Wednesday, April 17, 2019

My version of "Medicare for All" is not Bernie's nor apparently any other Democrat's health care plan

When "ObamaCare" was being created, I said to anyone around me who would listen that all we need to do is remove the age 65 limitation from Medicare and then tweak the law and regulations ... and increase the employer-employee Medicare tax and apply it to all gross income.

In my view, it would have worked out.

But for those who don't know anything about the current Medicare only for folks over 65, you should know that
  1. ...it has annual deductibles and co-pays...
  2. ...and you have to pay premiums for Part B which covers doctors office visits and other costs not related to hospitalization with co-pays...
  3. ...and you have to pay premiums for prescription coverage which has co-pays...
  4. ...although if you enroll in Medicare-approved private insurance plans you might be able to save money on some of this coverage...
  5. ...and it doesn't cover routine dental or vision or hearing or long term care for which you have to buy coverage elsewhere...
  6. ...and one-third of the costs of Medicare is paid for by a payroll tax of 1.45% for the employer and 1.45% for the employee or 2.9% of total payroll but there is an additional 0.9% Medicare Tax paid when an individual’s combined wages, compensation, or self-employment income (together with that of his or her spouse if filing a joint return) exceed $125,000, or $250,000 if filing jointly,...
  7. ...and the other two-thirds is covered by the budget deficit (no, it is not like Social Security in that no one ever said it would be funded), meaning theoretically some future generation will pay for it but realistically nobody is going to pay for it...
  8. ...and, again, it only covers that portion of the population that is over 65.
In other words, to fully pay for the current Medicare costs that only covers people over 65 - coverage that has deductibles, co-pays, and premiums - the Medicare payroll taxes would have to be tripled.

I always thought that putting everyone under the current Medicare provisions with obvious additions for maternity coverage and a few other age-related things could be pretty much paid for by increasing the employer Medicare tax enough to total what employers now pay for insurance, increasing the employee Medicare tax enough to total what employees now pay, triple the current Medicare tax and apply it to all gross income, plus taxing all gross income to equal current expenditures by states and territories for such things a Medicaid, would pretty much cover the costs...if Medicare negotiated all drug prices.

I've read Bernie's new Medicare for All proposal. Maybe it represents the health care a truly moral nation would want to provide. But given that people will still going to get very ill and people will still die, its far more complicated particularly for progressives who also want to raise taxes to eliminate world-wide child hunger and homelessness and unemployment.

We look at what Canada does, and Britain, and European countries. But none of those have even one-third the population we do, and most have a genetically narrower population base. Then there is China - you know, the Communists about whom we are paranoid - which has significant problems with their health care system in which about 95% of the population has at least basic health insurance coverage...oh golly, that sounds like the U.S. They too struggle, something with which Bernie and AOC ought to become more familiar.

Though I will rattle on about my version of Medicare for All, no version has any chance for serious consideration by Congress between now and 2021. And look, we couldn't even get a "public option" added to "ObamaCare" during the last effort at a time Democrats controlled all three branches of the federal government.

So are the Democrats going to vigorously march into the 2020 election advocating replacing The Affordable Care Act ("ObamaCare") with something not particularly well defined? Trump intends to without any proposal in hand? Are we going to advocate replacing it with Bernie's unaffordable Medicare for All proposal?

Or what the heck. Maybe we should just do it. Two-thirds of our current Medicare system is funded with debt. Isn't that the American way? As the graphic to the right indicates, the people like it! Maybe that is the way to go. At least until we can't and by then it will be a problem for the Millennials and Gen Z....

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