tpc

It was a different healthcare world in the 1990s. The same issues i mentioned apply. Every single one of them. The processes, care mechanisms and economics for every company and person that touches the HC system we have today, would have to change. All that you have done is taken a group of people who are more likely to get sick, relative to a younger population, and put that burden on the taxpayers. What are you going to do for taxes to pay for them? Medicare has a 255b cash reserve. (FYI, non profit hospitals have a 280b cash reserve) and is expected to require a 20pct or more premium and tax increase in 2033, with a most likely reduction in services. And again. Those numbers are always wrong. Do you plan on saying that when you hit 55 or 60 your taxes go up ? Do you plan on increasing from 2.9 percent for those at the age that qualify. Or increasing the taxes on everyone, to only pay for that age group and losing every younger voter ? Politicians need to learn that IDEOLOGY IS NOT A STRATEGY You have to put yourself in the shoes of everyone that is impacted, which for HC is everyone. Then you have to put together a plan and figure out what needs to be done to get from where we are to where we want to be, and who will do it. You have to recognize that our culture, politics, size , expectations, costs to educate doctors, desire to extend life as long as we can, our entrepreneurial culture that is always investing in new drugs and technologies to solve what once seemed like unsolveable problems, is unlike every other country in the world. If you can't recognize our strengths and differences, you won't be able to put together a plan, let alone legislation. That's where both parties always fail. They try to use ideology to legislate. Which makes it very easy for money to sway them. Because, when you don't have a plan, and you don't understand the details of what it actually takes to disrupt the status quo and create change , you are willing to defer to the people that give you the most money. I've been doing nothing but healthcare every day. This shit is opague, convoluted, dominated by huge companies that have no interest in anything but getting bigger, and if they help a few people along the way. So be it If you think this legislation, in any way shape or form scares them, you are wrong. They are laughing at both sides because they know they can buy them , mislead them, or sue them, so that nothing changes. The same thing they do to their customers But I will say. I truly do appreciate that you engage with me in an honest fashion. I know you want to do the right thing. But I can't say it enough times Ideology is not a strategy.

Asmongold gives his BASED opinion, says: "You're not being oppressed by the top 2% of society. You're being oppressed by the bottom 2% of society instead 👀 "People ain't gunna like this one: the bottom 2% of society have caused all of the manifest problems in your lives”

Mark, I appreciate your thoughtful and sincere approach on. Are you familiar with Alison Galvani work at Yale. She shows that extending Medicare to 55 is not that expensive. It would save costs because Medicare has lower administrative costs. People aged 55-64 some of the most expensive in private market and you would reduce spending on them. You also need Medicare to have more leverage to negotiate for drug prices --something you have led on. Yes, there is a cost but having progressive taxation to pay for it means that working and middle class Americans would be paying less than on their premiums and employers would be paying less than they would premiums. You eliminate a lit of the middlemen costs like hospital facility fees, private insurance executive cost, administrative and advertising costs, high mark up on drugs etc. Do you agree that a single payer system would be better for costs? Are you open to expanding Medicare? What would it take to get you on board? If you made the case and on the administration, it would help!

1. It’s not about “needed care won’t be denied “. It’s about implementing the MOST COMPLICATED OPERATIONAL TRANSITION in the history of the world. Moving from the mixed system we have today to a system that is run by the feds is a lot harder than implementing high speed rail. Who does it ? How do they do it. What’s the actual plan ? Anyone who thinks the transition can happen in two years is an idiot. Truly. This will be so complicated, if it’s done in ten years, with only a few dozen patients getting lost in the system and dying , it would be a miracle. Companies have a hard time restructuring in two years. You are asking thousands of hospitals, thousands more clinics, practices , and doctors to restructure how they do business. You are asking EVERY BUSINESS IN THIS COUNTRY , to restructure how they do benefits. It’s easy to say they won’t have to do anything. BUT LET ME GIVE YOU AN ABSOLUTE FACT. BIG COMPANIES WONT CHANGE THEIR BENEFITS PLANS TO SAVE THEMSELVES TENS OF MILLIONS OF DOLLARS OR MORE, because dealing with care navigation can be difficult. Where in that legislation is there a transition plan for patients to move from the care they are getting today to what is available via your legislation ? Do you really think those hospitals getting paid a premium to do things that only our hospitals can do are just going to accept a fraction of the amount for patients they already have ? Where is your plan for these patients ? Who helps them when companies disband their benefits people and their TPA/Care Navigation people are fired because the Feds are now in charge ? 2. CBO Projections are ALWAYS WRONG. It is literally impossible to get the projections right. What happens if they are off by tens or hundreds of billions of dollars ? 3. How many years of litigation do you think there will be ? Have you noticed the shifts in our courts and the reality you face there ? Then of course there are the political realities. Now and in the uncertain future. Legislation is not a plan. Implementation is not easy. Leadership for anything like this is hard to hire. There are so many challenges that no one in your party even begins to address There is a path to universal care. But as I have posted,IMO, it starts with either Breaking Up the Big Medicine bill and/or working with the largest employers and providers to eliminate the friction and cost of all the middlemen involved.

Why not start with expanding Medicare to 60, then 55, then 50? This is what Johnson thought would happen and that Moynihan believed made the most sense in the 1990s healthcare hearings.

Sanders plan would mean: ✅ No hospital A deductible. Zero ✅ No Part B deductible for doctor visits. ✅ Expanded dental, vision, hearing ✅ No co-pays ✅ No Medicare Advantage upcoding, ripping off taxpayers.