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Warren's big healthcare plan relies on big assumptions


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Warren's big healthcare plan relies on big assumptions

By Jason Lange and Amanda Becker

 

2019-11-01T210106Z_2_LYNXMPEFA03HR_RTROPTP_4_USA-ELECTION-WARREN-MEDICARE.JPG

FILE PHOTO: Senator Elizabeth Warren (D-MA) speaks during an event to introduce the "Medicare for All Act of 2017" on Capitol Hill in Washington, U.S., September 13, 2017. REUTERS/Yuri Gripas/File Photo

 

WASHINGTON (Reuters) - Democratic presidential candidate Elizabeth Warren's plan for universal healthcare rests on an assumption she can radically change an industry the size of Germany's entire economy without new costs for the average taxpayer.

 

On paper, the plan by the senator from Massachusetts to use government bureaucracy to create a more efficient healthcare system gets credibility from the fact that most rich nations, including Canada and France, already do just that.

 

But the specifics of her proposal, released on Friday as Warren seeks her party's nomination for the 2020 presidential contest, reveal the scope of an overhaul that would be one of the largest economic experiments in modern history.

 

By trying to cut costs aggressively across a $3.5 trillion healthcare sector that makes up nearly a fifth of the U.S. economy, Warren would hit the finances of enough people to create major political blowback.

 

"The plan makes a lot of assumptions about how seamlessly this could be enacted and implemented," said Larry Levitt, a health policy expert at Kaiser Family Foundation, adding that there was no precedent for such a large overhaul.

 

Not only would medical businesses large and small resist decisions by the government to pay less for drugs and services, the plan could paradoxically underfund an expanded health insurance bureaucracy, said Linda Blumberg, an economist at the Urban Institute's Health Policy Center.

 

Warren would largely scrap the private health insurance industry, whose profits and high administrative costs are a factor behind Americans spending about twice as much on healthcare as their peers in advanced countries - while getting similar quality services.

 

In its place, Warren would make the United States' Medicare federal health insurance program, which currently covers people over 65 and the disabled, into a "Medicare For All" universal benefit.

 

But economists say the transition to a system guided less by market economics and more by the government might be difficult.

 

Warren, who is a leading contender to be the Democratic Party candidate taking on Republican President Donald Trump in the November 2020 election, said her plan would not cost the middle class "one penny" in taxes.

 

As part of its bid to do that and lower costs, Warren's plan puts such strict limits on Medicare administration spending that the government might not have the resources to do a good job at setting prices for vital services, Blumberg said.

 

"You don't want to overly disrupt the healthcare system," Blumberg said.

 

Warren estimates her plan would require $20.5 trillion in new federal spending over the next decade. Cost-cutting measures aside, she would rely on an array of new taxes to fill the gap.

 

About half of the new federal spending would be covered by having businesses direct most of their current spending on private health insurance into a government fund.

 

The rest would largely come from new taxes on Wall Street, big businesses and wealthy individuals.

These include:

 

- A transactions tax of 0.1% on most securities and transactions involving derivatives.

 

- A systemic risk fee on financial institutions with $50 billion in total assets.

 

- A repeal of corporate tax breaks in the 2017 tax law, returning the top corporate tax rate to 35%.

 

- A new 2% tax on net wealth above $50 million and a 6% tax on wealth over $1 billion.

 

Warren advisers said the added levies would make America's overall tax burden - currently one of the lowest among rich nations - into a merely average one.

 

Health policy experts see the feasibility of Warren's plan in a similar light: If other governments can provide universal care without breaking the bank, surely America can as well, at least technically.

 

But the long list of tax and healthcare policy changes is seen as standing little chance of passing Congress even if Democrats gain control of both chambers, given the opposition from some moderate members of the party.

 

"Warren's challenge is more about politics than arithmetic," said Levitt.

 

(Reporting By Amanda Becker and Jason Lange in Washington; additional reporting by Joseph Ax in New York, Editing by Soyoung Kim and Jonathan Oatis)

 

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-- © Copyright Reuters 2019-11-02

 

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2 hours ago, donnacha said:

The biggest assumption is that Warren isn't just stealing Bernie's policies to cater to the sudden leftward swing of Democrat party activists.

As recently as 3 years ago she was a relatively middle-of-the-road Democrat, and never before espoused the whacky ideas she is currently pushing. Watch how quickly she discards Socialism as soon as she wins the nomination and has to start appealing to mainstream American voters to win the Presidency. The Bernie supporters already know that and are horrified that their hero may now have to bow out and officially endorse her.

I still think Hilary should jump in. The current field of candidates for the Democrat nomination is woefully lacking, she has nothing left to lose, and the entertainment value of another Trump vs Clinton war would be off the charts.

 

At this point, very hard to see which Democrat candidate could win the presidency. Most people aren't enthusiastic about Trump, in particular the "soccer moms" demographic, but it all depends on the alternative they are offered. Socialism is not going to fly among American families who already pay more in than they get out, they know where this is going.

Biden probably still has the best chance of winning the presidency but not the nomination. The activists hate him and may inflict permanent damage with another round of #metoo allegations. Warren will almost certainly get the nomination anyway, her lead will be unassailable once Bernie pulls out, but re-inventing herself enough to win the presidency is another matter entirely.

 

I’m sorry to hear the tragic outcome for your mother.

 

You don’t mention which ‘European nation’ this has occurred in, or the circumstances under which ‘basic checks’ were not made.

 

Again, my sincere condolences for what your mother has been through.

 

 

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1 hour ago, donnacha said:


Somehow, not being American has not affected our cognitive abilities.
 

 


If I understand this correctly, you wanted your wife, who is Thai, to receive free care for a non life-endangering dental problem, to be paid for by American tax payers. From what you say, she does not have a job that provides her with health insurance.

So, you decided to bring your wife to live in the United States, a country with notoriously expensive healthcare, and NOT buy her health insurance. Husband of the year. Now you are angry, and consider the system to be "a wreck", because there was no way for you to get other people, presumably the people who HAD bought health cover for their families, to pay for YOUR wife.

This is the greatest danger to your country. A growing number of people who make bad decisions and inadequate provision for themselves and the ones they are supposed to love and protect. Instead of taking ownership of your situation and correcting course, you feel that is you make yourself angry enough at other people, you can intimidate them into picking up your tab.

God help America, because that tactic might actually work as more Millennials reach voting age.

 

On nationality of posters, let’s keep that where it belongs, off topic.

 

But I agree with you, in this topic views of non Americans offer welcome Insights into the health services of other nations.

 

 

In the rest of your post you make an awful lot of assumptions, most derogatory personal attacks.

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6 hours ago, Tug said:

As far as the media making us biased against trump all we have to do is see what he says on tv and his foreign policy fiascos,My wife needed a bridge a few years back the cost with my co pay it was cheaper to fly her from San Diego to Bangkok get the work done let her visit with family for 2  weeks then fly back home the healthcare sys in this country is a wreck everyone is one illness away from homelessness don’t kid yourselves but you and top dead sender aren’t Americans anyway so go figure

Please. Was it the Golden Gate Bridge she needed? Sounds like it. A dental bridge isn’t that much. Shop around and you can even go to great dental schools in Cali and get work done by third year students who are great. 

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5 hours ago, bristolboy said:

You clearly entirely misunderstood his post. First off, health insurance plans that offer meaningful payments dental care in the US are very scarce and very expensive.  Nowhere did the poster say he was relying on government programs to help him out. He was simply pointing out how expensive dental care is in the USA. It's cheaper to travel to Thailand to have the work done than to have it done in the USA where his wife lives. Have you never heard of medical tourism? It's a booming business in Thailand.

 

 

For a dental bridge several years ago?? No I have NEVER heard of medical tourism for that from anyone. You can go to UCLA dental school or Many others and get incredible work done by 3rd/4th year students that are watched over by other Doctors for a great price. I read his post clearly. It has holes in it. Spare me a link. 

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18 minutes ago, Thaidream said:

I am sorry to hear about your mother.   My best to you and her.

 

However, you have some misconceptions about Healthcare, at least in America and some serious misconcetions about human behavior.

 

My Thai wife died of cancer and we lived in America for years where we both had top notch medical insurance.  Most insurance polices in America do not  provide yearly check-ups; dental or vision.  When one becomes ill they go to a doctor which normally is not paid by insurance  unless the copay is met.

 

My wife's cancer was actually found in Japan where I was transferred and surprisingly enough after being initially treated at a US Military Hospital- they were unable to handle the treatment.  We opted to return to Thialnd and be treated at the National Cancer Center in Bangkok.  My wife's cancer went into remission using radiation and chemotherapy and using medication that was not allowed by the American Health System.   Thailand's medical  system imports drugs from all over the World ( And very expensive)   My wife lived an added 10 years and would have certainly expired had we stayed in Japan or went back to the US.

 

While the medical insurance covered everything- I had to pay up front and seek reimbursement.  Eventually, the Insurance Company  starting rasing rates -first from $200 per month to $500 per month and then to $2000 per month making it virtually impossible to continue.  I covered the rest out of pocket with savings which were eventually exhausted as well as selling a home we owned.  The total treatment cost was  many millions of baht.  Had we gone back to America-  the cost would have been  5 times the Thai cost plus higher insurance premiums based on the higher cost.

 

II thought I was well funded; great insurance;  large savings; fully paid home.  Bad things happen to decent people.  

 

Medical care is a human right.  No one should have to die or go bankrupt from a lack of money.  People in America are dying and going broke from the current system, This is not from poor planning but from a system that is fuelled by greed and a lack of caring for  peole.

 

All Governments need to provide medical care for everyone in their country. This is not Socialism .  This is what governments exist for.  If things like healthcare; education and  good order are not the responsibility of governments why do people pay taxes?

 

The American system is the most expensive in the World because of an insestuous relationship between for profit medicine; Insurance and Big Phamaceutical.  Thow in lawyers and accountants and you have a system that is in need of a complete tear down and replacement.

 

Medicare for All has to be the goal- the American public can no longer afford to let the current system exist.  

 

However, Elizabeth Warren , if elected will get tremdous pushback from interest groups who want to keep the status quo so these  interests can grow richer while the sick continue to die.

 

IMO-  I would offer Medicare for All as an option for both Companies and individuals for 10 years and I would mandate that any medical provider must treat a person who has it and use the prices listed in Medicare For All.   I would also mandate the same for the drug industry. 

 

 What will eventually happen is through the years, more and more people will start to switch to Medicare for All as the costs are lower and privaate insurace will need to lower their premiums to compete for go out of business.

 

Every industralised country in the World has government sponsored medical care- all of Europe: Canada; Japan; Australia- but not the USA.   It;s time for America to join the rest of the World.

 

 

Very well said, nothing much more to say. as you said, the rest of the world can do it , except the "can do country"!!! 

Some People don't realise, it is to their advantage to live in a healthy , educated country.

That's how it needs to be sold. People are selfish, so they need to shown what's in it for them. 

Healthy, educated people, pay more taxes, consume less government resources, are more pleasant to be around, and provide less danger to the public. This is a mantra that needs to be repeated until it penetrates  even in to the more dense segment of the population.

Edited by sirineou
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19 hours ago, sirineou said:

So why can't we do it?

Because government sucks at reducing the costs of anything. Specifically to Warren's proposal, there are a plethora of flaws. The most obvious is dumping tens of millions if not more people into a system that up until now people paid into for decades without receiving benefits.

 

For example, a hypothetical Medicare recipient: at age 65, becomes eligible for benefits. Begins benefits with tens of thousands of dollars vested over decades.

 

New Medicare recipient: eligible now with little to nothing vested.

 

Pretty big financial hole to plug up. Going after evil rich people won't cut it.

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2 hours ago, Crazy Alex said:

Yes, it did cost you. You are entitled to your own opinion. You are NOT entitled to your own facts. At any rate, I'm happy you're going strong at 75 and wish you the best. I wish we had ear surgery for my tinnitus.

You are entitled to your own opinion”

 

Agreed, but I note you present a lot of opinions without any backup, by example:

 

“Because government sucks at reducing the costs of anything.”

 

How about dealing with the reality of how much the US failing healthcare system is costing, a comparison to other nations is instructive.

 

https://www.healthsystemtracker.org/chart-collection/how-do-healthcare-prices-and-use-in-the-u-s-compare-to-other-countries/#item-the-u-s-performs-more-knee-replacements-than-comparably-wealthy-countries_2018

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1 hour ago, Crazy Alex said:

I had no intention of answering your question. I was rebutting your accusation and stand by it.

 

 

of course you don't, because you do not have an answer , so instead you want to talk about the price of tea in China. As much as I like tea and China I am not taking the bait.

Let me refresh your memory.

I said: "So why can't we do it? "

You replied"Because government sucks at reducing the costs of anything. " (so far so good)

I said "Who is doing it in all these other countries? " (since government is doing it in other countries and they have lower costs)

To which you  engaged in a diatribe toward medicare budgets , liberals . military overspending claim. 

T which I replied " But none of these is answering the question I asked."

To which you replied:

"I had no intention of answering your question. I was rebutting your accusation and stand by it. "

That you have no intention of answering any of my questions is abundantly clear, what is not clear is what occupation you were  rebutting.

Please point out in which of my replies I made an accusation. 

 

 

 

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17 minutes ago, sirineou said:

of course you don't, because you do not have an answer , so instead you want to talk about the price of tea in China. As much as I like tea and China I am not taking the bait.

Let me refresh your memory.

I said: "So why can't we do it? "

You replied"Because government sucks at reducing the costs of anything. " (so far so good)

I said "Who is doing it in all these other countries? " (since government is doing it in other countries and they have lower costs)

To which you  engaged in a diatribe toward medicare budgets , liberals . military overspending claim. 

T which I replied " But none of these is answering the question I asked."

To which you replied:

"I had no intention of answering your question. I was rebutting your accusation and stand by it. "

That you have no intention of answering any of my questions is abundantly clear, what is not clear is what occupation you were  rebutting.

Please point out in which of my replies I made an accusation. 

 

 

 

 

You replied to me:

 

"Talking points of those who need you to do their dirty work."

 

I simply explained to you why you are wrong.

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On 11/2/2019 at 6:15 AM, Tug said:

you and top dead sender aren’t Americans anyway so go figure

But I am. My accountant says Trump is doing a great job. And Warrens plan is a farce.

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