Thread by @Gormogons

GP "One: No American should ever, ever die or go bankrupt because of health care costs."

No one dies because of health care costs. Hospitals are required to treat all comers.

https://twitter.com/ewarren/status/1190247301308207105

GP "Let’s be clear: America’s medical professionals are among the best in the world. Health care in America is world-class. Medicare for All isn’t about changing any of that."

Your plan changes all the critical incentives for America's best and brightest going into medicine.

GP "In 2017 alone, health industry players whose profiteering would end under Medicare for All ..."

Hey, health care industry workers! You're all profiteers.

GP "... the bill does not directly incorporate specific revenue measures. While much of this ambiguity results from the reasonable choice to delegate significant implementation discretion to the Executive Branch ..."

Because the executive should legislate?

GP "Everybody gets the doctors and the treatments they need, when they need them."

So, we can't have the doctors and the treatments we want when we want them, even if we pay out of pocket.

Great plan. Way to maximize personal freedom for patients and providers.

GP "The $11 trillion in household insurance and out-of-pocket expenses projected under our current system goes right back into the pockets of America’s working people."

And be taxed as ordinary income, no deductions or credits. You're raising taxes on $11B/year of MC income.

GP "Because nobody can actually see the future, some of this variation results from different assumptions about how parts of our health care system might work differently under [MFA]."

Basically, Warren's admitting they made sh*t up using the rosiest predictions possible.

GP "Their analysis begins with the assumptions of a recent study by the Urban Institute ..."

Oh. The Urban Institute. The one LBJ founded to hammer his Great Society welfare programs through Congress. Totes a neutral arbiter on issues.

en.wikipedia.org/wiki/Urban_Ins…

GP "My plan will ensure that Medicare for All functions just as efficiently as traditional Medicare by setting net administrative spending at 2.3%."

Uh huh. Because government mandated cost ceilings have always resulted in high quality products and services.

GP "We pay more for physicians and nurses. We pay more in administrative costs. We pay more for prescription drugs."

Warren to medical professionals: Suck it. You're wage slaves now. Welcome to government scale.

GP "My plan will also rebalance rates in a budget neutral way that increases reimbursements for primary care providers and lowers reimbursements for overpaid specialties."

I'm reminded of Granny telling me "you get what you pay for." Welcome to third-tier docs.

GP "The nonpartisan Institute of Medicine estimates that these wasted expenses account for 13% of the revenue for physician practices, 8.5% for hospitals, and 10% for other providers."

Narrator: most of these "wasted expenses" are required by government (over)regulation.

GP BTWs, the Institute of Medicine is a creation of government. Just thought that little tidbit might add a bit of flavor.

GP "Today, for example, insurers can charge dramatically different prices for the exact same service based on where the service was performed."

Today government pays employees different wages for the same work based on where the service was provided.

federalpay.org/articles/local…

GP Under a section titled "RESTORING HEALTH CARE COMPETITION" there's this:

"And I will direct my FTC to block all future hospital mergers unless the merging companies can prove that the newly-merged entity will maintain or improve care."

So less competition = more competition.

GP You have to be profoundly brain damaged to believe that by limiting competition you're actually increasing competition. But government obviously believes this because it steadfastly refuses to permit widespread competition in public education.

GP And for @molratty, Warren proposes:

"If negotiations fail, I will use 2 tools – compulsory licensing and public mfg – to allow my admin to ensure patient access to medicines by either overriding the patent ... or by providing public funds to support mfg of these drugs ..."

@molratty GP This is formula for cratering America's robustly creative drug market.

Also, Warren fails to mention how she's going to revenue source those "public funds to support manufacturing of these drugs." Did she calculate it into her plan?

@molratty GP Warren on cost control:

"And if growth rates exceed this rate, I will use available policy tools, which include global budgets, population-based budgets, and automatic rate reductions, to bring it back into line."

Welcome to Cuba's medical system, the envy of no one.

@molratty GP Warren to states: "You may suck my metaphorical balls, serfs."

"Under my approach to Medicare for All, we will redirect $6 trillion in existing state and local government insurance spending into the Medicare for All system."

@molratty GP "[T]he experts conclude that total new federal spending required to enact Medicare for All will be $20.5 trillion."

That's *new* spending. That doesn't count the $1.3T (as of 2017) or so now spent on Medicare/Medicaid annually.

@molratty GP "My idea is that instead of these companies sending those payments to private insurance companies, they would send [insurance premiums, workers comp, and disability] payments to the federal government for Medicare in the form of an Employer Medicare Contribution."

It's a tax!

@molratty GP "To calculate their new Employer Medicare Contribution, employers would determine what they spent on health care over the last few years + divide that by the number of employees of the co. in those years to arrive at an average health care cost per employee at the company."

@molratty GP "Under the first year of Medicare for All, employers would then take that average cost, adjust it upwards to account for the overall increase in national health care spending, and multiply it by their total number of employees that year."

You're gonna get fired.

@molratty GP Seriously, I would flat out start firing people and automating jobs as fast as possible. Unemployment will skyrocket.

@molratty GP "People who are self-employed would be exempt from making Employer Medicare Contributions unless they exceed an income threshold. "

Welcome to everyone being a member of the gig economy! I'm only hiring independent contracts on a project basis.

Rx The Institute of medicine is largely in habited with eggheads to Lowe’s participating in direct patient care along side academics to spend maybe 5% of their time with direct patient contact even as they do enjoy that aspect of their job.

Rx The Institute of medicine recommendations for no co-pay items in private health insurance included annual well patient visits. My liberal primary care colleagues were inundated with healthy patients who do not need to see a Primary care doctor annually.