal, how is that not an easy trade-off for the people? I interpreted as not. They pay the same amount but can choose how much they pay to their employees and to the government. These employers will choose to pay their employees and not to the government. This is Warren's answer to the gold package from unioned health care. Those folks lose their gold health care pkg but get a pay raise or other unioned benefits, plus universal health care from the government. While the focus has been on cost and who pays for them (it's the rich, dummy), the real focus should be on how it will be run, who run it, how to make it efficient, the administration of it, how to continue innovation, how to reduce pricing outside of cutting layers of fat, how to maintain and increase quality and service, how to reduce fraud. The overall cost and who pays is the "easy" portion of this. Simply moving everything into the existing medicare structure may be a start, but there is room for improvement within that structure. Overseas Contingency Operations military fund is a slush fund, hanging around doing nothing until it's needed (or being abused by admin to build a wall or other pet project). Time to get rid of it. She tried to throw together a plan that answers the question of - who pays for it. It's the rich dummy is her answer. Move on. It's a political promise that won't get realized. The hard work of doing something like this is in Congress - the executive set a direction and goal and overall answer on where the fund comes from. She did that.
Of course, this creates a gigantic hole in her $8 trillion financing plan... No it's not. She's already more than doubled the rate of her maybe-constitutional wealth tax. Support for that is just going to go down. She makes a huge mistake thinking Americans hate the wealthy - they hate the corruption that often comes with it, but people don't hate the idea - they dream of being the wealthy. Bill Gates is worth something like $60B and spends his life and much of his money making a huge social impact all over the world. Do you really think he should pay $3B/year in taxes just for existing? Do you think it's reasonable to take nearly 25% of his wealth over 5 years even if he doesn't make a single dime? 50% over 15 years? And once you've taken 50% of their wealth and dramatically slashed your revenue sources, where will your money come to pay for all this stuff? Nothing about this works or is going to remotely feasible. Neither the "cost" nor the "who pays" are easy - both basically make this entire plan unfeasible. Is it ultmately used each year? If so, it's still a hole in the budget that needs to be filled. She's using accounting gimmicks here, rather than actually addressing the costs.
Ouch, what a bad take. Tell me again how a 3% wealth tax on any assets over a billion dollars results in him losing half his wealth especially when he actively invests his money all the time? Can you show your math? Also, Bill Gates charity would be placed to better use as tax revenue because it's been proven time and time again, that as a society, we allocate resources to public resources better as a collective with a governing body where there is debate and national discourse on how these funds should be located than individual wealthy people chosing pet projects to be charitable with. The reason is individual wealthy people don't have the broad scope to determine all the gaps in social services that are needed amongst constitutients to better society that a governing body that represents in citizens can do. I just don't see a morally justifiable reason why we can have billionaires in the world's wealthiest nation when at the same time we have citizens who work full time and still have to file for bankruptcy with medical bills because someone in their family decided to get cancer. The way I see it, the nation's most wealthy take massive advantage of US infrastructure and social services to maximize their profits from using public research from public research universities to elderly citizens buying their products only because Medicare and social security allows them to walk about and purchase their products instead of dying early. So no I don't feel bad if we take 3% of a billionare's wealth every year. They'll still live exorbitant lives full of luxury. Infact I see a wealth tax as a motivation for trust fund babies to not sit on their wealth. Imagine being inherited 500 million dollars and knowing that anything beyond 20 million will be taxed at 2% . That incentiveces you to not sit on that wealth.
She doubled her wealth tax to 6% to fund health care. 0.94 ^ 15 = 40%. That's 60% of wealth taken away over 15 years. It's pretty basic math. Investing money comes with its own risks and taxes as well - that's an independent thing. This is not actually true - government-funded social programs have benefits of scale. That is their key strength. But Bill Gates also has benefits of scale - and far less red tape and rules that slow the process. Government hasn't been able to address worldwide malaria remotely as effectively as Bill Gates has over the past 15 or so years. But if you do believe this - that government is better able to use resources than individuals - that's basically full-on socialism. Which is fine, but again, you're not going to find support for that in America. Why not say the same about business? Maybe government should replace small businesses too - they can do it more efficiently, after all.
It's something much less than 8T. There are about 14M union members in the US. If you assume that ALL of them are on a gold health plan that costs ~30k for each member, that's around $0.4T total. Of course, probably far fewer people are on such a plan. Is it reasonable or sustainable that the rich keep getting richer and everyone else is staying put or going backward? That's, however, is a different argument. It's easy. You tax the rich to pay for it. That's an easy message. There is money to pay for it. Is that fair, a good way to do it, can you ever get such a plan pass is a different story. But the math works. She redirects it to M4A. If the military needs something extra, go through Congress to get it. People know the military is bloated and this is probably the least controversial part of her plan.
So you have a very basic misunderstanding of wealth tax to the point I feel no need to further engage with you until you actually read the proposed policy. Your math implies a wealth tax that taxes the entire wealth rather than a marginal rate. ".94^15" seems like you are assuming that the wealth tax isn't marginal and the entire wealth is taxed at 6%. No, it's like a marginal income tax rate. For example, 6% would be applied to any wealth over 10 billion. 2% would be applied to anything between 20 million and 10 billion and 0% would be applied to anything below 20 million. Your math also assumes that this hypothetical exuberantly wealthy individual is literally sitting on his wealth for 15 years and is doing zero investments. Full on socialism is the elimination of private property and replaced with public ownership of all property It's amazing that you think a 6% wealth tax on wealth over 1 billion dollars is "full on socialism". Propaganda of incremental social polices being labeled communist for 60 years has brainwashed so many. Public research has done far more in advancements in medicine and technology than individual charitable donations. Don't worry, these people will still have exuberant amounts of wealth. It's just now full time working families won't have to file for bankruptcy because their child was diagnosed with leukemia.
I think Warren will be the one who wins the nomination as Biden is unenthusiastic and was successfully kneecapped by the GOP with Ukraine (although at what cost to the GOP). I hope all these plans are more aimed at wining the nomination as the "change" candidate because I think Warren is a smart woman who knows this won't fly in practice. At least I hope so. I agree with those who want to build on ACA.
She's politically savvy enough for me to think that's exactly what she's doing. "I got a plan" for that is more about "I got a plan" to win.
I believe a single payer system with private supplemental coverage for elective procedures is the most efficient model. I believe essential healthcare services such as cancer treatment or life saving ER treatment doesn't work well in a free market due to their inelastic demand as in cost of said services does not effect the demand curve as a parent of a child who is diagnosed with leukemia will file for bankruptcy if necessary to make sure their child receives the life saving treatment. Competition in this case doesn't work because of game theory which results in pseudo cartels that are legal. A single payer system means we have public health insurance put private hospitals and clinics. Currently we are being double dipped by two entities with a profit motive, the insurer and the hospital hence why private insurance has far higher overhead costs than public insurance since private insurance has to also generate a profit. Having multiple segmented private insurance companies also increases the cost per consumer because a method in which insurance premiums for individuals is reduced is when an insurance company increases their customer pool which distributes risk to more people which lowers cost. Think of it this way. In a private insurance model, 20-40 year old healthy individuals who only use their coverage for at most yearly check ups disproportionately pay for the costs of those who use their insurance for expensive treatments. In a public insurance model, that burden is shifted from healthy 20-40 year olds to people who make more than 500 thousand dollars in yearly income. Also, in a single payer public insurance model, there is far more leverage for one insurance entity to negotiate prices with pharmaceutical companies.
$8T is over 10 years... so your $0.4T just became $4T. This is a good example of why the math is so important - so many people are just glossing over all this and coming up with analyses like "it'll all just work out". When you actually look at the math properly, it all falls apart.
