1. Warren has just put out her plan on the finances of M4A. @Robillard has the story (with a small assist from me). huffpost.com/entry/elizabet…
2. Remember, with M4A, health care spending shifts from individuals and employers (no more premiums & copays) over to the federal government.
Key questions:
(a) What does new program cost?
(b) Where does gov't get the money?
(c) Who comes out ahead, who doesn't?
Key questions:
(a) What does new program cost?
(b) Where does gov't get the money?
(c) Who comes out ahead, who doesn't?
3. On (a) -- how much it costs -- Warren envisions a program that would require $20T in new fed spending over the next decade. A lot of money, though substantially less than some other estimates have suggested M4A would require.
4. Why the difference? Her campaign assumes more aggressive control of prices and drug costs, bigger savings from efficiencies, more contributions from states. 
5. On (b) -- where gov't gets the money -- Warren hikes taxes on the wealthy and on corporations, pulls in money from other sources like defense cuts, and gets higher tax revenue because paychecks are higher.
6. On (c) -- who comes out ahead -- she says only the rich end up paying more and, on paper, that seems to be true. But her assumptions above are subject to criticism and question, plus there are always potential tradeoffs for the economy, as well as health care access & quality.
7. The provider payments, in particular, are likely to generate political pushback from docs, hospitals, etc.
Notable she doesn't shy away from specifying those payments. To be clear, campaign says that docs and hospitals will be just fine financially. huffpost.com/entry/bernie-s…
Notable she doesn't shy away from specifying those payments. To be clear, campaign says that docs and hospitals will be just fine financially. huffpost.com/entry/bernie-s…
8. Cannot emphasize this enough: We're just getting our first look at this plan. It will take a while to figure out exactly what it means and what the implications are.
9. To reiterate, it is certainly possible to create a system like M4A in which, overall, poor and middle-class come out ahead. But hitting that goal requires overcoming political challenges and accepting some tradeoffs. huffpost.com/entry/medicare…
10. Of course, as @Robillard notes, it's quite likely this proposal can't become law, at least in the near future. One question is whether this sets up a bargaining position, from which an effective compromise can eventually emerge. huffpost.com/entry/elizabet…
@Robillard 11. If you want an example of why the provider cuts are simultaneously reasonable and difficult to pull off, consider the proposal on physician payments. The plan calls for paying docs at Medicare rates.
12. The average all payer rate for physicians today is 107% Medicare, the campaign says, but simplified billing etc should more than make up for that -- and average physician income could actually rise.
13. That seems plausible, at least on paper. But we are talking averages.
It will feel like a raise to some physicians, a cut to others -- especially because the plan also envisions balancing payments, to boost primary care and at expense of specialists.
It will feel like a raise to some physicians, a cut to others -- especially because the plan also envisions balancing payments, to boost primary care and at expense of specialists.
14. There is a very good argument for that kind of change on the merits. We should pay more for primary care! But it will raise strong objections from specialty societies, especially given the extra years of training (and medical education debt) specialty training requires.
