Now that we’ve set the ground rules, and the five main questions to consider, let’s look at the various plans. At the time we taped this episode (in mid February), there were ten that we could get full answers for. How they break down is the topic of this week’s HCT.
Senate Medicare for All bill:
House Medicare for All bill:
Medicare at 50 Act:
Medicare for America Act:
Healthy America Program:
The CHOICE Act:
Medicare Extra for All:
Medicare X:
The “Choose Medicare” Act:
State Public Option Act:
Related HCT episodes:
1. Medicare for All: What Does it Actually Mean?
2. Medicare for All Admin Costs:
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There’s a reason Bernie’s plan is popular, it’s the best plan. And let’s be clear about the “cost” of that plan: it is less expensive than what we spend on healthcare as a nation now.
+Agtsmirnoff I am not sure where this comes from. Why would this plan cause a cut in doctor’s reimbursement?
+Mitch It outlaws private insurance which mean doctors will have to accept Medicare rates which are 20-30 percent lower than private insurance…and that’s assuming the goverment’s new monopoly on insurance wouldn’t further drive reimbursement rates down.
James Adams clearly has no idea how the world works, but it’s okay. We’re gonna get you healthcare too, even if you aren’t bright.
I had not heard of the details for the various plans before, so I found this very informative. Thanks.
To be clear, if a candidate isn’t in support of Medicare for all of some sort, they’re done.
Push that message. Establishment leaders don’t like changing the system because it’s their system. It made them rich and powerful.
We should oust them from office ASAP and install leaders who don’t have to be forced and prodded to represent us. Support candidates who don’t take corporate money.
Brian Harper You must be more specific than that statement due to the changed popularity % for Medicare For All compared to 2016 the corp. politicianshave changed their verbal messaging to subtly trick us into thinking they are for Everyone getting the best coverage at the most affordable price.New trick messaging ” I support Medicre for All but we need a pathway to get there” -Why do they insist on a pathway because it allows private insurance to still keep a portion of the market which allows them make enough S for political donations much larger than we can + It gives them a long time period to lobby to weaken,halt,further stall+privatize(example medicare advantage).Sanders+Jayapals plan are the only plans that do not allow private insurance to offer competing plans on the market+ they reduce cost the most by getting rid of the middleman and with either of these plans we will have the biggest group(all of us) that will allow us to have the most leverage on bargaining down the price of procedures,visits and drugs keeping the costs down the most-Current pres candidates for this besides Sanders are Gabbard,Castro,Gellibrand(although keep in mind she used to be repub and more recently a conservative Dem)
You mean Democrats. Not all of us are stupid enough to support such economic illiteracy. And I don’t even support Republicans either, but at least I’m smart enough to not be a Democrat.
James Adams .Meidcare 4 All is not aparty issue it is a people issues as polls show amajority of Americans want Medicare 4 All+James Adams including Republican voters. The Mercatus Center Study is not a Democratic or Republican think tank and it contradicts your statement of economic illiteracy on this matter as it shos a 2 trillion $ over 10 years switching over to Medicare4All.Also name calling will do nothing to prove your point.
+James Adams You sound smug, apathetic, and incredibly stupid. The only way to effect change is to invade and take over a major party. What us progressives are doing is working. Apathy is how we got Trump, 49% of the country didn’t even fucking vote… that is stupid. Trump won because he riled up a base and they fucking voted. Get with it.
If you don’t have your health, you don’t have anything. We need to help all of our people. Thanks for the great content as always.
Dr. Carroll, I’m interested in which plan you like the best. It would also be enlightening if you could have an economist on the show to give their opinion. I think an expert opinion should have more weight than the opinion of someone like me, a retired military musician.
I think it’s important when talking about Bernie’s Medicare For All plan to mention that supplemental insurance for things like plastic surgery and other things that aren’t covered by the bill will still be allowed. When you say it would completely get rid of private insurance and the individual market, that is not entirely accurate and could mislead people to think supplemental insurance on the private market would no longer be available under Bernie’s plan.
+Elliott Collins I checked and you’re correct, at least based on the 2017 bill he sponsored. Took a bit of searching through to find. It says it won’t be lawful to “duplicate coverage provided for in this bill” but is lawful to provide services not covered.
Well, I don’t support that, primarily because it seems totally pointless. It also won’t pass. I imagine this will be one of the first things to be compromised on.
Maybe Bernie takes the view that allowing this will lead to an upper and lower class arrangement, and Medicare will end up gutted by Republicans. That’s possible, but such services have such high approval ratings around the world, I’m not sure this is likely. The vast majority of people will not want to pay a crazy amount for supplemental private insurance.
It’s worth noting that whether supplemental insurance is allowed or not it’s pretty pointless under Bernie’s plan because it is designed to cover everything (except cosmetic surgery) and there are no copays or deductibles.
If hospitals want to create fast lanes that you pay extra for I guess that would be up to them, doesn’t necessarily have to be an insurance thing.
+Daniel Jensen Right, which is why in the UK only 10.5% of citizens have private health insurance of any kind. Usually what happens is that for whatever reason someone isn’t happy with the healthcare they’re receiving, and decide to “go private”. Or super rich people who want the absolute best of everything. It’s not very common.
d_dave there actually is a point. Two comments down is a comment addressing administrative waste. I’m not really interested in getting into a weedsy argument over which approach is *best,* but the argument for this approach is that it’s cheaper for everyone.
When talking about the cost of these bills, I think it’s important to mention the cost of the current system. There are many studies out there, including one funded by the Koch brothers, that show that Medicare For All would cost Americans less money over a 10 year period than the current system. So, sure you’d be paying more in taxes, but the increase in taxes would, on average, be less than the price that people are currently paying for insurance and would no longer have to pay under a true Medicare For All system.
Under the Sanders and Jayapals Medicare$All ,the type of plan which the study was based off everyone would automatically be enrolled and get this health insurance.The only area the plan would not cover is elective procedures which area cosmetic surgery if you felt you would prefer to change or “enhance your appearance. you would have to either buy a private plan that just covers cosmetic surgery only or pay directly for the procedure.+Matt Skelton
+patrick steele wrong! The private insurance market operates at LOWER administrative costs than Medicare. Why this lie stays alive is because leftist political hacks keep pushing a dishonest metric. They aren’t actually factoring in the entirety of Medicare’s administrative costs.
The study I”m getting this info. from is the Libertarian(farther Right than Republicans in regards to keeping government as small as possible) Mercatus Center funded by the Koch brothers. It projects Administratve costs to be reduced from 13% to 6% by switching from the system we have now to Medicare4All(like Sanders model). What study are you referring to that contradicts this?+James Adams
+patrick steele I’m referring to the reality of private insurers having a lower administrative cost per patient than Medicare.
https://mises.org/wire/medicare-all-administrative-costs-are-much-higher-you-think
+patrick steele yeah james u keep posting that koch article, but it doesnt mention that half of health spending happens when you’re elderly and the more you interact with the health system the more it costs… not that hard to understand (and dollar for dollar its way cheaper)
and it also doesnt mention insurance company overhead is 20-30% because of profits, advertising & everything else.. because why would they mention it if facts dont matter to them
So all these plans are a variant of Tricare Prime and Tricare Select. The premium free, free or low decidable, free or low cost sharing, low or no max out of pocket, government sponsored health plan for service members & their families.
Off all the plans, the only M4A plan that addresses the elephant in the room i.e. ‘the vast administrative waste’ in the system is Bernie’s plan. If you want to keep the private insurance – employer based system in place in the name of choice, it means you want to burn money in the name of administration
+James Adams yeah i cant teach people basic logic.. if you use a service more often it costs more.. it’s not that hard to understand.
and if you can show me where medicare overhead is 20-30% of total expenditures (as it is with private) then go ahead (guess what: it’s a lot less)
im not a leftist but its obv you’re just babbling at a wall parroting easy to debunk fox news koch memos without thinking
+Pet “muh basic logic” is not a substitute for data, you dimwit. You claimed that Medicare is lower in administrative costs. It isn’t, and now you’re trying to move the goalposts.
Private isn’t 20-30%. Try again.
You are a leftist. You’re a leftist shill pushing leftist talking points with no citations. I gave you mine.
I will happily burn money to have a plan that is seperate from my employer. 4 years now and every 4 months I have new medical cards and paperwork to file, different rates which keep my check inconsistent, and minimal care facilities to get free of copay which is never low. My pcp has 30 doller. Anywhere else i go its close to 90. I’m all for medicare for all.
+Michael Pilz sure, then crowdfund it and don’t force others to fund it for you.
If you can get everyone Medicare, and have it be cheaper and better than the current system, seems like a no brainer to me. Medicare for all costs were even analyzed by a conservative research group and found to be cheaper by 2 trillion over the next 10 years. Which makes sense as the government is a nonprofit and would have more power to negotiate drug prices.
No, they didn’t find that. They found it with a totally unrealistic 40% cut in reimbursement to doctors.
Calling most of these “Medicare for all” seems more like marketing to confuse people by tagging new proposals to what they associate with a more popular one…
+G G nothing impractical or blind about it. You just sound mad that you can’t win in debate.
James Adams I’m actually fine with people taking radical ethical positions or pushing for novel political ideas, I was just giving Arvind a heads up that you probably won’t be receptive to his points. It’s really not about winning.
+G G to me it’s about being right and finding the correct answers based on solid logic. To different people the word “ideologue” has different meanings. Some use it to suggest being uncompromising. To that I agree. Others suggest it as being mindlessly dogmatic or devoted to unworkable ideas. I reject that.
I’d take # 10
Only the first two plans (Sanders and Jayapal) are Medicare for All. I don’t think any of the other plans even claim to be that.
As a democratic socialist, while I like Bernie’s plan most (of course), any of the first four options seem like they would be huge steps forward. I’d be pretty thrilled with any of them honestly. The rest aren’t really Medicare for All in any meaningful sense, no matter what politicians call them. Though I suppose they’d be better than nothing. Still, if we try to get one of the weaker plans, we’ll end up with nothing. You can’t negotiate starting from the middle.
Very true. Push for the entire policy though. Be ruthless in the primaries and make it clear that half measures and capitulation will not be tolerated. We have enough “compromise on everything” candidates to topple the party… wait a minute.
I don’t get it… Is the joke supposed to be a normal YouTube video on April 1st? I guess you got me then….
Medicare for all would save at least $2,000,000,000,000.
Seems obvious
No, it wouldn’t. It would increase the size and scope of the government. The notion of “saving” money is based on a projected cut of reimbursement to providers by 40%. It is economic disaster. To suggest that it would save money is economic illiteracy at its finest. Medicare itself was projected to cost much less than it actually costs today.
Cut the fat from the defense budget and transfer it to health and human services. The country would become stronger and the world a more free place.
What’s gonna happen in real life:
More spending on military
Less spending on human services
More wealth for people in the military industrial complex
Less service for people who need help
What are we fighting for if we don’t care about maintaining the health of our citizens?
Medicare for All by Bernie Sanders or Pramaila Jayapal seem to be the simplest. People need a good plan, not choices.
A lot of the other plans with option complexities are a bit like Boeing trying to stabilize an unstable plane design with software fixes.
How would it be possible to eliminate all private insurance, essentially killing the Big 5 insurers plus the Blues?
The other politicians other than Bernie Sanders are still trying to protect the insurance companies along with pharmaceutical companies. Corruption and politics go hand in hand hopefully Bernie can Free us.