how would medicare for all transition in increasing taxes?

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  • linate
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    linate

    we can have universal care that is cheaper than it is now, with better quality and shorter wait times. 

    but if we did medicare for all, how would our tax system transition?

    i'm coming at this from more of a conservative angle, and would like to debate or discuss with a medicare for all proponent. 

    take someone who makes 50k. they are average. one would think we would take obamacare's basic structure of taxing businesses that are large enough. but wouldn't that person making fifty k also get taxed? what if they in the current system make fifty k and get free healthcare from their boss? wouldn't the transition make that person end up getting a tax they otherwise wouldn't if things stayed the same? 

    i mean, if we were starting from scratch, this is a no brainer that medicare for all is best. i'm just worried about the winners and losers in trying to get to that point now. kinda makes me think some sort of public option would be better, for practical purposes, or at least political purposes 

  • dustryder
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    But would that extra tax be such a bad thing? It's probably been said to death before, but most other 1st world countries have a successful implementation of a healthcare tax and universal healthcare. I don't understand this attitude of Americans where you say fuck you to your less fortunate countrymen and accept the obvious price gouging of hospitals.
  • linate
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    --> @dustryder
    well, i agree someone making fifty k can afford to pay a little more in taxes. i'm not sure how much that extra amount would be, though, and that matters. if the average cost in the usa is seven to ten grand a year, that's a hefty extra tax, unless the businesses of the country do enough to bring it down, along with all the other cost saving measures. 

    but even if you and me agree, it would piss off a lot of people. if we can jam medicare for all down the throats of the country, that's fine by me. but what if the problem of the extra tax, along with all the other winners and losers means for political practical purposes that we can't just cram it down people's throats. public option might be best?
  • oromagi
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    Well, Sen. Sanders says that Medicare would cost about $3.25 billion for the first ten years.  Americans presently spend $3.5 billion ($10,740 per capita).  So, we'd have to redirect roughly 92% of our present healthcare spending to taxes- an increase in tax for an avg. family of four of $25,760 but an overall savings of $2,240.  That assumes that the healthcare system maintains it present level of care, which, while I believe is an achievable end, cannot be guaranteed.  If we emulate successful prior models and learn from their mistakes we could theoretically bring that cost way down over ten years.  With improved efficiencies and adept technological adaptation we might reasonably get the cost down to $12-13,000 a year which is about what Canadians and Germans do their healthcare for.
  • Greyparrot
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    More government is the ultimate reason why healthcare costs so much already. Medicare for all will be gasoline on the existing fire.
  • linate
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    --> @oromagi
    even if the tax was thirteen thousand that's still a lot of money if it falls on a dude making 50k. i think i read that someone making that much pays 12k in income and payroll taxes. if you add another thirteen on top, you're bringing their take home down to 25k. that's gonna rub a lot of people the wrong way, and id wonder about all the poor people who don't pay taxes basically ending up the same as someone making 50k. 

    plus you're assuming we could get down to 13k in taxes as germans etc do. the thing is, they regulate costs, all developed countries do, to get their costs down by a half of what the usa pays. i dont think we can regulate costs as much as everyone else, because healthcare businesses need to make enough profit to innovate and exist. these companies can afford to pay knock off countries less because they make their real money in the usa. 

    but it would make sense that a family of four in the usa would pay 40k in taxes, cause per capita healthcare costs are ten k each. i think your numbers at 25k make sense only if we assume the top ten percent of payers are going to pay half the costs, proportional to how it's done now. 

    so anyways, i think we're talking about somewhere between 13 and 25k in taxes. still a lot of money. a lot of pissed off people, for sure. 


  • linate
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    --> @Greyparrot
    well if you can show a free market way to provide healthcare to everyone at reasonable costs, we're all ears. 

    didn't you once say you thought  a public option for poor people wasn't such a bad idea? that's where i might end up thinking is best. 
  • linate
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    it might be best to just expand eligibility to medicaid and medicare. put people on obamacare on medicaid, increase the amount they can earn, and cover everyone who is on the poorer side. then lower medicare's age eligbility to 55. if we did these two things, we'd cover everyone, and people can keep their existing health care if they want. if you make 50 k, taxes might have to go up to cover medicaid more, but i dont think it'd be such a monumental shift as medicare for all that it would break the bank. 
  • linate
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    if we did it as i said in my last post, the only people who would be uninsured would be people who are healthy and make a lot of money but dont want health insurance. they only pay for the extra taxes it takes to fund mediciad. medicare is more self sufficient, though unfortunately general taxes do make up a lot of the revenue for it. 
  • Greyparrot
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    --> @linate
    Like I said before. Who do you trust? Politicians bought and paid for by rich lobbyists? How about your neighbor? How about a lawyer that works for you on a 33% commission, do you trust him? Who do you trust? 
  • linate
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    --> @Greyparrot
    i don't trust anyone. i know i don't trust the free market to provide for everyone. the government is often incompetent, but i trust it enough to provide a basic threshold for the necessities. i figure, every other developed country has affordable healthcare that is almost always better quality than us, so what makes us different? how would you answer the question of what makes us different? what about who do you trust?
  • Greyparrot
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    --> @linate
    I trust people I can pay.
  • linate
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    --> @Greyparrot
    if every other developed country provides affordable healthcare that is almost always better, why do you think the usa would be an exception?
  • linate
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    here are some interesting facts that can help someone do thought experiments. 

    healthcare costs three and a half trillion in the usa. 
    employers cover half the costs currently 
    the average income in the usa is around forty or fifty thousand for a person
    the top ten percent of tax payers pay half the income taxes and of course the rest of people pay the rest
    the richest people pay a trillion in taxes and the rest pay another trillion
    almost every other developed country pays half as much as the usa does on healthcare
    healthcare costs ten k in the usa per captia and half that elsewhere

    using thought experiments, we could assume employers would cover half the costs of healthcare in a universal system, or 1.8 trillion. that means if we doubled minus a bit people's taxes, we could cover the rest. of course, if it was possible to get our spending down to the level in the rest of the world, we wouldn't have to increase income taxes at all, as businesses could cover it all. or, you can do your own thought experiments to determine how much proportionally each segment of society would pay. 

  • Greyparrot
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    --> @linate
    I don't trust government statistics that say government run health care is better than market healthcare, especially if the politicians pay for their own health care instead of using government healthcare.

    Same thing with schools. If the politicians generally don't use public schools, then I don't trust public schools. Did you know that the last presidential kid that went to public school was Jimmy Carter's kid in the 70's?
  • linate
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    --> @Greyparrot
    no one is saying it's better, just adequate. politicians want the full service. they dont want copays or deductible, and they want things covered like long term care which isn't covered with medicare. 

    it's hard for someone to be against something they dont know anything about. if every other country does it, this deserves a person to be educated about it before judging it. the link in the opening post is a good place to start, but google will work wonders if you dont know basic healthcare policy. 
  • TheDredPriateRoberts
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    this would end private non government healthcare and all the employees there of, which now will add I don't even know how many unemployed people to the tax burden, taxes will have to go up to cover these newly unemployed people.
  • Greyparrot
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    --> @linate
    Even Canada healthcare allows the parliamentary members to opt out and use private health care. If public health care was really superior in Canada, why would they opt out? I mean it looks bad for their political image plus they have to pay out of pocket.

    The old joke in Canada is that the health care in Canada is superior...until you get really sick.
  • linate
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    --> @Greyparrot
    canada is the only exception to better quality that i know of. in that commonwealth study, it showed they were the only one that had worse wait times than the usa. not surprisingly, they also have less doctors than us, where we already have fewer doctors than everyone else. politicians in canada want to be able pay for their own doctor so they dont have to have wait times or other problems. canada is truly single payer  where healthcare is outlawed. the thing is, medicare for all in the usa doesn't have the problem of being single payer technially speaking, and we dont have the doctor and wait time problem as much as they do. 
    i mean, you focus on the one country who might be a bad example. id expect you next to compare us to the VA or UK where it's actually socialized medicine, when that's not anything anyone is even promoting. 
  • Greyparrot
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    --> @linate
    I suppose if you outlawed the private competition, then the people would be forced to accept the "new normal" for healthcare.
  • linate
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    --> @TheDredPriateRoberts
    i have too much faith in the american economy to think masses of people would be relegated to unemployment permanently. why is it when there are inefficiencies elsewhere conservatives are quick to want to do away with them and figure out the rest later? also, if we kept medicare as it is, insurance wouldn't even be outlawed, so they would just adapt to different dynamics. there might be some downsizing, but like i said, the economy will adapt to a higher priority and more efficient outcome. 
  • Greyparrot
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    --> @linate
    People are not outraged enough to destroy the current monopoly structures in place for healthcare.
  • linate
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    --> @Greyparrot
    i think you are right. people don't like change. doesn't mean the change is wrong though. just like, people didn't like obamacare when it came out, then once they got use to it, they didnt want it changed. medicare for all is too ambitious to act like it's gonna happen. incremental change is more realistic. something like a public option, so people have options. tinker with medicare's age eligbility. find a way to cover the currently uninsured. things like that. i think even you said you might be open to a public option for the poor? one of you conservative guys said that. 
  • Greyparrot
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    --> @linate
    I didn't say people don't like change, I said people need genuine outrage to make changes, not fake outrage.
  • TheDredPriateRoberts
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    --> @linate
    i have too much faith in the american economy to think masses of people would be relegated to unemployment permanently. why is it when there are inefficiencies elsewhere conservatives are quick to want to do away with them and figure out the rest later? also, if we kept medicare as it is, insurance wouldn't even be outlawed, so they would just adapt to different dynamics. there might be some downsizing, but like i said, the economy will adapt to a higher priority and more efficient outcome. 

    such as?

    the power of the government to regulate, control and negotiate will kill the private industry, how do you think a private company could compete against a government monopoly?
    if you made the health insurance lean and streamline, you don't think that would put a lot of people out of work?  What about the degrees people get to work in the industry?  you think they will all become government workers?