
'Everybody In, Nobody Out': What's Known About the Medicare for All Act of 2019 - howard941
https://www.commondreams.org/views/2019/02/07/everybody-nobody-out-what-we-know-so-far-about-medicare-all-act-2019
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aaronbrethorst
I think that being able to leave a job and still have the same health care
would be transformative for entrepreneurialism in the United States.

I’ve known lots of folks over the years who’ve felt tied down to a job because
they were the only member of their family to have health insurance, and they
couldn’t afford to risk their spouse or children getting sick.

~~~
minikites
I think that's a big reason so many non-insurance companies are fighting
against the idea of universal healthcare for all citizens, they like having
this tremendous power/leverage over their employees.

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drewrv
That's interesting. I've wondered for a long time why non-healthcare
industries don't lobby hard for universal healthcare. It's a huge cost and
administrative nightmare.

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jcriddle4
Want to bet the actual legislation is just minor tweaks to ObamaCare re-
branded as "Medicare for all"? Why do I suspect the article is overly
optimistic and that the author is just reading into vague and noncommittal
comments made in meetings that they think will make it into the bill?

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aaronbrethorst
The ACA is loosely based on the ultra-conservative Heritage Foundation’s
1990s-era alternative to ‘Hillarycare.’

Medicare for All, definitionally, offers single-payer access. The Heritage
Foundation was trying to prevent _exactly that_.

Also, I can tell you’ve never spoken to Congresswoman Jayapal, because she
doesn’t make vague or noncommittal statements (source: I’m a constituent and
have been to several of her constituent coffee events.)

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jcriddle4
"Medicare for All, definitionally, offers single-payer access..." Yes that is
what the definition of Medicare for all should be but we are already seeing
presidential candidates trying to redefine "Medicare for All" to the point
that it doesn't mean much at all. I hope you right on Jayapal but till we see
the bill's text we won't know.

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aaronbrethorst
_we are already seeing presidential candidates trying to redefine "Medicare
for All" to the point that it doesn't mean much at all._

What are you referring to?

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jcriddle4
[https://www.cnn.com/2019/01/29/politics/kamala-harris-
medica...](https://www.cnn.com/2019/01/29/politics/kamala-harris-medicare-for-
all-eliminate-private-insurers-backlash/index.html)

~~~
aaronbrethorst
That is disappointing. Thanks for the link.

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naveen99
Maybe the government should treat healthcare like it does student loans. A
healthy, educated person is more likely to make more money, and pay more in
taxes. So, its more of an investment then a handout. Money flow wise, it makes
more sense for government to pay the healthcare for a working adult then a
retired one. And they already pay for > 65 year olds and offer student loans
to any student.

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Mirioron
The problem with over promising with healthcare is that you can't walk it back
and healthcare becomes the most expensive or second most expensive thing on
the government budget.

The other problem with government healthcare is that you're basically giving
the government some control over your body. It will be the government's
business whether you're out of shape or overweight or indulge in too much
sugar etc, because the government is paying the medical bills.

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jogjayr
> healthcare becomes the most expensive or second most expensive thing on the
> government budget.

Has that happened in other advanced economies? Genuinely curious - I don't
know what share of the UK national budget the NHS consumes, for instance.

> It will be the government's business whether you're out of shape or
> overweight or indulge in too much sugar etc, because the government is
> paying the medical bills.

First off, this happens to a small extent already with private insurance
companies. Companies do "wellness fairs" for employees, insurance companies
give people discounts for going to the gym etc. It could increase in future
right?

Second, I think most people want to be healthy, regardless of who's paying the
bills, because your quality of life is so much better. I could see many people
not changing their oil on time and driving terribly if they were guaranteed
free car repairs forever. But healthcare isn't like that.

~~~
Mirioron
> _Has that happened in other advanced economies? Genuinely curious - I don 't
> know what share of the UK national budget the NHS consumes, for instance._

Yes, this is the case in the UK.[1] Public sector spending for 2019 is around
£842 billion for the UK. £256 billion is spent on "social protection" and €166
billion on public healthcare. That's 18-19% of the total budget being spent on
healthcare. Keep in mind though that healthcare in the US would be much more
expensive. US healthcare workers earn more compared to GDP per capita than UK
healthcare workers.[2] I think it would be rather likely that healthcare such
as this would rival social security in terms of cost if it applied to
everyone.

[1]
[https://www.gov.uk/government/publications/budget-2018-docum...](https://www.gov.uk/government/publications/budget-2018-documents/budget-2018)
\- under section 1.7

[2] [https://economix.blogs.nytimes.com/2009/07/15/how-much-do-
do...](https://economix.blogs.nytimes.com/2009/07/15/how-much-do-doctors-in-
other-countries-make/)

> _First off, this happens to a small extent already with private insurance
> companies. Companies do "wellness fairs" for employees, insurance companies
> give people discounts for going to the gym etc. It could increase in future
> right?_

I think it's likely that it will increase, but now the _government_ has more
of angle to argue why they should have the right to control your behavior.

> _Second, I think most people want to be healthy, regardless of who 's paying
> the bills, because your quality of life is so much better. I could see many
> people not changing their oil on time and driving terribly if they were
> guaranteed free car repairs forever. But healthcare isn't like that._

Most people don't want to be told that they're not allowed to eat X, because a
bureaucrat living a thousand miles away says it's bad for you, especially when
the evidence isn't stellar. It also allows for corporations to lobby harder on
laws around people's habits.

If the government finds that using "a screen" for more than 8 hours per day is
bad for you, you probably wouldn't like it if the government would now argue
that they should be able to monitor your usage of screentime and potentially
penalize you in some way, right?

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robomartin
Medicare is NOT health insurance. It is a credit card that starts to fill-up
after age 55. States, by law, are required to collect on the debt you and your
family acrue for your medical care. The government, in collecting this debt,
will place a lien on your estate. Beyond that, your children can be liable for
what you owe.

If everyone in the US were to be shifted into this program it would likely be
the largest private property grab by a government anywhere in the world in
modern history.

Don’t take my word for it, start here and do your own research:

[https://www.medicaid.gov/medicaid/eligibility/estate-
recover...](https://www.medicaid.gov/medicaid/eligibility/estate-
recovery/index.html)

Not saying a better aporoach to healhcare isn’t necessary in the US. It is.
Just saying this is not a good idea.

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skybrian
Can someone explain why it's worth paying attention? With a Republican
majority in the Senate and Trump in office, the chance anything like this will
pass before the 2020 election is nil. And whatever might pass then will be
different.

I'm reminded of how when Obama was in office, the House attempted to repeal
Obamacare 61 times [1] and it seems it was entirely symbolic.

[1]
[https://en.m.wikipedia.org/wiki/Efforts_to_repeal_the_Patien...](https://en.m.wikipedia.org/wiki/Efforts_to_repeal_the_Patient_Protection_and_Affordable_Care_Act)

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smacktoward
Because every Democratic candidate for President is going to have to have a
position on health reform, and Medicare for All is emerging as one of the most
popular options among those that have declared so far. So the question of what
exactly Medicare for All would mean in practice is of primary importance to
the agenda the eventual Democratic nominee will bring to the table.

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tboyd47
I still think some kind of Medicare-for-all legislation or "Trumpcare" is
Donald Trump's ultimate goal for his presidency. "I am going to take care of
everybody... Everybody’s going to be taken care of much better than they’re
taken care of now."

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dsfyu404ed
Trump only does what benefits Trump. Trump will sign what bills benefit Trump
to sign.

If congress can put a healthcare bill in front of Trump that can be branded as
"medicare for all" for one audience and "we repealed Obamacare" for another
audience (the possibility of the latter branding being a necessity in order to
get any Republicans in congress to vote in favor of the bill) then Trump will
almost certainly sign it. It doesn't actually have to provide "medicare for
all" or "repeal Obamacare". It just has to look enough like it does to pass it
off that way to the American public. He just wants to be able to say "look
everyone, I repealed Obamacare" whether or not it's technically true.

The "which news is fake news" circus and people's increased skepticism of what
they read and see on the news should make the latter part much easier because
it gives Republicans more wiggle room to vote for something that looks a lot
like Obamacare 2.0 or "medicare for all" and then turn around and act like
they repealed Obamacare in front of their base in 2020.

I for one am hopeful. This seems like a potential win for everyone (well,
scummy insurance companies notwithstanding).

