2020 Democratic Primaries/General Election Thread

[Surtt]

Originally Posted by Lathum

90% were looking for pictures of her in a camouflage bikini.

Seriously, "camouflaged" ?

If you do enter "Tulsi Gabbard" in google...
You (at least I get ) get:

Tulsi Gabbard polls
Tulsi Gabbard surfing
Tulsi Gabbard husband
Tulsi Gabbard debate
Tulsi Gabbard height
Tulsi Gabbard policies
Tulsi Gabbard platform
Tulsi Gabbard twitter
Tulsi Gabbard Assad

[Chief Rum]

Originally Posted by Surtt

Seriously, "camouflaged" ?

If you do enter "Tulsi Gabbard" in google...
You (at least I get ) get:

Tulsi Gabbard polls
Tulsi Gabbard surfing
Tulsi Gabbard husband
Tulsi Gabbard debate
Tulsi Gabbard height
Tulsi Gabbard policies
Tulsi Gabbard platform
Tulsi Gabbard twitter
Tulsi Gabbard Assad

You understand he was joking right?

[JPhillips]

Yeah, the real search was "Gabbard patriotic undies."

[ISiddiqui]

No, no, that Buttigieg, obviously. How else was he able to raise $23mil .

[Radii]

Originally Posted by Arles

I'll just remind everyone that in the summer of 2016, Clinton (13 points) and Sanders (12 points) had big leads over Trump in the polls.

Yeah the polls feel meaningless to me. I'm just trying to find the best candidate that matches my views.

I do get that this is just a game in a lot of ways and people follow it and discuss it as such (I don't mean that in a negative way, you can enjoy following the "Game" of the primary but still take your vote and what actions you can take seriously).

[Lathum]

Originally Posted by Surtt

Seriously, "camouflaged" ?

If you do enter "Tulsi Gabbard" in google...
You (at least I get ) get:

Tulsi Gabbard polls
Tulsi Gabbard surfing
Tulsi Gabbard husband
Tulsi Gabbard debate
Tulsi Gabbard height
Tulsi Gabbard policies
Tulsi Gabbard platform
Tulsi Gabbard twitter
Tulsi Gabbard Assad

[Surtt]

Originally Posted by Chief Rum

You understand he was joking right?

Yes, that is why I replied about the camouflage, I was jokingly replying.

But I thought what the heck, lets see what people actually were looking for.

[BYU 14]

Originally Posted by Surtt

Yes, that is why I replied about the camouflage, I was jokingly replying.

But I thought what the heck, lets see what people actually were looking for.

[GrantDawg]

Originally Posted by Radii

Yeah the polls feel meaningless to me. I'm just trying to find the best candidate that matches my views.

I do get that this is just a game in a lot of ways and people follow it and discuss it as such (I don't mean that in a negative way, you can enjoy following the "Game" of the primary but still take your vote and what actions you can take seriously).

In some sense meaningless, but not totally. Like for one if you are polling so low you are left out of the debates, you might as well drop out. For another, donors do pay attention to polls. Big jump in numbers can equal big bucks, big drops can equal disaster. Polls are not going to tell us who will win right now, but they do play a factor.

[Arles]

Yeah, I think the polls matter more within your own primary than the "against other party opponent". As GrantDawg said, they dictate funding and airtime.

I'm just a little discouraged that it seems like we are destined to have a democratic candidate who wants free health care, free college, higher taxes on anyone making over 100K and support this crazy Green New Deal. On the republican side, we will deal with a candidate who is pro-life, doesn't support gay marriage, is against any kind of reasonable high magazine/AR restriction and not remotely interested in balancing the budget or paying debt. I think I'm as disenfranchised a citizen as I have ever been between these two parties. My best hope is a democratic president who protects the social side with a republican congress that stops all the crazy fiscal policies.

[Surtt]

Originally Posted by BYU 14

[Radii]

Originally Posted by Arles

I'm just a little discouraged that it seems like we are destined to have a democratic candidate who wants free health care, free college, higher taxes on anyone making over 100K and support this crazy Green New Deal.

Your pessimism about all of this inspires me. I desperately want all of those things, and believe we'd still be pretty far right of most of the countries I wish we would emulate even if we got all of that, and I have very little hope of any of it actually happening.

Anyone can run on this stuff but how much of it would ever happen without dominant control of both the house and senate, and the supreme court is stacked to make political judgments so even dominant control of two branches might not matter.


Also keep an eye on even places that are liberal echo chambers and you'll find a large number of people who are just as scared of Bernie and Warren as the right is. I'm heavily in on the Warren train right now and fully expect to be disappointed as the most moderate candidate of all ends up winning.

[Radii]

Originally Posted by Arles

I think I'm as disenfranchised a citizen as I have ever been between these two parties.

The best thing for all of us would be an overhaul of the voting system to some sort of ranked choice system that seems multiple parties thrive in other countries. Trump and Jeb Bush shouldn't be in the same party, they are very different flavors of right wing. Bernie and Beto shouldn't be in the same party. You should be able to vote for someone on the right who isn't trump and who more matches your values. Biden fans should be able to vote for him based on their ideals and not have to worry about "settling" for Bernie because of our two party system. I should be able to vote for Bernie without thinking "shit i'm gonna have to hold my nose and vote Biden aren't I?"

Sadly it'll probably take something close to revolution to fix this, and we don't have that in us.

[cuervo72]

Under no plan is health care going to be "free." Either we pay for it privately, we pay for it through our employer and lower wages, or we pay it through taxes. So it's a question of how we pay for it, how much do we pay for it, and who gets covered.

I have to admit that some of the arguments against a government-managed system sound like a case where folks are saying "I don't believe everyone deserves to be covered."

[molson]

I'm much more Dem than I used to be because the alternative has gotten much, much worse. And I actually think the crop of 2020 Dem candidates is much more impressive than say, the group in 2004. They're all further to the left than me on many issues, but, that has little impact on what America will actually look like if any of them are elected.

My perfect candidate doesn't exist, I'm way too far left and right on different issues, but, the Dems will give us a smart progressive grown-up. I'll always be a conservative at heart and definitely understand how the Dem rhetoric rubs people the wrong way, but, I can't have anything to do with this Republican party. And there's no third-party nominee more qualified than the Dem nominee will be.

I'm kind of surprised there's not more of me. Regular, moderate, conservative on some things people who are disgusted by Trump and the Republicans. I will only vote for a Republican going forward in a state election where the Republican candidate is the truly the most qualified (which happens a lot in red states). I think our AG and Governor do a great job.

[Chief Rum]

Originally Posted by molson

I'm much more Dem than I used to be because the alternative has gotten much, much worse. And I actually think the crop of 2020 Dem candidates is much more impressive than say, the group in 2004. They're all further to the left than me on many issues, but, that has little impact on what America will actually look like if any of them are elected.

My perfect candidate doesn't exist, I'm way too far left and right on different issues, but, the Dems will give us a smart progressive grown-up. I'll always be a conservative at heart and definitely understand how the Dem rhetoric rubs people the wrong way, but, I can't have anything to do with this Republican party. And there's no third-party nominee more qualified than the Dem nominee will be.

I'm kind of surprised there's not more of me. Regular, moderate, conservative on some things people disgusted by Trump and the Republicans. I will only vote for a Republican going forward in a state election where the Republican candidate is the truly the most qualified (which happens a lot in red states). I think our AG and Governor do a great job.

You're not alone in this. Pretty much describes me as well. I too have wondered why there aren't more of us. Are we just not speaking out? It feels like the fiscal (as opposed to social) moderate conservative has disappeared, whoch other GOP members have either fallen into a Trumpist subset or the old ultra conservative Christian side.

[Surtt]

Originally Posted by Arles

I'm just a little discouraged that it seems like we are destined to have a democratic candidate who wants free health care, free college, higher taxes on anyone making over 100K and support this crazy Green New Deal.

Where did you see the 100k figure.


The free tuition plan would be paid for through a "speculation tax"

Under the Sanders proposal, trades would be taxed at a rate of 0.5 percent for stocks and 0.1 percent for bonds. A stock trade of $1,000 would thus incur a cost of $5.

I can not see this really harming anyone but the computer trades.

[JPhillips]

High frequency micro trading should be illegal, and a small tax won't stop what is just skimming from legitimate trades.

[PilotMan]

Originally Posted by JPhillips

High frequency micro trading should be illegal, and a small tax won't stop what is just skimming from legitimate trades.

Just one more way the general public is separated from money by the elites.

[Radii]

Originally Posted by cuervo72

I have to admit that some of the arguments against a government-managed system sound like a case where folks are saying "I don't believe everyone deserves to be covered."

Fuck the poor! - YouTube

[ISiddiqui]

Originally Posted by Chief Rum

You're not alone in this. Pretty much describes me as well. I too have wondered why there aren't more of us. Are we just not speaking out? It feels like the fiscal (as opposed to social) moderate conservative has disappeared, whoch other GOP members have either fallen into a Trumpist subset or the old ultra conservative Christian side.

Emphasis mine. There are some moderate Republicans who are speaking out, but readily dismissed (such as George Will, David Brooks, and to an extent, Ross Douthat).

And then there is the other phenomenon. My wife's parents are big Trumpers. They have the hats, bumper stickers (along with other bumper stickers about "libtards" - regardless of the fact that both of their daughters are very liberal), etc. My wife recently told me that when Trump was running, they were adamant that they weren't going to vote for him. They thought he was abhorrent. Now, they weren't as moderate as you and molson. They were definitely far more conservative, but made a big show about they weren't voting for him. Then they said, well because of Hillary, we had to vote for him, but we didn't like it. And now they've gone fullbore supporters. And part of it is probably because "he makes liberals mad" and part of it is that it speaks to things they believe but never really wanted to speak openly (they have quite a racist streak - thankfully they stopped posting anti-Muslims shit on Facebook after meeting my family and really liking them - yes Muslim can be humans too).

Anyways, that being said, I think a lot of moderate Republicans just went in too deep. Trump voters became like old people - they aren't that much of the electorate, but you know they'll vote and they are loud about what they don't like, so they are captive to them.

If only a few of the moderate Republicans had the strength of their convinctions (we'd always joke that Jeff Flake would be very anti-Trump in rhetoric and then vote with him anyways), maybe we'd see more.

I thought for a bit that with 2016, TRUE moderate Republicans were going to start having to become Democrats. Because the current Republican party just went deep into the tank for Trumpism. I know there is an idea some moderate Republicans have that after Trump is gone, they can come back and resurrect the party into something they'd rather see, but I think that is gone.

[JPhillips]

Originally Posted by ISiddiqui

Anyways, that being said, I think a lot of moderate Republicans just went in too deep.

This has been my argument for years. Plenty of GOP electeds weren't personally racist, but they were willing to do what they needed to do to make sure the racists voted for them. Every time they'd examine what needed to be done to expand the party enough of them would push back so that the goal was to motivate more white voters. Eventually enough of them became comfortable limiting voting access. Eventually enough of them became comfortable attacking religious minorities. Eventually enough of them became comfortable with cruelty towards immigrants.

Every step of the way it was justified by saying the Dems made us go there, band so few people objected that now the GOP is a White Nationalist party with no obvious path towards a more inclusive party.

[Arles]

Originally Posted by cuervo72

Under no plan is health care going to be "free." Either we pay for it privately, we pay for it through our employer and lower wages, or we pay it through taxes. So it's a question of how we pay for it, how much do we pay for it, and who gets covered.

So, based on the bolded part, do you really think if Bernie enacted universal health care tomorrow and employers no longer paid for it - that we would all get a raise in our wages? That's pretty funny. No, workers just would lose the employer subsidized portion and then have to pay higher taxes for worse coverage.

I don't see the need to throw away a system that works for a vast majority of workers in this country. I'm fine setting up a plan to cover those people who make less than a certain amount (say 60K) and have a subsidized scale moving up to help people making under 100K cover their premiums. But leave employer subsidized heath care the way it is. The focus should be on finding better ways to subsidize coverage for those not currently covered - not throw the baby out with the bath water and setup a system that gives a majority of this country worse coverage at a higher price to them.

Originally Posted by Surtt

Where did you see the 100k figure.

It's his raising of marginal rates and upping the payroll tax on people who make between 75 and 120K. These people already pay 40% wage tax, Sanders would up that to almost 50%.

[ISiddiqui]

Originally Posted by Arles

So, based on the bolded part, do you really think if Bernie enacted universal health care tomorrow and employers no longer paid for it - that we would all get a raise in our wages? That's pretty funny. No, workers just would lose the employer subsidized portion and then have to pay higher taxes for worse coverage.

I don't see the need to throw away a system that works for a vast majority of workers in this country. I'm fine setting up a plan to cover those people who make less than a certain amount (say 60K) and have a subsidized scale moving up to help people making under 100K cover their premiums. But leave employer subsidized heath care the way it is. The focus should be on finding better ways to subsidize coverage for those not currently covered - not throw the baby out with the bath water and setup a system that gives a majority of this country worse coverage at a higher price to them.

Employer subsidized health care is a disaster. Just about every economist agrees on this point (whether left or right). It hides the true cost of health care from most people for one.

Now, I do get like $150 a month taken out of my paycheck for health care. I don't know if my employer (the US Government) would give that back to me. I suspect a number of employers would give some of that back (because it was a garnishment based on a choice for insurance made above an employement contract signed). The lower wage jobs likely would not.

Anyways, I know that people irrationally like their private insurance (probably because there is a fear of the unknown), so I'd like to see a public option in place first and a gradual move away from private employer insurance.

It's his raising of marginal rates and upping the payroll tax on people who make between 75 and 120K. These people already pay 40% wage tax, Sanders would up that to almost 50%.

So the stuff below $250k is just a repeal of the Trump tax cuts, IIRC.

[panerd]

Originally Posted by ISiddiqui

And then there is the other phenomenon. My wife's parents are big Trumpers. They have the hats, bumper stickers (along with other bumper stickers about "libtards" - regardless of the fact that both of their daughters are very liberal), etc. My wife recently told me that when Trump was running, they were adamant that they weren't going to vote for him. They thought he was abhorrent. Now, they weren't as moderate as you and molson. They were definitely far more conservative, but made a big show about they weren't voting for him. Then they said, well because of Hillary, we had to vote for him, but we didn't like it. And now they've gone fullbore supporters. And part of it is probably because "he makes liberals mad" and part of it is that it speaks to things they believe but never really wanted to speak openly (they have quite a racist streak - thankfully they stopped posting anti-Muslims shit on Facebook after meeting my family and really liking them - yes Muslim can be humans too).

My parents (mostly my mom) are the same way. Were big Bush and then Kasich supporters and were repulsed by Trump. They claim to have both voted for Gary Johnson (I question my mom didn't vote for Trump) but now my mom is a big facebook pro-Trump meme poster.

My conclusion is a lot different than yours though. The hypocrisy of two party politics can be found on any issue. (i.e. "Border cages" during Obama administration, Betsy Ross flag right behind Obama at his inauguration, Hillary Clinton laughing with Trump in pictures...) The liberal side isn't really winning over anyone by just being anti-Trump all of the time when what they complain about is easy documented in pictures and new reports from when they were firmly in power. I'm scared it's just going to reelect him for another 4 years to talk about how bad he is about stuff that is easily traced back to them. Doesn't always have to be racism...

EDIT: And Trump is awful don't get me wrong. Needs to be removed from office in 2020.

[ISiddiqui]

Here's a few articles on employer subsidized health care:

https://www.nytimes.com/2017/07/07/h...deduction.html

But economists on the left and the right argue that to really rein in health costs, Congress should scale back or eliminate the tax exclusion on what employers pay toward employees’ health insurance premiums. Under current law, those premiums are not subject to the payroll or income taxes that are taken out of employees’ wages, an arrangement that vastly benefits middle- and upper-income people.

That one policy tweak could reduce health care spending, stabilize the health insurance market and, according to Congressional Budget Office estimates, shrink the federal budget deficit by between $174 billion and $429 billion over a six-year period.

Lawmakers briefly pondered the idea this year but quickly abandoned it, recognizing how politically explosive it would be. Still, as Congress seeks to push ahead with major changes to the health system and the tax code, there has been a growing awareness of how long-established tax subsidies — like the mortgage deduction for homeowners — have contributed to economic inequality in the United States.

https://niskanencenter.org/blog/what...lth-insurance/

Despite its popularity, though, serious health economists tell us that ESHI is “broke,” after all. No comprehensive reform can succeed unless it is phased out. This commentary examines three of ESHI’s biggest problems: job lock, which reduces labor mobility for ESHI beneficiaries; the fundamental inequity of the way the benefits of EHSI largely accrue to the highest -paid workers; and the increased fragmentation of health care finance inherent in a system administered by thousands of separate employers. We conclude with a plan for phasing out EHSI in a way that can fix these problems while minimizing the disruption for workers who are satisfied with their current coverage.

[Radii]

Originally Posted by Arles

Could you share which article that came from?

Tax rates definitely have to go up in any medicare for all plan. I guess I need to see the source for myself to believe that Bernie's tax plan raises income tax on the $75k-$118k dramatically and then drops it significantly for the $118k-$230k portion of one's income.


One of the biggest knocks against Sanders is that he has often had a lot of plans that are simply not fleshed out enough to explain how they'll be paid for. I know he's starting to nail some of that down, but that doesn't pass the immediate smell test.


That said, I make low 6 figures. I expect to pay more in taxes for medicare for all. I expect I probably lose a little money in doing so. If we get our 70% marginal rate on $10 million plus in income, I'll happily do my part as someone who lives in complete comfort and privilege by paying more than i do now to try to actually take care the huge range of people who make too much for medicaid, but who cannot afford healthcare, for which a single medical emergency either results in death or crippling lifelong debt.

[Radii]

dola, i'll leave my comments out there for the world but ISiddiqui's note that these rates are just a repeal of the trump tax plan puts it in a better light, the weird differences are in payroll taxes, is that correct? I still don't quite understand it though.

[Chief Rum]

The real problem in the health care system is rhe excessive bloat worked into the system by every partner in it, including hospitals/doctors, health insurers and Big Pharma. They are all complicit in keeping the costs of health care higher than they should be so that they can pass those costs on to consumers while raking in profits.

Until we fix that, no matter what healthcare delivery and payment system we decide on will be a mere bandaid.

[bob]

I'm not an economist, so please someone explain this to me:

"But economists on the left and the right argue that to really rein in health costs, Congress should scale back or eliminate the tax exclusion on what employers pay toward employees’ health insurance premiums."

How does increasing taxes on health insurance premiums reduce overall healthcare costs?

[Radii]

Originally Posted by Chief Rum

The real problem in the health care system is rhe excessive bloat worked into the system by every partner in it, including hospitals/doctors, health insurers and Big Pharma. They are all complicit in keeping the costs of health care higher than they should be so that they can pass those costs on to consumers while raking in profits.

Until we fix that, no matter what healthcare delivery and payment system we decide on will be a mere bandaid.

This is true but Medicare by its sheer size and influence forces many of those costs down if you want to work with medicare and accept medicare patients. I believe a lot of that naturally goes away in a single payer system.

[Chief Rum]

Originally Posted by Radii

This is true but Medicare by its sheer size and influence forces many of those costs down if you want to work with medicare and accept medicare patients. I believe a lot of that naturally goes away in a single payer system.

I'm not going to pretend I know enough to make a call one way or the other, but from what I have read, the problem isn't economics related, and won't be solved by market forces or changing tax subsidies or expanding Medicaid (which is just government payment into that same system). It's basically collusion amongst those three industries (the healthcare system, health insurers and Big Pharma) to keep costs intentionally high AND to hide actual costs from the public, so the public can't make reasoned choices on the best places to spend their healthcare budgets. The government could step in to change this, of course, but the above industries have well-funded lobbies and make sure the politicians are paid off to go after other issues and let this one roll on.

[ISiddiqui]

Originally Posted by bob

I'm not an economist, so please someone explain this to me:

"But economists on the left and the right argue that to really rein in health costs, Congress should scale back or eliminate the tax exclusion on what employers pay toward employees’ health insurance premiums."

How does increasing taxes on health insurance premiums reduce overall healthcare costs?

A few ways and it depends on what you'll replace it with. Right leaning economists would argue that employer sponsored insurance encourages workers to buy the most expensive insurance coverage and then use it as often as they can (and not caring about the medical providers they use). And they would say that knowledge of what health care costs would have people making more rational decisions on that care as it would impact them more. I think they'd also argue that providers would get more serious about reducing prices because now they know that employer sponsored insurance will pay just about whatever they bill if a patient has coverage.

Left leaning economists would argue than in state run health care systems, the government can negotiate lower prices (as is done in other countries - you'll note that American health care spending per capita is far higher than in other first world countries). The argument can also be as Chief Rum pointed out, the excessive bloat and overhead increase costs exponentially as well.

[larrymcg421]

Originally Posted by panerd

My conclusion is a lot different than yours though. The hypocrisy of two party politics can be found on any issue. (i.e. "Border cages" during Obama administration, Betsy Ross flag right behind Obama at his inauguration, Hillary Clinton laughing with Trump in pictures...) The liberal side isn't really winning over anyone by just being anti-Trump all of the time when what they complain about is easy documented in pictures and new reports from when they were firmly in power. I'm scared it's just going to reelect him for another 4 years to talk about how bad he is about stuff that is easily traced back to them. Doesn't always have to be racism...

EDIT: And Trump is awful don't get me wrong. Needs to be removed from office in 2020.

Your examples are ridiculous. WTF does the Betsy Ross flag being flown at Obama's inauguration prove? Clinton laughing in pictures with Trump? So what?

[JPhillips]

Originally Posted by Arles

So, based on the bolded part, do you really think if Bernie enacted universal health care tomorrow and employers no longer paid for it - that we would all get a raise in our wages? That's pretty funny. No, workers just would lose the employer subsidized portion and then have to pay higher taxes for worse coverage.

I don't see the need to throw away a system that works for a vast majority of workers in this country. I'm fine setting up a plan to cover those people who make less than a certain amount (say 60K) and have a subsidized scale moving up to help people making under 100K cover their premiums. But leave employer subsidized heath care the way it is. The focus should be on finding better ways to subsidize coverage for those not currently covered - not throw the baby out with the bath water and setup a system that gives a majority of this country worse coverage at a higher price to them.

It's his raising of marginal rates and upping the payroll tax on people who make between 75 and 120K. These people already pay 40% wage tax, Sanders would up that to almost 50%.

I'm surprised that Vox ran a chart like that. Marginal tax rates don't mean much, what matters is effective tax rates, what people actually pay. Nobody, except perhaps the people at the bottom, is paying those percentages currently, nor would they pay the full Sanders percentages.

[panerd]

Originally Posted by larrymcg421

Your examples are ridiculous. WTF does the Betsy Ross flag being flown at Obama's inauguration prove? Clinton laughing in pictures with Trump? So what?

Always nice to see you too. They are social media (and often mainstream media) manufactured "controversies" that embolden people like my parents that even though they don't like Trump (as I said in my original post... not sure my mom doesn't actually like him) the alternative are just hypocrites.

For example: The border crisis that almost every Democratic politician is on record at some point prior making statements similar to Trump's policy, the cages were around prior to Trump. Doesn't mean these aren't real issues but to blame Trump when quickly pointed out as a hypocrite just makes my parents feel like they are correct.

Every day there is some new sign that Trump's America has sent us to the edge of 1930's Germany. (people wearing a MAGA hat, the Betsy Ross flag, etc)

I've said before I don't agree with my parents but disagree with you that they have no point whatsoever.

[Arles]

Originally Posted by Radii

Could you share which article that came from?

Tax rates definitely have to go up in any medicare for all plan. I guess I need to see the source for myself to believe that Bernie's tax plan raises income tax on the $75k-$118k dramatically and then drops it significantly for the $118k-$230k portion of one's income.

Here's what the tax code would look like if Bernie Sanders got everything he wanted - Vox

The increase is basically a sort of "payroll tax" to help pay for universal health care.

Originally Posted by ISiddiqui

Employer subsidized health care is a disaster. Just about every economist agrees on this point (whether left or right). It hides the true cost of health care from most people for one.

Now, I do get like $150 a month taken out of my paycheck for health care. I don't know if my employer (the US Government) would give that back to me. I suspect a number of employers would give some of that back (because it was a garnishment based on a choice for insurance made above an employement contract signed). The lower wage jobs likely would not.

It's not a disaster, it just helps offset the cost to the employee by having their company shoulder a chunk of it (and get a write off in the process). If we went to a single payer plan tomorrow, it going to cost nearly the same - it's just a matter of who pays most of the bill. Let's look at an example - say a person makes 100K for simplicity. Their taxes would go up around $8,000 a year under Bernie, but they would get their $150 a paycheck in health care premiums back. So, they would get $4,000 back, but pay $8,000 in taxes and end up with worse coverage. Plus, that $150 is currently tax free, so they would actually get less back since their AGI would go up by that $4,000 they get back by not paying premiums. Currently, employers pay a big portion of a person's medical premiums because it is a write off for them (they cover about 70% at our company). You can see that by looking at the explanation of benefits from your company each year.

I don't understand how the left gets so made at corporations for not paying enough, yet wants to have them stop paying one of the major advantages they give their employees (paying a large portion of their health care cost). It's not like everyone is going to get a 10% raise if employers stop paying for their health care - they employee will just have to pay 100% out of their pocket then (instead of the 30-50% they pay now). The companies will just be off the hook and make slightly more money (I say slightly because covering health care expenses is a form of a write off for them right now - so they wouldn't get all that money back).

Originally Posted by ISiddiqui

A few ways and it depends on what you'll replace it with. Right leaning economists would argue that employer sponsored insurance encourages workers to buy the most expensive insurance coverage and then use it as often as they can (and not caring about the medical providers they use).

I think that is starting to change. People are leaving PPO/HMO for HSA "high deductible" coverage in droves right now. We've had over 40% switch in the last two years and it makes a lot more sense to just put your $300-$400 a month in premiums into your HSA account instead and pay cash until you hit your deductible (ours is around $3,000). These HSA plans also do a pretty good job of curtailing excessive visits. When a doc visit costs $90 instead of a $30 copay, people aren't as excited to use it. These plans are the future, IMO.

As to the broader question, it really doesn't impact the cost whether the government or private companies setup the plans. The government does a ton of health care coverage for older people (Medicare) and lower income (called Access here in Arizona). Costs are still equally high for services geared towards those plans. If the US goes to a single payer system, many middle-upper class families and higher will purchase a supplemental plan and we will be in a similar position to where we are now from a health care cost standpoint (the supplemental plans will get overcharged while the rank and file still pay high costs on the government plan). The only difference is people will now foot the entire bill (instead of the employer paying for 50-70% like they do now).

I just don't see how this is a good idea. We have a factory worker that makes $75K a year and has our HSA plan ($3000 deductible) that doesn't have a monthly premium (since it is a high deductible). If he puts his normal $300 a month in premiums into the HSA, he would have $3,600 (tax free) in his HSA to cover the full deductible and some extra coinsurance costs after. Chance are he would roll a bunch of that $3,600 over into next year and have a savings account for health expenses. Now, let's say Bernie is president and that plan is no longer available. The US plan would have a higher deductible and not as good coinsurance (ours is 90%). He would be paying $5,000 - $6,000 more in taxes for a worse plan. So, then his option would be to either put more in his HSA (to cover the higher costs) or buy a supplemental policy that makes up the coverage gaps (and costs yet more money). Chances are that person would be out $7,000-$9,000 in real money to be part of this new system where he gets worse health coverage.

It is just amazing to me that people think getting rid of employee subsidized health care is going to be good for most people. Its like saying an employer pays 50% of all rent expenses for 10,000 employees in a small town and gets a tax write-off from the local government for doing that. So, a family in one of these employer subsidized rent control apartments is paying $1,500 a month for a place that should cost $3,000. The government then decides to ban the employer from subsidizing apartments in this city (and takes back the write-off) and forces this family to either live in much worse place for their $1,500 or pay the going rate of $3K for that place. While the majority of this town would face a massive increase in expenses, the government thinks that years down the road the rent will decrease in this city to where small percentage of people not employed by this company would be able to afford a better place. That is basically the argument to get rid of employer subsidized health care. Soak all people with employer covered health plans for the next 5-10 years on a hope (that has never happened with Medicare for seniors, FYI) that costs will eventually decrease.

[molson]

I've never figured out how a healthcare program that costs more per capita than any other system in the world, but actually covers less people than the vast majority of them is a "good" system from a conservative's perspective.

[ISiddiqui]

Originally Posted by Arles

So, they would get $4,000 back, but pay $8,000 in taxes and end up with worse coverage.

Worse coverage? Wha? Every single payer program I've seen has far better coverage than American private insurance. Why do you think this groundswell for Medicare for All has been coming from? People in other countries are flabbergasted by the level of our cost sharing (mainly deductible amounts, which don't really exist in single payer systems - have you considered those costs in your analysis?).

I'm not entirely sure why you come to the conclusion that single payer health system is just going to be like the employer sponsored health system but with the government instead of insurance companies.

People will of course be paying more, but with better health coverage and more equitable health care coverage. And the country will be paying less overall as overhead costs decreases substantially, and the government can negotiate services as a whole.

Not to mention that a lot of times private insurance freezes you to your job (which creates a massive inefficiency to the job market).

[Arles]

It much easier to have a great health care system when your country's population is 37 million (Canada) or 17 million (Netherlands). The US has a population of 329 million. The only real comparable countries are China and India. The US ranks 37th in WHO ratings, while China (144) and India (112) are both sub 100. It is nearly impossible to have high health care quality with 300 million people. Yet, the US does. It is very expensive because of our population, lifestyle (fast food and little exercise) and expectation of services/coverage. No system will solve those issues. A single payer just increases the coverage total by a small amount while increasing the cost to individuals and decreasing the quality of coverage. To me, a smarter way would be to focus on find a more affordable way to cover the 12% of uninsured people - not drastically increase the cost (and decrease service) for the 88% currently covered.

[Brian Swartz]

Originally Posted by Molson

I've never figured out how a healthcare program that costs more per capita than any other system in the world, but actually covers less people than the vast majority of them is a "good" system from a conservative's perspective.

Most of them don't think its good, and a lot of the growth in the support for single player has been right-leaning people just giving up and bowing to the perceived need for that. But more importantly, there's still a lot of people who think that it's very possible for a bad system to be made worse, who don't want to give up the freedom that more government control mandates, and who generally don't trust the government in general.

[JPhillips]

The idea that health insurance costs would double and coverage would be significantly worse is nuts. It's roughly similar to arguing that healthcare under Bernie would be literally free.

[JPhillips]

Originally Posted by Arles

It much easier to have a great health care system when your country's population is 37 million (Canada) or 17 million (Netherlands). The US has a population of 329 million. The only real comparable countries are China and India. The US ranks 37th in WHO ratings, while China (144) and India (112) are both sub 100. It is nearly impossible to have high health care quality with 300 million people. Yet, the US does. It is very expensive because of our population, lifestyle (fast food and little exercise) and expectation of services/coverage. No system will solve those issues. A single payer just increases the coverage total by a small amount while increasing the cost to individuals and decreasing the quality of coverage. To me, a smarter way would be to focus on find a more affordable way to cover the 12% of uninsured people - not drastically increase the cost (and decrease service) for the 88% currently covered.

We pay significantly more for drugs, hospital visits, procedures. surgeries, etc. How does that have anything to do with population size?

[Arles]

Originally Posted by ISiddiqui

Worse coverage? Wha? Every single payer program I've seen has far better coverage than American private insurance. Why do you think this groundswell for Medicare for All has been coming from? People in other countries are flabbergasted by the level of our cost sharing (mainly deductible amounts, which don't really exist in single payer systems - have you considered those costs in your analysis?).

I'm not entirely sure why you come to the conclusion that single payer health system is just going to be like the employer sponsored health system but with the government instead of insurance companies.

But it's not apples to apples with a country that has 10% of your population (Canada). There is no magic bullet to decrease costs when you have a massive population of unhealthy people who eat fast food everyday and expect a high level of service. It's just whether you prefer that employers subsidize it or individual shoulder all the costs themselves via taxes.

People will of course be paying more, but with better health coverage and more equitable health care coverage. And the country will be paying less overall as overhead costs decreases substantially, and the government can negotiate services as a whole.

Again, you are handing most workers a $4-$7K bill each year for a lower level of coverage with the "hope" of costs to eventually decrease.

Not to mention that a lot of times private insurance freezes you to your job (which creates a massive inefficiency to the job market).

70% of private employers offer subsidized health care. I don't think a person at a company stays there because all the similar jobs out there don't have private health insurance.

Originally Posted by JPhillips

The idea that health insurance costs would double and coverage would be significantly worse is nuts. It's roughly similar to arguing that healthcare under Bernie would be literally free.

The costs to the employee would double, there is a distinction there. Currently, the employer pays between 50 and 70% of the cost of the health care plan. If that goes away, the employee is faced with 100% of the cost (either through taxes or premiums).

Originally Posted by JPhillips

We pay significantly more for drugs, hospital visits, procedures. surgeries, etc. How does that have anything to do with population size?

It's a factor - more people mean more sick people and more diverse set of serious illnesses. We also have one of the worst lifestyles when it comes to health. So more people living a worse lifestyle = higher cost. We also foot the bill for a big chunk of research and innovation. Finally, we have a higher expectation of service than most Canadian and European counterparts. We wait maybe 2-3 weeks for most surgeries - those waits in Canada or the UK are closer to 12 weeks and 20 weeks in places like Norway and Finland.

[molson]

Originally Posted by Brian Swartz

Most of them don't think its good, and a lot of the growth in the support for single player has been right-leaning people just giving up and bowing to the perceived need for that. But more importantly, there's still a lot of people who think that it's very possible for a bad system to be made worse, who don't want to give up the freedom that more government control mandates, and who generally don't trust the government in general.

But if most of them don't think its good, why aren't alternative plans a part of Republican policy debates or legislative pushes? Healthcare only seems to come up with Republicans when they're opposing change. Which indicates support for the status quo.

[Brian Swartz]

Because they don't typically have a better idea they can get behind. They don't like the ACA and like the old way better than that, but they don't have a coherent idea on how to do better. The whole country doesn't really. All the polling the last several years that I've seen is that there is a consensus for several things:

** reduced cost,
** keep stuff like portability and pre-existing conditions
** cover as many people as possible, preferably all of the uninsured
** retain freedom of choice within the system
** modest increase in taxes at most, preferably no increase
** continued high investment in new research etc., to Arles point

The problem of course is that you can't do all of those things at once, and people aren't generally willing to give on any of it, so while public opinion is trending towards single-payer there's not strong agreement on any remotely realistic option. It wasn't until a couple years ago that we got to the point where there was a clear majority in favor of single-payer - a decade ago that idea was significantly underwater. And even within that agreement, once you get into the details the consensus fractures badly.

[Arles]

While a registered democrat, I consider myself more conservative when it comes to health care and economic policy. instead of a single payer, here's what I would try to do:

1. Fully or partially subsidize health care plans for people making under a certain amount (say $100K) who don't have employer provided health care. Maybe under 50K it is 100%, 75% under 75K and 50% under 100K. The government would just give them a tax credit that could be used for their premium costs per year (basically act like the employer).

2. Setup better exchanges for small business owners with some % subsidies for premiums there as well.

If you focus on getting coverage for people who don't have it, then you can look at finding ways to reduce the cost in certain areas. The prescription drug thing is a tough one. Currently the US pays 3-times more for the same drug in Europe, but that extra money helps fund research and innovation. There could be a massive hit to R&D if we capped prices like Europe - but I'm certainly open to ideas here.

I'm also not sure we can do a ton with overall cost given the number of unhealthy people/lifestyles we have and our expectation of service. If we were willing to wait 3-5 months more for most elective surgeries, that might help. If we lost a lot of choice for specialists/doctors (like in other countries), that may help too. I'm just not sure this country has the stomach for those type of changes.

If I waved a magic wand and we had the health care system in Canada here tomorrow - there would be riots in the streets when people saw their tax bill, how long they had to wait for surgeries/care and how restricted the list of doctors/specialists would be.

[BYU 14]

Originally Posted by Arles

While a registered democrat, I consider myself more conservative when it comes to health care and economic policy. instead of a single payer, here's what I would try to do:

1. Fully or partially subsidize health care plans for people making under a certain amount (say $100K) who don't have employer provided health care. Maybe under 50K it is 100%, 75% under 75K and 50% under 100K. The government would just give them a tax credit that could be used for their premium costs per year (basically act like the employer).

2. Setup better exchanges for small business owners with some % subsidies for premiums there as well.

1-Government needs to stop living in 1952 and legalize marijuana, two immediate needs for the tax revenue, healthcare and education. It also opens up research, allows MD's to prescribe and impacts the opioid crisis. The biggest obstacle here are obviously big pharm and middle aged conservatives who still think Harry J. Anslinger is a saint.

2-This is the big thing. Meritus the Arizona exchange was an absolute disaster and was a convoluted mess run by people better suited to selling used cars. They created plans to try and appeal to everyone, including things that officers of the company wanted covered for themselves, which made them almost impossible to administer effectively.

Training was sub-par, cost containment was nearly non-existent, and since they were playing with house money they had no immediate sense of urgency to stop hemorrhaging funds. The federal government gave them far too much leeway and should have mandated a very select group of plan tiers. Meritus put bids out to TPA's with the understanding they would offer a dozen plan options. That number increased to over 90 when time came for implementation and it was a shit show in terms of configuration. To go down this route again there needs to be a standard template, which ideally should follow CMS guidelines like Medicare and offer PPO, HMO and Select options with no more than 3-4 plans in each tier.

[ISiddiqui]

I simply don't get this worse coverage thing and that's the major stumbling block. I think single payer is vastly improved coverage and its no contest. That's why people are willing to pay more in taxes. Detectables would be essentially eliminated. You wouldn't have hidden payments (a very American issue right now as is this new thing of "True Emergency" initiated by insurance companies). People daily get screwed by their health insurance, who will deny valid claims and try to assign cost sharing on things they shouldn't until the government cites them for it (Investigating and citing health insurance companies is part of my job, mind). That's not even getting into self funded Heath plans that run out of money, leaving participants on the hook for procedures they thought was covered. Our system, for people that HAVE insurance, is a complete mess. The reason people are for single payer is because it's better coverage. And if you disagree on that that we simply don't have enough basic agreement to have a conversation about this.

And its fascinating to me that you have never ran into someone who turned down a job they liked better because of health care benefits. 70% of employers offering health care doesn't mean it's all the same quality.


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[thesloppy]

Yeah, I don't understand how folks think needlessly involving a third-party-insurance company (and all their overhead) in their healthcare somehow results in cheaper costs (and/or better care) for them.