2020 Presidential Election

[masterpanthera_t]

(03-04-2020, 02:59 PM)Crazyjdawg Wrote: I'm not certain whether or not Bernie would actually get rid of insurance companies or just render them obsolete.



I'm pretty sure there'd still be private insurance companies if M4A were passed. They'd probably just be supplement programs to, for example, skip the "line" for non-emergency surgeries and the like.

Maybe he will phase them out over time except for non-emergency / "skip the line" scenarios.

Quote:But regarding the middle man that is sucking money out of the system without providing any meaningful value? Yea, I don't mind them going extinct.

Agreed.

Quote:The concern I have with the public option is that the majority of people who currently have insurance through their employer are not necessarily going to go with "Medicare for all who want it" over their private insurance for a variety of reasons, whether that be uncertainty of the new system or just general inertia to the familiar. Why risk a new healthcare system when you have one that you know, at the very least, won't bankrupt you?

 
I don't see the applicability of this point because ( unless I'm mistaken) Bernie doesn't propose the "all who want it" option. His is an across the board M4A proposal. There's a risk with a new system, yes, but why would it bankrupt an individual? Is Bernie proposing a cap on coverage after which you pay out of pocket personally? And even if that was the case, most private insurance policies have a cap anyway, so why would there be any more risk for individual bankruptcy?

Quote:If the public option is not taken on, en masse, by working, healthy people who are already getting private insurance through their employer, that would leave the system to only insure the most unhealthy and/or oldest people in the country, who may not have access to insurance any other way.

See previous comment. This would not be an issue when Bernie will pay for his system from tax dollars. I am not clear on whether that's possible, but that's the claim in theory. Unless there is some assumption that you want spell out, reading your post at face value leads me to think that existing Medicare should cover a majority of these cases. Probably people who are not yet of retirement age and therefore ineligible for Medicare (I could be wrong about eligibility being 65 or older) might add costs after leaving their private insurance plans. In theory, these costs should be offset by the taxes paid by everyone (including the young and healthy, who will mostly not add much in terms of costs) and by cutting out the administrative cost of middle men. I am not arguing for M4A, but just laying out how it would theoretically address the point you made above.

Quote:The way an insurance system works is that the young, healthy and active members spend into the system but don't use it very often (because they are young and healthy) and offset the costs of the older, less healthy people who also pay into it, but use it more often.



I think there's a very high risk that only unhealthy and old people will take the public option, leaving the system extremely bloated (because the premiums being paid in are not offsetting the costs of the healthcare given to the unhealthy and old people) and is, therefore, extremely expensive. As it gets more expensive, premiums and deductibles go up.

 
I think my previous comment applies here also.

Quote:It's my understanding that this was essentially what happened to Obamacare, with the system being overloaded with "uninsurable" people who were expensive to cover, but young, relatively healthy people who were previously uninsured often decided to just take the penalty instead, as it was cheaper than having insurance that they didn't think they'd need.



As the public option bloats (with expensive patients and relatively few cheap patients), the more expensive it gets and the less capable it is of competing with private insurers. This ultimately defeats the entire purpose of the proposal.


So how do you convince already insured people/healthy people to buy into a new system, in order to keep the costs balanced?

In theory, there is no more penalty option, because the taxes will be levied on all working folks and proportionate to their income. So while the system will get funded, the young and healthy will still use up a very small portion of it. The older folks who currently use Medicare will hopefully use the new system the same way and add no more significant new costs. ( I'm not sure if these are too simplistic and I'm missing something). This would leave the middle aged folks to be covered with: their own taxes, the largely unused portion of young folks' taxes and savings by cutting out middlemen. In theory.

Quote:Plus, there's the most obvious problem with the public option that it doesn't cover people who can't afford insurance. The people who can't afford a monthly premium, or are unwilling to pay one because they think they don't need it, before having a catastrophic injury and going bankrupt.



So there will still be millions of people with no insurance, so was the problem even really solved?

 
I'm guessing people who don't have income or make enough to be taxed will be funded by the taxes on everyone else into the system. Kinda like welfare and other things. I'll say it again, I'm not advocating for or against M4A, unless the numbers make sense, but that's the theoretical reply. I guess Bernie would say that cutting out insurance companies from most of health care is good enough to get everybody covered nicely and still save the middle class tax payer money while not hindering the economy based on higher taxes on the wealthy. IMO, it remains to be seem if that's true.

Quote:If this were to occur and a public option was instituted and subsequently buckled under its own weight, we'd lose the ability to push for universal healthcare for the next...3 decades at least. Any time you'd bring it up, conservatives (and moderates) would just say "we tried that already in 2020, don't you remember? It failed!"...Again, kind of like what they say about Obamacare now haha.

Agreed. If this is shown to not work for whatever reason, including properly planned implementation ( even if theoretically sound), I would say the idea will be DOA for longer than 30 years.