So...unlike Bernie Sanders and Elizabeth Warren in 2020, El Sayed does NOT have a set in stone healthcare plan. However, after watching a Secular Talk video today, El Sayed said that he doesn't plan on banning all private insurance. This brings him closer to my own stance on paper. At this point I support a public option due to costs, specifically the medicare extra for all framework, although my moderation is driven by my support for UBI and its costs not being affordable along side full blown single payer. So I decided to delve into what his plan actually seems to be.
So it seems like he doesn't support full on single payer, he emphasizes he doesnt wanna ban all private insurance. Mainly because unions get pissy about it. "I EARNED my private insurance benefits blah blah blah." Not gonna lie, love unions, but unions do stupid stuff like this all the time. Their ideology is ruined by jobism and fixation on work and jobs, when we should be trying to break that obsession. M4A is a step in that direction.
Still...given my own compromises, I can get behind it. THere are downsides to not having ANY private options. Not just high costs but what if republicans wanna ban access to say, abortion? They could do it through the healthcare system. Having a multi payer system could mean we dont put all of our eggs in one basket. It also makes things cheaper, which is my angle.
Which brings me to other aspects of this. What exactly IS his plan? Well, it seems like he wants to eliminate all out of pocket costs. This goes further than I would. medicare extra for all does maintain a system of premiums, copays, and deductibles. However, it reduces them to managable levels. I'm willing to accept this because those things will scale with income, meaning those on the poor end of things still get free healthcare, while those who are higher income pay increasingly more as their incomes go up. Of course, given this exists along side UBI, most people would benefit in net under this plan vs just M4A. The extra income your typical family would get would offset higher out of pocket healthcare costs and then some.
Honestly, people will pay for healthcare under either system. Premiums and taxes start looking kind of similar when discussing the ins and outs of universal healthcare plans. Just different ways of paying. The right screams about higher taxes, the left screams about out of pocket costs. The real key is, who pays what? The right wants a market based system tied to employment that doesnt guaranteed access. The left wants a socialized system that guarantees access and offloads some costs onto the wealthy while guaranteeing free/cheap access to others. All in all, universal healthcare systems are generally better in my view, but this is very much ideological. Which is why I took a jab at the union guys too. They want to preserve market based employment linked healthcare because of their jobist tendencies. I want a more universalist system in theory, but I'm willing to accept some compromises so I can fund other projects.
Speaking of which, how much will El Sayed's plan cost? Without any solid plans, it's hard to tell. The general gist is probably "more than medicare extra for all, less than single payer." Single payer would cost an additional $3 trillion a year at this point, with a total healthcare bill to the government being $5 trillion. Its why I backed off of it. Im already supporting a $4.6 trillion UBI plan, so I went with a cheaper medicare extra for all idea, which would cost $300-600 billion give or take. Maybe a bit more with inflation. Honestly, and this is the rub. The more you cover, the more expensive it gets for the government. The reason medicare extra for all has so many variables is different structures of coverage for different income groups. Medicare extra for all covers 80-100% costs depending on the plan and the income bracket. THe more that's covered, the pricier it gets. The more people you cover, the pricier it gets. And the better the public plan is vs private plans, the more people go on the public plan, and the pricier it gets. Due to these variables, it's hard to get an idea on costs. I'm imagining it would expand healthcare costs by over a trillion, assuming it covers all healthcare for roughly 2/3 of the country though.
Maybe this guy doesnt wanna put anything in stone because of political backlash, or the uncertainty of whatever plan would end up making it through congress. THere are a lot of possible plans out there, and the details of which would have to be hashed out in congress.
Either way, if theres anyone who knows more about this issue than me, its this guy, he literally wrote the book on the subject, and having read it, yeah, he's well familiar with all of the stuff im talking about and the options we have. Still, being a bit of a policy wonk myself, I would like to have some concrete ideas here.
I just wanted to discuss this since he seems a bit more moderate than full blown medicare for all, but still more radical than I am on the subject, given my preferred plan accepts some level of out of pocket costs.
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