What is Medicare for All?
Perhaps I should have said a relatively easy lift, for the reasons already stated.
Q: What is Medicare for All?
A) A worthwhile long-term goal.
B) A losing campaign strategy.
C) Both
The answer is C.
jimmurphy said:
Q: What is Medicare for All?
A) A worthwhile long-term goal.
B) A losing campaign strategy.
C) Both
The answer is C.
Sadly C is correct.
I'm thinking Medicare for all is something we will never see. I know many union members believe they have good healthcare deals. Deals that were negotiated with great difficulty.
But will those deals hold when retired from the labor force and long term care is needed by 50% or the retirees? How will elderly or their children feel when they realize most of the retiree savings will feed the healthcare industry instead of going to the children? How is it a good deal when a portion goes to private insurers instead of healthcare? How much of a good deal is it when negotiations have to be split for healthcare benefits and salaries instead of just concentrating on salaries? How is it a good deal when so often healthcare benefits tie you to your job or union?
Sisyphus, congratulations! You finally got this boulder up the hill! Now go back down and push up that watermelon. It’s a relatively easy lift.
DaveSchmidt said:
Sisyphus, congratulations! You finally got this boulder up the hill! Now go back down and push up that watermelon. It’s a relatively easy lift.
Is Sisyphus happier with the melon or the stone?
BG9 said:
But will those deals hold when retired from the labor force and long term care is needed by 50% or the retirees? How will elderly or their children feel when they realize most of the retiree savings will feed the healthcare industry instead of going to the children? How is it a good deal when a portion goes to private insurers instead of healthcare? How much of a good deal is it when negotiations have to be split for healthcare benefits and salaries instead of just concentrating on salaries? How is it a good deal when so often healthcare benefits tie you to your job or union?
These are all parts of the case that can be made to unions. Just step aside, which appears to be DB’s preference, is not among them.
PVW said:
Is Sisyphus happier with the melon or the stone?
That’s some Camus (I think) that I never got to, but I’d have to say the stone. Even a gray rock is better than melon color, baby.
DaveSchmidt said:
BG9 said:
But will those deals hold when retired from the labor force and long term care is needed by 50% or the retirees? How will elderly or their children feel when they realize most of the retiree savings will feed the healthcare industry instead of going to the children? How is it a good deal when a portion goes to private insurers instead of healthcare? How much of a good deal is it when negotiations have to be split for healthcare benefits and salaries instead of just concentrating on salaries? How is it a good deal when so often healthcare benefits tie you to your job or union?
These are all parts of the case that can be made to unions. Just step aside, which appears to be DB’s preference, is not among them.
I did not say they should just step aside. I said they should be involved in lobbying for M4A so that their specific needs are met.
drummerboy said:
I did not say they should just step aside. I said they should be involved in lobbying for M4A so that their specific needs are met.
They are lobbying right now for the specific needs as they see them. Given all the advantages of M4A, it should be a relatively easy lift for its supporters to convince them otherwise.
DaveSchmidt said:
drummerboy said:
I did not say they should just step aside. I said they should be involved in lobbying for M4A so that their specific needs are met.
They are lobbying right now for the specific needs as they see them. Given all the advantages of M4A, it should be a relatively easy lift for its supporters to convince them otherwise.
well, their lobbying at the moment comes down to "screw you America, we've got what we want"
very noble
Unions know that noble is not a smart position to start with in negotiations.
Canada, UK, etc. all have some "supplemental" or other roles for private insurance together with a robust national healthcare program. I really cannot imagine that we can just get rid of private insurance in one fell swoop and I'm not convinced that will ever happen.
back to the union health care plans - how do we know they're so good in the first place? Or that they would be better than M4A?
Maybe the culinary worker's plan kinda sucks.
https://www.peoplespolicyproject.org/2020/02/13/the-culinary-health-insurance-is-not-that-great/
From that article:
But this reporting always omits the fact that Sanders’s Medicare for All proposal requires unionized employers with net health savings to pass through those savings to their workers. The proposal does not just vaguely gesture towards such a requirement, but spells out how to actually implement it via contract renegotiations overseen and enforced by the National Labor Relations Board.
From Sanders’ plan:
When Medicare for All is signed into law, companies with union negotiated health care plans would be required to enter into new contract negotiations overseen by the National Labor Relations Board. Under this plan, all company savings that result from reduced health care contributions from Medicare for All will accrue equitably to workers in the form of increased wages or other benefits.
The plan does not require a pass-through of savings. It requires only renegotiations, then assumes savings “will accrue” through them.
After all, it’s a relatively easy lift.
According to this Labor is split.
https://www.politico.com/news/2020/02/18/medicare-for-all-labor-union-115873
DaveSchmidt said:
From that article:
But this reporting always omits the fact that Sanders’s Medicare for All proposal requires unionized employers with net health savings to pass through those savings to their workers. The proposal does not just vaguely gesture towards such a requirement, but spells out how to actually implement it via contract renegotiations overseen and enforced by the National Labor Relations Board.
From Sanders’ plan:
When Medicare for All is signed into law, companies with union negotiated health care plans would be required to enter into new contract negotiations overseen by the National Labor Relations Board. Under this plan, all company savings that result from reduced health care contributions from Medicare for All will accrue equitably to workers in the form of increased wages or other benefits.
The plan does not require a pass-through of savings. It requires only renegotiations, then assumes savings “will accrue” through them.
After all, it’s a relatively easy lift.
You picked the part that doesn't talk about the current benefits.
drummerboy said:
You picked the part that doesn't talk about the current benefits.
I picked the part I know something about and could verify without relying on that article. It's also a part that will remain a hurdle no matter how a union's current benefits stack up against M4A.
Bernie will end up sick and miserable when he realizes that he, as president won't be able to get his m4a pass the Senate.
Jaytee said:
Bernie will end up sick and miserable when he realizes that he, as president won't be able to get his m4a pass the Senate.
He's not stupid. I'm sure he knows that already.
Jaytee said:
Bernie will end up sick and miserable when he realizes that he, as president won't be able to get his m4a pass the Senate.
He will have very good coverage. Many who won't will be truly sick and miserable.
ml1 said:
DaveSchmidt said:
I don’t know how calling studies into question — in the hope that a crucially important issue can be discussed and dealt with on firmer ground — is equated with throwing in the towel.
Instead, let’s all just take these savings at face value, bulldoze the unions and — voila — let the magic of M4A happen exactly as its proponents say it will.
my point still stands about criticizing these costs without providing context in order to oppose single-payer. If M4A isn't expected to be more efficient, why aren't the candidates showing their projections on how it isn't?
Context always wins. It undercuts both a declaration (Biden) that M4A “would cost more than the entire federal budget that we spend now” and a declaration (Sanders) that M4A “will lower health care costs in this country by $450 billion a year.” You’re welcome to keep hammering at the first one; I assume it’s understood why every link to a study might make me want to look under the hood of the second one.
As for efficiency, I don’t think there’s a dispute that M4A would be more efficient than a network of private insurers if the health care of every American is to be covered. If that’s your No. 1 priority, the choice is M4A. But if it’s not your be-all-end-all — if, like eliminating homelessness, it’s something you believe America ought to accomplish but can’t without too many costs that take away from other priorities — then efficiency is beside the point. It’s putting the cart before the horse.
I overlooked at least one efficiency-related dispute: the argument that the M4A pay structure would reduce incentives for drug research and medical innovation.
DaveSchmidt said:
I overlooked at least one efficiency-related dispute: the argument that the M4A pay structure would reduce incentives for drug research and medical innovation.
Drug research should be funded by the government anyway. Not sure we really need the 27th version of prozac.
drummerboy said:
Drug research should be funded by the government anyway. Not sure we really need the 27th version of prozac.
as with the answers to most of these questions, it's not that easy to answer the question of whether or not price controls on pharmaceuticals will end innovation. Partly because so many pharmas are multinational corporations, so assigning a specific country the credit for an innovation isn't always easy to do. Also because the US is a much bigger country than most, with a higher GDP, there's more money to spend on most things, including pharma innovation.
US Pharmaceutical Innovation in an International Context
US government officials have stated that other countries are not shouldering their fair share of research and development costs by paying lower prices.3 The pharmaceutical market, with the varying strength of its players through patent monopolies or government purchasing power, is hardly a perfect market. Perhaps other countries are paying an appropriate price and the prices in the United States are too high because the government does not leverage any power to purchase drugs. The financial success of the pharmaceutical industry compared with many other industries26 provides ample evidence that concerns regarding the future financial health of this industry and its ability to invest in drug development if the United States were to exert purchasing power are overstated. The relative success of the pharmaceutical industry in each country may be more related to the country-specific investments in human capital, education, technology, information infrastructure, and strategic choices. For example, per capita pharmaceutical research and development spending of the United Kingdom, Switzerland, and Sweden from 1995 to 2000 exceeded that of the United States.27 Some countries choose to invest in pharmaceutical research and development over other types of industries. Future research could examine the types of incentives and policies that promote country-specific investments that provide a superior environment for pharmaceutical research and development.
New evidence about Medicare for All increasing wages and jobs. Yes it's a video. Deal with it. 5 minutes 20 seconds.
drummerboy said:
And would those jobs make up for all of the insurance jobs lost?
I found the Newsweek article discussed in the video. It goes over the recent study by the Economic Policy Institute (EPI). They found that M4A would have a good effect on the economy and that the effect of job loss would be "relatively small." I have to spend more time with this, but it is positive news.
nan said:
I found the Newsweek article discussed in the video. It goes over the recent study by the Economic Policy Institute (EPI). They found that M4A would have a good effect on the economy and that the effect of job loss would be "relatively small." I have to spend more time with this, but it is positive news.
Yes, it was a video of some guy reading from a Newsweek article.
That's why the videos are a waste of time - everyone's time. Why not just post an article?
Better yet, why not just post the actual report, instead of some video rando giving his interpretation of an article giving a summary of the report? I know the video works better as propaganda, but that's not a good thing.
Here it is. People can see what it really says, all of it: https://www.epi.org/publication/medicare-for-all-would-help-the-labor-market/
Bringing a discussion on Democratic health care initiatives from another thread back to this one.
ml1 said:
drummerboy said:
I disagree. I think some wonk somewhere can figure out the approximate cost of the public option buy in. It's kind of a critical piece of info - surprised it's not part of the conversation for the PO because without it, they whole notion is meaningless.
there was a very reputable organization that did ten year forecasts on the ACA status quo, M4A, and Biden's "improved" ACA. I had posted a link to it a couple of months back. But of course because it suggested M4A was the least costly option, it got slammed because after all, it's a projection and who knows? Of course that didn't stop Biden and Klobuchar from using an out-of-context forecast for M4A costs to scare primary voters. The opponents of M4A talk only about its costs to the federal government without comparing it to all the costs public and private inherent in the current system.
But the striking part of the projection was that Biden's plan was projected to be significantly the most costly in total between public and private expenditures. Which makes perfect sense because it would cover more people than the ACA, and compared to M4A, it doesn't remove the profit and the marketing expenses baked into private insurance. It's one time that even a ten-year projection is almost certainly on target, at least directionally. There's virtually no chance that the Biden plan would not cost the country significantly more than the other alternatives.
It's crazy that a plan that will almost certainly cost a lot more than M4A is the "safe" proposal, and the scary one is the less costly. But nearly 60 years of opponents demagoguing government paid health insurance as "socialism", "communism" and the destruction of "choice", of course M4A is scary to a lot of people.
I think you're being too dismissive of the question of choice here.
One can argue that the push for universal health care is, at root, about expanding choice. Instead of spending time on the phone with Cigna or Blue Cross arguing about re-reimbursements or making employment choices based on health coverage, people can instead put their time, energy, and passion into things they actually care about.
I think that's a strong argument. I don't think that's quite the argument for single-payer, though. That argument is not just that universal health care will grant more choice, but that government-funded single payer will actually deliver on this. That second argument is a harder sell.
What offering a government-provided option alongside private ones does is make it a softer sell. It lets people say "yes, I'm open to giving this a chance" without a feeling of lock-in. And yes, that costs a lot more, but what you buy with that is giving people the feeling that they are in fact making a choice, rather than being forced to accept, and I think we downplay the importance of that at our peril.
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I’ve been in unions through three decades of contract negotiations. Every single one was a slog, and a bitter one more often than not. It’s better than the alternative — ownership and management hegemony — but nothing about these negotiations is a somewhat easy lift.