Middle Class taxes will go up.
Warren should own it, defend it, and explain it. If she doesn't get in front of this, Trump will.
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Medicare for All plummets in popularity once people are given information about its features as it relates to them.
Medicare for All reduces choices. Seniors fear the Medicare they have will be crowded out. Unions and others with good employer-based health insurance fear they will lose it.
Medical professions fear it and will publicly oppose it because it doesn't pay its way.
And one more big thing: Middle class taxes will go up.
Elizabeth Warren's Democratic opponents are pointing it out, but she conspicuously avoided answering the question in the third debate, and again when asked by friendly comedian Steven Colbert.
Elizabeth Warren's Democratic opponents are pointing it out, but she conspicuously avoided answering the question in the third debate, and again when asked by friendly comedian Steven Colbert.
She does, in fact, have a plausible answer. Get rid of the whole insurance friction and cost, and apply it to health care instead, and rebate imbedded personnel costs for insurance back to employees as higher wages.
Health insurance has enormous transaction friction, with the employer, within the practitioners' offices, and at the insurance companies. The theory of Medicare for All is that this friction is significantly reduced, which then pays for expanded coverage.
Health insurance has enormous transaction friction, with the employer, within the practitioners' offices, and at the insurance companies. The theory of Medicare for All is that this friction is significantly reduced, which then pays for expanded coverage.
Here is the problem for progressives: progressive messaging is that corporations are self serving and selfishly grab way too much of the productivity pie. They note that when corporations get a windfall, as in the 2017 Tax Bill, they pass the savings onto stockholders, not to employees. It happened. Voters saw it and believe it.
Hard sell. Medicare for All only works as a benefit to workers if the employers who slough off the personnel costs of insurance, then re-include them as wages. That premise will be a hard sell since it directly contradicts their own populist message that businesses grab value from workers and that wealth does not trickle down.
That means the 155 million Americans with employer-based health insurance have something at risk--replacing insurance they know with something new. Plus there is a new risk--higher taxes--with no guarantee at all that they will have higher wages to compensate. Lose lose.
Trust employers to pass along the savings? Really? From a progressive?
Trust employers to pass along the savings? Really? From a progressive?
The Trump ads write themselves, and they position Trump as the anti-elitist, the corporate skeptic, the man of the people:
"Socialists Bernie and Liz admit your taxes will go way up to pay for the trillion dollar catastrophe of Medicare for All, that takes away your private insurance options. Don't worry, they say. Corporations will increase your wages to compensate. What are they smoking? It's another windfall for big business. Trump says drain the swamp--for working people, not big business."
What should Elizabeth Warren do? Listen to Steve Colbert and get in front of this.
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Steve Colbert gave her the big picture answer: Medicare for All is cheaper.
Warren needs to make one other point, that Medicare for All will require employers to calculate, reveal to employees, and re-distribute the savings from ending private insurance. She needs to present herself as the business skeptic and note that the re-distribution will not happen by itself and that it is part of the law. That hasn't been a discernible part of the message.
We have heard about higher taxes, but not about workers getting the savings.
The message that she will force businesses to put their health cost savings back into wages will put her back on the side of protecting the working and middle class. That is a vulnerable spot for Warren. She has the image of being friendly to managers and elites, not working people. Progressive taxation will mean upper middle class professionals and the wealthy will pay more. She might as well own it and make a positive out of it.
She will have chosen her team: the poor, working, and middle class. Wealthy people will pay more, for the good of the whole country. Sell it.
She will have chosen her team: the poor, working, and middle class. Wealthy people will pay more, for the good of the whole country. Sell it.
If she doesn't make clear that she is protecting the middle class from un-reimbursed higher taxes her image as an elitist will be solidified. She needs to get on this.
10 comments:
I know quite a bit about this subject as a victim of the health care "system" in America and from work experience. CONSUMERS ALREADY PAY through payroll deduction for their health insurance; through deductibles, co-insurance and co-pays; through limits on services and outright denials of services...pay yourself; unnecessarily high insurance administration costs; and insurance company profits.
As for employers that currently pay for PART of their employees' health insurance, they can be REQUIRED BY LAW to keep paying. This is required under Obamacare already.
It is really not that hard. And some medical professionals support this type of comprehensive coverage. The ones that are not greedy. The ones who hate dealing with all of the insurance company gatekeepers telling them what to do. The ones who spend their time an money doing unnecessary insurance paperwork every day.
Anyone who doesn't understand what a mess the current "system" is is very priviledged, and has had the pleasure of being in the health care trenches of America.
Sorry for the typos above. Please add a mental "not had" to the last sentence.
I absolutely agree with you, Peter. I was extremely frustrated watching the last debate when a more complete and positive statement for Medicare for all (or what amounts to that) wasn’t made. How could those candidates not recognize that?!
This was a most informative and I believe accurate blog. As a physician who worked with Medicare for 35 years, I believe persons must not think this is a panacea. Coverage for all persons is a terrific goal, but just because you have Medicare, be aware that there are many restrictions and demands that must be met before many surgical procedures can be performed. One of my major gripes was that the surgical fee was always reduced by about 75% and if you had a medicare-approved surgical facility, the facility was paid about four times the surgical fee. Also, there are many rejections, as many what we call paper pushers do not allow many procedures, which I and the patient felt were appropriate, to be rejected. I am now enjoying operating on people around the world without having to do the tedious work of getting approval, and it is a joy to work almost hastle free. I do fear the possibility of government control of health care. I have many surgical friends around the world who work in such a system, but Canada is the only country where there are also opportunities to use private insurance, and thus there really is a two tiered system in all these countries
I made an inaccurate statement. Canada is the only country without private insurance with which to compete. Other countries have a two tiered system, especially the United Kingdom
First of all, if Warren and Sanders, etc, could make it clear how the average middle class person would save money by directly comparing any added taxes with the estimated costs of co-pays, deductibles, and the awful expenses with actually getting really sick. They have yet to set up a table of these comparisons. Or just stories that show actual figures would help get the point across. The point would be to show a total family budget and how they would likely save with universal health care. If if is offered as an option, most would probably take that one.
Also, with everything covered, would not a doctor's OK on a needed procedure allow (require) it to be covered? For example, I am on Medicare with full Medicaid coverage, which covers a heck of a lot, but I have a problem. Medicaid would cover needed dentures, but won't cover an operation to remove a palate torus on the roof of my mouth to allow for the dentures!
So I would not call the proposals Medicare for All, as Medicare is not in any way a free service. Nor does it cover everything,
And really, so many people I know work for companies that do not cover them, either because they are part time, or because the company does not offer insurance. The big deal about needing to keep one's company health insurance is over-rated, I think. Many people cling to really awful jobs because of the health care coverage.
Democrats have to make the argument that access to health insurance should not be tied to one’s employment. We have to admit that the only way to solve the problem of out of control healthcare costs really is a single payer system. Obamacare guaranteed some essential protections and got more people covered, but costs went up because because for profit insurance companies remained as part of the system. Healthcare costs are less in countries with single payer—countries where they’ve mostly eliminated that extra layer of cost—aka third party payers. Many health outcomes such as infant mortality rates are better too. Now before I’m accused of being a socialist, I’d like to say that in many countries with single payer systems, only the insurance system is socialized, so providers (doctors, hospitals, clinics) can operate as for profit by sinesses and yes, you can choose your physician. The problem Peter brings to light about employers keeping healthcare insurance premium savings for themselves rather pass these savings directly to employees by raising their pay can be addressed in the law. When Sanders and Warren claim no one likes their private insurance plan—that rings true to me. I have a union job and my union negotiates our health benefits every year. It still basically “sucks”. Deductibles are high and since costs keep skyrocketing, we are constantly worried that our benefits will decreased each year. I would much rather pay more taxes and be guaranteed health insurance regardless of my employment. With a single payer plan or Medicare for All, my union could focus on increasing teacher salaries and limiting class sizes—-rather than have to constantly renegotiate healthcare.
Might be useful to understand what Medicare for All might mean, and what it might deliver and what it would cost.
Here is an Oxford style debate on the question:
https://www.intelligencesquaredus.org/debates/replace-private-insurance-medicare-all
Let me start by telling you that the use of the word “lie” does not come easy to me. I often will tell people to reconsider the use of the word. I feel that one must be careful that the non-fact is delivered with intent in order to be considered a lie. Otherwise it is merely a misrepresentation or error. I also employ the use of the word “disingenuous” in times where there is intent to mislead, but the technicality of the statement could be considered factual in some eyes.
I also supported Obama’s and Biden’s efforts in regards to the ACA and the Public Option, and I believe that there is a time and a place for incrementalism on politics in order to eventually get to a policy that we desire.
But, in this case, that I will lay before you, I believe a lie has been told.
Medicare for All does not take anything away from anyone. Too many people…too many Democrats…are saying that it does.
I believe they know that this is a lie and they are simply playing on people’s fears in order to either:
A. Get a policy that they prefer (ACA with a Public Option), or
B. Play politics by saying what they believe they have to say to get elected and eventually get to Medicare for All.
Either way, they must know that what they are saying is a lie. Saying that Medicare for All is taking away healthcare from folks is just flat wrong. MfA gives every single citizen of this country complete medical coverage. MfA increases coverage and eliminates premiums, co-pays, and deductibles.
It is also a lie to talk about raised taxes without pointing out that most people will see a net decrease in costs with MfA when compared to the current premium based system. Overall, Americans will be paying less for Medical services. This has proven to be true in every other country that has implemented similar systems to MfA. So saying that MfA costs money is a lie. It actually saves money overall.
Saying that the majority of the American public do not want MfA is also a lie. Polls show that somewhere around 70% of the American people want MfA, including just over 50% of Republicans. Some will attempt to make the point that when asked if they still support it even though they may “lose” their current insurance and their taxes may go up, the support for MfA goes substantially down. But, those questions, asked with the added details, are just lies disguised as questions.
If the questions were asked as such, I can virtually guarantee you that the support would remain the same, or higher:
1. Would you support MfA if it completely replaced your current insurance plan with a plan that covered more than your current insurance does and completely eliminated premiums, co-pays, and deductibles?
2. Would you still support that plan if there was a possibility that your taxes may go up, but for most middle and lower income individuals and families any increase in taxes would be outweighed by the money saved in the elimination of all of your current health insurance premiums and out of pocket costs?
The bottom line is that saying MfA takes something away from people, without explaining that MfA will save most people money and increase benefits, is a lie. There is a net gain, not a loss. Nothing is being taken from people.
Democratic leaders need to stop spreading this lie. And, they need to stop it now.
https://politicalmeus.com/f/the-big-lie---that-will-get-trump-re-elected
To clarify: The Big Lie comment posted above was not meant as an attack on…nor as a direct rebuttal to…Mr. Sage. It was meant more as an adjunct to his article. I apologize for not making that clear. I actually agree with most of what Mr. Sage has said in this particular blog. The Big Lie was something Political Me had written in the past; and was directed at some of the Democratic candidates for president who have directly stated that MfA would take away health care from people. I believe this is a political calculation that they are making to misstate the facts around MfA in an attempt to scare people into voting for them in the primary.
My comment was meant to draw attention to the fact that MfA not only enhances most people’s coverage. The coverage gets worse for (or taken away from) no one.
As Mr. Sage points out, the funding gets a little more complicated. But, I believe that he is absolutely correct when he says that Warren should own the fact that for the lower incomes, and for most middle incomes, the overall costs for healthcare would decrease. For some at the higher income levels (who would bare the largest brunt of any increased taxes) the total costs might increase some.
The differing individual scenarios complicate matters. Those, for whom their employer pays 100% of their premium, are the toughest cases in which to illustrate the individual cost benefits of MfA. Although we can remind them that MfA increases covered benefits and eliminates copays and deductibles, it is hard to say with certainty that their paychecks will increase based on the savings that the employer will see with the elimination of the premiums. But, they will see the cost savings of increased benefits and elimination of out of pocket costs on the back end, as I pointed out above; and there is a high probability that the market will force employers to apply at least some of the eliminated premium savings along to the employee in the form of higher wages or increased other benefits.
But, it is important to note that, even under the ACA, employer’s currently only pay (on average) about 70-80% of employee’s insurance premiums. Many employees have a deduction out of their paycheck to pay for the remainder of their insurance premiums. Those employees would see an instant increase in take-home-pay once the premium is eliminated under MfA.
Also important is the fact that many people who work for small businesses are exempt from the ACA’s employer’s mandate, and do not receive any assistance from their employer. Those people would also recognize an instant savings as their personally paid premium would go away altogether under MfA.
The bottom line is that MfA:
1. Increases benefits for all.
2. Eliminates Premiums for individuals and employers.
3. Eliminates co-pays and deductibles for all.
4. Lowers overall healthcare costs for the USA as a whole.
5. Results in a net dollar savings for most individuals who fall in the lower to mid income ranges.
www.politicalmeus.com
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