Medicare works. It’s popular.

Of course it’s popular. It’s costs are subsidized by the Feds and by private insurance cost-shifting. If seniors had to pay the actual cost of their plans, it wouldn’t be so popular. :-)

People keep their doctors and get care at a lower cost.

The first part of that is not always true, and RARELY true if you are among the tens of thousands who have any sort of uncommon condition for which special treatments are necessary to keep you alive.

The second part of that is a lie. The underlying cost of care never changes. It’s just that a portion of the bill goes someplace else, and gets paid for in another way.

Let’s not lose sight that we have a Medicare system that’s already working.

Define “working”. The current system, funded by the payroll tax, will start eating into its cash balance in the early 2020’s, as tax receipts no longer cover the system’s costs. When the cash balance is expended a decade or so later, benefits under Medicare will be automatically cut to about 70% of their current levels, and seniors will have to pick up the rest.

Doesn’t sound like its “working” to me. YMMV.

And I’ll institute a serious audit of prescription drug costs to ensure pharmaceutical companies are not charging more than other comparable countries

Whether that impacts the quality of the pharmaceuticals and research pipelines is a topic that stands on its own. Suffice to say that it is questionable that the net result of such policies will be as positive as everyone thinks.

, a comprehensive maternal child health program to dramatically reduce deaths among women and infants of color

Yes, very important to include some racist policies in there. Good call.

and meaningful rural health care reforms, such as increasing residency slots for rural areas with workforce shortages and loan forgiveness for rural health care professionals, to promote high-quality access for people regardless of their zip code.

Those are actually good ideas, but you don’t have to rip up the current delivery chain to achieve them.

But I am clear-eyed about the challenge of achieving this goal. It will not be easy, and it will not happen overnight. So here is my plan to get us there.

First, when we pass my plan, all Americans will immediately have the ability to buy into Medicare. Right away, it will lower costs and give us a baseline plan as we transition to Medicare for All.

Not seeing how this gives us lower costs. It costs as much to treat a medicare patient as it does any other patient. So, where do those savings, if they actually exist, come from? (No Democrat wants to answer this one. Sanders, to his credit, has been honest about this, that the plan will cut provider compensation (doctor, nurse, med-tech, adminstrative) by about 40%.

And of course nobody wants to talk about that. If it were to become clear to the workers in the industry that they were voting to cut their own pay, nobody would do it.

This will expand the number of insured Americans and create a new viable public system that guarantees universal coverage at a lower cost. Expanding the transition window will also lower the overall cost of the program.

Same question. A 10 year window does nothing to lower overall costs of any significance. Neither does universal coverage. The input costs into the system (labor, materials, etc) remain largely the same.

Third, in setting up this plan, we will allow private insurers to offer Medicare plans as a part of this system that adhere to strict Medicare requirements on costs and benefits. This would function similar to how private Medicare plans work today, which cover about a third of Medicare seniors, and operate within the Medicare system. Medicare will set the rules of the road for these plans, including price and quality, and private insurance companies will play by those rules, not the other way around. This preserves the options that seniors have today and expands options to all Americans, while also telling insurance companies they don’t run the show.

OK. So, basically, this is the same model they use in Switzerland. That’s why I can’t see where the savings are coming from.

Well, at least its a free market system. You can’t be accused of promoting socialized medicine as long as there’s a private option. But why not just go whole hog and institute the Swiss system, then? And like Switzerland, let the states run it rather than the Feds?

This isn’t about pursuing an ideology. This is about delivering for the American people.

Fair statement. Sanders is pushing a “single payer or bust” ideology. Screw that. Single payer has its warts as well.

More than 200 economists have said we will dramatically save money over the long run if we expand the Medicare program to include everyone and limit profits for drug companies and insurance companies.

It’s not hard to find 200 stupid economists. :-). Pharma companies do make high profits, but insurance companies do not; there’s no savings there. You might get some economies of scale, but without slashing provider compensation, you’re not looking at a lot of money. MAYBE you book a one time cut of 5–10% of cost, but that leads us an even more important issue….

…..which is the rate of health care cost inflation. Unless the cost of health care inflation can be dropped to the COLA (currently it runs 2–2.5X the COLA) all are instituting is a temporary solution. It’s not the COST of health care which is sinking the ship, it’s the inflation rate of those costs; the costs are increasing faster than we can bail the water out. :-)

So, unless you change the inflation curve, any proposal anyone puts out is just (keeping to the analogy) rearranging the deck chairs on the Titanic as it sinks. The ship is still sinking.

And there’s only one way known to bend that inflation curve, and that’s getting the patient to put some financial skin in the game. As long as the patient views medical care as “free”, it will be overused and hyperinflation will continue.

However, one of Senator Sanders’ options is to tax households making above $29,000 an additional 4% income-based premium. I believe this hits the middle class too hard.

It’s rather hard to make the math work without a substantial (greater than Sen. Sanders’) middle class tax increase. Any proposal for a truly universal care system that does NOT include a substantial middle class tax increase is not honest.

To pay for this specific change, I would tax Wall Street stock trades at 0.2%, bond trades at 0.1%, and derivative transactions at 0.002%.

That’s about twice what the capital markets can tolerate without recession behavior kicking in. I think a capital trades tax is not a bad idea, but if you set it too high, liquidity suffers. And that’s a big deal.

In total, this plan will reduce our country’s health care costs and lower Americans’ out-of-pocket costs, all while extending health insurance coverage to every American.

….and we just have to pretend that cutting the income of medical professionals by 40% will not cause any decrease in the quality of care. :-)

Good luck with it. The current “system” is a mess, but I trust it more than I trust the government running it.