r/FluentInFinance • u/The-Lucky-Investor • 11d ago

“Medicare for All” would save the U.S $5.1 Trillion over 10 years Discussion/ Debate

https://www.commondreams.org/news/2018/11/30/easy-pay-something-costs-less-new-study-shows-medicare-all-would-save-us-51-trillion
21.5k Upvotes

92% Upvoted

2.6k comments sorted by

View all comments

21

u/MoneyGrapefruit1000 11d ago

Is this similar to how the ACA was going to make healthcare affordable without making people change their doctors? Because that didn’t happen for most of us.

39

u/GeekShallInherit 11d ago

From 1998 to 2013 (right before the bulk of the ACA took effect) total healthcare costs were increasing at 3.92% per year over inflation. Since they have been increasing at 2.79%. The fifteen years before the ACA employer sponsored insurance (the kind most Americans get their coverage from) increased 4.81% over inflation for single coverage and 5.42% over inflation for family coverage. Since those numbers have been 1.72% and 2.19%.

https://www.kff.org/health-costs/report/employer-health-benefits-annual-survey-archives/

https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html

https://www.bls.gov/data/inflation_calculator.htm

Also coverage for people with pre-existing conditions, closing the Medicare donut hole, being able to keep children on your insurance until age 26, subsidies for millions of Americans, expanded Medicaid, access to free preventative healthcare, elimination of lifetime spending caps, increased coverage for mental healthcare, increased access to reproductive healthcare, etc..

1

u/[deleted] 10d ago

[deleted]

0

u/interzonal28721 10d ago

All I got from aca was a high deductible plan

2

u/GeekShallInherit 10d ago

Deductibles were increasing faster before the ACA than after as well. And, of course, you likely got access to an HSA now with a high deductible plan, which is pretty much the best investment opportunity in the country.

-1

u/Old_Height_8351 10d ago

Thanks for taking the time to put numbers to this.

While the % may have decreased, the absolute values (amount of money spent on healthcare) are much larger so the percentage is misleading. 2.79% of a trillion is about the same at 3.92% of 800bil. I’m no so sure the decreased percentage is due to the bill or just because the amount we spend is just insane. I could be wrong tho

3

u/GeekShallInherit 10d ago

the absolute values (amount of money spent on healthcare) are much larger so the percentage is misleading.

Except they aren't when healthcare spending has had a greater than 100 year history of increasing exponentially. Even then you're wrong. Just looking at inflation adjusted spending, single premiums increased $2,074 and family premiums $7,283 in the decade before the ACA went into effect; and $791/$2,727 in the ten years after the law went into effect.

3

u/Old_Height_8351 10d ago

Thanks for clarifying the premium portion. You have a good point there.

I’d be curious about the other portions like coinsurance, copayments and deductibles. It could be the case the insurance shifted costs to those things. They do want to make more money after all.

This is a very complex topic, so many things contribute to an increase in healthcare spending. General population health, insurance, regulation, labor, etc. We have so many problems it’s hard to know which way is up

2

u/GeekShallInherit 10d ago

In 2003, the average employer provided single PPO plan was $3,505, with a deductible of $275. That's $5,771 and $453 adjusted for inflation.

In 2013, the average employer provided single PPO plan was $6,031 with a deductible of $799. That's $7,835 and $1,038 adjusted for inflation.

At the same rate of increase, the single PPO would have cost $10,636 in 2023 with a deductible of $2378.

In actually in 2023, the average employer provided single PPO plan was $8,096 with a deductible of $1,281. From 2003 to 2013 saw an average of 5.58% in premiums and 8.65% in deductibles after accounting for inflation. 2013 to 2023 saw an average increase of 1.30% and 2.13%.

And, of course, all of this is encapsulated in the total spending which I previously addressed.

2

u/Old_Height_8351 10d ago

In summary, the ACA had an effect of reducing the % increase on insurance spending for employer sponsored plans. I think I’m interpreting that correctly.

Do you think the individual has an increased out of pocket expense? Such as coinsurance and copayment

2

u/GeekShallInherit 10d ago

Do you think the individual has an increased out of pocket expense?

Deductibles have increased more slowly as well.

In 2003, the average employer provided single PPO plan was $3,505, with a deductible of $275. That's $5,771 and $453 adjusted for inflation.

In 2013, the average employer provided single PPO plan was $6,031 with a deductible of $799. That's $7,835 and $1,038 adjusted for inflation.

At the same rate of increase, the single PPO would have cost $10,636 in 2023 with a deductible of $2378.

In actually in 2023, the average employer provided single PPO plan was $8,096 with a deductible of $1,281. From 2003 to 2013 saw an average of 5.58% in premiums and 8.65% in deductibles after accounting for inflation. 2013 to 2023 saw an average increase of 1.30% and 2.13%.

And everything, including out of pocket spending, is included in the total spending I addressed above.

1

u/Old_Height_8351 10d ago

Those numbers are factoring in coinsurance or copays, but that could be only a small amount to add to those totals

1

u/GeekShallInherit 10d ago

If anything, additions such as max out of pocket and increased coverage for preventative care should have reduced such costs. Feel free to provide a single shred of evidence otherwise.

I can tell you total household spending on healthcare accounted for an average of 29.6% of healthcare spending in the decade before the ACA went into effect; 28% since.

→ More replies (0)

16

u/slayer828 11d ago

The aca was gutted by Republicans and democrats owned by the Healthcare corporations.

Look at the original draft vs the final one.

Money is the problem and always was. Take money out of medical care and the problems will shrink.

15

u/timemoose 11d ago

Democrats had the votes to pass whatever they wanted. No Republicans even voted for it and it still passed.

17

u/dontaskdonttells 11d ago edited 11d ago

Pretty sure Joe Lieberman blocked it similar to how Manchin/Sinema blocked recent bills.

The public option was initially proposed for the Patient Protection and Affordable Care Act, but was removed after independent Connecticut senator Joe Lieberman threatened a filibuster. As a result, Congress did not include the public option in the bill passed under reconciliation. https://en.wikipedia.org/wiki/Public_health_insurance_option#:~:text=The%20public%20option%20was%20initially,the%20bill%20passed%20under%20reconciliation.

-1

u/timemoose 11d ago

Without getting too far into the details, I'll just point out that he's not a Republican.

6

u/contemplativecarrot 11d ago

not a Democrat anymore either

15

u/bailtail 11d ago

No they didn’t. Huge, fatal concessions had to be made to get Lieberman to vote for it. He single-handedly hobbled the efficacy of ACA.

3

u/timemoose 11d ago

(not a Republican)

3

u/BagOnuts 11d ago

Lieberman was officially an “Independent Democrats” and caucused with the Democratic Party. He was more of a Democrat than Bernie Sanders is.

2

u/bellj1210 11d ago

yup- it passed on the slimmest majority that everyone knew was about to go away (i think it was Ted Kennedys death that created the really short window and hyper thin majority).

When that happens- a single member of the majority becomes super easy to buy off to get what you want for a lobbyist. The republican party has seen that a lot in recent years with the speaker stuff- they gave too much power to each congressman- and a few use it to mess everything up.

IT is honestly a feature and the downfall of a 2 party system. It is also the issue with politicians being so far removed from their actual voting base. Congress should never never had a cap- and stuck with the 1 per 10k people (or whatever it was) since then we would actually know (or at least be less than 1-2 steps from) our representation. We would actually know if they are a jerk- and would actually be able to vote for people we want to represent US vs. having to rely on a political party platform- it is really common to vote straight ticket since the voter has no actual clue who Congressman X is aside from the R or D next to their name.

3

u/slayer828 11d ago

That's why I also included owned democrats.

6

u/timemoose 11d ago

Right but not gutted by Republicans because they had no say.

5

u/slayer828 11d ago

They had tons of say. Go Google it. There are hundreds of amendments written up by Republicans.

This wasn't in 2020. The government used to work in compromise. Wasn't until the republican party's stance changed from governing to owning the libs did things turn. You can thank the tea party, and magats for that.

1

u/CatzonVinyl 11d ago

You’re intentionally obtuse

3

u/timemoose 11d ago

Feel free to point out where I'm wrong.

1

u/thatnameagain 7d ago

They only had a supermajority by one vote, which means they could not vote for whatever they wanted, but can only vote for what one member of Congress wanted.

1

u/timemoose 7d ago

The democrat party could have gone in a room, gotten a consensus, and passed it, all without republican input.

1

u/thatnameagain 7d ago

What makes you think they could have gotten a consensus for a public option when they tried to do exactly that and couldn’t convince the conservative members of the party?

2

u/StreetcarHammock 11d ago

Is it really taking money or of medical care or aligning the money to incentivize good care? So much money is wasted on onerous insurance overhead and expensive catastrophic care that could be avoided with regular, accessible primary care.

1

u/Extension-Tale-2678 11d ago

So basically we should expect the same thing but with Medicare for all?

1

u/slayer828 10d ago

Medicare for all is step 1. Lots of reforms needed to get us anywhere

1

u/Intrepid_Perspective 9d ago

Can you provide some sort of proof for this? This is such a commonly held reddit belief, but I have no idea where it comes from.

1

u/slayer828 9d ago

There are tons of articles if you look. You just have to scroll past all of the ones since then if Republicans trying to repeal parts of it....

Here's one.

https://www.usatoday.com/story/opinion/2017/08/01/set-health-record-straight-republicans-helped-craft-obamacare-ross-baker-column/523952001/

I mean the entire act is pretty conservative in itself. Lots if it came directly from mitt Romney.

If it were truely a "socialist agenda" it would have been much different. Things like medicare reform to be accepted everywhere, full drug and cost negotiations, hard cap on profit, full opt in, government ownership of hospitals and clinics shut down in small communities.

Instead we got mandated private insurance. Whoopee.

10

u/FDRomanosky 11d ago

The ACA has made healthcare affordable to millions, it has been very successful at helping low income folks. People making decent money don’t qualify for the subsidies unfortunately.

There are also numerous parts of the ACA that impact everyone outside the cost of premiums that people tend to gloss over.

5

u/Omnom_Omnath 11d ago

You have a funny definition of affordable.

3

u/FDRomanosky 11d ago

I run a team that helps folks navigate the ACA market, subsidies were increased drastically for certain parts of the population a few years ago, it was part of the COVID bill, more people are utilizing ACA plans than ever before, get the net

3

u/Omnom_Omnath 11d ago

Why should only certain specific groups get subsidies? Not really fair to the rest of us paying out the ass for shitty healthcare

2

u/FDRomanosky 11d ago

It’s based on income, like most things

1

u/Omnom_Omnath 11d ago

Sure, and thus only really helps a tiny minority of the population. Better than nothing I suppose but also isn’t the major win the democrats laud it as imo

5

u/MsAgentM 11d ago

Well I hope you are voting for Dems that will vote for universal healthcare in the future. Republicans are just gonna try to reduce subsidies.

2

u/Omnom_Omnath 11d ago

Which Dems would those be. Biden is against it

3

u/MsAgentM 11d ago

Depends on your area. It's the legislatures that matter here really. I think Biden would at least get us closer than any Republican. At least he put more subsidies to it and worked to allow medicare to negotiate with drug companies for certain drugs.

→ More replies (0)

1

u/Sufficient_Meet6836 10d ago

Biden is against it

Blatant lie. It was part of his platform

→ More replies (0)

2

u/njackson2020 11d ago

So vote for the guy that has had 50 years to do something about it? For some reason I don't think he's going to jump on doing a whole lot different than he has his entire political career

2

u/MsAgentM 10d ago

I said vote for Dems and you would do well to vote for Biden too. He was vital to Obama getting the ACA passed. If it had passed with all they wanted it would have had a public option and expanded Medicaid access access the country. It doesn't because of one Dem and Republican governors that sued and opted out of the Medicaid expansion

1

u/PotatoRover 11d ago

I was looking at the market place a while ago and you have to be making pretty good money to not get any subsidies. Although plans are so expensive a 200 dollar subsidy doesn't seem like much when the plan is like 600 for one person.

2

u/FDRomanosky 11d ago

Plans that used to cost $200-300 month are now $50-100 month, if you make less than 200% FPL plans are basically free.

Point being these plans help those who are lower rung mostly

1

u/Least_Palpitation_92 11d ago

The ACA was a giant bill. The biggest impact it had was standardizing insurance practices. Prior to the ACA you could get health care denied for pre-existing conditions which is no longer the case. People would also buy cheaper options that only covered up to certain amounts and many policy holders wouldn’t even realize it until they hit the max and found out they were screwed.

Basically insurance can’t be as scummy anymore so it costs more.

1

u/bailtail 11d ago

ACA has slowed the growth rate of healthcare costs compared to pre-ACA. And that’s despite major concessions that had to be made to get it to pass, one of those being a public option which would have forced private insurers to actually sharpen their pencils rather than allowing healthcare providers to simply charge more because insurers are required to spend at least 80% on claims, but if you don’t push back on providers charging more, then that 20% they get to keep is bigger.

1

u/best_of_badgers 10d ago

The ACA had two critical components that were gutted.

The first is the tax penalty for having no health insurance. Insurance only works if there are enough people who don’t file claims to balance out the ones who do. If only high risk people have insurance, it goes into a death spiral.

The second is the public option. This would capture all of the extremely high cost people who insurance companies couldn’t affordably take on.

The first was gutted by the GOP afterwards and the second was implemented as an optional state level enhancement to Medicaid.

It’s important to remember that insurers were wildly in favor of the ACA that the Obama campaign proposed… and then opposed to the final law.

1

u/burnthatburner1 10d ago

Because that didn’t happen for most of us

Yes it did.  

1

u/ChiefStrongbones 10d ago

ACA pumped more dollars into healthcare coverage without doing anything to address healthcare pricing. That's like the current student-loan forgiveness scheme which retroactively pumps more dollars into higher education but doesn't do anything to reduce the inflated cost of higher education.

And why has "single payer" been rebranded "Medicare for All"?

-3

u/SuperFrog4 11d ago

Ah but do you know why it didn’t happen?

Hint: Republicans in Congress stripped out provisions that would have provided that.

13

u/timemoose 11d ago

Republicans did not control either the House or Senate at this time.

1

u/[deleted] 11d ago

[removed] — view removed comment

1

u/AutoModerator 11d ago

Your comment was automatically removed by the r/FluentInFinance Automoderator because you attempted to use a URL shortener. This is not permitted here for security reasons.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

1

u/[deleted] 11d ago

[removed] — view removed comment

1

u/AutoModerator 11d ago

Your comment was automatically removed by the r/FluentInFinance Automoderator because you attempted to use a URL shortener. This is not permitted here for security reasons.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

-1

u/SuperFrog4 11d ago

They did not but they had enough seats in the senate to block the legislation from passing if they wanted to. Back then you needed 60 senators to vote yea to pass legislation. The democrats had to rely on several moderate republicans to pass the legislation and becuase of this republicans were able to remove some important sections of the legislation in an effort to make the law as weak and ineffective as possible and hopefully because of that campaign in the 2012 election on that failure and win the house or senate and get rid of it entirely.

Just because you have a majority doesnt mean you can do what you want as has been seen by the current house.

3

u/timemoose 11d ago

You need to google cloture.

3

u/Abollmeyer 11d ago

It couldn't possibly be the 100% burden of an expensive individual insurance plan vs the 40% an employee would pay for a comparable plan.

4

u/thicckar 11d ago

Could you tell me more? I believe you just want to learn more

0

u/SuperFrog4 11d ago

I would read the section on legislative history. All that information is taken from congressional records.

https://en.m.wikipedia.org/wiki/Affordable_Care_Act

Of note at this time you needed 60 votes to pass legislation in the Senate hence why the Republican minority was able to scale back a lot of great parts of the ACA. Their goal was to make it less than optimal so people would hate it and they could run in the next election on the campaign promise to and the ACA.