In addition to the technical pluses and minuses noted by Tim Higginbotham concerning Elizabeth Warren’s funding of her Medicare For All (MFA) plan. David Dayen, executive editor of The American Prospect, has also given an informative, objective analysis of Warren’s MFA funding plan.
One can quibble and find gaps in parts of Elizabeth Warren’s and Bernie Sanders’ MFA plans and funding of same. Their universal single-payer plans also have a lot in common. Warren’s plan will eliminate premiums, deductibles, and copays amounting to $11 trillion in savings for the middle class. Unlike Sanders’ plan, there will be no more new taxes for the average family household under Warren’s plan.
David Dayen concludes that Warrren explains more precisely how to realize the significant cost savings of a universal single-payer plan for all. For example: how to deal with very high provider prices by making changes to the reimbursement of doctors and hospitals; how to reduce brand-name drug prices 70% and generic drugs 30%; how to vastly reduce administration costs not only by eliminating insurer profits but also making much simpler administration processes much simpler; how to handle the existing state and local share of funding for Medicaid and CHIP; how to end the huge geographic provider cost differences where wildly varying rates for same treatments are charged by hospitals and doctors (stemming in part from highly concentrated hospital market, group purchasing organizations, out-patient clinics).
A concern I have (as does Tim Higginbotham) is that under Warren’s MFA plan middle class families will pay no more new taxes than the current taxes they now pay on Medicare and taxes to fund a state’s share of health programs. I would like to see what the figures would look like, e.g., under Warren’s and Sanders plans, if all taxpayers contributed a modest added new tax on a progressive scale of, for example, 3% up to 5% or 6% of gross income.
This is because offering a MFA plan 100% free of any new taxes for middle class families (that make up over 75% of our population) has a real risk of encouraging a gross misuse and/or unnecessary resort to far better medical coverage a MFA plan will (and must) have. Bernie’s plan gives some protection against this risk.
It would be extremely helpful if experts translated Bernie’s and Elizabeth’s MFA plans into a SIMPLE OVERVIEW chart - illustrating the effect on a family household (or individual) earning annually, e.g., a gross income of less than $100,000, of $100,001 to $250,000, of $250,001 to $1 million, and more than $1 million. What does the wiping away of premiums, deductibles, copays - replaced by a small new progressive tax increase in Bernie’s plan and no new middle class taxes under Elizabeth’s plan (where new revenues come mostly from employers, corporations, investors, banks, the wealthy) - do to the pocket of an average family household assuming a gross income range along lines noted above?
Another concern about the MFA plans of Bernie and Elizabeth is that EU countries have universal health care plans at HALF the cost of the U.S. for far better medical coverage for relatively small country populations varying from 10 milllion to 80 million. Is it impossible for us to do the same with a phase one optional MFA plan approach where 120 million or more are initially MFA insured out of our 325 million people?
Our for-profit-powered health care system over 50 states is a complete MESS with its complex, immense fragmentation and non-standardization of plans making it an ideal playing field for corruption and insurance plan manipulation for provider and insurer profit mazimization. Why not first introduce an optional phase 1 MFA plan aimed at the self-insured private health care market of over 70 million households (or ± 200 million people).
The MFA insured households would make a committment to stay with the optional MFA plan for at least three years. Eventually, proven success in terms of quality, coverage and cost will stir many if not most to join the MFA plan. This will in turn provide ever larger economies of scale for greater system efficiencies, purchasing leverage, innovation and extended coverage for 90% of normal health issues.(California Free Press - Is Bernie’s & Elizabeth’s Universal Medicare Plan Better Done in Phases? by Frank Thomas, Oct. 21, 2019)