This will be a major line of attack against Medicare-for-all, as proposed by @SenSanders -- and it's premise is accurate.
But remember...
(Yes, here comes a thread.)
1) With M4A, you lose choice of insurance but you *gain* choice of doctor. No private insurance networks.
But remember...
(Yes, here comes a thread.)
1) With M4A, you lose choice of insurance but you *gain* choice of doctor. No private insurance networks.
2) Coverage in the @SenSanders plan would be more generous than even the best employer plans. And it doesn't get rid of Medicare so much as it enhances it, by filling gaps.
Remember, Sanders M4A has virtually no out-of-pocket expenses. huffingtonpost.com/entry/bernie-s…
Remember, Sanders M4A has virtually no out-of-pocket expenses. huffingtonpost.com/entry/bernie-s…
3) With M4A you pay taxes instead of health insurance premiums. And on paper, the majority of people should end up paying less than they do now, though that wouldn't be true for everybody.
4) The Ryan criticism applies only to pure single-payer plans, like the one that @SenSanders proposed. Other proposals, like @amprog americanprogress.org/issues/healthc… and @JonWalkerDC shadowproof.com/2017/07/24/her… make the new government plan voluntary.
More here: huffingtonpost.com/entry/liberal-…
More here: huffingtonpost.com/entry/liberal-…
5) There are caveats, tradeoffs, etc. for all of these.
For example, networks and managed care aren't a bad thing if they are designed to steer people into better quality or more cost-efficient providers.
For example, networks and managed care aren't a bad thing if they are designed to steer people into better quality or more cost-efficient providers.
6) It's possible to think that out-of-pocket costs are way too high right now without thinking they shouldn't exist at all.
Most systems abroad have some token cost-sharing, typically waived for the poor & people with chronic illness -- which seems like a sensible arrangement.
Most systems abroad have some token cost-sharing, typically waived for the poor & people with chronic illness -- which seems like a sensible arrangement.
7) And of course the math of the @SenSanders plan relies on substantial cuts in payment to doctors, hospitals, drugmakers, etc. -- which, however justified on merits, are politically and/or practically difficult.
See this new @urbaninstitute report urban.org/research/publi…
See this new @urbaninstitute report urban.org/research/publi…
8) So a lot to debate and ponder when it comes to M4A. But as this debate unfolds, it's worth remembering that losing your current plan may not be bad thing. It depends entirely on what you're getting instead and what you think of it. Of course, YMMV.
9) If you really want to dive into this and the different plans, I highly recommend the new @KaiserFamFound interactive on M4A and its variations kff.org/medicare/issue…
10) And just to circle back to the top, I said that @speaker premise was accurate, by which I meant @SenSanders plan really does put everybody into a single government plan.
But Ryan was suggesting this would mean a loss of freedom. I wouldn’t stipulate to that.
But Ryan was suggesting this would mean a loss of freedom. I wouldn’t stipulate to that.
11) On the contrary, the whole point of the @SenSanders proposal — and, really, any good universal coverage scheme — is to *increase* freedom, and not just by offering more choices if doctors...
12) Untreated illness is debilitating. So are unpaid medical bills — and fear of generating them. I.e. people who don’t have access to affordable, quality health care don’t have the same freedom as those who do.
13) In the system @SpeakerRyan prefers, literally tens of millions would be uninsured or underinsured, struggling with medical bills. In the system @SenSanders and other universal coverage advocates prefer, almost nobody has those worries.
14) BTW this is an argument that @SenSanders makes powerfully and persuasively all the time. I suspect that even Democrats who don’t support M4A could learn a thing or two by listening.
15) One more thing: I'm talking about M4A, as written. If Congress took up such a proposal, you'd have to watch closely to see how it changed. Providers would fight cuts, for example, and that could change financing, perhaps changing generosity, etc.
16) We've seen this before: ACA as passed was different from ACA as written. Or any other legislation that's ever gone through Congress.
Which is why you have to watch the process closely, and note how legislation is changing -- for better, worse, or both.
Which is why you have to watch the process closely, and note how legislation is changing -- for better, worse, or both.
17) Similarly, you can have docs opting out of the system altogether if reimbursements are too low, as @Neoavatara points out. I doubt it'd be many -- more likely to err in other direction, with payments that stay too high. But something to watch.
