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This is an excellent article, and sets out some of the issues confronting us on cost...as well as some of the tradeoffs involved.
I have a few thoughts coming...
I have a few thoughts coming...
1. Note how all four models really believe you will have to INCREASE payments to doctors. (Blahous does too, though he wanted to us 0% increase as a baseline).
Some pols have suggested otherwise, and even that you could cut payments by 1/3rd (looking at Sanders and Jayapal).
Some pols have suggested otherwise, and even that you could cut payments by 1/3rd (looking at Sanders and Jayapal).
2. On Rx drugs, all think prices will drop. I think that is probably right, but Friedman suggests a 30% drop. If that happens, I can guarantee that R&D would plummet. Even the Urban Inst estimate of a 20% drop is unrealistic.
3. They ask how much Medicare would cost to run. The current estimate hovers around 2%...and is impossible. The reason they can do that now is because of private insurers.
The cost will probably be in 5-8% range, according to several experts.
The cost will probably be in 5-8% range, according to several experts.
Lets note 6% is the number many large employers pay now. Insurers are probably slightly higher, but not much so.
4. The biggest question mark is how they'll pay for it. I really wish they had put forward the cost. For example, Sanders suggests a payroll tax. Would be nice to see how much that would cost average individuals. The price would be significant.
Additionally, they didn't confront the level of services.
There is no chance, none whatsoever, that they could meet these cost constraints and maintain the level of insurance that, say, I, or many labor union employees, currently have.
That would be far costlier.
There is no chance, none whatsoever, that they could meet these cost constraints and maintain the level of insurance that, say, I, or many labor union employees, currently have.
That would be far costlier.
M4A uses a baseline of Medicare, adds some supports, and then presents it as wholesale plan.
But Medicare is far less luxurious than most people's current plans. What the cost construct would look like if we went to that level of care...nobody wants to talk about.
But Medicare is far less luxurious than most people's current plans. What the cost construct would look like if we went to that level of care...nobody wants to talk about.
"After Mr. Sanders’s presidential campaign released a tax proposal in 2016, the Urban Institute tried to calculate the effects on different groups. But it found that the proposed taxes would pay for only about half of the increased federal bill."
In short, taxation and level of services promised are the two most critical issues to answering if this entire endeavor is possible....
...and advocates refuse to answer questions regarding either.
I wonder why that is?
...and advocates refuse to answer questions regarding either.
I wonder why that is?
