Sanders to introduce single payer medicare for all bill

[[DHT]Osiris]

I'd buy this, except that the VA still has horribly long wait times.

Why don't they let anyone have the option to enroll in Medicare? Of course people under 65 would pay absurdly high premiums, but at least that would set a floor and a benchmark.

That'd be super, then everyone can deal with the complete PITA that is Medicare and understand how miserable it is, then maybe it'll change. (see same for VA depending on location)

 

[IronWing]

That'd be super, then everyone can deal with the complete PITA that is Medicare and understand how miserable it is, then maybe it'll change. (see same for VA depending on location)

Qualifying for Medicare almost turned my parents into Democrats. They have to use the hell out of it and never once called it a PITA nor miserable. They needed medical care and weren't bankrupted by it.

 

[woolfe9998]

He's been doing it for decades and we are no closer politically than we were then. Clearly what the public thinks doesn't matter, otherwise we'd have gun control and higher taxes on the wealthy.
No matter how good your ideas are its irrelevant if you have no path to move them forward through Congress. He has no path. His legislative record is bare because he has a history of not having a way to get his ideas implemented.

All I'm saying is that if you are relying on Bernie to get things done, history shows you will be disappointed.

Yeah, I agree with that, basically. I'm not relying on Bernie in particular. It's going to take more than Bernie introducing a bill. Like I said, we need to sell the public on it. I view this as a step in the right direction, because as I said, the time is ripe - not to pass a bill today - but to convince the public that this is what we need. I expect we will be running a candidate who supports it in 2020 - which would be the first time that has happened - so introducing a bill now to call the public's attention to it, and to the fact that the dems are the only ones with a viable idea here, is a good thing.

I didn't vote for Sanders BTW. I voted for Clinton in the primary and in spite of the outcome, I still think she was the better choice.

 

[woolfe9998]

How about VA for all? Like this article from this author - https://www.yahoo.com/news/americans-could-cheap-health-care-172302829.html

Sounds like a decent idea, and I would support in as an alternative to what we have now. However, it isn't single payer because it maintains private health insurance, and I would not support it over single payer. The reason it's important to have only one insurer for the entire healthcare system is because it means the medical providers don't need to generate itemized patient billing. With single payer, the provider supplies the government payer with a cost accounting - which they would have to do as a business anyway - and the payer then reimburses the provider for all its costs, including everyone's salaries. Typically, hospitals employ 50 people just to generate itemized bills, while a similar number of people in the insurance companies are tasked with reviewing those bills line by line. This is a huge amount of bureaucracy which adds 15-20% to our healthcare costs. All that goes away with single payer. It's one of the main reasons you can get similar quality care for lower cost.

 

[ivwshane]

Yeah, I agree with that, basically. I'm not relying on Bernie in particular. It's going to take more than Bernie introducing a bill. Like I said, we need to sell the public on it. I view this as a step in the right direction, because as I said, the time is ripe - not to pass a bill today - but to convince the public that this is what we need. I expect we will be running a candidate who supports it in 2020 - which would be the first time that has happened - so introducing a bill now to call the public's attention to it, and to the fact that the dems are the only ones with a viable idea here, is a good thing.

I didn't vote for Sanders BTW. I voted for Clinton in the primary and in spite of the outcome, I still think she was the better choice.

My concern is with people who do view Sanders as the savior, such as those that will vote for a third party or not vote at all because the Democrat candidates isn't "progressive" enough. They are the ones who are putting their hopes and dreams into fantasy. Conservatives, Republicans, and the right did the same thing and they ended up with complete control of government and yet unable to accomplish anything.

People continue to fail to realize that our government was set up to act slowly with major changes happening gradually. This belief in all or nothing almost always gets us nothing.

Its cool to support those with the ability to see how the future should be but if they support that vision then they also need to support people who can get is there, even if it's in incremental steps. Its that ability that caused me to see Hillary as the better candidate. Bernie had the vision, he just doesn't have a plan to get there so I'd rather support someone that can get us moving in the right direction.

 

[blackangst1]

This would possibly solve one of two issues. The cost of insurance. But the biggest problem is still unaddressed: the cost of healthcare itself. I honestly dont know of a constitutional way to regulate that.

 

[theeedude]

There is nothing in the Constitution that requires government health care spending to be a blank check.

 

[Puffnstuff]

Anyone who's been buying health insurance knows that the larger the group is the cheaper the plan gets.

 

[Jhhnn]

Faced with the fact that people who depend on medicaid & subsidized ACA plans will be lucky to escape the Repubs with their hides attached, let's attack what they have from a different direction, right?

Of course. Let's make the perfect the enemy of the good. And unicorns for everybody, too.

 

[Jaskalas]

The Affordable Care Act mandated coverage without actually paying for it. Medicare "for all" is simply a means for us to match our demand with actual supply. It is to fulfill past promises and ensure our people get healthcare in the first place. I fully endorse it.

 

[Maxima1]

Faced with the fact that people who depend on medicaid & subsidized ACA plans will be lucky to escape the Repubs with their hides attached, let's attack what they have from a different direction, right?

Of course. Let's make the perfect the enemy of the good. And unicorns for everybody, too.

Huh? How is advocating for a single payer plan going to put them in a worse position? Which countries that have gone universal reversed?

 

[Jhhnn]

Huh? How is advocating for a single payer plan going to put them in a worse position? Which countries that have gone universal reversed?

Please. The whole thing tears down the ACA as "not good enough!" giving cover to Repub efforts to destroy it. I mean, it's so terrible that somebody has to do something, right?

If Repubs refuse to fully fund the ACA what would give anybody the impression that they'd be willing to spend even more for single payer?

 

[Maxima1]

Please. The whole thing tears down the ACA as "not good enough!" giving cover to Repub efforts to destroy it. I mean, it's so terrible that somebody has to do something, right?

If Repubs refuse to fully fund the ACA what would give anybody the impression that they'd be willing to spend even more for single payer?

Bull****. They'll want to destroy it regardless. Plus, anyone wanting single payer agrees Obamacare is better than what Republicans want (see polls). From your posts, it's obvious you want the discussion to be center-right/ far right. Don't act surprised if such an imbalance produces consistently right wing results.

 

[Jhhnn]

Bull****. They'll want to destroy it regardless. Plus, anyone wanting single payer agrees Obamacare is better than what Republicans want (see polls). From your posts, it's obvious you want the discussion to be center-right/ far right. Don't act surprised if such an imbalance produces consistently right wing results.

I merely point out that now isn't a good time to indulge in divisive Bernie Bro fantasies about single payer when we need to fight to keep what we have & expand upon it when we can create the opportunity. The ACA can serve as a bridge to single payer or something like it when that time comes.

You're just giving Repubs reason to mess with it.

 

[Maxima1]

I merely point out that now isn't a good time to indulge in divisive Bernie Bro fantasies about single payer when we need to fight to keep what we have & expand upon it when we can create the opportunity. The ACA can serve as a bridge to single payer or something like it when that time comes.

You always sound ignorant or conservative when you say this. Even countries with lower GDP per capita have gone universal. And it doesn't have to happen in a short time frame to advocate for it. You just keep pushing. That's a ridiculous notion you have.

You're just giving Repubs reason to mess with it.

You want to control the agenda in a way that supports Republican policies. Again, don't be surprise when the nation tilts right when only the right wing attempts to embrace conservative policies and uses their media platforms to do so, while liberals only have Maddow and a few others.

https://en.wikipedia.org/wiki/Agenda-setting_theory

 

[Jhhnn]

You always sound ignorant or conservative when you say this. Even countries with lower GDP per capita have gone universal. And it doesn't have to happen in a short time frame to advocate for it. You just keep pushing. That's a ridiculous notion you have.



You want to control the agenda in a way that supports Republican policies. Again, don't be surprise when the nation tilts right when only the right wing attempts to embrace conservative policies and uses their media platforms to do so, while liberals only have Maddow and a few others.

https://en.wikipedia.org/wiki/Agenda-setting_theory

So, uhh, embracing the ACA is supporting Repub policy? Only in some post-truth pseudo-reality.

I haven't decried the idea of single payer, at all. I merely point out that we can get there if we want using the ACA as a vehicle. It's what we have & it's well worth keeping &expanding given Repubs' alterrnatives.

It's better than going on about what is currently unobtainium.

 

[Jaskalas]

You're just giving Repubs reason to mess with it.

You want to lead from behind.

Meaningful change comes from pushing forward, and inspiring a meaningful change in this country. See Franklin Delano Roosevelt. Nothing short of a New Deal will inspire the voters to divorce themselves from the Republican stranglehold. You have to show them that you believe in yourself and demonstrate policy that can help them. Only then will they believe in you.

The ACA demonstrated more harm than good. It cost Democrats everything they lost since 2010.

 

[Jhhnn]

You want to lead from behind.

Meaningful change comes from pushing forward, and inspiring a meaningful change in this country. See Franklin Delano Roosevelt. Nothing short of a New Deal will inspire the voters to divorce themselves from the Republican stranglehold. You have to show them that you believe in yourself and demonstrate policy that can help them. Only then will they believe in you.

The ACA demonstrated more harm than good. It cost Democrats everything they lost since 2010.

Kee-rist. The 2016 election had nothing to do with policy & everything to do with slime & delusions. Hillary's detailed policy positions & the platform didn't mean anything, although they were concrete proposals designed to help people.

What mattered was the Wall, White identity politics, Benghazi, Can't trust Hillary & her fucking emails. What mattered was this bitter "yeh, well, fuck you" attitude among too many white Americans. What mattered was the greatest performance by any con man in the history of humanity.

How in the Hell did the ACA demonstrate more harm than good when it covered nearly 20M more people than what came before?

 

[Maxima1]

So, uhh, embracing the ACA is supporting Repub policy? Only in some post-truth pseudo-reality.

LOL It doesn't even have a public option. It''s basically what Republicans have put forth before the increasing polarization after Gingrich's Contract with America.

I haven't decried the idea of single payer, at all. I merely point out that we can get there if we want using the ACA as a vehicle. It's what we have & it's well worth keeping &expanding given Repubs' alterrnatives.

It's better than going on about what is currently unobtainium.

You could say that with any movement that has resistance. There's no point in going into aw shucks mode. Advocating for change is more likely to get people behind it instead of waiting for corporate shills like Feinstein to back it.

 

[Maxima1]

How in the Hell did the ACA demonstrate more harm than good when it covered nearly 20M more people than what came before?

It led to the extreme gerrymandering because it undoubtedly played a role in them getting crushed as a result. That controversial legislation was paraded out for many months. The other large mistake being Reid getting rid of filibuster despite the fact that it was obvious that Democrats weren't going to keep/get House/Senate (which generally happens to party in power) and the presidential race being likely in Republican's favor.

http://thehill.com/policy/healthcare/225300-schumer-dems-erred-with-obamacare

 

[[DHT]Osiris]

Qualifying for Medicare almost turned my parents into Democrats. They have to use the hell out of it and never once called it a PITA nor miserable. They needed medical care and weren't bankrupted by it.

I've had to use it quite a bit for the GF, and have had substantial issues with either doctors being in retarded out of the way locations (1+hr away in some case, first world problems though I guess) or fighting with offices/medicare over what is/isn't provided.

Not the worst system on the planet but it sure could be a lot easier. I miss Tricare, where the everything was covered, always, no matter what, zero questions asked.

 

[ivwshane]

You want to lead from behind.

Meaningful change comes from pushing forward, and inspiring a meaningful change in this country. See Franklin Delano Roosevelt. Nothing short of a New Deal will inspire the voters to divorce themselves from the Republican stranglehold. You have to show them that you believe in yourself and demonstrate policy that can help them. Only then will they believe in you.

The ACA demonstrated more harm than good. It cost Democrats everything they lost since 2010.

So to be clear, you want the dems to do what they did in 2010?

Can you name someone besides Roosevelt who was pushing for the same policies he was at the time? Can you also compare and contrast the political climate back then to now?

What you'll find is that right now the only option is leading from behind.

 

[IEC]

Any of you MDs or midlevels who have to deal with actually providing care? Medicare is a PITA to deal with (to be fair, some private insurance is as well) and the incentives are all wrong.

Medicare and Medicaid suck and are lousy for patients, for doctors, and for taxpayers. Yeah they're better than nothing, but with all the hoops we have to jump through and all the unnecessary diagnostic work we *HAVE* to order before we can get them approval to get what they really need... waste of money, waste of time, waste of resources. And that's without mentioning the mountain of supporting documentation we need... Government bureaucrats (and office workers in general) deciding what is medically "necessary" from their air-conditioned offices 2000 miles away REALLY grinds my gears.

We provide FREE care once a week for the working poor who do not qualify for Medicare or Medicaid (or for whatever other reason, can't afford a doctor). These patients despite their absurd wait times to be seen (see: once per week) get seen more promptly and taken care of better than some Medicare patients due to the friggin' bureaucracy and the lack of providers willing to take new Medicare patients. And I don't blame them! A Medicare annual visit eats up as much time as seeing two patients, pays less, and you can't even address all their new health issues in the visit! Which brings me to my main points:

The answer IMO isn't more government distribution of healthcare (i.e. my time and other providers' time) - it's:
1) reducing the paperwork and bureaucratic burden
2) letting doctors decide what is medically necessary
3) tort reforms
4) reducing the role of insurance in general to more of a catastrophic coverage - see below for why:

When I get out of training I'm probably going to go to a direct primary care model. By cutting out the middleman (insurance/gov't) we can actually provider BETTER care, faster, and cheaper. All the basic lab work, preventative care, and routine diagnostic procedures (e.g. pap smears) can be included in a monthly fee with a certain # of patients assigned to each provider. Because we don't need to wait for friggin' insurance/Medicare, with a large enough group we can have our own pharmacy, lab, etc. and meet all patients' basic medical needs. We can do a lot of same day appointments and we're highly motivated to keep people healthy and well - because people needing to see us less frequently means we can keep our schedules open for same day visits and even housecalls - a real patient satisfier. Combined with a med/high deductible/"catastrophic" coverage plan the patients *AND* insurance companies can save money as well by catching things earlier. And we can set aside a portion of the subscriber fee to be used to care for people in our community who would otherwise be unable to see a doctor. Yeah probably some details I'm leaving out, but I really think for primary care the answer is not more Medicare.

See:
http://www.aafp.org/practice-management/payment/dpc.html

P.S. I semi-retired from a lucrative career to pursue medicine so IDGAF about physician reimbursements. I'll see patients regardless of their ability to pay. But we need a better and more sustainable model - and that model is not Medicare.

 

[theeedude]

I am not sure we should have universal single payer now. Let Republicans kill off their base with "free market" health care first.

 

[Jhhnn]

LOL It doesn't even have a public option. It''s basically what Republicans have put forth before the increasing polarization after Gingrich's Contract with America.

Repubs never introduced legislation at the time. It was just an idea from Heritage that never found favor in the Party. They've never supported govt intervention in the healthcare market. It sure as Hell isn't their position today.

You could say that with any movement that has resistance. There's no point in going into aw shucks mode. Advocating for change is more likely to get people behind it instead of waiting for corporate shills like Feinstein to back it.

I could say that tilting at windmills isn't constructive, which is what you're doing entirely. So when the Repubs put the bone to millions of Americans dependent on Medicaid & ACA subsidies then people can just say it wasn't worth a damn anyway.