One thing about the M4A debate that I'm super frustrated at when it comes up every debate and Biden/Buttigieg/etc. go "$30 trillion!!!!!!111" is how neither Sanders or Warren ever fire back with a detailed reply about how the actual comparison price tag should be the current amount going into the industry through insurance companies at present.
They touch on it peripherally with the stats about how the average family spend 12k on healthcare and how costs would go down but I feel like that - in the debates at least - neither has made it crystal clear that this isn't some $30t compared to the 0 of the status quo. The status quo cost is likely higher in (or at least in the relative ballpark of) the current system!
John Oliver's latest piece in Last Week Tonight (which got linked here earlier in the week iirc) did a good job diving into this and while I get they don't have the time he has to do so, it's also not like he spent the whole segment on that issue.
It is the relevant comparison, but there are a couple caveats:
Even the 30 trillionish estimates that Sanders/Warren state are optimistic projections (and the revenue estimates are optimistic too). If youre too optimistic on both of them by 10% or something, suddenly you have a 6 trillion dollar hole. And these numbers could certainly be off by more than that!
You need a mechanism for actually recapturing the money that employers are currently spending on healthcare, and Im not sure this is quite so simple as just saying it goes right into taxes (e.g. employers are paying different amounts depending on the plans theyre offering; if you set it at the average rate, some of those companies probably cant afford it, and I would assume differential rates based on what they used to be paying would be ripe for a lawsuit). Maybe Im wrong here and somebody can convince me!
Particularly for Bernies plan, hes promising a lot more (covering literally everything is that no copays or deductibles) which starts the number off way higher. Count me skeptical that administrative savings and cutting out the relatively small profit margins of insurance companies are gonna make up the difference. Having no copays and deductibles also leads to moral hazard where people are more likely to have unnecessary procedures done, raising costs more.
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