An unlimited promise of free and a budget are simply not compatible.

Anything is possible, even getting people to accept the impossible. Following are a few excerpts from a recent Wall Street Journal editorial concerning Sen Warren’s proposals for changing America. There is something appealing to everyone which I suppose is the intention.

I have selected only two of the proposals for comment.

Medicare for All tax: Charge com­pa­nies with at least 50 work­ers an “Employer Medicare Con­tri­bution,” equal to 98% of their re­cent out­lays on health care, while ad­just­ing for in­fla­tion and changes in staff size. These varying fees “would be grad­u­ally shifted to con­verge at the av­er­age health care cost-per-employee na­tion­ally.” Es­timated rev­enue: $8.8 tril­lion over a decade. If receipts fall short, add a “sup­ple­men­tal” tax on “big com­pa­nies with ex­tremely high ex­ec­u­tive com­pen­sa­tion and stock buy­back rates.”

Say what? Employer plans with their deductibles and co-pays/co-insurance and networks cost far less than any plan without such things not to mention any provider, any care suggested no questions asked as promised by M4A. In other words, receipts are guaranteed to fall short. And, what has executive compensation to do with any of this; it’s pandering.

Medicare for All: Mandate gov­ern­ment cov­er­age for every­one, in­clud­ing for il­le­gal im­mi­grants, with no co­pays or de­ductibles. Phase out the pri­vate plans of 170 mil­lion Amer­i­cans. She says this would cost $20.5 tril­lion over a decade, which most econ­o­mists say is $10 tril­lion short of re­al­ity. Keep the growth of health spend­ing be­low 4% a year with tools like “pop­u­la­tion-based bud­gets” and “au­to­matic rate re­duc­tions.”

Say what? “pop­u­la­tion-based bud­gets” and “au­to­matic rate re­duc­tions.” Think about those words. What do you think that means? What do you think it means when you fit an open-ended promise for “free” health care into a budget? What do you think are the consequences of rate reductions? Do you seriously believe that either can be accomplished without changing how health care is delivered in America, without creating shortages, cost/benefit analysis requirements, increased wait times? An unlimited promise of free and a budget are simply not compatible.

Pay doctors at “Medicare rates” and hos­pi­tals at 110% of that. This means cut­ting pay­ments 25% or more rel­a­tive to pri­vate in­sur­ance, per the Mer­ca­tus Cen­ter’s Charles Bla­hous. Trim rates fur­ther on “over­paid spe­cialties.” To save 70% on branded pre­scrip­tions, “ne­go­ti­ate” with drug mak­ers by threat­en­ing ex­cise taxes and “pub­lic man­u­fac­tur­ing” af­ter “over­rid­ing the patent.”

Say what? So, you think doctors are overpaid? Relative to who, a college professor, member of Congress, college football coach or union leader?

SOURCE: https://www.medscape.com/slideshow/2019-compensation-overview-6011286?src=WNL_physrep_190410_comp2019&uac=37831BZ&impID=1933305&faf=1#3

And, if you cut reimbursement rates, what might happen to utilization rates, especially in the promised “no interference between you and your doctor” environment?

Negotiating with threats is hardly negotiating. Is it possible to cut prices by 70% without consequences? I doubt it. And, those consequences are probably world-wide.

So­cial Se­cu­rity: Increase ben­e­fits by $2,400 a year across the board. Raise them fur­ther “for lower-in­come fam­i­lies, women, peo­ple with dis­abil­i­ties, pub­lic-sec­tor work­ers, and peo­ple of color” by chang­ing “out­dated” rules that Ms. War­ren says dis­ad­van­tage them.

Pay for this by lift­ing the 12.4% So­cial Se­cu­rity pay­roll tax, which to­day cov­ers wages be­low $132,900, to 14.8% on wages above $250,000. Es­tab­lish a matching 14.8% sur­charge on net in­vest­ment in­come, paid by those earn­ing more than $250,000.

Say what? Nothing much, just throw the basic concept of funding Social Security out the window and turn it into a welfare program. Much can be done via tax laws to improve our retirement system while relying on the actions and initiative of American workers, but why bother, just have government make all our decisions. And what happened to the Social Security 2100 Act? which is still worth consideration.

Elizabeth Warren Has a Plan, Oh My Wall Street Journal

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