Here is some reporting on a new study by highly respected epidemiologists from highly respected universities and published in the world’s leading peer-reviewed medical journal. The finding . . .
Medicare-for-all funded by a progressive tax system would result in 68,000 fewer deaths, lower overall healthcare spending by $450 billion and save the typical family $2,400. Every year. These findings are not surprising in the least. Virtually every developed country – other than our own – enjoys such benefits from their Single Payer health finance systems.
Tidewater News and Opinion Forum 
Those other countries citizens pay their way. Middle class tax rates in Scandinavian countries, when VAT, payroll and income taxes are accounted for, pay in excess of 50%.
The US alone expects the top 10% to pay for everyone else.
If you want Scandinavian style social programs paid for by everyone proportionately, then that is a viable choice, but those programs with our tax system would render us a third world country in a generation.
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@Tabor
If you count – as you should – what people in this country pay (directly or indirectly) for medical coverage and for student debt then our middle class “tax” rates are already at Scandinavian levels or close enough for government work.
I will not disagree that our tax system needs a major overhaul. It is the sort of dog’s breakfast that one would expect in a country where money talks louder than people.
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Our middle class tax is not a whole lot less. 24% plus 15% payroll, plus state of 6% plus a myriad of property, sales and other taxes.
Then add in the average of $20,000 plus for health insurance for a family of four. Which depending on income, but let’s pick about $85,000 as middle class is almost another 25%. More if you add in deductibles, copays and other out-of-pocket expenses.
So we are paying around 70% for taxes and health care costs. Admittedly deductions, etc, could cut that down some.
So are we getting our money’s worth?
I am not so sure.
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No middle class taxpayer has an effective 24% income tax rate. You only pay that rate on the top portion of your income.
But again. if you want Scandinavian social programs, then pay it with Scandinavian tax structures.
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OK, let’s drop the middle class burden to 12 % which is for up to 40K or so. That is still 58% for taxes and healthcare.
The point is that we are already paying as much or more for both taxes and health insurance. Toss in college tuition and we are really not at any advantage over Europe.
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RE: “Medicare-for-all funded by a progressive tax system would result in 68,000 fewer deaths, lower overall healthcare spending by $450 billion and save the typical family $2,400. Every year.”
I’m skeptical. The link doesn’t explain how these miracles would be achieved, and the study itself is behind a paywall.
I also have in mind that the Blue Cross/Blue Shield model for financing medical expenses was sold to the public with similar promises back in the day (1929/1939). The model itself was a type of lottery system in which many paid a little so that a few could receive a lot. M4A would merely federalize the same approach which we already know to be unworkable.
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@Roberts
“We already know to be unworkable”
Small steps.
What is the basis for your skepticism? We already spend almost twice what other countries spend on healthcare and get measurably poorer results.
What you describe as a “type of lottery” is what other people call “insurance.” If insurance is not workable – federalized or not – how should healthcare be financed? Pay as you go?
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RE: “What you describe as a ‘type of lottery’ is what other people call ‘insurance.'”
Exactly.
RE: “If insurance is not workable – federalized or not – how should healthcare be financed? Pay as you go?”
Yes. Pay as you go is the best model.
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Insurance of any kind has always been based on many subscribers covering the costs and benefits of a smaller subset.
Even life insurance.
Otherwise, the premiums would be the actual cost of benefits. Or, in other words, pointless.
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RE: “Insurance of any kind has always been based on many subscribers covering the costs and benefits of a smaller subset.”
Correct.
RE: “Otherwise, the premiums would be the actual cost of benefits. Or, in other words, pointless.”
Correct again. For insurance to work, some number of people must be willing to give away their money for nothing in return. By the same token, if all people have insurance, some people must be denied benefits that they “paid” for.
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“By the same token, if all people have insurance, some people must be denied benefits that they “paid” for.”
I suppose if you are healthy, that is a curse.
But then again, a perfectly healthy individual could be hit by a car.
The reality is that not everyone needs insurance all the time or at the same time.
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RE: “The reality is that not everyone needs insurance all the time or at the same time.”
Exactly. And if people who don’t need it don’t pay for it, there’s no benefit for people who do need it.
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I obviously phrased that a bit vaguely.
It should have been “The reality is that not everyone needs benefits all the time or at the same time.”
That is why it would be affordable if it were universal.
Modern medicine is complicated and expensive. Not just in the US, although ours is the most expensive by a good margin. And for the same or worse outcomes.
Pay as you go is fine if you have the resources which few have until late in life if they had well paying jobs. And we still have to save for education and retirement. And with median family income from all sources at around $60K, that does not bode well for even a broken leg with a few days in the hospital. Never mind a cancer.
Hence, insurance to spread the risk.
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RE: “That is why it would be affordable if it were universal.”
It still doesn’t work out. The math is such that increasing the number of policy holders also simultaneously increases the insurance company’s liability. There is no economy of scale to be gained solely by making participation universal.
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“By the same token, if all people have insurance, some people must be denied benefits that they “paid” for.”
Again, you are an idiot….
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RE: “Again, you are an idiot…”
Could be, but unless you can explain my error, you’ve wasted your time saying it.
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@Roberts
There is no specific error. What you are asserting about insurance is just monumentally stupid. Something only an “idiot” would actually believe.
Now do you understand?
You are welcome.
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@Roberts
“Idiot” was about right.
When you buy a lottery ticket and you lose, you lose.
When you buy insurance and you “lose” it means you won.
You didn’t get a catastrophic illness.
Your house didn’t burn down.
Your car wasn’t totaled.
And, while waiting for the unknown future to happen, you enjoyed peace of mind.
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RE: “When you buy insurance and you ‘lose’ it means you won.”
That’s a good example of thinking wrong, which is why insurance doesn’t work.
When you pay for insurance but don’t use it, your payments are a material loss to you. Maybe you rationalize the expense by saying, “At least I had peace of mind,” or some such thing, but the material loss remains real.
If you pay for insurance and do use it, maybe you think, “Thank goodness I had insurance,” but if the covered expense is greater than the premium you paid during the period in which the covered event occured, then someone else is paying for your loss. Having others pay your way may seem like a good deal, but it is impossible for everyone to operate on the same principle.
Bottom line, “losing” an insurance bet means paying money out for nothing, whereas “winning” an insurance bet means having other’s give you money. Same as a lottery.
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RE: “There is no specific error.”
Of course not. Because it is true: An insurance program and a lottery work in exactly the same way. But try selling M4A as a lottery and see how that works out. Better to lie about it.
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I seem to recall just recently that Obamacare would reduce Americans health insurance by $2500 a year. Well that didn’t happen and it didn’t cost $60 trillion to find out that fact. Next…
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@Bobr
Obamacare ended three years ago. We now have Trumpcare and, yes, it can get pretty ugly and is only getting worse. Time for Medicare-for-all.
As for $60 Trillion???
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That is the figure your hero Sanders puts on it and the enormous taxes that would have to be collected to support it. At least he is trying to be honest that “free” isn’t free. We all know the lowball opinion of a few epidemiologists doesnt mean squat in socioeconomic theory.
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@Bobr
Sanders has never made such an estimate. At least that I can find. Several lying liars in “think tanks” have come up with some huge numbers. The disreputable Heartland Institute may be the source of your $60 Trillion (over ten years) figure.
All of these sky high estimates ignore the basic fact that Medicare-for-all is simply a different way to finance what we are financing NOW. It will be a rational system instead of the dog;s breakfast of greed and paperwork we have today. Its only major impact on ACTUAL spending for healthcare will be to reduce it because (1) it will no longer tolerate rip-off deals for suppliers and (2) there will be less severe disease because people will get help sooner than they do now.
As for your scoffing at the “lowball opinions of a few epidemiologists,” they are publishing in peer reviewed journals and their professional reputations are on the line if their analyses don’t stand up. This particular study was published in The Lancet which is known for its demanding standards.
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Even the left leaning Urban Institute concedes that healthcare spending will rise to $59 trillion and additional government costs will exceed $34 in a single payer system. And that figure assumes doctors and hospitals will accept drastically reduced reimbursements so it most likely would far exceed those figures.
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@BobR
The figures you quote are for one of the Single Payer options they studied. And that happens to be for coverage far more generous than current Medicare. A real Cadillac plan. There would be no premiums or cost sharing. It would provide dental, hearing, vision and long term care that are not covered by current Medicare. And, it would cover 36.4 million people who currently have no coverage including all the undocumented.
To provide this level of service, government expenditures would increase by $34 Trillion over ten years. However, the people of the country would have offsetting savings so that national spending would go up by just $7 Trillion over ten years. It is currently projected to be $52 Trillion. Add that $7 Trillion to get to the $59 Trillion you quoted.
That is their take on a gold-plated Cadillac plan.
Another option they studied is a plan that would basically extend current Medicare benefits to people legally in this country. THAT approach would add 25.6 million to the insured population and DECREASE national spending by $200 billion per year.
In short, if you understand what the Urban Institute is saying, it is an endorsement of Medicare-for-all. The open question is just how good do we want it to be.
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22 different studies show SAVINGS under M4A. Check out my post today to see what I am talking about.
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