Objections to Medicare-for-All — and the first, necessary step

Twitter: @rodgermitchell; Search #monetarysovereignty
Facebook: Rodger Malcolm Mitchell

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It takes only two things to keep people in chains: The ignorance of the oppressed and the treachery of their leaders..
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The Republicans put forth their “Health Care Only for the Rich” plan, and saw the public, for some strange reason, not wanting health care to be available only for the rich.Image result for rich government poor people

So now, after 7 years of searching for an idea, the GOP is searching for an idea.

We long have recommended Step #2 of the Ten Steps to Prosperity: FEDERALLY FUNDED MEDICARE — PARTS A, B & D, PLUS LONG TERM CARE — FOR EVERYONE (See below). The Federal government, being Monetarily Sovereign, easily can fund the whole program, without any FICA collections.

Financially, the solution is a no-brainer. The federal government can afford it; the public is strapped for funds. So who should pay?

But a recent article in The Week describes problems other than mere finances. Here are some excerpts, along with our comments:

Why ‘Medicare for all’ is easy to say and near impossible to do
David Faris

Bernie Sanders premised his primary campaign in large part on a radical promise to ditch Obama’s signature legislative achievement in favor of extending Medicare to all Americans.

The phenomenal success of Sanders’ insurgent socialist campaign proved again that the ACA was unpopular in large part because millions of Americans think the state should be doing more rather than less. 

Yet there are a number of important questions about any single-payer plan that remain not just unanswered, but mostly unasked.

Let’s imagine that, somehow, progressives succeed in enacting “Medicare for all.” What does the transition period look like between the passage of such legislation and its full implementation?

What would happen to the health insurance companies that employ over half a million people? Would they be compensated for their losses?

Health insurance companies still could exist, though in a much-reduced form. They could provide coverage for those who do not like Medicare, either because they believe it to be too restrictive in its coverages, or because their doctors won’t accept it, or for other reasons.

If people have a choice between free health care from Medicare or paid health care from private insurance, most will choose free, but some will chose private.

So yes, like many industries through the years, the health care insurance industry will shrink. Think of the coal industry.  And the record-pressing companies.

And, when was the last time you used a public land-line telephone? Their manufacturers must be feeling the pinch.

Most industries that continue to exist today have become more efficient (i.e. use fewer people and more machines). Business evolves.

What would happen to the medical debt of doctors who would almost certainly face diminished economic prospects under single-payer? (Most Americans think physicians are rich — true in some cases — yet many doctors rack up over $200,000 in debt to attend medical school.)

These problems are not the fault of Medicare or of any future Medicare-for-All.  They result from the Big Lie, the ridiculous claim that somehow our Monetarily Sovereign federal government can run short of its own sovereign currency, so it needs to husband its financial resources.

For that reason, Medicare underpays doctors, a situation in need of change, whether or not Medicare-for-All is instituted.

And medical school, like all other schools, should be free.  See: Free education for everyone.  Again, this has nothing to do with Medicare-for-All.

Primary care doctors and rural areas — generally pay the worst and already have trouble attracting physicians for that very reason. What happens to the supply and demand of care when tens of thousands of doctors earn less?

And yet again, why pay them less? This has nothing to do with single payer.

Do we have even remotely the civilian bureaucratic know-how we would need to scale Medicare up to the entire 320-million-strong population of the United States? The Centers For Medicare and Medicaid Services employ more than 6,000 people. That number would probably need to be, conservatively, quadrupled.

That probably was one of the objections to the original Medicare.  Yet here Medicare is, functioning better than most federal programs.  It is far more difficult to begin a program from scratch than to expand an existing, functioning program, which federally funded, Medicare-for-All would do.

And note the concern about hiring more people, juxtaposed against the concern about insurance companies firing people.  Strange.

Remember that a committed and well-intentioned Democratic administration had trouble just setting up a website for a tiny fraction of the number of people who would be covered by a new single-payer system.

Running a nationalized health care system would be considerably more complicated than cutting monthly Social Security checks to people.

A Medicare-for-All  website would be nearly identical to the currently, well-functioning Medicare website.  The primary difference would be simply handling more people — an easily solved Internet problem, not a program problem.

Political questions abound as well. Republicans spent seven years hammering ObamaCare, which remained mired in negative approval ratings.

Medicare, by contrast, is not “mired in negative approval ratings.” Medicare-for-All transfers people from the less-loved ACA program to the highly appreciated Medicare program.

Americans who just months ago were complaining about the ACA’s deductibles and coverage options were faced with the prospect of losing their insurance coverage altogether, along with their right to be covered if they have a pre-existing condition.

ObamaCare has drifted into majority approval, and the Republicans’ hot, hastily conceived, cruel, vindictive mess of an alternative was opposed by a whopping 3-1 majority.

A similar problem would vex Democrats almost immediately, in the same way that it did when they got to work on the ACA in the first place. It’s what happens when various stakeholders in existing, complex, and flawed processes realize that their interests are deeply threatened.

The above is a rather pitiful argument for never making any big changes. It was true of Medicare, Social Security, Medicaid and enlisting women, blacks, and gays into the military, and going to the moon.

The maximal version of “Medicare for all” would involve, in a quite literal sense, stripping hundreds of millions of people of their existing private insurance coverage.

No, it would give people the choice of free health care insurance vs. paid-for health care insurance. Undoubtedly, more people would select free, but some people might prefer what the private insurance companies offer.

No one would be “stripped.”

There are only three hundred million people in all of America, so the notion that “hundreds of millions of people” would lose health insurance is laughable or outrageous, depending on one’s sense of humor.

The GOP has waged a scorched-earth campaign against the ACA and has failed spectacularly. For Democrats, launching another huge, divisive struggle over health care would be like if Truman had decided to go ahead and fight the Soviets over Eastern Europe at the conclusion of WWII.

What a ridiculous analagy. No, it isn’t like that at all (though then, the Soviets were weak).  The first step would be to convince the populace that the Big Lie indeed is a lie.  Once people understand Monetary Sovereignty, the institution of Medicare-for-All would be a “why-have-you-waited-so-long?”

Bottom line: Medicare-for-All is a natural outgrowth of Monetary Sovereignty. The only reason not to adopt it is the affordability myth, the notion that taxpayers would have to pay for it.

Once people understand that they would not have to pay for other people’s health care, and that yes, for a Monetarily Sovereign nation, lunch really can be free, objections to Medicare-for-All would melt like a snowman in a summer sun.

Rodger Malcolm Mitchell
Monetary Sovereignty

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The single most important problems in economics involve the excessive income/wealth/power Gaps between the have-mores and the have-less.

Wide Gaps negatively affect poverty, health and longevity, education, housing, law and crime, war, leadership, ownership, bigotry, supply and demand, taxation, GDP, international relations, scientific advancement, the environment, human motivation and well-being, and virtually every other issue in economics.

Implementation of The Ten Steps To Prosperity can narrow the Gaps:

Ten Steps To Prosperity:
1. ELIMINATE FICA (Ten Reasons to Eliminate FICA )
Although the article lists 10 reasons to eliminate FICA, there are two fundamental reasons:
*FICA is the most regressive tax in American history, widening the Gap by punishing the low and middle-income groups, while leaving the rich untouched, and
*The federal government, being Monetarily Sovereign, neither needs nor uses FICA to support Social Security and Medicare.
2. FEDERALLY FUNDED MEDICARE — PARTS A, B & D, PLUS LONG TERM CARE — FOR EVERYONE (H.R. 676, Medicare for All )
This article addresses the questions:
*Does the economy benefit when the rich can afford better health care than can the rest of Americans?
*Aside from improved health care, what are the other economic effects of “Medicare for everyone?”
*How much would it cost taxpayers?
*Who opposes it?”
3. PROVIDE A MONTHLY ECONOMIC BONUS TO EVERY MAN, WOMAN AND CHILD IN AMERICA (similar to Social Security for All) (The JG (Jobs Guarantee) vs the GI (Guaranteed Income) vs the EB (Guaranteed Income)) Or institute a reverse income tax.
This article is the fifth in a series about direct financial assistance to Americans:

Why Modern Monetary Theory’s Employer of Last Resort is a bad idea. Sunday, Jan 1 2012
MMT’s Job Guarantee (JG) — “Another crazy, rightwing, Austrian nutjob?” Thursday, Jan 12 2012
Why Modern Monetary Theory’s Jobs Guarantee is like the EU’s euro: A beloved solution to the wrong problem. Tuesday, May 29 2012
“You can’t fire me. I’m on JG” Saturday, Jun 2 2012

Economic growth should include the “bottom” 99.9%, not just the .1%, the only question being, how best to accomplish that. Modern Monetary Theory (MMT) favors giving everyone a job. Monetary Sovereignty (MS) favors giving everyone money. The five articles describe the pros and cons of each approach.
4. FREE EDUCATION (INCLUDING POST-GRAD) FOR EVERYONE Five reasons why we should eliminate school loans
Monetarily non-sovereign State and local governments, despite their limited finances, support grades K-12. That level of education may have been sufficient for a largely agrarian economy, but not for our currently more technical economy that demands greater numbers of highly educated workers.
Because state and local funding is so limited, grades K-12 receive short shrift, especially those schools whose populations come from the lowest economic groups. And college is too costly for most families.
An educated populace benefits a nation, and benefitting the nation is the purpose of the federal government, which has the unlimited ability to pay for K-16 and beyond.
5. SALARY FOR ATTENDING SCHOOL
Even were schooling to be completely free, many young people cannot attend, because they and their families cannot afford to support non-workers. In a foundering boat, everyone needs to bail, and no one can take time off for study.
If a young person’s “job” is to learn and be productive, he/she should be paid to do that job, especially since that job is one of America’s most important.
6. ELIMINATE FEDERAL TAXES ON BUSINESS
Businesses are dollar-transferring machines. They transfer dollars from customers to employees, suppliers, shareholders and the federal government (the later having no use for those dollars). Any tax on businesses reduces the amount going to employees, suppliers and shareholders, which diminishes the economy. Ultimately, all business taxes reduce your personal income.
7. INCREASE THE STANDARD INCOME TAX DEDUCTION, ANNUALLY. (Refer to this.) Federal taxes punish taxpayers and harm the economy. The federal government has no need for those punishing and harmful tax dollars. There are several ways to reduce taxes, and we should evaluate and choose the most progressive approaches.
Cutting FICA and business taxes would be a good early step, as both dramatically affect the 99%. Annual increases in the standard income tax deduction, and a reverse income tax also would provide benefits from the bottom up. Both would narrow the Gap.
8. TAX THE VERY RICH (THE “.1%) MORE, WITH HIGHER PROGRESSIVE TAX RATES ON ALL FORMS OF INCOME. (TROPHIC CASCADE)
There was a time when I argued against increasing anyone’s federal taxes. After all, the federal government has no need for tax dollars, and all taxes reduce Gross Domestic Product, thereby negatively affecting the entire economy, including the 99.9%.
But I have come to realize that narrowing the Gap requires trimming the top. It simply would not be possible to provide the 99.9% with enough benefits to narrow the Gap in any meaningful way. Bill Gates reportedly owns $70 billion. To get to that level, he must have been earning $10 billion a year. Pick any acceptable Gap (1000 to 1?), and the lowest paid American would have to receive $10 million a year. Unreasonable.
9. FEDERAL OWNERSHIP OF ALL BANKS (Click The end of private banking and How should America decide “who-gets-money”?)
Banks have created all the dollars that exist. Even dollars created at the direction of the federal government, actually come into being when banks increase the numbers in checking accounts. This gives the banks enormous financial power, and as we all know, power corrupts — especially when multiplied by a profit motive.
Although the federal government also is powerful and corrupted, it does not suffer from a profit motive, the world’s most corrupting influence.
10. INCREASE FEDERAL SPENDING ON THE MYRIAD INITIATIVES THAT BENEFIT AMERICA’S 99.9% (Federal agencies)Browse the agencies. See how many agencies benefit the lower- and middle-income/wealth/ power groups, by adding dollars to the economy and/or by actions more beneficial to the 99.9% than to the .1%.
Save this reference as your primer to current economics. Sadly, much of the material is not being taught in American schools, which is all the more reason for you to use it.

The Ten Steps will grow the economy, and narrow the income/wealth/power Gap between the rich and you.

MONETARY SOVEREIGNTY

9 thoughts on “Objections to Medicare-for-All — and the first, necessary step

  1. What always bugged me about the running out of money people is they never consider how much more technologically advanced we are now, especially with IT and the Internet being so big. As you said, many of the technical issues can be easily solved. I was listening to NPR the other day and I got the feeling this was more of a problem of not having enough IT people working in government jobs. You would need to make the positions more attractive and deal with the visa issue too. I’m sure there would be tons of people willing to try to solve any technical problems with the current Medicare/Social Security site and things of that nature.

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  2. Your position “Medicare for All” is noble and one that is for the betterment of all. There is only ONE WORD that needs to be removed….”FREE”.
    The one word between ‘a benefit for all’ and a method to achieve it.
    Even a Monetary Sovereignty can not create “real genuine money ‘out of thin air’ and turn that ‘thin air’ into real goods and services. Period.
    Your position is not valid; why not FREE Military spending, Free SS ?

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    1. Justa,

      How many times have you commented on this site? 100? 200? And still you refuse to understand Monetary Sovereignty.

      Our Monetarily Sovereign government does indeed create dollars out of thin air. In 1775 there was not a single dollar in the entire world. By 1780, there were millions. Where do you think those dollars came from?

      Yes, for a Monetarily Sovereign government, military spending is free, as is Social Security.

      FEDERAL TAXES DO NOT FUND FEDERAL SPENDING.

      State and city taxes do fund state and city spending. That is the difference between a Monetarily Sovereign entity and a monetarily NON-sovereign entity.

      Sorry, old boy, but you hereby are banished from this site until you can demonstrate you understand Monetary Sovereignty. Enough, already.

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  3. I would be against totally free schooling for adults, not because our Monetarily Sovereign governemnt couldn’t afford it; of course it can (at least if most of its members stop denying their country’s legal, Constitutional, historical and economic basis for Monetary Sovereignty). The Federal Government can afford anything where the amount returned is greater than the amount spent. This lets out the military, where only 70 cents is returned on a dollar spent, according to most studies of the money multiplier, but it certainly allows for Social Security ($1.80 – $2.00 returned for every dollar spent, according to studies from the Southern Rural Development Center and AARP, respectively), and almost certainly for Medicare, whether current or expanded into a For-All program.
    It would include higher education too, CURRENTLY.
    But the problem is with the incentives for the schools, not whether the governemnt can afford to spend money it can create essentially for free.
    What we need to watch out for is not to turn public higher education into the ripoffs that many private higher education institutions have become, or even worse, profit-mills that exist solely to rake in billions of Federal Dollars via enrollment of unqualified students. These schools are incentivized to process students, to charge them whatever the Federal Government will pay, and to push them out the door after 4 years with as little money spent on them – read: poorly educated – as possible. The results have been high costs – some of which are borne by naive students in the form of loans that should never have been made – and useless degrees.
    Even legitimate universities can have bloated budgets and overpaid “star” faculty who never even teach, if Federal money comes with no strings attached.
    Adult students – that is, those over age 18 – should have some skin in the game. (Students who are so smart that they can skip a year or two in primary education should be able to go to college for free until they are 18, a good incentive to study hard and get through primary education swiftly). They need to pay something – but not so much that they can’t realistically pay it back after college through working.
    There should be no profit for the Monetarily Sovereign Federal Government; loans should be public and interest-free, but not principal-free. Certainly the relatively high – 7% or so – Federal student loan rate is a travesty and completely unnecessary.
    No student who qualifies based on grades should be unable to go to college simply because she or he cannot afford it.
    There should be a loan forgiveness options for students who commit to put their talents to use in under-served areas, like rural doctors, or public education, etc.
    Like most people of a “certain age” I went through college on a combination of summer work, parent payment, and school loans. This combination doesn’t seem to work anymore, with too much burden placed on students and too little from the Federal Government, which can certainly afford most of the burden (with the caveats above), or the States, which probably should have some skin-in-the-game too, but differ drastically from the Federal Government in that they are no more Monetarily Sovereign then the students attending college. States’ contributions to public colleges should be much less than Federal contributions.

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  4. The real reason we don’t have single payer has nothing to do with cost (its actually cheaper than what we do today) and everything to do with, of all things, trade ideology.

    In 1994 President Bill Clinton signed us into the WTO which containes what is basically an agreement to privatize (and then globalize) everything.Only services “supplied in the exercise of governmental authority” are exempt

    with that being defined as only those:

    “supplied neither on a commercial basis, nor in competition with one or more service suppliers”

    – Since US healthcare is commercial, it can’t become public. Generally exempt public services are allowed if they are totally noncommercial to everybody rich and poor and were completely public and free up to and before January 1 1995.

    Learn about the four WTO “modes of supply” for services.

    Importing cheap health insurance and healthcare workforce for the poor and serving as a destination for wealthy health tourists are important to the US.

    Serving as a destination for poor insured Americans (as long as they dont have to insure people who are already sick) is important to countries like india. India’s healthcare system is ideologically compatible with the US as India is also a very unequal country that does not beleive in healthcare being any kind of human right. Thats very important to the United States and Modi, the Indian leader. They are cut from the same cloth.

    International trade in health care and health care insurance is at the top of the global agenda.

    Basically, because exporting health insurance to the world’s wealthy is a cherished dream, which depends on forcing other countries to privatize and globalize, we in the US cannot get any kind of sweetheart deals.We have to get the worst deal of all to show we mean business.

    Poor Americans who dont have pre-existing conditions or genetic issues – who have enough money, may be compelled by WTO rules that “all measures of general application” “affecting trade in services” be “not more burdensome than necessary to ensure the quality of the service”. This may translate into poor people having to leave the country to get health insurance, if they receive help from a government. Read up on the concept of trade restrictiveness. US regulations like the ACA would likely have been framed as a trade barrier by the US as it stands in the way of maximal profitability for insurance companies, domestic or foreign. Also it violates a standstill because its a new regulation adopted after the cutoff date. that makes it likely to be challenged successfully which would be embarassing.

    Here is the document which imposes the standstill on financial services. https://www.wto.org/english/docs_e/legal_e/54-ufins_e.htm

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    1. The U.S. government is not permanently bound by any foreign agreements. It can do anything it wishes, whenever it wishes.

      What does bind the U.S. is Gap Psychology — the desire to distance ourselves from those below us on the income/wealth/power scale — and The Big Lie — the false belief that federal taxes fund federal spending.

      In short, we are bound by our own beliefs.

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