The not-so-secret reason the business community is fighting single payer in the US is because 18-20% of our economy depends on the healthcare industry. A good portion of that is paper shuffling, marketing, accounting, and related middle/upper management -- they would serve no purpose in a system where you show up with identification, prove you're a citizen, and then get healthcare. So single payer means maybe 8-10% of the country is out of a job.
That's why Medicare/Medicaid is cheaper per person even though they serve the poor and elderly.
Sometimes I wonder if the way to make changes in these sorts of industries (with a powerful rent seeker that prevents change... e.g. health insurance, tax prep, etc) is to bite the bullet and just agree to bribe them... say, "we are winding down private insurance... we will pay you guys what your profit has been each year, diminishing each year, for the next 10 years. You can take that money and try another industry."
It might seem expensive and wasteful, but it might be better than the status quo.
That's how Japan abolished the samurai. The Meiji emperor promised very generous pensions to all samurai if they turned in their swords and retired.
A few years later, there was a budget crisis and the government cut the pension to a fraction of what was agreed on. But the ex-samurai were too demobilized to overthrow it by then.
Not trying to draw too much of a comparison here, but Britain did this when they formally abolished slavery. It's still very controversial today, but it did thwart the opposition to abolition among Parliament's pro-slavery lobby and plantation owners, particularly in the Caribbean. Paying off health insurers for years' worth of profits would be very expensive, but on the flip side I doubt it would be as unpopular as the slavery payments.
Probably applies to other cases as well. I think many people would be ok with "ok Disney, you have Mickey mouse exclusivity for 200 years if you stop messing with copyright extensions".
I believe that's called a transition period and we saw how it worked with Obama care.
We could also drag the obstructionist leeches into the capital and roast them like Jim gaffigan just roasted Karen.
When someone's abusing an entire country you don't pay them to stop, you throw them in jail. People are dying are dying by the truckload and we care about
Insurance companies are already making money from Medicare, and not just on Medicare Select. The Feds pay the bills, but there are 5 regional contracts under which private insurance companies actually administer Medicare.
If you work for a large company it’s pretty much the same thing. Your employer brings a risk pool and then a private insurance company like Cigna quotes for how much it takes to “fill” it while taking their vig.
I would expect the same under M4A: 5 really big insurance companies would continue to cost-plus bill the Feds, and then maybe there would still be a few re-insurance companies to cover stuff M4A doesn’t cover.
My mom worked very hard and well for a company that administered benefits for union employees. The way that things worked would be that if you worked at least a certain number of hours in January you would have medical insurance coverage in March. But not February. If you worked the required number of hours in February, you'd be covered for April. And so on.
In going through her things after she died, I found letters to her bosses about how well she'd treated the plumbers, electricians, etc. I know she would take work home and do it off the clock.
What was really unfortunate, for me, is believing that her job shouldn't exist. To me it's crazy the expenses we have a universal healthcare system.
Of course, that also applies to avoiding taxes, etc. There was an attorney interviewed on a recent podcast about tariffs - he specialized in finding things like shipping bikes from China without tires and the tires from Vietnam would be much less in tariffs than just shipping from China.
Medicare for all wouldn't put 10% of the population out of a job. Not even close. Also, Medicare/Medicaid are cheaper primarily because they pay providers a lot less than private insurers for the same service.
> Also, Medicare/Medicaid are cheaper primarily because they pay providers a lot less than private insurers for the same service.
Do you have numbers to back this up? I'm not saying you're wrong, but my mom worked for a GP for ~20 years (recently retired) and listening to her talk about it this was not true for her employer at all. She said that in many cases the private insurer paid less, and on top of that required more back and forth to get claims addressed.
They work in small businesses or for themselves[1] because they don't have to worry about health insurance. Or they become a teacher[2]. Or they don't have to work at all because they are raising kids or getting a better education - again, because they don't have to worry about health insurance.
Eventually, they would join other parts of the economy in the US, but in the short term, the unemployment rate would spike and the economy in general would suffer.
> Eventually, they would join other parts of the economy in the US, but in the short term, the unemployment rate would spike and the economy in general would suffer.
And if an administration managed to get this through in the beginning of their first term, they'd never get re-elected, and most of the Congresspeople who supported it would be out as well. The next group voted in would dismantle it and put things back the way they were.
Any plan to dismantle the US private insurance industry will need to ensure a very soft, cushy landing for the people employed in that industry, or it'll never work.
Hopefully something more useful but the point is that nobody wants to be the administration that created 10%+ unemployment overnight and the ensuing ripples.
That's why Medicare/Medicaid is cheaper per person even though they serve the poor and elderly.