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Vox: Bernie Sanders outlines his single payer bill

pigeon

Banned
Feb 14, 2011
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I have no idea. Can you expand on that?

Sure! 70% of Americans have government-subsidized employer-provided health insurance. In almost every case, the employer pays some portion of the premium, since they will receive a subsidy from the government in the form of a tax exemption for doing so. Often that portion is 100%.

As a result, an analysis that compares the out-of-pocket cost to the tax increase is not necessarily reasonable. Most Americans have no exposure to the out-of-pocket cost of their insurance, because it comes as wages in kind. Nor is it safe to assume the removal of those wages in kind will lead to the corresponding increase in wages in cash, because those are sticky.

It is quite possible that the actual experience for most Americans will be a loss of their current health insurance provisions, no corresponding wage increase, and a noticeable tax increase. That doesn't mean we shouldn't do it, but we should be clear about the outcome.
 

Zoe

Member
Jan 3, 2007
45,101
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Sure! 70% of Americans have government-subsidized employer-provided health insurance. In almost every case, the employer pays some portion of the premium, since they will receive a subsidy from the government in the form of a tax exemption for doing so. Often that portion is 100%.

"Often" seems debatable.

Average Single Premium per Enrolled Employee For Employer-Based Health Insurance
Average Employee-Plus-One Premium per Enrolled Employee For Employer-Based Health Insurance
Average Family Premium per Enrolled Employee For Employer-Based Health Insurance
 

E-Cat

Member
Jan 14, 2013
4,148
709
725
Sure! 70% of Americans have government-subsidized employer-provided health insurance. In almost every case, the employer pays some portion of the premium, since they will receive a subsidy from the government in the form of a tax exemption for doing so. Often that portion is 100%.

As a result, an analysis that compares the out-of-pocket cost to the tax increase is not necessarily reasonable. Most Americans have no exposure to the out-of-pocket cost of their insurance, because it comes as wages in kind. Nor is it safe to assume the removal of those wages in kind will lead to the corresponding increase in wages in cash, because those are sticky.

It is quite possible that the actual experience for most Americans will be a loss of their current health insurance provisions, no corresponding wage increase, and a noticeable tax increase. That doesn't mean we shouldn't do it, but we should be clear about the outcome.
Huh. I would have assumed that Bernie's calculations were accounting for the percentage of the out-of-pocket costs that are actually paid, well, out-of-pocket! Presumably, those costs still aren't zero for most Americans, even if most have employer-based insurance.

In any case, yeah, you should do it anyway! We Scandinavians don't mind paying a little more in taxes to make sure that everyone gets humanely treated for their ailments when in need. The national integrity and unity gained by so doing cannot be measured in money.
 

Ziltoidia 9

Member
Jul 1, 2013
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Lewisville, TX
Sure! 70% of Americans have government-subsidized employer-provided health insurance. In almost every case, the employer pays some portion of the premium, since they will receive a subsidy from the government in the form of a tax exemption for doing so. Often that portion is 100%.

As a result, an analysis that compares the out-of-pocket cost to the tax increase is not necessarily reasonable. Most Americans have no exposure to the out-of-pocket cost of their insurance, because it comes as wages in kind. Nor is it safe to assume the removal of those wages in kind will lead to the corresponding increase in wages in cash, because those are sticky.

It is quite possible that the actual experience for most Americans will be a loss of their current health insurance provisions, no corresponding wage increase, and a noticeable tax increase. That doesn't mean we shouldn't do it, but we should be clear about the outcome.

It still comes from an employer funding a position, and it would go from a monthly premium amount to a tax% that would would be less be less than what the premium was for most of the country.

Do you know how much your employee pays for your health insurance? if so times your yearly income by .075 and see which is lower. What the employeer would do with the savings though is a different story.

When I run my numbers, it would cost my employeer about 4k less a year under a single payer system, and I wouldn't have a deductible.

Edit: The average cost of healthcare per year that people pay was about 10K last year. You would have to earn like 140k a year or something to get to that level of proposed tax.
 

pigeon

Banned
Feb 14, 2011
19,361
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It still comes from an employer funding a position, and it would go from a monthly premium amount to a tax% that would would be less be less than what the premium was for most of the country.

Do you know how much your employee pays for your health insurance? if so times your yearly income by .075 and see which is lower. What the employeer would do with the savings though is a different story.

When I run my numbers, it would cost my employeer about 4k less a year under a single payer system, and I wouldn't have a deductible.

That's pretty much my entire point? Yes, your employer would save money. But they probably wouldn't give you that money. If you had that kind of negotiating leverage you'd already be getting paid more.
 

Ziltoidia 9

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Jul 1, 2013
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That's pretty much my entire point? Yes, your employer would save money. But they probably wouldn't give you that money. If you had that kind of negotiating leverage you'd already be getting paid more.

Well at least we agree it costs less for coverage for most of the country.

I imagine we would then have all the stats that show how much a company is saving and how much employees wages are going up. If they don't go up, it will just add to the list of the inequality as it is.

You would also have people that feel locked into a company move on to something else, because they no longer fear losing health coverage.
 

pigeon

Banned
Feb 14, 2011
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Well at least we agree it costs less for coverage for most of the country.

Sure. I never disputed that, so I don't know why you would expect me not to agree with it.

You would also have people that feel locked into a company move on to something else, because they no longer fear losing health coverage.

Reducing job lock would certainly be a huge advantage of single payer.
 

Kin5290

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Jan 12, 2015
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A huge problem with this plan is that cost sharing is being done away with. If nothing else, reduction of cost sharing means that people consume significantly more health care, even if they don't need it. That's going to be very expensive.

Also, how cost reductions will work and how M4A will be paid for remain "Step 2: ???" kinds of things.
 

Henchmen21

Banned
Apr 14, 2008
9,668
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Well at least we agree it costs less for coverage for most of the country.

I imagine we would then have all the stats that show how much a company is saving and how much employees wages are going up. If they don't go up, it will just add to the list of the inequality as it is.

You would also have people that feel locked into a company move on to something else, because they no longer fear losing health coverage.

Also why we need stronger unions again (thank the Clinton's for fucking us over on that one). We used to have a robust union system in this country.
 

Foffy

Banned
May 14, 2009
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Sure. I never disputed that, so I don't know why you would expect me not to agree with it.



Reducing job lock would certainly be a huge advantage of single payer.

Reducing job lock should be a core goal of any society with sense.

Speaks volumes that we trap people in benefits games, from stem to stern. We only complain about the traps at the bottom, though..
 

blackw0lf

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Oct 22, 2014
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Lieberman.

Actually Lieberman gutted the expansion of Medicare to 55 and older, which was in the bill until Lieberman stopped it.

We would be looking at a vastly different landscape right now if that had been included. Honestly I'm pretty sure Dems would still have full control of the White House and legislature if that had been in there.
 

Ocara

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Nov 18, 2015
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Do other countries with private/public insurance have the same ridiculous company lobbying power as in the us? Honestly with the money in politics and the private industry poised to take a hit even in a public + private situation (just from competition alone), i cant imagine a public + private insurance not just turning into private insurance companies slowly neutering the government healthcare via lobbying until we're back where we are now.

With that said the ban on private insurance which covers the same as govt health care made sense to me, especially coming from bernie who's taken a classicly strong stance against money in politics.
 

Epsilon-delta

Banned
May 9, 2006
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Actually Lieberman gutted the expansion of Medicare to 55 and older, which was in the bill until Lieberman stopped it.

We would be looking at a vastly different landscape right now if that had been included. Honestly I'm pretty sure Dems would still have full control of the White House and legislature if that had been in there.

I agree.

To this day I cannot stand Nelson or Lieberman.

Fuck them.
 

Rockandrollclown

lookwhatyou'vedone
Oct 17, 2007
3,608
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I know this can't pass currently, but its important to start the conversation. I believe that income inequality is the biggest issue facing us today. A big part of that is crippling medical debt. Number 1 cause of bankruptcy in the US. Single payer goes a long way to addressing income inequality. You know, and healthcare should be a right and all.
 

Neoweee

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Oct 8, 2014
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I know this can't pass currently, but its important to start the conversation. I believe that income inequality is the biggest issue facing us today. A big part of that is crippling medical debt. Number 1 cause of bankruptcy in the US. Single payer goes a long way to addressing income inequality. You know, and healthcare should be a right and all.

"Start the conversation"

The conversation has been going for decades, man.
 

Neoweee

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Oct 8, 2014
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It was swept under the rug for the longest. The conversation has been reignited if that makes you feel better.

Literally the last two Democratic presidencies have had healthcare expansion as a major initiative, and the W. Bush administration did a massive expansion of Medicare. Expansion of healthcare has literally been the most important and constant political issue and political battle for most American GAFfers' lifetimes.
 

Croatoan

They/Them A-10 Warthog
Jun 24, 2014
4,891
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fund single payer by cutting the military budget in half over 10 years.

You realize the the US spends almost twice as much on healthcare than it does the military right? Cutting the military budget in half wouldn't do shit to help pay for single payer and would actually adversely effect one of the primary means for people to get out of poverty, military service. I am not saying that there couldn't be ways to cut back military spending but thinking it can do anything to help get Bernie's plan to work is lunacy.

https://www.cbo.gov/publication/52408 2016

https://www.nationalpriorities.org/budget-basics/federal-budget-101/spending/ 2015


You can't look at our military spending as a dollar value itself, you look at it as a "percentage of our GDP which we spend to keep our position in the world". What is that percentage? 3.8% which is .3% lower than Russia and 1.8% higher than china.

https://www.usatoday.com/story/mone...countries-spending-most-on-military/12491639/
 

Spuck-uk

Banned
Jun 2, 2014
3,904
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Not knowing how to pay for it is an incredibly major flaw

You do realise your country spends more money per person on healthcare than the other first world countries, who have free universal healthcare, right?

Also sort out your lobbying system out, it's disgraceful for a democracy.
 

Tapioca

Banned
Aug 17, 2017
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A good private insurance plan that isn't loaded with co-pays and deductibles is expensive as fuck, especially if you have a family. I don't know why people are acting like people wouldn't give up their private insurance if this was cheaper and covered more. I know medicaid covers 100% of everything.

People getting fined for not being able to afford insurance is also really dumb.
 

Tapioca

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Aug 17, 2017
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My mother was laid off a few months ago. Her company gave her the same compensation as she was making working there for 9 months. All her benefits discontinued of course. She is paying $600 a month just for some basic ass insurance she found on the Obamacare market place. She makes too much to go on medicaid and is not old enough for medicare.

It is ridiculous.

If anyone knows of any cheaper insurance, maybe she just didn't know how to pick, I'm not sure... please let me know.
 

pigeon

Banned
Feb 14, 2011
19,361
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A good private insurance plan that isn't loaded with co-pays and deductibles is expensive as fuck, especially if you have a family. I don't know why people are acting like people wouldn't give up their private insurance if this was cheaper and covered more. I know medicaid covers 100% of everything.

People getting fined for not being able to afford insurance is also really dumb.

You understand that under a single payer system you would be taxed in order to pay for your insurance, regardless of whether you can afford to pay the tax, right?
 

Azure Dream

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Oct 30, 2004
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Actually Lieberman gutted the expansion of Medicare to 55 and older, which was in the bill until Lieberman stopped it.

We would be looking at a vastly different landscape right now if that had been included. Honestly I'm pretty sure Dems would still have full control of the White House and legislature if that had been in there.

Hell, Democrats probably would've won 2000 if it weren't for Lieberman.
 

Tapioca

Banned
Aug 17, 2017
519
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You understand that under a single payer system you would be taxed in order to pay for your insurance, regardless of whether you can afford to pay the tax, right?

Yeah, I have no clue why you are saying this to me. I was talking about the tax penalty you take for not having insurance at the end of the year. People can be"taxed" for not having private insurance.
 

mid83

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Mar 4, 2014
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No way in hell something like this passed anytime soon. The cost would be astronomical and despite Bernie attempting to say that the rich and corporations will take on the overwhelming majority of the cost, realistically we are all going to have a massive increase in taxes if something like this is going to be done. Middle and upper middle class families would see a huge decrease in take home pay, and most people are not going to be happy with that.
 

Inuhanyou

Believes Dragon Quest is a franchise managed by Sony
Jul 26, 2014
26,221
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America
No way in hell something like this passed anytime soon. The cost would be astronomical and despite Bernie attempting to say that the rich and corporations will take on the overwhelming majority of the cost, realistically we are all going to have a massive increase in taxes if something like this is going to be done. Middle and upper middle class families would see a huge decrease in take home pay, and most people are not going to be happy with that.

i mean, this isnt really true. the up front cost essentially doesnt matter, as what we would spend in enacting the plan would essentially be dwarfed by the ballooning costs of our current system over the next several years. As we spent over a trillion dollars on healthcare in this country every year as it stands on subsidizing private insurance and funding medicaid.

As said earlier in the thread, in its current form, the US spends over 10k per person on healthcare, whereas in a comparable single payer country like Canada, you can get comparable or better outcomes with the government spending around 5k.

So essentially, if set up right, we could significantly cut spending in the healthcare area while insuring everyone directly and cutting out the middle man that is the for profit industry.

Also, due to the sheer amount of people in the US, it would only take a relatively marginal increase in taxes on the middle class(going incrementally higher as you go past the 250k) mark to fund something like this, and that increase would be offset by employers not taking the money out of your paycheck that they would use to give you insurance, and people who dont have employer based coverage would save by not having to pay co pays, premiums or deductibles.
 

uncelestial

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Feb 25, 2015
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The four year rollout should phase in by age so that the first year gets the youngest, healthiest population in first, to help fund/set up the program.

But yeah, nice to read and daydream about, even though this has a snowball's chance.
 

Aaron Strife

Banned
Oct 10, 2006
26,804
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Hell, Democrats probably would've won 2000 if it weren't for Lieberman.
Ironically Lieberman had no problem with expanding Medicare to 55 and up when he was running for Vice President.

Only when he was in a position to actually do something about it did he reveal his true colors.
 

kirblar

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Oct 9, 2010
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For an extreme but very real-life example of a real concern with how we transition health care and premiums, here are the premiums for Loudoun County, VA's public school system: https://www.lcps.org/cms/lib/VA01000195/Centricity/Domain/74/FINAL 2017 rates for WEB.pdf (was helping a friend look for potential jobs in the area and stumbled on it.)

For the Open Access plan ( which is very good: https://www.loudoun.gov/index.aspx?NID=1072 ) a single teacher is paying 17.94 in premiums per month while their employer pays $762.00. This is a wage premium, because Loudoun County's a very well-off place, but it does mean that LCPS teachers are being "paid" $9K in benefits that isn't guaranteed to start going into their paychecks if the benefits stop being necessary.

That premium is so abnormally low, in fact, that it's clear LCPS is likely using the low premiums as a way to "virtually" raise wages since it's more efficient to give someone tax-free benefits than taxable income. (indeed, this is a strong argument for making Health Insurance benefits taxable as income!)