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THREAD: If you’re talking about how to pay for a BernieCare-style 100% “pure” MFA plan, it’s helpful to start out understanding what total healthcare spending is CURRENTLY projected to look like over the next decade.
Last summer, there was a big deal made out of an anti-MFA study which projected that Bernie’s S.1804 bill would EITHER “cost $32 trillion” OR “save $2 trillion”, depending on your POV. BOTH are true conclusions. 2/

Here’s the two key graphs. The first shows how much CMS projects the U.S. will spend out until 2031 under CURRENT law. That’s TOTAL spending by EVERYONE for EVERYTHING. Below the dotted line is public spending, above the line is private. 3/
The green section is what Mercatus projects total FEDERAL spending would look like under S.1804, replacing EVERYTHING else. This would replace all state spending, all premiums, deductibles, co-pays, employer contributions, Medicare taxes, Medicaid, CHIP, ACA, etc. 4/
The green section ABOVE the dotted line is where the “$32T in additional federal spending!” comes from. The gap between that and the blue line is where the “$2T saved!” comes from. 5/
The controversy over their projection is mostly about how much the savings would be. Note that their 3.4% savings assumes ALL healthcare spending is changed to Medicare rates...roughly 20% lower than private insurance pays doctors/hospitals, give or take. 6/
This savings would be partly cancelled out by increased utilization from the 90% currently underinsured but especially by the 10% not currently covered at all. Assuming the provider community accepted the lower rates, that’s what they think it’d look like. 7/
If, however, we stuck with CURRENT provider reimbursement rates, THIS is what Mercatus thinks it’d look like: a 5.5% *increase* in total spending. 8/
You can argue that their projections are too conservative (pun intended), but that’s what they concluded. Take it for what you will. /end
CORRECTION: in #7 above, “90% underinsured” should read “90% insured or underinsured”.
Thank you for coming to my TED Talk.
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