Bernie Sanders Promises a Government-Designed Ferrari, Payments Included


#1

“You deserve all the finest things in the world,” a young Homer Simpson once wrote to his beloved Marge, “and although I can give them to you, they will be repossessed.” Senator Bernie Sanders’ Medicare for All Act of 2017 (MFA) makes similarly sweeping promises while relegating financing to a Post-It note, affixed to our national refrigerator: “To do: design and implement the single largest tax increase in human history.”

To his credit, Homer Simpson understood where his generosity would lead.

MFA promises doctor visits, hospitalizations, drugs, home visits, mental-health care, vision, dental, and long-term care—with almost no deductibles, co-pays, or coinsurance. Where promises exceed resources, MFA would erect a multitude of new offices and send out swarms of officers to determine who gets what care, when, and how.

If you like your current insurance, there’s no way on earth you’ll keep that insurance—including present-day Medicare. The two exceptions are Veterans Affairs and Indian Health Service coverage—both plagued by life-threatening problems.

Federal bureaucrats would set prices for everything, based on the worst aspect of today’s Medicare—that program’s crony-driven, out-of-control, Soviet-style reimbursement scheme. Dissatisfied with MFA and wish to buy services or insurance on the side? That’ll be illegal.

Most justifications for this unparalleled power-grab dissolve on inspection:

No, MFA won’t liberate you from insurers. You’ll just trade the frustrations of private insurance for those of public insurance. British health officials once cooked up a requirement that patients go completely blind in one eye before receiving critical macular degeneration treatments—giving the disease time to ravage the remaining eye. (Protests eventually led the NHS to reverse this rule.)

No, Medicare doesn’t enjoy lower administrative costs than private insurers. That bedtime story derives from Medicare having a lower ratio of administrative expenses to health care expenses compared with private insurers. But that’s because Medicare serves older, sicker people whose health care expenses far exceed the average for younger, healthier private insurance enrollees. Higher denominator—not lower numerator. Medicare’s inadequate quality control allows a high rate of fraudulent claims.

No, an enlarged Medicare pool won’t generate significant savings. Currently, the single-payer system serving Medicare’s 55 million enrollees far surpasses the single-payer systems in, say, the Netherlands (17 million), Belgium (11 million), or Canada (36 million)—countries where MFA enthusiasts imagine they see sweet, sweet economies of scale.

No, single-payer systems don’t provide better care than America. For example, Americans’ slightly shorter average lifespan is largely explained by our high rate of violent, instantaneous premature deaths—murder and accidents. That’s a problem, but has nothing to do with health care.

No, it’s not insurer or pharmaceutical manufacturer profits that make American care expensive. Despite perceptions to the contrary, profits in those industries aren’t particularly high, and many American insurers are not-for-profits. MFA would merely replace the duplicative costs of multiple insurers with public sector dynamics that led the Defense Department to pay $2,228 around 1980 ($6,600 in 2017 dollars) for a monkey wrench.

No, America’s high ratio of health care spending to GDP doesn’t result from our insurance system. The primary cause is that Americans have low saving rates and consume loads of everything—including health care. As a percentage of household consumption, American health care spending is only slightly higher than other countries’—with that small difference easily explained by Americans tapping into their enormous accumulated household wealth to buy extra health care.

No, polls don’t mean much. “Most Americans support single-payer” say MFA enthusiasts, but support plunges when you mention that taxes will explode and health care choices will evaporate. Yes, polls show Canadians are happy with their health coverage; but Canadians are happy about all sorts of things—it’s a cultural thing, and there’s something to be said for grumpy, dissatisfied Americans.

No doubt, a high percentage of Americans would like to have a Ferrari. Far fewer would like a Ferrari plus Ferrari car payments. Almost no one would favor Ferrari-for-All: Ferrari car payments, coupled with a promise that politicians and bureaucrats will design and build their Ferrari.

MFA shuffles which gigantic, nonresponsive organizations will control your health care. Our real need is new, more cost-effective modes of care. MFA makes no progress in that direction.


How should our healthcare system work?
#2

Whether or not Bernie likes to admit it, even before Obamacare, nearly half of all health care spending in this country was attributable to our federal government thanks to Medicare and Medicaid.


#3

With a wealth tax, reparations, universal healthcare, and other benes I’m going to go broke! Didn’t we used to fight wars against communism?


#4

We never fought a single war to keep communism out of America. We did conduct plenty of CIA operations toppling democratically elected governments and replaced them with right wing dictatorships in the name of keeping communism out of many countries and we fought a couple wars to keep communism out of others, but… we aren’t any better for it, and you don’t win minds and hearts at the point of the bayonet!


#5

I wonder if a 3% flat across the board tax would cover that. No exemptions! It will come out of the damn EIC and welfare payments… 3% of every penny that is earned by individuals! I do not give a damn if you make 1000 a year! you are going to pay just like social security but no employer match.


#6

If you earn 1000 a year you really can’t afford 3%.


#7

Yes you can because you are getting welfare.


#8

Anyone in that level of poverty needs it.


#9

Well we need to think about this…

Section 8 housing, tax credits, SNAP, phone, medicaid, utility assistance…

I think they can afford it.


#10

We’re always going to have the poor with us, and they will always need some assistance. Surely, wish as you may, you don’t think that that will ever go away??


#11

I completely understand it and agree with much of it. It is that or demand to pay ten bucks for a hamburger.

I am saying that if they give up a little… Look - most of us make those decisions every day.


#12

Ok, I can meet you in the middle on that. Good night buddy.


#13

If the poor are completely subsidized then maybe it would be in their best interest to learn what it’s like to pay for services they need just like the rest of us. They would be using the money we give to them. It’s not like they earned the money for getting up early and being productive Americans. It’s our money, we get to dictate the terms. Not them.


#14

Well no, not really. It’s your money until you pay your share of taxes, then it’s the governments. And just like it grips my ass that trillions are spent on gratuitous wars that you believe to be legitimate self defense, money is spent on feeding people and making sure that they have access to health care and education that seems to grip your ass.


#15

One would think that there would be penalties for unhealthy behavior, poor life style choices.

But no, the government continues to enable people to chose poorly.


#16

There are no poor in America.

Poor perhaps when compare to Trump however everyone in the US is wealthy compared to the truly poor in the world.

You cannot have poor and 69% of the population over weight or obese.


#17

Yup! I have a family member that is a leech, smokes, husband is a druggie ex-con…


#18

There should be! If you get assistance then no drugs, drinking or smokes. If you cause your own health issues then go to the back of the line.


#19

I want to qualify myself. I have a disabled son and that is why I have my own business and do my own thing. I am the one that is fortunate enough to have a varied skill set and I can work from home on a very flexible schedule. You see I have had quite a few jobs over the past 9 years (one company did not want to let go. I went back 2 times to help them get ISO manuals taken care of and then I went back to help get things in order. This is after I gave them a 3 month notice before I left the first time.

I see all these people claiming they can not work for this reason or that reason. I would like nothing better than to take a full time position but at this point I can not but I damn sure do something. Why the hell should I bust my ass for someone else?


#20

Then tell the government/IRS to GTH and keep everything for yourself.