Listen, just wanted to let you know that, even though I dropped my registration from the party I'm still paying attention. Of course, I'm in New York, my de-Democrating won't officially take place until next year after the presidential election, so we are stuck with each other, at least on paper.
Yeah, I'm still paying attention, even though many people aren't. I mean, I watched both of the televised talk shows this week - debates, I think you called them? I not only watched, but I live-commented them for people, so I'm more than doing my part, I think.
And I need you to do your part, too. So, let's talk about health insurance, shall we?
Most of the candidates indicated in the debates that they supported Medicare for All. Well, guess what? That's a non-starter for me and for lots of other people - not just Democrats, but also disaffected Trump voters. Do you really want to throw those votes away?
I mean, think about it:
- You fought tooth and nail to get the Affordable Care Act passed, and now, a mere 10 years later, you're willing to throw the baby out with the bath water, instead of fixing the parts that need fixing? And can any of you articulate what those parts are, or haven't you looked?
- Employer sponsored insurance is some of the best insurance around, and good companies are happy to be able to provide it as a way to attract good talent in an increasingly competitive employment market.
- Union-sponsored insurance, purchased from and administered by private insurance companies, has long been a selling point for the unions that you all take money from, and helps support those union jobs you all think everyone needs to have. How attractive do you think unions will be when you strip away their biggest benefit?
- Do you realize how low Medicare reimbursement rates are? If doctors were required to rely solely on those payments, many would not be able to stay in practice. So, either those rates have to go up significantly, or we'll see hospitals and clinics and medical practices start to close, or we'll see them demand ever-larger shares of state and local taxpayer dollars in order to maintain financial viability. I say ever larger shares, because many of the country's hospital systems already receive a significant amount of taxpayer support. Oh - and insurance company support, don't forget - you know, fees like the ones paid here in NY that add 10% or so to the cost of claim payments on the insurer's side alone. And since our middle-class tax dollars are not unlimited, and will already be going up to pay for Medicare for All, will you be taxing the rich to get the financial support to keep these services running?
- Private insurers are leaders in community health initiatives, charitable giving, and supporting innovators - they are cornerstones of their communities. When you relegate them to performing breast implants and Botox injections, the negative consequences will ripple throughout our communities, large and small. What's your plan for that? Taxing the rich again?
- What will happen to the 500,000 people in the industry? How are you going to make up those salaries, or find everyone jobs paying comparable salaries and offering comparable benefits? What's the plan for that? I know, raising taxes again, or giving everyone a monthly stipend or something.
- How many more people will have to be added to the federal government payroll to support the administration of Medicare for All? How much will those low Medicare admin costs increase to accommodate all of the additional employees, increased tech costs, higher reimbursement rates, and so on? And who will be picking up that cost, middle class tax payers, or the 1%?
- One of the complaints about the ACA was that it did nothing to address the doctor shortage, particularly in the areas of primary care, geographic access (particularly in rural areas), and mental health. This is an ongoing issue with Medicare today. How does Medicare for All address that, or address other known issues with Medicare programs? Are you just going to throw people from one insurance plan to another and not address the issues first?
- In 2018, according to the Henry J Kaiser Family Foundation, about one in three Medicare beneficiaries was enrolled in a Medicare Advantage plan, and enrollment in these plans, many of which offer richer benefits at a lower cost that original Medicare, has doubled in the past 10 years. These plans are administered by private insurers, which means you're going to throw those away too, even though they may be more cost effective? So, not only are you taking private insurance away, but you're also taking Medicare away? Good luck with that!
- And help me understand this part. Pension and retirement funds are heavily invested in insurance company stock. What happens to all of that? How are those investments, which (again) benefit the middle class, going to be protected? What's the plan for that aspect of eliminating private insurance?
One more thing. Most of the candidates at the debates said they would provide health insurance to undocumented immigrants under their plans. Are you nuts?
Are you that out of touch with what people really think? And have you forgotten that we've spent 10 years fighting Republican lies about undocumented immigrants being eligible for insurance under the ACA?
That's a lie that will not die -- and now you're going to make it a truth? Do not conflate health insurance and immigration. I promise you, that's something that we all will regret.
That's a lie that will not die -- and now you're going to make it a truth? Do not conflate health insurance and immigration. I promise you, that's something that we all will regret.
Please, do not spend this long primary season trying to out-left each other to get the nomination and then spend the general election season tacking right to try and pick up us middle-of-the-roaders.
It won't work. No one will believe you that you didn't mean what you said during the primary, nor will they trust anything you say if you change your stripes for the general.
Don't blow this.
Don't. Blow. This.
