Thread by @Neoavatara

So, a classic terrible debate on health care today on @OnPointRadio hosted by Meghna Chakrabarti, with guest Warren unofficial advisor Simon Johnson and Mark Pauly of UPenn Wharton school.

https://twitter.com/OnPointRadio/status/1191732148929097728?s=20

Point of note: She had @CitizenCohn on at the beginning...and I missed that segment, so caveats and all that.

And, I don't blame Chakrabarti, who tried to ask intelligent questions during the debate portion.

But...Simon Johnson...seems not to understand one simple thing about health care:

IT IS ALL ABOUT TRADE OFFS.

Listen to Lebron....he knows what he is talking about!

Johnson happily spoke about the economic benefits of the Warren plan, where the middle and lower class (theoretically) will pay less taxes...and the money will all come from the rich.

That policy has its own trade offs, but lets put that aside for a second.

Simon goes on to make the assertion that the US system is the most inefficient in the world (that is a dubious assertion); and, that we simply need to pay hospitals, doctors, nurses, drug companies, etc less...and then, problem solved!

Mark Polly, to his credit, tried to make a point about the reality that these policies come with trade offs of their own...but Johnson wanted no part of that discussion.

So Johnson goes on about how we are going to cut funds to providers by a 1/3. OK, great.

And...does that come with any cost?

According to Johnson...NO! Access will remain the same! You will get the same level of service you get today!

The fact that we already have localized areas of doctor and nursing shortages...apparently are beyond Johnson's understanding.

In short, he completely dismisses the concept of supply and demand all in this dynamic.

For example: Radiology.

We already have a shortage. Try finding night coverage for a new hospital these days. It is painful.

Now...imagine you cut their pay by 1/3.

What exactly will the response be?

For someone like me, who is well established...we would simply have to cut services. It isn't because we are greedy, unfeeling humans...we simply can't find people that would do that work for that pay. It just is impossible.

Note Johnson happily says those pay cuts would be biggest for drug companies, doctors, hospitals..but he admits that nurses and other ancillary staff would be hit.

In some communities, those jobs are the PRIMARY economic force. Cutting those incomes would devastate many cities.

Now, it gets worse.

He talks about 'efficiencies' without, really defining that term.

What would efficiency mean in health care?

It would mean MASS LAYOFFS.

Medicine is a service industry for the most part...so the only way to save money is...by cutting services.

Johnson (and frankly, Warren) happily wave off this obvious trade off, because...well, it is pretty damn inconvenient.

LET US ONLY TALK ABOUT TAX BREAKS!

Oh, yeah, tax breaks.

You realize Simon Johnson is, honestly and openly, asserting that Warren's massive socialist undertaking of taking over the entire health care insurance industry...is a TAX CUT?

He states that it will be a $12 TRILLION tax cut!

This is such a ludicrous assertion, it isn't even worth a response.

Johnson claims massive savings by efficiencies...and claims Medicare has only 2% overhead, while private insurance have 15% overhead!

Of course, this is a myth. Why it persists is beyond me. From @avik....though numerous other sources back him up.

forbes.com/sites/theapoth…

@Avik Reality is Medicare does have less overhead, but one reason is that it is often managed by PRIVATE comp....who cover overhead, and do dirty business like scout for corruption.

The real difference in cost is probably between 1-2%...worth confronting, but not a huge money saver.

@Avik Look, I know people like Johnson do have a good argument to make. But when we have discussions where people like him and Warren say there are no trade offs, that everything is unicorns and rainbows...I wish journalists would speak up.