Medicare for All (M4A) retained its prominent place on the stage at the latest Democratic debate. In its purest Bernie Sanders form, concurrent with abolishing private health insurance, U.S. residents would be enrolled in “Medicare.” The program would pay for unlimited “medically necessary” health expenses, including pharmaceuticals, mental health and substance abuse treatment, vision, dental, and hearing services, and long-term care with no out-of-pocket costs. Some supporters were scared off by the $32 trillion over 10 years price tag. Not to be outdone, Elizabeth Warren’s “I’m with Bernie” plan comes with a $52 trillion over 10 years price tag including up to $34 trillion in new government spending. Our country’s entire yearly budget is a mere $3.5 trillion. For perspective, if your salary is $40,000 per year it would take 25 million years to earn 1 trillion dollars. As M4A’s dark side emerged, the candidates distanced themselves from Bernie-care.
Elimination of private insurance? Whoa, Nellie! Over 156 million Americans —half the country—are covered by employer-sponsored health insurance plans and another 23 million have private individual policies. And most of these folks like that arrangement. Then there was pushback from some unions who had excellent health insurance policies for which they had bargained and given up other perks.
In the June debate the candidates raised their hands indicating they would abolish private health insurance. Now Mayor Buttigieg wants to “unify the American people around, creating a version of Medicare, making it available to anybody who wants it, but without the divisive step of ordering people onto it whether they want to or not.” Vice president Biden, noting his desire to keep patient choice stated, “we should build on Obamacare … adding a Medicare option in that plan, and not make people choose.” Of course, Obamacare caused a rise in premiums, a decrease in choice of insurance coverage, and like any large government-run program was prone to mismanagement and waste.
Possible financing mechanisms were screaming for a deep dive. One analysis concluded that most Americans would suffer financially if M4A were implemented as proposed. An analysis by a bipartisan think tank estimated a 32 per cent increase in payroll taxes would be needed to fund M4A. Everyone—even the working poor—would have more payroll taxes extracted from their paycheck. The analysis concluded that most households would pay more in new taxes than they would save by eliminating their current spending on private health insurance and out-of-pocket medical expenses.
Senator Warren tries to hide the ugly truth by railing about the evil rich who would be taxed down to their underwear. Take the deceptively worded “2-cent” annual tax for households with more than $50 million in assets. If you have $51 million in assets, most probably tied up in your business, you’d have to cough up (.02)($1,000,000) or $20,000, not 2 cents. The devil’s spawn, aka our 535 billionaires, would be subject to a 6 percent annual tax on their assets. Who will be the next target when the government has driven the assets to a sunny island in the Caribbean? Finally, raising the corporate income tax back up to 35 percent likely would result in businesses paying lower wages to current employees or cutting back on hiring to compensate for the increased tax burden.
During the latest debate, Senator Warren retreated from her “all-in” approach, asserting she would first provide Medicare at no cost to “everybody under the age of 18, everybody who has a family of four income less than $50,000”—about 135 million people. Second, she would lower the Medicare age to 50 and expand Medicare coverage to include vision, dental, and long-term care. In the third year, “when people have had a chance to feel it and taste it and live with it, we’re going to vote and we’re going to want Medicare for all.”
Senator Sanders owns that payroll taxes would be doubled or tripled and proposes a 4 percent surtax on families earning more than $29,000. So if you earn $60,000, you’d have to pay (.04)($31,000) or $1,240, enough for a whole year’s membership in a private Direct Primary Care plan. Senator Sanders, staying true to his principles, is sticking with unadulterated Medicare for All with its financial warts.
Even those who are numb to government over-spending can see the broader problem of inviting Uncle Sam into their lives in exchange for a Medicare card in their wallet. Any remaining privacy is erased. Our medical records would be furnished to the Department of Health and Human Services and the National Coordinator for Health Information Technology. Physicians and patients would be robbed of their autonomy and choice by medical care policies set by the government monopoly. Lack of competition leads to lower quality and fewer services. Coverage becomes an illusion.
Medicare for All’s beauty is only skin deep and its ugly goes to the bone.
Dr. Singleton is a board-certified anesthesiologist. She is Immediate Past President of the Association of American Physicians and Surgeons (AAPS). Her opinions are her own. This is an edited column that originally appeared at www.pennypressnv.com, reprinted with permission.
For a long time, I have mostly written in this space about the ridiculous Democrats in the House who, tilting at left-wing partisan windmills, are heading in the direction of impeaching President Trump thus almost guaranteeing his re-election in 2020 since there is no chance the Senate will remove him.
This week, however, I have stumbled into an equally ridicules situation which has no relationship with what is currently happening in Washington but could have a serious impact on America’s largest employer—small business.
You may have seen some TV commercials for a non-bank lender named Kabbage. It features actor Gary Cole playing a spokesman from 10 minutes in the future talking to some small business people. After they get the funding they needed, Cole pops in as even further in the future after they got the Gundelfinger Account.
My company has used Kabbage for something like three years.
It’s not a huge credit line but we have made every payment on a timely basis and they have never had any problem with us.
On December 2, we made our normal monthly payment. A few days later, I checked to make sure it was recorded properly. It was. But there was a note on the app screen which said, “You are not currently eligible to take a loan. Call us at 88xx-xxxx to fix this issue.”
So I did.
What they told me was that there was a 60 day hold on our account, the computer makes these decisions and there is no appeal because they don’t know the reason that the computer made the decision.
I asked to speak to an executive who authorized the computer to make that decision.
“Sir,” said the young lady, “That team is not customer facing.”
Not customer facing?
Now I need to make two points here. Nobody is obligated to lend you money any more that anybody is obligated to borrow money. This is a business transaction. You lend me money and I pay it back with interest.
But good business practice dictates that if you make a decision like that—which, by the way, you have every right to make—you pick up the phone and FACE THE CUSTOMER! Maybe your precious computer got the wrong—or no—information.
Kabbage is part of a new group of financial institutions called fintech.
It’s the latest new thing.
They have a proprietary algorithm so they can evaluate risk and make loans fast.
That’s all well and good. And, as welcome as that may be to help fund America’s largest employer, a lender you cannot talk to is nobody you want to do business with.
Suppose, as an example, you are coming up on a payroll and are just a bit short—something which is not unusual in the wide world of small business. You know you have that available in your Kabbage line. Only, when you go to use it, there’s a note, placed there by a computer for a reason nobody knows that you cannot use the money. That’s the sort of thing that can break a small business.
What was point number two that I was going to make?
Only that I made it clear that I was not mad at the nice young customer facing lady. I was mad at her company and then only because information is as important as cash in small business and if Kabbage can’t tell you why, it’s very difficult to want to continue to do business with them—even after the 60 day hold is over. Resigning the Gundelfinger account is a real possibility.
Now, we can get back to politics. But I’ll bet that Kabbage CEO Rob Frohwein will see the logic in fixing this problem long before the Democrat morons in the House figure out that they are hamsters making the wheel go around. And I mean no insult to hamsters.