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'Everybody In, Nobody Out': What We Know So Far About the Medicare for All Act of 2019


What a coincidence! Glad it’s useful - though that link’s not what I read before - had a brief look and can’t find it, but it was an economist, I suppose, who ‘went to Lott’s level,’ critiquing his argument within the framework of the field, admitting it was a thankless task.

And maybe a pointless task: creatures like Lott could only be produced by a right wing culture, same way “cranium science” could only be produced by a sexist or racist culture, imo. Resistance will spring up at every level of culture - perhaps unevenly; but it will take movements to make the big changes that will consign such characters to the Museum of Intellectual Creeps.

Interesting to hear your personal connection w/statistics - I seem to recall 40 years back in h.s. a friend mentioning a statistical model that showed…I don’t know…Victorians should have been up to their chins in horse manure?


I dunno, that sounds a lot (sic) like what I read! I skimmed through it again and realized that the hilarious graphic toward the end failed to load the first time. I looked up the author, and he is a retired sociologist from Rutgers, but I seem to recall a set of takedowns of Lott a few years ago, and one could well have been written by an economist.

We are certainly living in a debased culture, a dying empire on a dying planet which we are hoping to resuscitate. I’ve been reading a fascinating book recommended by a friend, A People’s History of Science, a remarkable compendium from mostly secondary sources of the remarkable feats of observation and discovery by people from the Paleolithic onward. The point of the author Clifford Conner is that everyone including the ancient Greeks and even their forerunners has stood on the shoulders of giants. I can’t get away from Mark Twain’s conclusion that “History does not repeat itself, but it rhymes.” There is a long-term trend, but with many quasi-cycles imposed upon it.

There will be cycles and trends in the future, with or without us, but we are certainly at a “singularity,” a discontinuity in the trends of at least the past 200,000 years, the blink of an eye in geologic time but ten thousand human generations. Have you ever read A Canticle for Leibowitz? I’m not a Sci Fi buff, but I stumbled on that one fifty years ago, passed along by a colleague, and only learned a few years ago that it is considered a classic. I seem to have stumbled my way through life, and by blind luck and grace wound up in a pretty agreeable place that I could never have predicted (that word again!)

I have to ask what you teach. I grew up with pretty good schools, before the “reformers” began deforming public education. But only one teacher would have dared to tackle a subject as controversial as gun violence, even though people would have discussed it among friends, including friends who saw things differently.


Mark Dudzic Of the Labor Campaign for Single Payer and Benjamin Day of Health Care Now (began by Marilyn Clement) have been putting up the good fight for many years to help get us to this point. We need to support these organizations and the fine work they do to make Medicare for All a reality.

I am encouraged by this article because I was getting some of the misinformation the article alludes to. And we have to ready to show a unified response in large numbers for when those who want to diminish or gut portions of the bill at the behest of the insurance and pharmaceutical companies.

We should fully appreciate the work of those activists who in the face of years in the wilderness but with determined and sustained effort have created the present moment. Let’s stay unified in our support to get to the goal line.


That’s a bogus critique. It has to do with coverage for everyone and no one excluded or denied coverage for any reason. It’s the way to do it. Has nothing to with fascism, and in fact is on the other end of the spectrum since corporate power is eliminated.


We really got hit big time! Over a foot of snow this morning…

Interesting comment about a “Megalopolis.” I get it. There are too many people out here and Seattle has become overly gentrified! Unless you make a ton of money, you can’t afford to live in the city anymore.


I read this in the same way as @economagic was explaining - if the insurance company goes under before the completion of the transition period. (All companies would go under or be limited to non-covered procedures or private bed upgrades or some other marginal market after the transition period).

I could be wrong, but at this point, I guess I’ll just wait for the bill and then we’ll have a lot more concrete information to discuss (though it will still be more malleable and we should as voters let our representatives know if we aren’t happy with some aspect of the bill).


It’s a pipe dream until we see details. Exact details.

What is the cost? Is it really 3.2 Trillion per year, 32 Trillion over 10 years which has been stated by various government departments? Keep in mind the annual Federal budget is 3.8 Trillion with a 1 Trillion deficit.

Whatever the cost how is it paid for?
This is critical. Overall, if the cost is 3.2 Trillion then overall the Federal Budget will be 42% of the entire GDP. Everyone is going to to end up paying a significant part of their income towards this including those (~40%) who currently pay no Federal Income Tax. I am perfectly fine with this but it needs to be included in any discussion of healthcare for all. If it isn’t when the economics are finally put forward the enthusiasm with disappear and so will the dream.

People need to stop talking about healthcare being a “right”. It isn’t. There is nothing that states that any of us are entitled to the labor of others which is exactly what healthcare for all is. We are asking an industry to provide their labor for all US Citizens at a cost we the people determine. Rights are individual rights, they are our personal rights, they do not extend or infringe on the rights of others. Labeling it as a “right” is easily shot down and diminishes the benevolent nature of this legislation.

Until we see the numbers enthusiasm should be muted. This is a dramatic change in our healthcare system and a revolutionary change in the nature of our country. Level heads with advocates who can defend this with actual impacts and numbers are the only way other Americans and legislators will buy in.


MediCare for All is exactly the way to go so long as it’s done properly. With the exception of the truly indigent, all policies should incorporate deductibles and co-pays. Health care should not be “free” for non-indigent people ; it is a service which has tremendous value and should be treated as such. As economists tell us, “as the price of a good or service approaches zero, the demand for it approaches infinity”. People need to employ health care thoughtfully and not run off to the doctor with a runny nose. Otherwise the system will be so overutilized that you’ll wait six months for an appointment like they do in England and Canada.


Libertarian nonsense.

Nothing is a “right” unless humans declare it so. So what world do you want? Is life a “right”? Is any form of liberty a “right”? Anyone can take your life any time, should we not work to avert that? Most wealthy countries in the world have determined that EVERYONE IS BETTER OFF if everyone has health care, and with their systems they PAY LESS and have BETTER HEALTH than we do. It’s not at all about being “entitled to the labor of others.” No one is “entitled” to ANYTHING. So how do we organize society? How do we organize the economy?

There are HORRIFIC outcomes from the current system. USA pays the HIGHEST COSTS IN THE WORLD, and has FAR FROM the best health outcomes. The top source of personal bankruptcy, which has lots of multiplier costs throughout the economy. Thousands of people NEEDLESSLY DIE every year. YOU need to answer THOSE problems.


That $3.2 trillion is the current total annual cost of healthcare in the US, about 65 percent of which is already paid by government, most of it by the federal government. The rest consists mostly of insurance premiums and out-of-pocket expenses such as deductibles and co-pays.

Every single study, including one funded by the Koch brothers, and also the experience of every other major nation all of which have some form of single-payer health care financing, shows that the total cost will be significantly less with single-payer, with how much less depending upon the details of the proposal. The expenditures of insurance companies for marketing, administration, and profit would be eliminated, so the money now spent on insurance premiums, deductibles, and co-pays would more than cover the other 35 percent of current costs.

Ideally that amount would be collected in the form of a single dedicated tax which could not be used for any other purpose as is the case with the FICA tax for Social Security, though in practice it might be collected by a combination of new taxes and changes in current taxes. The difference between what is now paid and what the reduced cost under the new system would fund a higher level of care for all of the population, including the 28 million people currently without any health care insurance. The plan will include both dental and vision coverage and presumably hearing aids (which Medicare does not cover), freeing up those out-of-pocket expenditures as well.

As for health care being a right, it is so considered in every developed country except the US, and also in many less-affluent countries. This change would go a long way toward moving this country closer to the greatness we have yet to achieve.


You believe what economists tell you?!? Don’t!!! I AM an economist, and my mantra has always been, “Don’t ASSUME that anything any economist including me tells you is true.” Do your own research, and you will find that support for the mainstream “neo-classical” economic paradigm is at an all-time low and falling. The idea that “as the price of a good or service approaches zero, the demand for it approaches infinity” is based on the assumption that the wants of every human for every good is infinite, which is so absurd that many people accept it BECAUSE they don’t understand it. Research, and the experience of the many nations that do have universal coverage, show resoundingly that the idea that deductibles and co-pays are not necessary to keep costs down and are actually counterproductive. How many hip replacements were you planning on having this year, anyway?


Not nonsense. Just because you can take a life does not mean you have the “right” to do so. Is that so hard to understand? Healthcare is not a right, it is something we choose to do because we think it is the correct or moral thing to do. Phrase it as a right and this will not get off the ground floor.

No where did I say anything about the current US healthcare system. It’s a straw man to say I did.

As for thousands of people dying needlessly every year. I do not HAVE to answer those problems, I choose to. Again, keep framing it that way and it is guaranteed to fail.

Lastly, lets not kid ourselves that healthcare is the cause of 1000’s of people dying needlessly every year in the US. We are in the top 5 for Obesity, headed to number one and a majority of deaths in this country are from PREVENTABLE disease. If we are going to truly going to address healthcare as we should there will also have to be a personal accountability portion included.


You’re blinded by your ideology. “The problem” is not obesity, fer crissake. The problem is systemic looting, corporate colonizers who prey on ecology and society and bamboozle us with endless propaganda. We need to get the looters, the blood-sucking vampires, the fuck OUT of the health care system, and frankly, out of the economy entirely.

You won’t want to notice, but this system, this looting colonizing predatory system that we are taught to love as “free-market democracy,” has – LITERALLY – brought us to the brink of ecological collapse, mass extinction, and the end of civilization if not humanity.

So feel free to parse approaches to health care as if “the problem” were personal irresponsibility and the desire for “free stuff.” You are spouting nothing but the propaganda of the looting class, who are happy to have you fighting in the trenches on their behalf. Good day.


OMG, I am not blinded by my ideology. How many times do I have to say that we need to pursue healthcare for all?

Obesity and preventable chronic disease are choking our healthcare system to a point that no system, not even the healthcare for all I am advocating for, will be affordable. And then what? We create a system that is going to fail just like the current system and throw up our hands? Seriously, focus on the goal and yes, just like England is now doing, people are either going to take a role in their healthcare or they are going to go to the back of the line.

This “end of humanity” stuff is exactly what the other side is going to use to shoot this down before if even begins. Stay on target and discuss with less emotion, more benefits and why we CHOOSE to help those who cannot help themselves. Emotional arguments and lashing out are signs of a lack of critical thinking skills.


The larger the pool of insured people, the more stable and cost-efficient the risk-sharing system we call insurance. Universal healthcare in the US will uniformly cover about 325,000,000 people.

That’s just one of the reasons the economics will work — once we bulldoze corporate naysayers in both parties out of the way to actually get it done.


The bill…will not allow participating institutions and providers to offer private care for covered services to the rich. Allowing the wealthy to “buy out” of the system has led to the erosion of care for everyone else…

I wonder how well a prohibition would work in practice. I envision an explosion of super-premium medical clinics, hospitals and doctor groups clustered just over the border in Mexico and/or anywhere readily accessible by plane — fed by an air shuttle service and dedicated fleets of aircraft — all to serve the needs and whims of families who can afford it.

Our nation’s experience with prohibiting alcohol, drugs, gambling or anything else does not suggest a good outcome for prohibiting premium private healthcare services, regardless of how desirable such a prohibition might be.

Such artificial scarcity (of premium services) would be an open invitation for creative profiteers to game the system — a niche just begging to be exploited on behalf of well-heeled clientele.

On the other hand, if the rich want to buy their own healthcare services, so what? They will still pay into the universal public system, just like you and me. Consider: even if they send their kid to a ritzy private school, they still pay their taxes supporting public education — exactly as it should be.


The article discussing Jayapal’s forthcoming bill doesn’t mention student debt, an enormous issue for many doctors and other healthcare professionals. It’s all connected.

Thus student debt cancellation and free tuition need to be addressed as part of comprehensive universal healthcare. In strategic terms, it’s not unlike AOC’s Green New Deal addressing much more than just renewable energy. There too, it’s all connected.


‘this is a serious bill’ compared to HR 676 … and everyone is eligible. WTF, everyone was eligible under ObamaCare. They just could not afford it. Sorry folks but all we will get out of the neoliberal wall street democrats is ObamaCare with lipstick … Pelosi’s that is: ‘My main interest is protecting ACA (ObamaCare!!)’. Ole balance budget Pelosi says we can not afford it, then calls for the next bill:
Where is that trillion dollar warmongering bill that was suppose to be on my desk yesterday?


That is precisely the reason there is a burgeoning grassroots movement for single-payer. “Demanding” anything of Congress is barely even symbolic when a few thousand people do it, but it can force a change in the discussion if a few million do it (the 3% rule). In fact, that is the ONLY non-violent action that leads to change.


Hi, economagic, I’ve taught middle school English in NYC for the last 15 years, w/a few stints of American and world history. (Following prior grad school in art history, until my wife got pregnant and I hadn’t finished my dissertation - bailed out into NYC program that puts you fast in the classroom w/subsidized coursework for permanent certification.)

Not always the most intellectually curious students, but never a dull moment. One of your not predicted changes.

The gun violence unit was part of a debate/argumentative writing minor - not a prob in the schools so long as you show both sides. Which I did.

Nupe, haven’t read that sci fi book - reading Oz’s A Tale of Love and Darkness now, but will put it on my very long list of recommended unread books.

See ya’ around the website!