Medicare For All-Mercatus Study of Sanders' Plan

[Apollyon]

I was on Emirates recently (in First) but I was back slumming it at the Business class bar.

This literally made me LOL, while drinking my Labatt Blue!

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[deleted480308]

We fixed the problem of the hole in the ozone layer through governmental policies & the economy didn't crumble. We put a man on the moon. We won WW2. These all required significant sacrifices and our success was not certain.

I paid more for my house so I could walk to work, I pay more for my groceries so I can bike to the store, I limit my choices and buy my meat from my neighbor (a hog farmer), I grow my own vegetables in the summer and eat canned veggies in the winter. I spent my bonus on solar panels a couple of years ago...but I bet you're not convinced. So be it. The fact that something is hard to do is not a reason not to do it.

I'm very fortunate to be able to choose to live this way, but I'm not perfect & there's much more that I could do. Let he who is without sin cast the first stone. Nevertheless, my individual actions will not save the world without systemic change.

This thread is going nowhere except convincing me that polite & reasoned discussion will not be an effective approach in 2020. That's too bad.

But there isn’t anything polite about trying to force the rest of the country to live like you want them too. The pitch made by the climate change crowd is that we’ll put you in jail if you don’t do these things

 

[GeneralVeers]

But there isn’t anything polite about trying to force the rest of the country to live like you want them too. The pitch made by the climate change crowd is that we’ll put you in jail if you don’t do these things

It's rather like a religion. Pray to Jesus and you WILL go to Heaven. No one can prove what Heaven is like or even if it exists, but you have to recite the dogma and do what they tell you......or else.

 

[enalli]

If you believe in CO2 and GW so much, it should start as local as possible and NOT on a national 300+million people scale.

This statement makes no sense. If you believe climate science, then ideally things should start as globally as possible, in a world-wide 7 billion+ people scale. But thanks for posturing, I guess.

 

[deleted480308]

This statement makes no sense. If you believe climate science, then ideally things should start as globally as possible, in a world-wide 7 billion+ people scale. But thanks for posturing, I guess.

So just....control the lives of 7billion people by drastically altering their economics and lifestyle for something no one really believes will change anything significantly?

 

[enalli]

So just....control the lives of 7billion people by drastically altering their economics and lifestyle

Any legislation can be described this way in hyperbolic terms

something no one really believes will change anything significantly?

This is textbook begging the question.

 

[deleted480308]

Any legislation can be described this way in hyperbolic terms



This is textbook begging the question.

All climate change advocates have been for sweeping significant alterations to life/economics. That’s not hyperbole

And it’s not “begging the question” to point out that those pushing climate change reform have not demonstrated consistent ability to predict changes, consistent abilty to prove causes of changes, proof that proposed reactions will have significant effects, or the intellectual honesty to weigh the opportunity costs of those changes

 

[enalli]

And it’s not “begging the question” to point out that those pushing climate change reform have not demonstrated consistent ability to predict changes, consistent abilty to prove causes of changes, proof that proposed reactions will have significant effects, or the intellectual honesty to weigh the opportunity costs of those changes

I wouldn't be proud of dismissing an entire field of science and I'm surprised so many people here are.

It's a shame when science gets politicized, but I suppose that's the way things have always been.

 

[deleted480308]

I wouldn't be proud of dismissing an entire field of science and I'm surprised so many people here are.

It's a shame when science gets politicized, but I suppose that's the way things have always been.

And if your “science” was not so politicized it would not be dismissed

 

[deleted941485]

Let them run with it. It's interesting that Medicare-For-All polls at close to 60% positive, but support drops to 37% when you tell people they will have to lose private insurance. It's a losing issue, and will definitely motive Trump voters to get to the polls.

Raise your hands if you want free healthcare...gets the whole audience to cheer lol. Health stocks lose a total of $30B. The guy is a menace and has a dedicated following. The UHC response was weak sauce and didn’t help the situation. I was debating between retraining or Leaving for industry maybe get an MBA. Guess that decision will be made for me come 2020.

 

[GeneralVeers]

I wouldn't be proud of dismissing an entire field of science and I'm surprised so many people here are.

It's a shame when science gets politicized, but I suppose that's the way things have always been.

Science typically acknowledges its limitations. Climate science doesn't seem to acknowledge their inability to accurately predict a timeline for the desire catastrophes, nor can they admit the inability to recommend viable solutions which will enact change. Signing on to these economy-altering but nonsensical agreements like Paris is insanity. I would respect them more if they had the intellectual honesty to admit the past failings of their climate models, and concede that their current predictions might be wrong as well.

 

[Birdstrike]

No but you see Venezuela didn't practice TRUE socialism. This time we can get it right! Plus.....Climate Change!!!

Lol That's right.

 

[futuredoctorwazzup]

Going back to the question of salary, I have seen a couple of studies which make it seem like EM compensation would either be cut very little or basically not at all, like the study out of UMass Amherst which states EM compensation would go down by .2%: PERI - Economic Analysis of Medicare for All. But I'm wondering whether hospitals operating at a loss overall will affect compensation? Even if the ED is drawing in about the same amount of revenue.

 

[GeneralVeers]

Going back to the question of salary, I have seen a couple of studies which make it seem like EM compensation would either be cut very little or basically not at all, like the study out of UMass Amherst which states EM compensation would go down by .2%: PERI - Economic Analysis of Medicare for All. But I'm wondering whether hospitals operating at a loss overall will affect compensation? Even if the ED is drawing in about the same amount of revenue.

It depends on your hospital and where you practice. If you are in an inner-city hospital with predominantly self-pay or medicaid then potentially could see a pay increase. At most community hospitals (where the bulk of EM physicians work) we see a large portion of insured patients. Almost certainly there will be a pay cut for those physicians if private insurance is lost.

Also once we are all paid with "Medicare for all" rates, there will be incentive by the government to control the costs of the natural explosion in utilization which comes with making something "free". The low-hanging fruit is provider reimbursement. The typical ways that governments do this:

1. Salary caps (as were tried in Canada in the early 2000's)
2. Gradual reduction in payment schedule (they already try this with Medicare as it is)
3. Quality Measures. We will see more of these arbitrary non-payment devices as the budget gets worse

If you actually read the Sanders Bills, it makes us indentured servants. Once you agree to participate in the Medicare-for-all plan, it forbids physicians from taking private money for ANY covered services under the plan. This is a terrifying bill, and every single physician should be against it.

 

[deleted836128]

It depends on your hospital and where you practice. If you are in an inner-city hospital with predominantly self-pay or medicaid then potentially could see a pay increase. At most community hospitals (where the bulk of EM physicians work) we see a large portion of insured patients. Almost certainly there will be a pay cut for those physicians if private insurance is lost.

Also once we are all paid with "Medicare for all" rates, there will be incentive by the government to control the costs of the natural explosion in utilization which comes with making something "free". The low-hanging fruit is provider reimbursement. The typical ways that governments do this:

1. Salary caps (as were tried in Canada in the early 2000's)
2. Gradual reduction in payment schedule (they already try this with Medicare as it is)
3. Quality Measures. We will see more of these arbitrary non-payment devices as the budget gets worse

If you actually read the Sanders Bills, it makes us indentured servants. Once you agree to participate in the Medicare-for-all plan, it forbids physicians from taking private money for ANY covered services under the plan. This is a terrifying bill, and every single physician should be against it.

Well said. I completely agree with you. But ... this plan ain’t gonna happen. There are enough people left in the country with common sense.

The Left is growing increasingly radical and more terrifying by the minute. The Left is swallowing ignorant people whole. But anyone with a half brain can see what our president has done for our country thus far. I am almost positive we’re getting a second term out of Trump. MAGA!

 

[miacomet]

But there isn’t anything polite about trying to force the rest of the country to live like you want them too. The pitch made by the climate change crowd is that we’ll put you in jail if you don’t do these things

Jail? I'm dying to know who said this....

 

[GeneralVeers]

Jail? I'm dying to know who said this....

Well they are going to tax people heavily for "wrong behaviors". Failure to pay those taxes/fines will result in jail time.

The threat of force is what keeps Tyranny in business.

 

[namethatsmell]

I find it amusing that people arguing against cleaner forms of energy than we currently have somehow tied their argument to the premise that economic devastation will occur.

How will the economy do when Wall Street and Silicon Valley are underwater when the ice caps finish melting?

I’d argue the stage is bring set for new entrepreneurs to revolutionize energy, like Standard Oil did over a hundred years ago.

I see no reason why capitalism and clean energy can’t co-exist.

 

[namethatsmell]

A Medicare-for-all plan is myopic and a setup for mediocrity. So many better ways to provide coverage for people without making patients and physicians cattle. I doubt it will gain significant traction, but if it does I hope no physician group supports it unless, at a minimum, there are significant medmal protections for physicians and physician satisfaction becomes a metric that hospitals have to answer to.

 

[GeneralVeers]

I find it amusing that people arguing against cleaner forms of energy than we currently have somehow tied their argument to the premise that economic devastation will occur.

I'm not sure how they link environmentalism with single payer healthcare, guaranteed jobs, free tuition etc. It's just an excuse to push through these tired old socialist dreams under the guise of "saving the planet"]

How will the economy do when Wall Street and Silicon Valley are underwater when the ice caps finish melting?

Not going to happen. I'll bet you $1,000,000 on this. Al Gore got it wrong 15 years ago, and so has every environmental prediction of doom for the past 30 years.

I’d argue the stage is bring set for new entrepreneurs to revolutionize energy, like Standard Oil did over a hundred years ago.

I see no reason why capitalism and clean energy can’t co-exist.

Agree. They absolutely can co-exist, which is why government should stay out of it. If companies can offer safer, cleaner, more efficient energy sources let them do so, and certainly they will be successful. It's not capitalism if the government is throwing out mandates, penalties, and fees, while picking the winners.

 

[GeneralVeers]

A Medicare-for-all plan is myopic and a setup for mediocrity. So many better ways to provide coverage for people without making patients and physicians cattle. I doubt it will gain significant traction, but if it does I hope no physician group supports it unless, at a minimum, there are significant medmal protections for physicians and physician satisfaction becomes a metric that hospitals have to answer to.

Never going to happen. Those on the left want single payer because it represents power for them. It would be a huge infusion of money to the government which these elected Gods-Among-Men can then distribute to their favorite classes of people. They don't care about physicians, and the trial lawyers (who are also most politicians) will make sure that there is never meaningful national tort reform.

Worst case is that we end up in a Government-run gulag where we are all indentured employees of the government with ever-decreasing salaries and continued exposure to frivolous malpractice claims.

 

[deleted480308]

Jail? I'm dying to know who said this....

Taxing things that get you jailed if you don’t pay

Banning things and activities that end up in jail if you do/use

 

[miacomet]

Taxing things that get you jailed if you don’t pay

Banning things and activities that end up in jail if you do/use

Could you be more specific? This is very vague. Citation, too please, for the penalties as stated....

 

[deleted480308]

Could you be more specific? This is very vague. Citation, too please, for the penalties as stated....

Light bulbs being banned, wood fire stoves/furnace restrictions, rain collection, lawn watering restrictions, efficiency mandates on equipment

Do you really not know these exist?

 

[GeneralVeers]

Could you be more specific? This is very vague. Citation, too please, for the penalties as stated....

Most of the environmental policies involve coercion through carbon taxes, energy taxes, fines for using too much. Failure to pay those taxes in fines results in armed men coming to your door and taking you to jail for a non-violent act.

Worse still, just thinking or saying "bad thoughts" could get you sued or in criminal court. One only has to look at several states attorney's general who are suing Exxon among other oil companies for costs associated with them contributing to "climate change".

 

[miacomet]

Never going to happen. Those on the left want single payer because it represents power for them. It would be a huge infusion of money to the government which these elected Gods-Among-Men can then distribute to their favorite classes of people. They don't care about physicians, and the trial lawyers (who are also most politicians) will make sure that there is never meaningful national tort reform.

Worst case is that we end up in a Government-run gulag where we are all indentured employees of the government with ever-decreasing salaries and continued exposure to frivolous malpractice claims.

Veers is psychic, clearly, with his 100% certainty regarding the future.
Medmal? Pretty hard to get sued as a military, VA or IHS doc already.

 

[miacomet]

Light bulbs being banned, wood fire stoves/furnace restrictions, rain collection, lawn watering restrictions, efficiency mandates on equipment

Do you really not know these exist?

I meant, can you please cite where the penalty for these things will be jail? Where are these armed men? Just inside the tinfoil hats?

 

[deleted480308]

I meant, can you please cite where the penalty for these things will be jail? Where are these armed men? Just inside the tinfoil hats?

Financial penalties are backed up with jail, that’s why they get paid.

Please don’t pretend to be ignorant of this

 

[GeneralVeers]

Veers is psychic, clearly, with his 100% certainty regarding the future.
Medmal? Pretty hard to get sued as a military, VA or IHS doc already.

I'm psychic when it comes to political reality. The Democrats will never even waste their time with a more moderate healthcare proposal. They've sunk all their chips in the Medicare-For-All slot machine and aren't looking back. The trial lawyers, who donate a whole lot of money to political campaigns and own most of the Democratic politicians aren't going to stand idly by while their golden goose gets cooked. The Military, VA and IHS represent a tiny fraction of healthcare. It's terrifying to think of the VA or even worse IHS models get expanded to the entire country in exchange for a bit of legal immunity.

 

[VA Hopeful Dr]

I meant, can you please cite where the penalty for these things will be jail? Where are these armed men? Just inside the tinfoil hats?

Do you not understand how taxes and fines work?

 

[GeneralVeers]

I meant, can you please cite where the penalty for these things will be jail? Where are these armed men? Just inside the tinfoil hats?

I'm confused as to how you don't know how taxes and the law works.....I suggest you avoid paying income tax this year and see what happens.

 

[miacomet]

I'm confused as to how you don't know how taxes and the law works.....I suggest you avoid paying income tax this year and see what happens.

Can you give me a link to these proposals, please?

 

[miacomet]

Financial penalties are backed up with jail, that’s why they get paid.

Please don’t pretend to be ignorant of this

So, send me a link to this proposal, please.
And show me the science debunking climate change.
All ears and eyes!
Anything on vaccines while you are at it?

 

[GeneralVeers]

So, send me a link to this proposal, please.
And show me the science debunking climate change.
All ears and eyes!
Anything on vaccines while you are at it?

Democratic platform with carbon taxes:

A carbon tax should be the centerpiece of the Green New Deal

The actual amount of taxes, and what will be taxed varies by individual proposal. There are almost as many bills as there are socialists in the caucus.

As for global warming, it's impossible to prove a negative. Anyone who says they know what the climate is going to be like in 10 years has an incredible amount of hubris. The climate is influenced by millions of factors, only some of which we can account for and model. I'm going on the fact that "climate scientists" have been continually wrong about their changing predictions since at least the 1960's. There's no reason to think that we've suddenly nailed the science and developed a perfect model now that can tell us where we are headed in 10 years time. In fact, statistically it's a good bet to believe the OPPOSITE will happen based on the 0% track record at predicting climate apocalypse over 40 years. Whatever their ridiculous predictions, it's certainly not enough evidence on which to destroy our economy, change our way of life, and condemn billions of people to war and poverty.

Doug Casey and E.B. Tucker on the Climate Change Hoax, Part 1 - Casey Research

This article nicely explains some of the cognitive issues associated with these end-of-the-world concluusions.

 

[deleted480308]

So, send me a link to this proposal, please.
And show me the science debunking climate change.
All ears and eyes!
Anything on vaccines while you are at it?

What proposal are you talking about?

And seriously, answer straight. Do you not know that refusing to pay fines ends up with jail?

 

[namethatsmell]

I'm not sure how they link environmentalism with single payer healthcare, guaranteed jobs, free tuition etc. It's just an excuse to push through these tired old socialist dreams under the guise of "saving the planet"

Yup those claims are ridiculous. As equally ridiculous as saying the sum total of protecting the environment = destroying the economy.

Not going to happen. I'll bet you $1,000,000 on this. Al Gore got it wrong 15 years ago, and so has every environmental prediction of doom for the past 30 years.

I agree his time frame was off. It doesn't change the fact that ice is melting and sea levels are rising. There's no way to spin this. If the trend continues (~1/8"/yr per NOAA) it will probably be in the latter half of this century that the US starts to feel the pain of losing parts of land and cities to the sea. This will not improve our economy.

Agree. They absolutely can co-exist, which is why government should stay out of it. If companies can offer safer, cleaner, more efficient energy sources let them do so, and certainly they will be successful. It's not capitalism if the government is throwing out mandates, penalties, and fees, while picking the winners.

Yeah, the government isn't perfect but it is capable of enacting economic policies that benefit society without crashing the economy: ending child labor, enforcing (albeit anemic) financial penalties on entities that overtly pollute the environment, taxing the s**t out of cigarettes and restricting smoking in restaurants, etc. I think we'll have to agree to disagree, but I don't think the fed should totally stay out of this. For example, I like the idea of the government giving tax breaks to companies that try to develop methods of clean/renewable energy.

 

[namethatsmell]

Never going to happen. Those on the left want single payer because it represents power for them. It would be a huge infusion of money to the government which these elected Gods-Among-Men can then distribute to their favorite classes of people. They don't care about physicians, and the trial lawyers (who are also most politicians) will make sure that there is never meaningful national tort reform.

Oh I agree it very unlikely. There's no precedent for this to happen. Physicians, as a group, are terrible at representing our own interests. However, if a true single-payer system were to start to form I could see a glimmer of hope we'd fight for some protections. Even the spineless AMA may join this fight when the fed rips their precious ICD monopoly away from their small shriveled hands.

Worst case is that we end up in a Government-run gulag where we are all indentured employees of the government with ever-decreasing salaries and continued exposure to frivolous malpractice claims.

Agreed. If this happens I could envision the following: many doctors would leave medicine, the midlevels would "rise" to meet the occasion, and health outcomes (oh those precious outcomes) would take a nose dive. Then after a period of adjustment, new "outcome metrics" (ie "how many times did you smile when you met with your "provider?") would appear to account for the brain drain and the bar graphs the admins feed on would look pretty again.

 

[namethatsmell]

Light bulbs being banned

My understanding is that incandescent bulbs are not banned. They are phasing out inefficient incandescent bulbs but energy efficient incandescent bulbs are A-OK. Is this incorrect?

Have people been arrested for their light bulbs?

 

[southerndoc]

Veers is psychic, clearly, with his 100% certainty regarding the future.
Medmal? Pretty hard to get sued as a military, VA or IHS doc already.

Are you stating that with Medicare-for-All, it would be much harder to sue? If that were the case, wouldn't it already apply to Medicare patients already? Unless we are employed by the government, this would not apply.

 

[deleted480308]

My understanding is that incandescent bulbs are not banned. They are phasing out inefficient incandescent bulbs but energy efficient incandescent bulbs are A-OK. Is this incorrect?

Have people been arrested for their light bulbs?

Don’t play dumb. The ban was on the manufacturing. And if a company refused to stop and kept going there would absolutely be fines and police to enforce them with jail

 

[Dr Mantis Toboggan]

My fear is that they will restrict testing severely (make it much harder to get a CT) while we are still responsible for any bad outcomes for not ordering said testing.

Are you stating that with Medicare-for-All, it would be much harder to sue? If that were the case, wouldn't it already apply to Medicare patients already? Unless we are employed by the government, this would not apply.

 

[Birdstrike]

My fear is that they will restrict testing severely (make it much harder to get a CT) while we are still responsible for any bad outcomes for not ordering said testing.

Under a medicare for all scenario, the government would have no need whatsoever to restrict testing or treatments such as CTs or procedures. They don't even bother to now. That's the private insurers that do that; the Blue Crosses, United Healthcares, etc. The government just cuts how much they pay for a given service. And they don't need an act of congress or the president's signature to do it. The director of CMS, under Dept of Health & Human Services can and they do, on a yearly basis (November every year). Why restrict the number of CTs to half, when you can simply cut how much you'll pay for CTs in half? There's no reason to. And the only reason the private insurers don't, is because they depend more on keep the number of network doctors and policyholders up there. If they cut what they pay, they lose participating doctors, then ultimately lose customers if they can't find in network doctors. The government doesn't care about that. They get their money through tax law, not by persuading people to buy policies or through gaining "customers."

For government insurers, cutting the fee is much easier than enforcing some new set of restrictions on tens of thousands of doctors. They'd have even more power to do this, if Medicare had 100% (or close to it) as opposed to the 15% market share they have now. Of course, doctors would be completely screwed in that scenario, because without any higher private insurance options to select out, the government has a 100% monopoly to crush your fees and therefore your pay. If 100% of people were on medicare, and suddenly the government cut payment for EM physician evaluations and procedures by 20%, your employer's next move, effective immediately upon their next emergency board meeting is to cut your pay 20%. And yes, you'd still be 100% responsible for any CT results or bad outcomes, not 20% less responsible.

 

[GeneralVeers]

For government insurers, cutting the fee is much easier than enforcing some new set of restrictions on tens of thousands of doctors. They'd have even more power to do this, if Medicare had 100% (or close to it) as opposed to the 15% market share they have now. Of course, doctors would be completely screwed in that scenario, because without any higher private insurance options to select out, the government has a 100% monopoly to crush your fees and therefore your pay. If 100% of people were on medicare, and suddenly the government cut payment for EM physician evaluations and procedures by 20%, your employer's next move, effective immediately upon their next emergency board meeting is to cut your pay 20%. And yes, you'd still be 100% responsible for any CT results or bad outcomes, not 20% less responsible.

Under the Medicare-For-All proposals, participation is mandatory as there will be no private insurance. Additionally if you sign on to Medicare-For-All it is illegal to provide "covered services" with any other payment including cash. Effectively the government would have an instant monopoly and outlaw all alternatives.

This is how you get to EM docs being paid $66K/year like in the UK.

 

[southerndoc]

Under the Medicare-For-All proposals, participation is mandatory as there will be no private insurance. Additionally if you sign on to Medicare-For-All it is illegal to provide "covered services" with any other payment including cash. Effectively the government would have an instant monopoly and outlaw all alternatives.

This is how you get to EM docs being paid $66K/year like in the UK.

And that is when you'll see half the EM force leave for greener pastures. Urgent care would pay more than $66k/yr.

 

[Birdstrike]

Under the Medicare-For-All proposals, participation is mandatory as there will be no private insurance. Additionally if you sign on to Medicare-For-All it is illegal to provide "covered services" with any other payment including cash. Effectively the government would have an instant monopoly and outlaw all alternatives.

This is how you get to EM docs being paid $66K/year like in the UK.

Simply disastrous.

 

[GeneralVeers]

And that is when you'll see half the EM force leave for greener pastures. Urgent care would pay more than $66k/yr.

You couldn't. Under Medicare-For-All urgent care services are "covered" so you are subject to Medicare rates and all the regulations therein.

There is no provision for private medical services unless something isn't "covered". Even then if you take cash pay for something, the government requires you to fill out a form explaining why you are taking cash for a services. Very frightening stuff indeed.

As Birdstrike says, there wouldn't be rationing per se, but rather just drastic cuts to reimbursement when there are inevitable cost overruns.

 

[TooMuchResearch]

You couldn't. Under Medicare-For-All urgent care services are "covered" so you are subject to Medicare rates and all the regulations therein.

There is no provision for private medical services unless something isn't "covered". Even then if you take cash pay for something, the government requires you to fill out a form explaining why you are taking cash for a services. Very frightening stuff indeed.

As Birdstrike says, there wouldn't be rationing per se, but rather just drastic cuts to reimbursement when there are inevitable cost overruns.

Couldn't I just completely opt out of insurance? I.e. cash pay urgent care? With an actual menu of services.

 

[GeneralVeers]

Couldn't I just completely opt out of insurance? I.e. cash pay urgent care? With an actual menu of services.

Probably not. The text is vague on this point, but from what I understand the key points are as follows:

1. Everyone in the country would have MANDATORY participation in Medicare-For-All and pay the huge tax increases
2. Private insurance is not allowed on "covered services", meaning 99% of current medical care.
3. Every doctor could choose whether or not to enroll. Given that 100% of the population will be covered and there will be almost no private insurance they essentially will have no choice. Emergency Physicians would have no choice and would be indentured servants as the hospitals would take Medicare
4. Doctors who enroll are not allowed to take any payment other than Medicare for covered services.
5. A waiver is needed by the government for any participating doctor to take cash for a non-covered service

What's unclear in the bill is how this would affect cash payments to non-enrolled doctors for "covered services". It probably will be illegal for people covered under Medicare to pay cash for "covered services" but the bill doesn't really answer this particular scenario.

If this ever came to pass, I would suspect we would see all-private hospitals spring up along the Canadian/Mexican borders to service only Americans who can afford to pay cash pay for covered services. It would certainly be ironic to see wealthy Americans going to other countries for care. A reversal of how it works in Canada now.

 

[DrGasPasser]

Couldn't I just completely opt out of insurance? I.e. cash pay urgent care? With an actual menu of services.

In a true “single payer” system - no. It is illegal to accept cash payments. My wife’s family is Greek and spends 1/3 of the year in Laconia. Black market “tips” are customary in the villages if you want good care.

Anyway, the CBO scored this BS last week. A single payer system would essentially double our budget with an extra $3T needed per year. Keep in mind that we have a $1.0T shortfall on our current budget every year, so doubling everyone’s taxes wouldn’t work. Making matters worse, the CBO said there was a reasonable chance that such a system would increase costs; so much for the savings we would get by eliminating those evil insurance companies. Then, there is that pesky problem of 1 million insurance employees being suddenly displaced from their jobs once their industry becomes illegal.

 

[namethatsmell]

Don’t play dumb. The ban was on the manufacturing. And if a company refused to stop and kept going there would absolutely be fines and police to enforce them with jail

You’re insinuating the government is going crazy and banning light bulbs. It’s like saying the government was trying to ban cars when they required new cars to come with catalytic converters, which of course they were not.

Which one of us is playing dumb?

Or do you sincerely long for the days when Americans could fill up their cars with leaded gas?