Smooth, I’ll give you that. However, none of your talking points hold water. Let’s dissect a few of them.
There are no practical reasons for why private insurance needs to be banned. It’s not like private insurance and the public option progressives are proposing can’t coexist, and in most countries with single-payer healthcare, they also have private health insurance.
The cost of health insurance goes far beyond what the insurance companies collect for doing nothing. It also includes the administrative costs of staff that can navigate the myriad of companies, each with several plans, to assure receiving payment for services. This of course, only adds to the profit of insurance when “i”’s aren’t dotted or “t”’s aren’t crossed and payment is withheld. This cost is responsible for much of the cost increase in healthcare that has gone far past inflation.
On the surface, this cost may not seem like much, but it is the reason that billing departments in hospitals that used to occupy a room in the basement now take up entire floors. It also why your Doctor likely went to work for a patient mill or just retired. Sharing those costs with others is the only way providers can stay on top of them and both hospitals and Doctors are aggregating their services with others. Single-payer, with one set of forms and rules, may just bring back the single Doctor practice with a nurse doing double duty as his bookkeeper that everyone liked so well. This type of practice is still quite common in nations with single-payer.
The first, which I’ve already iterated here, is that it’ll take a choice away from consumers. It’s here that I can draw a lot of parallels between the healthcare debate and the abortion debate.
Single-payer will actually expand consumer choices. Insurance plans are all based on a “network” of providers who agree to the terms the insurance companies dictate. It would also be nearly impossible for providers to administer “all” plans from all insurance companies, so a policyholder is very limited in their choice of providers.
Going out of network, even if one isn’t aware of it, can cost thousands in uncovered expenses, which is very problematic in emergencies when there isn’t time to check everyone with billing privileges in a hospital for network affiliation. With single-payer, there is no network to deal with. Every licensed provider will be compensated for services provided to every patient. This means there are no restrictions on the choice of doctors or hospitals and patients are free to choose whoever they are comfortable with. Their coverage also extends to anywhere in the US so they can travel freely knowing they won’t be bankrupted by an unexpected medical issue.
Equating choice of insurance to the abortion issue? Really?? No words for that.
All of that is fine, but the problem is that they’re taking it too far. Not just do they want people to use the public option, if they had it their way, everyone would have to use the public option.
People make irrational choices all the time, especially with hot-button political issues. However, this is too costly and is threatening our economy and democracy, mostly because of false propaganda such as you are spreading. I’m highly doubtful that you support many progressive causes.
It should be pointed out that of all countries that have single-payer or some other form of universal healthcare there is none, nada, zilch, even contemplating going to our insurance model. That is because they know that the people would not stand for it and any politician even suggesting it would not have a long career. They prefer to have their healthcare in the hands of people they can fire rather than those who have a large stake in denying you care and sheltered many layers deep in corporate bureaucracy.
Single-payer polls very well among all voters, like in the low ’70s. I highly doubt that even those ideologically opposed to anything hinting at socialism would hold out long when the benefits become obvious. With that approval level as a starting point, the opposition should be short-lived. Of course, conservatives, such as yourself, will make the same noises they make against Social Security and Medicare, but that is because they are ideological purists, not thinking individuals. They are like Gibbons slinging their feces randomly, not a serious political force. Single-payer would quickly become another third rail politically, just as Social Security did, which is why the right is fighting it so hard.
Banning private insurance also ignores a hard reality: the health insurance industry is a huge portion of our economy. In 2019, health insurance produced $1 trillion in revenue and consisted of over 7,500 businesses with over 620,000 employees. If, as progressives have proposed, we decide to completely ban the private health insurance, all of this goes away.
Finally, some reality interjected into your tirade.
The transition can’t be done in a day, and Bernie is well aware of that. This has been discussed among his econ team, extensively. Unlike the right, which lets people fend for themselves when business screws them, the progressive left will make sure they are taken care of. There will be offsetting economic incentives to cover the loss of dollars and specific programs targeted to those in the insurance industry.
You can bet the economics will work out, as Bernie has the best team in the world working to see him elected, and to serve the people long after the election. Together they will end the neoliberal domination of our economy and the perpetual wars that drain so much potential away from the public purpose that is the reason for government. America has been bled out for so long that it seems normal, but it’s not, and we are facing down the barrel of problems that will require every potential resource to fix.
If done right, that fix can open the floodgates of prosperity again for America without the wonton destruction that crony capitalism has inflicted without any reward for the people. There is no reason to support an unproductive industry such as insurance that returns very little economic gain for the pound of flesh it demands, up to one-third of our economy currently. Whatever it costs to end such crony capitalism will be small change compared to the gains doing so offers.
Medicare only covers 80% of hospital costs at current rates, which advocates for banning private insurance have said will stay the same.
Hospitals and doctors shouldn’t expect Medicare to pick up costs that are incurred from the insurance industry, such as massive administrative costs and non-payment of billing that easily add 20%. However, I know of no one who has stated that any such reimbursement is set in stone.
The system must work for everyone, including the providers, and there is plenty of room to make adjustments once insurance costs and profits are not part of the equation. No one is looking to make hospitals and doctors the scapegoats. Offering free education to those wishing to enter the medical field will go a long way to defray much of any drop in pay for providers and allow the field to ramp up much quicker.
Hospitals in less affluent areas will find the benefit of every patient walking through their doors being a paying customer a godsend. The unpaid billing, both with and without insurance, must be shifted onto those who can pay and that is much tougher where being uninsured is more the rule than the outlier. Those hospitals will be able to make critical investments in technology and staff that have been confined to the more affluent areas to date. More of them will be able to resist the pull toward consolidation and will be more a part of their communities again, instead of corporate profit machines sending vital income to Wall St listings and uncaring shareholders.
All countries who currently have single-payer healthcare also let people use private insurance if they wish.
This is a half-truth, as is the claim that all insurance will be made illegal. What the bill says is that insurance is not allowed to sell coverage that duplicates what Medicare covers, as doing so would be a con from the start. Other countries have similar provisions to protect their citizens from con artists that will sell policies they know will never be claimed on. There will be segments of the medical field that will not be covered, just as there is now without specific riders that tend to be very expensive.
Cosmetic and other elective surgeries are the first to come to mind, although I don’t see those as good prospects for insurance. Most insurance in single-payer countries is sold to those who travel extensively and may find themselves in need while not under the umbrella of their nation’s coverage. I think, while what you claim is technically true, that the market is extremely small as a portion of the overall dollars involved. One would have to be more specific about which country and which procedures before making an accurate comparison. Given that Medicare For All will cover vision, dental, and hearing, which even few Cadillac plans now cover, I see little use for any insurance beyond insuring travelers so they will be assured of first-rate care wherever they go.
