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Medicare-for-All would save >68,000 lives and >$450 billion annually, according to Yale study

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The entire system could be funded with less financial outlay than is incurred by employers and households paying for health-care premiums combined with existing government allocations. This shift to single-payer health care would provide the greatest relief to lower-income households. Furthermore, we estimate that ensuring health-care access for all Americans would save more than 68 000 lives and 1·73 million life-years every year compared with the status quo.

 

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Reducing reimbursement rates for hospitals
If all hospital fees were reimbursed at 2017 Medicare amounts, the fees would overall be 5·54% lower (default); however, if reimbursed at Medicaid rates, fees would be reduced by 18·74% (upper bound).


Reducing reimbursement rates for physician and clinical services
If all physician and clinical services were reimbursed at current Medicare rates, the fees would be 7·38% lower (default), and if reimbursed at Medicaid rates, fees would be reduced by 19·23% (upper bound).


Reducing pharmaceutical prices via negotiation
The Department of Veterans Affairs has the authority to negotiate prices in accordance with therapeutic value, achieving prices that are 40% lower than those paid by the Medicare scheme (default).


Reducing overhead expenditure
Within the US health-care system, insurance overheads range from 2·2% for Medicare (lower bound; default) to 12·4% for the private sector (upper bound).26
Improving fraud detection


Given estimates that 4% of health-care expenditure (default) could be eliminated through fraud detection within the first two years of implementing a single-payer system,27 we allow fraud reduction to range from 0% (lower bound) to 10% (upper bound) upon enactment of the Medicare for All Act.

 

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Revenue generation

 

Payroll tax


The $536 billion spent by employers on health-care premiums is equivalent to a 12·29% payroll tax (upper bound). Any payroll tax that collects revenue below the 12·29%-level expenditure would represent savings, including our default value of 10%.


Household income tax


Households currently pay $738 billion towards premiums and out-of-pocket expenditures. Only $64 billion of out-of-pocket costs would remain under the Medicare for All Act. If the remaining $674 billion in spending were replaced by a 5% household income tax (default) on income beyond the standard deduction, the tax would yield $375 billion annually.28 The $674 billion replaced by Medicare for All Act would be equivalent to a tax rate of 9% (upper bound).


The Sanders net worth tax


A 1% tax on household net worth above $21 million, applied to 0·1% of all households in the USA, would yield $109 billion annually.28 This tax rate can be modified to range from 0% (lower bound, default) to 2% (upper bound).

 

Other areas covered more in-depth in the article:

 

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  • Reduced fees for hospital and clinical services
  • Unified system for billing and administration
  • Expansion of coverage and services

 

BOTTOM LINE:

 

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Through the mechanisms detailed previously, we predict that a single-payer health-care system would require $3·034 trillion annually, $458 billion less than national health-care expenditure in 2017. Even after accounting for the increased costs of coverage expansion, our data-driven base case includes $59 billion savings on hospital care, $23 billion on physician and clinical services, $217 billion on overheads, and $177 billion on prescription drugs. Consequently, annual expenditure per capita would decrease from $10 7396 to $9330, equivalent to a 13·1% reduction. The expectation of savings is robust and remains following variation in the input parameters. For example, if overhead costs only dropped to 6% of total health expenditure—rather than Medicare's current 2·2%—the Medicare for All Act would still reduce costs by 10·3%. Conversely, savings would increase beyond our base case if our model overestimates the unfulfilled demand in people who do not have insurance or are underinsured. Given that $2261 billion is already allocated to health care by existing governmental and philanthropic sources (appendix p 5), a further $773 billion must be collected by the government to fully fund the Medicare for All Act.

 

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That’s 68,000 more people standing in line in front of me at the grocery store. No thank you.

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7 minutes ago, stepee said:

That’s 68,000 more people standing in line in front of me at the grocery store. No thank you.

Speaking of waiting in line...

 

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Bah! That’s some liberal university, how about you give me a study from someone reputable?

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Just now, MarSolo said:

Bah! That’s some liberal university, how about you give me a study from someone reputable?

 

*Study at local Scranton diner indicates that shit fuck dicky lick*

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Lives saved per year: 68,000

Costs saved per year: $450 billion

Owning libcucks with freedom: Priceless

 

So yeah, that equation really doesn't work out for a place like America.

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10 minutes ago, SaysWho? said:

 

*Study at local Scranton diner indicates that shit fuck dicky lick*


DAMN STRAIGHT!

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Medicare/cal and I suppose caid for other states pay almost nothing. I've seen a $90,000 ER bill get reduced down to $250, which is  too crazy. Still, we can always rework the fee schedule. Healthcare in this country sucks, I already pay several hundred a month for coverage, and it still blows and I still don't won't see a doctor unless I absolutely have to, so bring on the "tax" for it. 

 

We definitely have to rework the fee schedule to make it all work though, so probably don't just take what they currently pay out and extrapolate it out to the whole population to figure out what it would all cost us. Because seriously, they pay peanuts on the actual bill. Yes the bills can and should be lower, but what the government pays currently has to be way too low to be workable. 

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28 minutes ago, b_m_b_m_b_m said:

Speaking of waiting in line...

 

Had to double check that wasn't some 3rd world country from 50 years ago.

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Price setting is the only thing that brings health care costs down. This should be abundantly clear by now.

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One of the biggest lies Republicans try to spread about Medicare for am is the idea it would cost everything we’re spending on healthcare now, plus the estimated billions it would cost. Which is ridiculous, because it would REPLACE the current healthcare system. 
 

what Republicans are basically trying to sell people on is that when you refinance a mortgage, you’re paying two mortgages now. 

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Does Sanders ever address doctor shortages in his plan? Medical schools need more slots and there needs to be more residencies. The AMA is rent-seeking and this has to be addressed.

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14 hours ago, Spawn_of_Apathy said:

One of the biggest lies Republicans try to spread about Medicare for am is the idea it would cost everything we’re spending on healthcare now, plus the estimated billions it would cost. Which is ridiculous, because it would REPLACE the current healthcare system. 
 

what Republicans are basically trying to sell people on is that when you refinance a mortgage, you’re paying two mortgages now. 

What if you need Medicare for pm?

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4 hours ago, Remarkableriots said:

What if you need Medicare for pm?

 

Then you buy Nyquil n00b.

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3 minutes ago, Reputator said:

 

Then you buy Nyquil n00b.

 

I just use the board's messaging system for pm

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13 minutes ago, SaysWho? said:

 

I just use the board's messaging system for pm

 

What if you PM the Prime Minister at 8 PM?

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Can I just say here, our insurance system is a complete and total failure, and the only people who don't call for change have never had to really use their insurance? This is my current rant.

 

I had to take my daughter to the ER because she fell and hit her head (again) then threw up soon after, so we had to get her to the ER for treatment of a probable concussion (this was after the urgent Care centers closed). She is ok, thankfully.

 

The first thought after making sure she seemed ok and calm was "can I afford an ER trip?" (Which is fucked up to begin with). Got the bills today, and after a $200 ER copay, I owe about $2900. Luckily I have a true family deductible (so my wife, daughter and I all share the same $4900 deductible) and an HSA with ~$1800 on it, plus I'm contributing to it with every paycheck pre-tax. I will be able to pay for all of the bills. Her last ER trip for a similar issue (fell and hit her the temple of her head, leading to a bloody nose, so similar concerns about a concussion) had cost me in total about $2300, almost exactly one year ago.

 

I haven't hit my deductible or out of pocket max for this year, so I'm still on the hook for various costs there. And then I get to do it all over again next year!!!

 

If I was on my previous employers plan now or last year we'd be fucked. I didn't have an HSA, had a similarly sized deductible (for an individual, so my liability was 3x), and also had a lower salary. And we're in relatively good shape financially. If you've got a shittier plan or a lower income, or both, this could very well be ruinous. It's fucking disgraceful that this is what we've got, and even if Bernie or even Warren wins, the odds of this changing are still virtually nil.

 

There's not a damn thing good about this country today if you aren't wealthy or really, really lucky. 

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I would also like to rant about the scam that is the medical insurance industry. Just for simple shit it is almost impossible to price something accurately so that you can prepare financially. Let alone the major, planned items.

 

My first son was born in 2017. My wife is super diligent and responsible with money. Much more so than I am and I consider myself pretty responsible. So for 6 months before the birth she was constantly calling our planned provider and insurance who kept sending us back and forth between each other trying to get a cost figured out. The provider and hospital said what we would be charged depends on the rates they have with the insurance and they couldn't tell us those rates directly. The insurance couldn't either and they said their rates that they contribute depend on how much the provider charges. And that didn't count anything outside of the birth itself--everything from medicines administered to epidural (which they also couldn't give us a price on) all of which could vary in rates based on the rates of each other. So, the birth comes, no complications, no extended hospital stays, nothing of the sort. Thank god. I get the bill: $4500 was our share. I was paying $390/mo for our health insurance. This all while I was making $20k less per year than I am now. I was able to pay that off in two years, thankfully.

 

My wife is pregnant again and she is due in June (another boy). I am now on a HDHP with an HSA. So I know the share I'm going to be paying will be higher than $4500. That is the only absolute knowledge that I have: It will be greater than $4500 because I'm on a health plan that covers less of a percentage. But we still can't get any firm info from anybody on how much we're going to be paying when all is said and done. Burn it all the fuck down.

 

Another fun story: A cinder block crushed my big toe over the summer while I was doing some yard work and getting rid of junk from the previous owners in our backyard. It was the single greatest pain I had ever experienced in my life. So while I'm writhing in pain I'm also going online to my insurance's website to find a provider that's in-network. Couldn't handle the pain so I just looked for an urgent care that was in-network instead of looking for a podiatrist. The nearest one was closed. The next nearest one was too. So I had to drive to the only one that was open on a weekend that was in-network. Which was half an hour away. With a broken and bleeding toe. It gets taken care of. A few weeks later I have to remove the toenail. I decided to do that on my own. That was fun/gross. I decided to make an appointment with a podiatrist to make sure there was no infection and that I was going to heal up okay. Again I can't get any pricing info. So I just go to the one that the insurance site says is the cheapest (on a scale of one to four dollar signs they ranked it as 1.5). The doctor checks out my foot. "No infection. It should heal up fine. Here's a bandaid." A week later a bill in the mail for $150. For what in my opinion was preventative treatment.

 

I shouldn't have to weigh heavy financial decisions when I'm writhing in pain and can't even see straight. Nobody, and I mean absolutely nobody who is financially responsible "loves" their medical insurance. Burn it all the fuck down.

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12 minutes ago, GeneticBlueprint said:

I would also like to rant about the scam that is the medical insurance industry. Just for simple shit it is almost impossible to price something accurately so that you can prepare financially. Let alone the major, planned items.

 

My first son was born in 2017. My wife is super diligent and responsible with money. Much more so than I am and I consider myself pretty responsible. So for 6 months before the birth she was constantly calling our planned provider and insurance who kept sending us back and forth between each other trying to get a cost figured out. The provider and hospital said what we would be charged depends on the rates they have with the insurance and they couldn't tell us those rates directly. The insurance couldn't either and they said their rates that they contribute depend on how much the provider charges. And that didn't count anything outside of the birth itself--everything from medicines administered to epidural (which they also couldn't give us a price on) all of which could vary in rates based on the rates of each other. So, the birth comes, no complications, no extended hospital stays, nothing of the sort. Thank god. I get the bill: $4500 was our share. I was paying $390/mo for our health insurance. This all while I was making $20k less per year than I am now. I was able to pay that off in two years, thankfully.

 

My wife is pregnant again and she is due in June (another boy). I am now on a HDHP with an HSA. So I know the share I'm going to be paying will be higher than $4500. That is the only absolute knowledge that I have: It will be greater than $4500 because I'm on a health plan that covers less of a percentage. But we still can't get any firm info from anybody on how much we're going to be paying when all is said and done. Burn it all the fuck down.

 

Another fun story: A cinder block crushed my big toe over the summer while I was doing some yard work and getting rid of junk from the previous owners in our backyard. It was the single greatest pain I had ever experienced in my life. So while I'm writhing in pain I'm also going online to my insurance's website to find a provider that's in-network. Couldn't handle the pain so I just looked for an urgent care that was in-network instead of looking for a podiatrist. The nearest one was closed. The next nearest one was too. So I had to drive to the only one that was open on a weekend that was in-network. Which was half an hour away. With a broken and bleeding toe. It gets taken care of. A few weeks later I have to remove the toenail. I decided to do that on my own. That was fun/gross. I decided to make an appointment with a podiatrist to make sure there was no infection and that I was going to heal up okay. Again I can't get any pricing info. So I just go to the one that the insurance site says is the cheapest (on a scale of one to four dollar signs they ranked it as 1.5). The doctor checks out my foot. "No infection. It should heal up fine. Here's a bandaid." A week later a bill in the mail for $150. For what in my opinion was preventative treatment.

 

I shouldn't have to weigh heavy financial decisions when I'm writhing in pain and can't even see straight. Nobody, and I mean absolutely nobody who is financially responsible "loves" their medical insurance. Burn it all the fuck down.


congrats on the sex

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Also, at my last employer, I was there for four years. In those four years we had three different insurance providers. How the fuck is anybody supposed to fall in love with their insurance when moving through providers so fast ?

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15 minutes ago, GeneticBlueprint said:

Also, at my last employer, I was there for four years. In those four years we had three different insurance providers. How the fuck is anybody supposed to fall in love with their insurance when moving through providers so fast ?

 

I've often wondered this, too. Where are all these people that love their insurance? I have never met one. Either they don't care or they hate it.

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3 minutes ago, Jose said:

 

I've often wondered this, too. Where are all these people that love their insurance? I have never met one. Either they don't care or they hate it.


The only person I’ve ever met is my former colleague (and now good friend), who did so by proxy; she opposed M4A because she saw ‘how hard [her] mom’s teachers union fought’ for their good health care (editors note: said union is in one of the richest school districts in the state). The extent to which otherwise good people overlook the have-and-have-not paradox of health care is incredible. 

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I like our insurance, but I picked it myself to make sure my employees aren’t boned by such things. I’m often left wondering what people are paying for when I hear the details of their plans.

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