But the fact is, we can’t afford not to.

It’s generally not a good idea to start any article with a logical fallacy. But, let’s carry on.

Universal healthcare is fiscally responsible, and American taxpayers already provide socialism for corporations and for the rich. Our blended economy would derive enormous benefit by moving to single-payer healthcare.

There are two egregious errors in this paragraph. The first is watering down the definition of “socialism” to include something other than “government control over the means of production. The second is the conflation of “universal healthcare” and “single payer health care”.

Universal health care means that everyone in the country has access to an affordable health insurance plan that sufficiently mitigates their health care risk, while “single payer” is only one of the many different systems used in the world that delivers that universal care (and not a particularly good way to deliver it, at that — most nations with universal care do NOT have single payer care.)

They are not the same thing; a person can be FOR universal care and DEAD SET AGAINST single payer, quite easily.

In his State of the Union address, Donald Trump declared that “America will never be a socialist country.”

Amen.

Dr. Martin Luther King would often point out that America is already a socialist country¹ — our government provides socialism for the rich, powerful, and corporations. And the rest of us pay for it

Dr. Martin Luther King was incorrect.

Universal healthcare is fiscally responsible. Our current path is not.

Hmmmmm. This sounds more like a bumper sticker than a cogent thought.

During my 2018 campaign for US House of Representatives

Ah. It WAS a bumper sticker.

Republican candidates in Texas used the word “socialist” in the hope of frightening voters into supporting them and to fear-monger around candidates like me

I agree with you that the GOP dilute the definition of “socialism” at least as much as the Dems do.

who chose to listen to the people of Texas instead of corporations and lobbyists.

False dichotomy. The health care discussion is not a choice between “what the people want” and “what corporations want”. It’s meeting the needs of individuals in a way that does not trample on economic reality or freedom.

(Despite those claims, our first-time campaign, relying 100% on individual grassroots donations, swung our heavily gerrymandered “red” district 12 points.)

I don’t want to digress, but this leftist virtue-signalling (“I only took individual donations”) becomes tiresome. I know your tribe loves to hear it, because you’ve bought off on the myth that “the people” and “the corporations” are at odds with one another. (Although corporate direction and citizen direction are not *completely* aligned, they’re correlated more than they are not. One of the things the progressives get the most wrong is their insistence that corporate direction and citizen direction are opposed to one another.)

How can that be, when the large corporations employ more than 40% of us?

(Snips a bunch of nonsense about immigrants, Trump, and more screwups on what the term “socialism” means”)

The fact is that the majority of Americans favor single-payer healthcare — that support is broad and bipartisan.¹²

Sure. And the fact is that everyone loves a free lunch. Until it’s not free. There are two realities that require discussion here:

  1. In general, if you want European style benefits, you’re going to have to pay European style tax rates, and incorporate a European style tax system. In the US, this means the institution of a national sales (VAT) tax which raises the price of most goods and services by 10–35% at the register, slight tax increases on the wealthy while middle class taxes double and triple, and the collection of taxes, for the first time in nearly thirty years, on the bottom 40% of our taxpayers. (Now this MAY not be necessary for universal care only, but it is entirely true if one envisions a European style social benefits system.)
  2. As soon as you mention additional taxes or the end of private insurance, that “majority” you refer to flips. And that is well documented.

WASHINGTON (AP) — Americans like the idea of “Medicare-for-all,” but support flips to disapproval if it would result in higher taxes or longer waits for care.

Yet while our insurance premiums — and with them, the amount of people unable to see a doctor or afford their prescriptions — continue to increase, and while medical GoFundMe’s become the norm, those in power have stymied any efforts at healthcare reform.

Well, true. The GOP blocks the Dem plans (which all include this odd fetish for single payer type systems), and the Dems block the GOP plans (which for thirty years have been a full implementation of HSAs).

How did our Congressional priorities get so out of whack?

Heh.

Those politicians’ campaigns are massively funded by the for-profit insurance, healthcare, and pharmaceutical lobbies.¹³

Hmmmm. Although true, those lobbies are *not* opposed to universal care. In fact, they are rather supportive of universal care, because it brings them more customers. What they are NOT supportive of is government policies which destroy their business models. (Unsurprisingly.)

The Supreme Court ruled in Citizens United that corporations were people and money was speech.¹⁴

That’s really not correct as stated. The concept of corporations-as-people goes all the way back to the early 1800’s, as does the money-is-speech issues. What Citizens United did was overturn an FEC regulation that limited the corporations right to fund political messaging. It was, in my view, correctly decided from a Constitutional perspective, although the resultant money into politics has not been particularly pretty.

In my view, CU got it right. If I am a part owner of a company, I want my company to be able to politically advocate in my own best financial interests. That’s why I invested in the company, for crying out loud.

That unleashed a dangerous amount of spending by PACs, corporations, and special interests

Chuckles. You just got done bragging about how you can run a campaign without any institutional money. Good for you. But now you want to take away my ability to counter your noninstitutional money with other money that looks out for MY best interests, as a shareholder?

Sorry. Doesn’t work like that.

Pharmaceutical and insurance corporations are able to buy influence and outcomes through lobbying, PAC contributions and sympathetic political appointees.

Hmmmm. The assumption here (again) is that corporate advocacy always runs counter to the consumer.

Things are a lot more complicated than that. Sorry.

One of the complaints we often hear deployed amongst those politicians who oppose universal healthcare is: “You, the taxpayer, shouldn’t have to pay for someone else’s healthcare.”

Kind of an odd straw man there. The GOP just got done, a year or so ago, voting on a universal health care plan. Now, it went down in flames, mostly because they underfunded it, but that’s another matter.

You already pay for everyone’s healthcare. You just do it in the most expensive, inefficient and wasteful way,¹⁵ with the worst outcomes.¹⁶

Nobody is arguing that the current non-system is anything other than horribly inefficient and wasteful. (The outcomes issue is another matter, but let’s not digress unless we must.)

The discussion is how best to improve it.

Oh, how I want to discuss this graphic. :-) True as it is. But each of them begs the question of it they are SOLVEABLE or not, and if solved, what is the unintended consequence.

ONE. Administrative costs are high because in the US, the majority of health care is delivered by what are essentially small businesses. Each small business has its own record-keeping function, IT, administrators, etc. There are remarkable economies of scale that can be delivered by incenting providers to congregate into integrated care facilities such as Kaiser in CA, or Kelsey-Seybold in the Houston area. The ACA included some of these incentives; we can all agree, I think, that we would be better served if there were more integrated care facilities, and in the process, that admin cost number would drop down closer to the international average.

Notice here that solving that problem doesn’t raise taxes on anyone, or require changes in our non-system. All we do is use the tax code to disadvantage small practices, and advantage larger ones that provide integrated care.

TWO. Pharmas. (sighs). This is a huge problem. Around the world, each and every country has solved the problem by limiting the price the pharma is allowed to charge for various products. This dumps the massive costs in R&D involved in bringing new products to market on the only country that does NOT have these limits, which is us.

If you live in a country that does limit those charges, however, you pay a price; some new and expensive treatments are simply not available to you. This doesn’t affect the average person, but most certainly affects people needing leading edge treatments for things like cancer and lupus.

Now, what happens in the US if we, by law, limit what the pharmas can charge? Well, they stop working on products where they don’t believe they’ll get a return on their investment. So, no new treatments for conditions which are rare, fewer new treatments for conditions which are uncommon. There are not enough customers to justify the expense.

Solution? Patent law reform. We have this (IIRC) 15 year patent protection window on new pharmaceuticals; the company has to pay back its investment in the new product and turn a profit in that window; after that, the product goes to generic. But the 15 year clock starts before testing starts, not when the product goes to market. Since trials and FDA approvals can take a decade, the recoup of costs and turning a profit end up all occurring in a tiny window of a few years, which quite obviously requires the company to jack up the price of the product. If the clock were to start when the product is approved for sale, the company would have a much larger window to recoup their costs, and prices could drop precipitously.

Note again that the solution here doesn’t require new taxes or screwing with the existing health care environment.

THREE. Let’s just say here that no sane person believes that you can drop the compensation of health care professionals and keep the same quality of care, and move on.

The argument against socialized medicine is clearly being made in bad faith, because it’s too late — we already pay for universal emergency care regardless of whether someone has insurance or can pay for it.

So what’s the difference between what we have — wasteful, expensive, inefficient, propped up by the status quo, and subsidized by the taxpayer — and what we should have?

Well, the reality is that the total (federal/state) cost of uninsured ER care is less than the cost of insuring all the uninsured people. So, although you and I can agree that it’s a horribly nasty way to deliver care…….it’s actually cheaper than covering those people.

Preventive care is life-saving, and providing it for everyone is fiscally responsible — it is a fraction of the cost of emergency care. Until we provide preventive care for every single person in this country, everyone’s taxes and insurance premiums will continue to go up.

Uh, no.

Let’s take two very treatable chronic illnesses as examples

Let’s not, because you’re comparing apples and oranges.

Taken on an individual basis, yes, of course, treating the diabetic or hypertensive PRIOR to their condition leading to more serious problems is cheaper for that individual.

But, the discussion here is about public health policy and its cost. And for every uninsured chronically ill patient that you SAVE money on by insuring them which catches their condition early, you’re going to insure 10 perfectly healthy individuals that you weren’t’ previously spending any money on at all.

If a patient comes in through an emergency room because they’re in cardiac arrest that could have been prevented by medication management and regular office visits with a physician, the cost of that patient’s care is exponentially more expensive because of the trip to the ER. Assuming a hospital charge of $160,000 for cardiac surgery and a hospital stay²⁰, a patient could have scheduled visits with his doctor over 1,000 times (assuming an office visit charge of $150).

Yep. But now you’re switching to a situation which affects 1 in 100 individuals. So I save 160K on this guy, but I insure 99 guys at a cost of (national average) 12K apiece. 99*12K= $1,188,000.

See the problem?

(Look, we both want universal care. But the ER/Preventative/It’s already socialism argument is NOT the way you make that case.)

Former Governor Rick Perry opted Texas out of Medicaid expansion.²⁵ That left Texas taxpayers footing the bill for billions of dollars in uncompensated care. You can thank him (and Governor Abbott) for high insurance premiums and high property taxes.

Hm. I’ve lived in Texas most of my adult life. High property taxes preceded Rick Perry. And if you want to see those property taxes go even HIGHER, expand Medicaid in a state without an income tax. Just the 10% of costs that are unmatched by the Feds would cause a significant drain on state finances which would have to be addressed with higher property or sales taxes.

So how do we lower healthcare costs for everyone?

Not sure that’s the right question to be asking. What we’re suffering from right now is the fact that the ACA focused on coverage first, and cost control second. The GOP argued strenuously that this is the wrong order. They were right.

If we don’t have cost control, all we’re doing here is arguing on how best to rearrange the deck chairs on the Titanic. The ship is sinking; all plans will ultimately fail.

We allow every American to seek preventive care, and to avoid unnecessary and preventable hospital visits.

That raises the costs, not lowers them.

We move to guaranteed universal healthcare — that reduces the administrative fees that all of us subsidize in the massively wasteful corporate healthcare business in America.

Universal health care doesn’t change administrative costs.

Insurance companies are the middle men we pay for administering insurance claims. Medicare’s administrative costs are 2%, and there is no profit margin with Medicare.

Very misleading. Medicare’s rather substantial IT expenses are carried on another department’s budget. There is no normalized, apples-to-apples study that indicates that Medicare is more efficient than private insurers.

Let’s begin with a fundamental point that almost everyone tends to ignore. Medicare is not actually managed by the federal government. In most places it is managed by private contractors, including such entities as Cigna and Blue Cross. To argue that Medicare is more efficient is tantamount to arguing that when Blue Cross is called “Medicare” it is more efficient than when it is called “private insurance.” Further, there is nothing particularly special about the way Medicare pays providers. Private insurers tend to use the same billing codes and their payment rates are often pegged as a percentage of Medicare rates.

On the other hand, insurance companies’ administrative fees and profit are roughly 20% of the costs of care they administer

Profit for the insurers is at 2%-3%. Otherwise, see above. There’s no money to be saved in admin costs.

; part of this 20% includes the 2017 compensation for health insurance CEOs of $342.6M; those costs are part of our healthcare costs.²⁷

Misleading. The cash compensation for each of those CEO’s is about 1M each; the rest comes in stock awards which do not cost the patient a penny; they are paid for by the shareholders. So, lowering CEO compensation would decrease the average premium by maybe a penny or two per month.

Insurance companies also notoriously deny claims, and hospitals pay millions of dollars annually fighting these denials; again, we, the American taxpayer, end up paying for these costs.

Uh, of course they deny claims. Not all claims are valid. That’s part of running an efficient business. Do you give your kids a dish of ice cream every time they ask for it? Of course not.

The reality is that our county’s mixed-market economy would derive huge benefit from healthcare reform

True.

, and specifically by introducing singe-payer healthcare.

Nonsense.

We are already the beneficiary of socialized programs. When you travel by highway or air, a federal agency ensures that your travel is safe.

See above. Again, you’re suggesting a government takeover of healthcare (socialized medicine) is the same thing as a shared government service. Not true.

(How anyone thinks that the same bozos that have run the country 22 Trillion into debt will do a good job running health care is beyond me.)

The economic benefits to single-payer healthcare are transformative and impossible to ignore. Imagine the increase in productivity across the American workforce: when people are well, they can live and work to their full potential. Imagine the freedom that would come with separating insurance from employment — when providing insurance is no longer a barrier to starting a business, or it’s no longer keeping you from chasing your version of the American dream.

Look!!!!! Rainbows and unicorns!!!!! :-)

Written by

Data Driven Econophile. Muslim, USA born. Been “woke” 2x: 1st, when I realized the world isn’t fair; 2nd, when I realized the “woke” people are full of shit.

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