American College of Physicians calls for radical change

Discussion in 'Current Events' started by Eleuthera, Jan 21, 2020.

  1. 3link

    3link Well-Known Member Past Donor

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    Your number is still made up.
     
  2. Seth Bullock

    Seth Bullock Well-Known Member Past Donor

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    All programs that are not fully funded by a dedicated tax are, in part, funded through deficit spending. Below is a chart provided by the Kaiser Foundation showing how Medicare was funded as of 2016. The column on the left shows the totals. The columns to the right break it down by Parts A, B, and D.

    medicare funding.png

    The column on the left shows that 45% of the revenue Medicare receives is from "General Revenue". This is the amount the federal government contributes from its general revenue. In 2016, that amount would have been about $319.6 billion.

    The amount of money the federal government takes in is less than the amount it spends. This is why I said that part of Medicare is funded through deficit spending.

    What I am suggesting is that if we want a Medicare For All program where everything is free at the point of service, that a good place to start would be with our present Medicare program. Raise payroll taxes to a level that fills in all the gaps for our seniors, eliminating private insurance for Medicare, and making it fully funded through dedicated taxes. Then, let some time pass to allow our economy to adjust. Remember, if only 36% of Medicare's funding comes from payroll taxes (Column 1), we would have to raise those taxes by a factor of about 3 to make this happen. The present Medicare tax is 2.9%, so the new Medicare tax would have to be about 8.7%. With the insurance companies out of Medicare, this amount could be less than that, however, but I don't know how much less. So even though that 8.7% amount may be a little high, it is still worthwhile to use to give us a feel for what is necessary to do this.

    I would suggest letting this new payroll tax be in place for a few years and then we could consider bringing in another demographic, like perhaps the 55-64 year group and raising taxes accordingly, gradually bringing in group after group, fully funding MFA through dedicated taxes.

    Seth
     
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  3. Eleuthera

    Eleuthera Well-Known Member Donor

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    Because they are fed up and frustrated with the status quo? Because they are not driven by $ but by other principles?
     
  4. jcarlilesiu

    jcarlilesiu Well-Known Member Past Donor

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    Do you know how expensive payroll taxes are now for employers?

    If were were to triple them, two things will happen.

    People will lose their jobs or the cost of consumables and services will escalate quite dramatically. Employers don't pay tax, any kind... corporate, payroll, etc. All of that comes from whatever they are selling. It's simply a pass through. At the end of the day, the general public pays for everything.. people do. The citizens simply can't afford to cover the cost of providing medical coverage or medical services to everybody that can't currently afford it.
     
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  5. jcarlilesiu

    jcarlilesiu Well-Known Member Past Donor

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    Non-sense.

    They stand to gain from their position. That's it. Nothing more nothing less.

    Again, this idea that you have that people wake up everyday and go to work for the betterment of society is fairy tale land. The only people that believe that are the people that don't wake up every morning and provide for themselves.
     
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  6. Eleuthera

    Eleuthera Well-Known Member Donor

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    My political agenda is based upon constitutional governance and human rights and decency. How about yours?
     
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  7. Eleuthera

    Eleuthera Well-Known Member Donor

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    Considering that the $ unaccounted for in Pentagon spending is approximately equal to the national debt, I think there are plenty of ways to fund universal health care.
     
  8. Eleuthera

    Eleuthera Well-Known Member Donor

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    We agree to disagree.

    I think there are many in the healthcare industry who are driven by altruistic motives.
     
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  9. Seth Bullock

    Seth Bullock Well-Known Member Past Donor

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    And this is why I framed my points by saying "If we want a Medicare For All program". You see, everyone would like to have free medical care. But what nobody talks about is what it would cost. The politicians (like Warren) put out these elaborate but nebulous plans to fund MFA that leave us with the impression that "someone else" will pay for it. And what I'm saying is that, if we want this, we have to look at ourselves and ask ourselves if we are willing to pay for it.

    How many times have we heard proponents of MFA comparing our medical care to that of foreign countries that have universal coverage? They tell us how great it is and how inexpensive it is compared to our system. But what they don't tell you is that the people in those countries pay for it. Not "someone else" - the people pay for it. So what I'm saying is that, if we want this, we need to have a realistic discussion about it, not some "pie in the sky" bs about the magical, mystical "someone else" who will pay for it.
     
    Last edited: Jan 24, 2020
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  10. Seth Bullock

    Seth Bullock Well-Known Member Past Donor

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    The budget for defense was set at $727 billion in 2019. In 2016, Medicare took in $710 billion, 45% of which was from general revenue (not dedicated taxes and premiums). We can see from these two figures that we cannot fund universal health care out of savings from the defense budget. That is just not possible. If we want a Medicare For All program, we will have to pay for it out of new taxes. There is just no two ways about it.
     
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  11. jcarlilesiu

    jcarlilesiu Well-Known Member Past Donor

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    Mine is based on human-nature and natural free market principals which understands that people's rights to individual liberty and participation in a free market results in the best advancement of society overall.
     
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  12. jcarlilesiu

    jcarlilesiu Well-Known Member Past Donor

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    Do you got to work everyday to make a difference in society, or do you go to work, be creative, work hard, and be innovative because there is money at the end of the effort?
     
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  13. jcarlilesiu

    jcarlilesiu Well-Known Member Past Donor

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    Absolutely correct.

    We are on the same page.

    People will point to Norway and see "It works", but they fail to tell you is that their EFFECTIVE tax rate is nearly 40%. Also what they wont' tell you is that any American's don't pay income tax, so 40% of zero is still zero. People that want MFA or Universal Healthcare expect somebody else will pay for it. If we told them we would be taxing 40% of their $25,000 income, they won't go for it.
     
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  14. Seth Bullock

    Seth Bullock Well-Known Member Past Donor

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    Right. Now you see what I'm driving at. I'm not saying that MFA is fundamentally a bad thing. What I'm saying is that the conversation has been controlled to leave out how we pay for it. Or, we get these complicated, nebulous, most likely failing ideas from Warren, et al. They go through these contortions to try to sell the public on the lie that we don't have to pay for it. That is utter baloney.

    If we want it, and if we don't want to bankrupt the federal government, then we must understand that we have to be willing to pay for it just like they do in other countries. The only way to do that with reliability and predictability is with new dedicated taxes and no deficit spending.

    And so this is why I suggested a modest beginning. If we want to do this, then start modestly by bringing about free medical care for our seniors, paid for in full by an increase in payroll taxes, filling in all the gaps and eliminating the insurance industry from Medicare. I pointed out that this would mean the payroll tax would have to increase from its present 2.9% to somewhere around 8%.

    If we not willing to take even that modest step, then what does that say about trying to do it for everyone? And so, the conversation has to be realistic, not a fairy tale that we don't have to pay for it because "someone else" will pay for it.

    Seth
     
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  15. James California

    James California Well-Known Member Past Donor

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    ~ Exactly. This is what many voters realized with the 'Obama Care' debacle. Promises of things with no real thought behind the idea.
     
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  16. squidward

    squidward Well-Known Member

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    Then you should be right beside them, offering some of your income, out of principle, if principle is your argument.

    ****ing doctors will do nothing to bring down costs.
     
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  17. Derideo_Te

    Derideo_Te Well-Known Member

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    Thank for providing that link and that data as the means to establish a basis for debating our options WRT Medicare for All.

    Not to nitpick but only a portion og the $319 billion from general revenues is borrowed so the impact on the national debt is smaller than that entire amount.

    Yes, we do NEED to raise the Payroll taxes in order to fully fund our existing Medicare. It is worth noting that had there NOT been the taxcut malfeasance at the beginning of the Bush/Cheney regime Medicare would be fully funded and the deficits and national debt would be a non issue. However we have to deal with our reality because we cannot change the past.

    Before we discuss how much we need to raise in taxes let's just look at how we spend our healthcare dollars.

    https://en.wikipedia.org/wiki/Health_care_finance_in_the_United_States#As_percentage_of_GDP

    The total spending on Healthcare nationwide comes in at about $3.5 trillion (2017) and of that $710 billion is the Medicare cost. That means that the Medicare is only 20% of overall healthcare spending. Medicare covers everyone who is 65 and older which is the MOST EXPENSIVE segment of the market and why the private sector wants nothing whatsoever to do with it. There are LOW OVERHEADS and contained costs under Medicare which account for 15% of the population.

    Compare that to the other 80% of spending on Healthcare which covers the other 85% of the population.

    By those numbers alone it is plain to see that the PRIVATE health insurance is DELIVERING only a FRACTION of the actual HEALTHCARE SERVICES to the healthiest segment of the population but CHARGING everyone as is they were receiving the same INTENSIVE healthcare services that are provided to the elderly under Medicare.

    That makes no sense until you examine the PROFIT MOTIVE!

    Remove the profit motive by instituting Medicare for All and the overall expenditure on healthcare would DROP by around a third and fall in line with the expenditures in all of the rest of the western civilized nations.

    [​IMG]

    If we were to SAVE one third of $3.5 trillion that would be around $1.2 trillion per YEAR just by implementing Medicare for All!

    That alone makes it worth doing and we have NOT raised any taxes. We are just substituting what we pay to PRIVATE HEALTH INSURERS and using that to fund Medicare for All.

    We could easily plug the Medicare general revenue gap out of that $1.2 trillion in SAVINGS and use the rest to BALANCE the BUDGET without increasing a single tax of any kind.

    Note that we are still using PRIVATE healthcare PROVIDERS so there is no change at all in the quality or service of what we are getting. Doctors and drug companies and still earning very comfortable livings and nothing has changed as far as they are concerned. For private practices their OVERHEADS will DECLINE because they will only be dealing with a Single Payer and not have to deal with all of those bizarre private insurers "plans".

    Medicare for All makes sense and works by providing AFFORDABLE high quality healthcare and we don't even need to raise taxes to make it work.
     
  18. Derideo_Te

    Derideo_Te Well-Known Member

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    You never addressed the question of the cost of healthcare bankrupting the family of a sick child.

    What justifies "making money" at the EXPENSE of others who have no option but to pay up because the alternative is to watch their child suffer and die?
     
  19. James California

    James California Well-Known Member Past Donor

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    ~ I think a big problem is getting qualified for Medicaid needs updates. Let people have more liquid assets and higher income for certain situations. It could also avoid many bankruptcies .
     
  20. squidward

    squidward Well-Known Member

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    We need to raise your dollar contribution to Medicare until it is equal with the guy that pays the highest dollar contribution currently.
    Then all the mouthy, grubbing little tax raising advocates can step up to the plate and do their part
     
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  21. David Landbrecht

    David Landbrecht Well-Known Member

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    What must be changed is the cost/financing of medical education.
    Technology may also help with more and more a. i. implemented in diagnosis as well as administration of medical care.
     
  22. Moonglow

    Moonglow Well-Known Member

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    I have healthcare through the VA and it is better than when I had private insurance healthcare.
     
  23. James California

    James California Well-Known Member Past Donor

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    ~ Give politicos on Capitol Hill the same healthcare everyone else gets and they will fix the problem ! ` :nod:
     
  24. Heartburn

    Heartburn Well-Known Member

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    Medicare pretty much sets the standards. I have never had a problem finding a Doctor or hospital or in getting any tests or treatment I needed. I have a good supplemental policy and that is where the division is, not everyone can afford the top tier Obama plans.

    Where we get ripped off is on the medication. The US pays higher prices than any other country in the world. I recently had reason to actually look into costs without insurance at Canada, Mexico and the US. Brand name products are ridiculously higher. What happens is you can afford to see a Dr. and they can tell you what is killing you because you can't afford the medication to at least slow the process.

    We should let Medicare bargain for lower costs. Right now the options for some are die from the health problem or die broke.
     
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  25. Eleuthera

    Eleuthera Well-Known Member Donor

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    Perhaps.

    I just read somewhere that Trump alone has spent hundreds of millions in his effort to install Guaido in Venezuela. So far no joy in that regard.

    Point being that sources of funding for MFA can be found. At this point there are no real specifics as to how such a system might work.
     

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