Elizabeth Warren's 52 Trillion dollar health plan

[crescent]

Medicare cannot negotiate drug prices even with the power they have now. If we are offering this Medicare to all, then that same Medicare doesn't have price negotiation.

Unless that is another in the long list of things that are part of Medicare that isn't going to be part of Medicare. Medicare 4 All is the ship of Theseus of Medicare.

Presumably any legislation that changes Medicare to that extent could also change the prohibition on the government setting the prices it pays for medication. The current status of non-negotiable drug prices for medicare was controversial from day one - as it should be because it is nothing but a blind giveaway. Medicare is not set in stone, it never was and can be changed through legislation. Nearly every federal program deals with at least some level of legislated change every year via the appropriations bills, and frequently other bills as well.

Legislation is legislation. We used legislation to set up the current Medicare prescription drug plan, we can use legislation to change it.

 

[Ladewig]

Sounds like it's time to cut down on military spending a bit.

Blaspheme! Blaspheme!
Apostasy!

I’m kidding, but that is pretty close to the reaction one will get when one makes that proposal. And in age of Trump, one will most certainly be accused of hating America and trying to make America fail.

Actually, I emphatically agree with your suggestion but military spending is a juggernaut.

 

[PhantomWolf]

Medicare cannot negotiate drug prices even with the power they have now. If we are offering this Medicare to all, then that same Medicare doesn't have price negotiation.

Unless that is another in the long list of things that are part of Medicare that isn't going to be part of Medicare. Medicare 4 All is the ship of Theseus of Medicare.

This is because of a stupid law that the Republicans put in place, all that needs to happen is to get rid of that law and allow them to do so.

 

[BobTheCoward]

This is because of a stupid law that the Republicans put in place, all that needs to happen is to get rid of that law and allow them to do so.

That is why I called it the ship of Theseus.

 

[varwoche]

I've read statements from a handful of centrist Dem senators (Tester, Manchin, Warner, Seneca) and I conclude the odds of the filibuster being eliminated are much slimmer than I previously guesstimated. And the possibility that Medicare for all can be implemented via reconciliation is non existent. Accordingly, v0.3 of the odds that Warren's plan will be enacted if Warren (or Sanders) wins nomination:

1. Blue wave, Dems win POTUS and Senate: 25%
2. Senate gets rid of filibuster rule: 10%
3. Senators Tester and Manchin (and other centrist Dem senators) vote for Medicare for all: 10%

Based on these rough, optimistic guesstimates: .3%

 

[BobTheCoward]

I've read statements from a handful of centrist Dem senators (Tester, Manchin, Warner, Seneca) and I conclude the odds of the filibuster being eliminated are much slimmer than I previously guesstimated. And the possibility that Medicare for all can be implemented via reconciliation is non existent. Accordingly, v0.3 of the odds that Warren's plan will be enacted:

1. Blue wave, Warren (or Sanders) win POTUS and Senate: 25%
2. Senate gets rid of filibuster rule: 10%
3. Senators Tester and Manchin (and other centrist Dem senators) vote for Medicare for all: 10%

Based on these rough, optimistic guesstimates: .03%.

But someone told me Warren will be able to influence sinema...

 

[Distracted1]

Blaspheme! Blaspheme!
Apostasy!

I’m kidding, but that is pretty close to the reaction one will get when one makes that proposal. And in age of Trump, one will most certainly be accused of hating America and trying to make America fail.

Actually, I emphatically agree with your suggestion but military spending is a juggernaut.

I wonder about that.
Used to seem untouchable, with the Soviets- then the Terrorists.
Maybe it's time to address that elephant. I am not so sure it's a third rail anymore.

 

[BobTheCoward]

Presumably any legislation that changes Medicare to that extent could also change the prohibition on the government setting the prices it pays for medication. The current status of non-negotiable drug prices for medicare was controversial from day one - as it should be because it is nothing but a blind giveaway. Medicare is not set in stone, it never was and can be changed through legislation. Nearly every federal program deals with at least some level of legislated change every year via the appropriations bills, and frequently other bills as well.

Legislation is legislation. We used legislation to set up the current Medicare prescription drug plan, we can use legislation to change it.

They want to make Medicare 4 all and also completely change Medicare. Meanwhile there is a program that already does this called Medicaid (and actually knows how to do things like cover healthy adults under 65).

 

[xjx388]

It’s a good point...Medicare as it is currently would not meet the needs of the entire population. It’s geared towards serving the retired and disabled. For one thing, there is very little preventive care as you currently understand it now; no annual physical, few immunizations, mostly screenings for diseases of aging.

It would have to be substantially expanded and altered in order to serve all of us. At that point it isn’t really Medicare anymore.

Medicare-For-All is just a catchy slogan that takes advantage of our familiarity with the Medicare name. What we’d end up with would look very little like Medicare.

 

[xjx388]

They want to make Medicare 4 all and also completely change Medicare. Meanwhile there is a program that already does this called Medicaid (and actually knows how to do things like cover healthy adults under 65).

Medicaid-For-All is not going to fly, methinks.

 

[Distracted1]

Medicaid-For-All is not going to fly, methinks.

I think you are correct about that, however, perhaps we could wind up with something like this:
https://www.pewtrusts.org/en/resear...be-a-new-health-care-option-for-the-uninsured

 

[xjx388]

I think you are correct about that, however, perhaps we could wind up with something like this:
https://www.pewtrusts.org/en/resear...be-a-new-health-care-option-for-the-uninsured

Medicaid presents another set of difficulties. For starters, the reimbursement would have to be raised if you want more docs to accept it. I think you’d have to introduce co-pays/co-insurance in order to reduce the over utilization problem. It’s also a program designed for a specific population.

That’s really the problem: the US does not have a medical program that could be readily expanded to cover us all.

 

[BobTheCoward]

Medicaid presents another set of difficulties. For starters, the reimbursement would have to be raised if you want more docs to accept it. I think you’d have to introduce co-pays/co-insurance in order to reduce the over utilization problem. It’s also a program designed for a specific population.

That’s really the problem: the US does not have a medical program that could be readily expanded to cover us all.

A) there are copays in Medicaid

B) it is not designed for a specific person. It covers people from birth to end of life in a nursing facility.

 

[xjx388]

A) there are copays in Medicaid



B) it is not designed for a specific person. It covers people from birth to end of life in a nursing facility.

A)Depends on the State

B)Medicaid provides care that is generally designed for vulnerable populations: mainly women and children. The benefits for those populations are, again depending on the State, more comprehensive than any other insurance plan. In Texas, there’s the women’s health program and the Health Steps for kids. The idea being that those vulnerable populations need extra support.

Medicaid is also designed to support Medicare for low-income people. It pays for home provider services and a bunch of stuff that would normally be paid out of pocket.

Those programs would not transfer well to the entire population at a cost that would be manageable.

 

[BobTheCoward]

A)Depends on the State

B)Medicaid provides care that is generally designed for vulnerable populations: mainly women and children. The benefits for those populations are, again depending on the State, more comprehensive than any other insurance plan. In Texas, there’s the women’s health program and the Health Steps for kids. The idea being that those vulnerable populations need extra support.

Medicaid is also designed to support Medicare for low-income people. It pays for home provider services and a bunch of stuff that would normally be paid out of pocket.

Those programs would not transfer well to the entire population at a cost that would be manageable.

Your initial claims are wrong. You don't have to introduce copays...they are already introduced.

It is designed to cover old and young, healthy and sick, male and female.

 

[Tsukasa Buddha]

I've read statements from a handful of centrist Dem senators (Tester, Manchin, Warner, Seneca) and I conclude the odds of the filibuster being eliminated are much slimmer than I previously guesstimated. And the possibility that Medicare for all can be implemented via reconciliation is non existent. Accordingly, v0.3 of the odds that Warren's plan will be enacted if Warren (or Sanders) wins nomination:

1. Blue wave, Dems win POTUS and Senate: 25%
2. Senate gets rid of filibuster rule: 10%
3. Senators Tester and Manchin (and other centrist Dem senators) vote for Medicare for all: 10%

Based on these rough, optimistic guesstimates: .3%

Yup. It's interesting as seeing how a candidate solves a problem, but there is little chance of it actually happening.

 

[Brainster]

I've read statements from a handful of centrist Dem senators (Tester, Manchin, Warner, Seneca) and I conclude the odds of the filibuster being eliminated are much slimmer than I previously guesstimated. And the possibility that Medicare for all can be implemented via reconciliation is non existent. Accordingly, v0.3 of the odds that Warren's plan will be enacted if Warren (or Sanders) wins nomination:

1. Blue wave, Dems win POTUS and Senate: 25%
2. Senate gets rid of filibuster rule: 10%
3. Senators Tester and Manchin (and other centrist Dem senators) vote for Medicare for all: 10%

Based on these rough, optimistic guesstimates: .3%

I think your 10% on removing the filibuster is high. Senator Kyrsten Sinema (D-AZ) has announced that she will not support getting rid of the filibuster.

 

[Bob001]

....
I think you’d have to introduce co-pays/co-insurance in order to reduce the over utilization problem. It’s also a program designed for a specific population.
....

What is the over-utilization problem? People are going to doctors with trivial stuff, or because they don't have any other place to go, or what? Some of that could be fixed with education, or phone consultations, or walk-in clinics staffed with NPs, or other methods. And the "specific population" for Medicaid is basically poor. But people are poor for a lot of different reasons. That doesn't mean they don't need or deserve good services.

Why is something that every other country provides its citizens just impossible for the U.S.?

 

[Bob001]

....
It would have to be substantially expanded and altered in order to serve all of us. At that point it isn’t really Medicare anymore.

Medicare-For-All is just a catchy slogan that takes advantage of our familiarity with the Medicare name. What we’d end up with would look very little like Medicare.

The basic structure of Medicare is that patients choose their own providers, and doctors and hospitals run their own businesses. Medicare is a single-payer insurance program that covers all Medicare patients and pays all Medicare providers. Expanding who is covered and what is covered wouldn't need to alter the basic framework, unlike, say, trying to copy the UK's NHS. And creating a Medicare-for-All-Who-Want-It public option would allow patients to compare Medicare with whatever other insurance is available. This just doesn't seem impossible.

 

[BobTheCoward]

What is the over-utilization problem? People are going to doctors with trivial stuff, or because they don't have any other place to go, or what? Some of that could be fixed with education, or phone consultations, or walk-in clinics staffed with NPs, or other methods. And the "specific population" for Medicaid is basically poor. But people are poor for a lot of different reasons. That doesn't mean they don't need or deserve good services.

Why is something that every other country provides its citizens just impossible for the U.S.?

No country provides what Sanders proposed.