Peter Morici — Opinion: Bernie Sanders's Medicare for all is a fool's journey

The looming debate. The American public overwhelming wants changes. Now the debate begins in earnest (again) over how to structure this reform. While this article takes a negative angle, it lays out some of the key issues that will be prominent in the ensuing debate.

What MMT has to contribute is understanding of how real resources economically and competing interests politically are the actual issue, whereas the financial issue of affordability is a non-issue for a government that funds itself through currency issuance.

The real resource issue is, well, real. There are only so many existing medical resources and vastly increasing the number drawing on them would result in some bottlenecks. However, this issue can be addressed in a fairly short time — five to ten years — by public investment in expansion. Some of this could required repurposing existing resources now being used on lower priority tasks.

The political issue is knotty is that all economic choices involve tradeoffs owing to opportunity cost. This comes down to winners and losers depending on the constituencies favored by a policy. Making everyone better off and no one less well off is often not possible, given the exigencies of distribution, including availability of real resources and how they are regulated.

In addition, universal health coverage and tuition-free education, and a universal guarantee of a job offers would likely require changing tax policy unless other spending, like military deemed unnecessary or wasteful would be reduced.

Anyway, the debate is now engaged and some of the issues are on the table explicitly.

As it tutns out, Stephanie Kelton anticipated this debate on a paper with Alla Semenova, Health Care Reform, Universal Coverage and Financial “Basics” A Functional Finance Perspective (August 2008).

MarketWatch
Opinion: Bernie Sanders's Medicare for all is a fool's journey
Peter Morici

Duncan Green — The Economist comes out in support of Universal Health Care – here are the best bits

This week’s Economist magazine leads on the case for Universal Health Care, worldwide. That’s a big deal – the Economist is very influential, can’t possibly be accused of being a leftie spendthrift, and the case it makes is powerful. A couple of non Economist readers asked me for a crib sheet of the 10 page report, so here are some of the excerpts that caught my eye:

Universal health care on the table, a raging debate over basic income or job guarantee — the frame is shifting rapidly. Apparently, TPTB are becoming concerned that the natives are getting restless over rising inequality and increasing precariousness.

Oxfam Blogs — From Poverty to Power
The Economist comes out in support of Universal Health Care – here are the best bits
Duncan Green, strategic adviser for Oxfam GB

Jack Peat — Some of the best healthcare systems in the World are publicly funded, the NHS just isn’t one of them

Donald Trump today used the NHS as a reason not to push for Universal Health Care in the US.

The President pointed to demonstrations yesterday in the UK with thousands of Brits taking to the streets to protest the poorly run system.

But even though Trump might have a point about the UK, he doesn’t have a leg to stand on in regards to publicly funded health care systems.

Indeed, many people have pointed out that some of the best healthcare systems in the World are publicly funded....

The London Economic
Some of the best healthcare systems in the World are publicly funded, the NHS just isn’t one of them

Jack Peat

Ryan Grim — The Obamacare Fight Is Over — Now It’s On To Universal Medicare

The train is pulling out of the station.

The Intercept
The Obamacare Fight Is Over — Now It’s On To Universal Medicare
Ryan Grim

Also

Bernie’s Army: 24 Organizations With Millions of Members Vow To Help Pass His Universal Medicare Plan
Zaid Jilani

Pharma CEO Worries Americans Will Say “Enough is Enough” and Embrace Bernie Sanders’ Single-Payer Plan
Lee Fang

Ed Dolan — Universal Healthcare Access is Coming. Stop Fighting It and Start Figuring Out How to Make It Work.

Fairly detailed analysis of the issues involved in a transition to universal access to health care in the US.

Ed Dolan's Econ Blog
Universal Healthcare Access is Coming. Stop Fighting It and Start Figuring Out How to Make It Work.
Ed Dolan

Robert Waldmann — Diabetes Diagnoses Surge in States Which Expanded Medicaid

Another life-saving and cost-reducing no-brainer. Cutting medical costs and related costs, which are much higher than medical cost to society, involves increasing availability and use of medical care not limiting it or using less. Early care and preventive care costs far less than later and more complicated care. 

In addition, there are three aspects of health care — treatment, prevention, and perfection — in declining order of expense. An ideal society aims at achieving perfect health for its members first and foremost, and then focusing on prevention, and finally treatment as a last resort.

Angry Bear
Diabetes Diagnoses Surge in States Which Expanded Medicaid
Robert Waldmann | Professor of Economics, University of Rome

Michael McAuliff — Bernie Sanders Got Republicans To Make His Argument For Universal Health Care

Hit them on competitiveness, they don't understand compassion.

But Bernie hasn't yet brought out the big guns — the MMT principles showing that "affordability" is never the issue when real resources are available.

The Huffington Post
Bernie Sanders Got Republicans To Make His Argument For Universal Health Care
Michael McAuliff

TASS — Moscow doctors demand healthcare system be more effective, accessible

Speaking at the rally, doctors expressed worries that the system of healthcare optimization could prevent citizens from receiving professional medical assistance on the immediate and free basis

TASS Russian News Agency
Moscow doctors demand healthcare system be more effective, accessible

Jeffrey Hutton — Indonesia launches world’s largest health insurance system

Indonesia is planning to phase-in the world’s largest single-payer health care insurance program between now and 2019. Under the new system, the government is committed to providing universal health care to its 247 million citizens, though employers and wealthier citizens are obliged to pay their own premiums.

"Indonesia goes socialist!" Or, US goes third world?

Christian Science Monitor
Indonesia launches world’s largest health insurance system
Jeffrey Hutton, Contributor

John Perr — Why the U.S. Should Treat Health Care Like a Utility, Not a Market

Let's start with the conservative free-market nirvana, where buyer and seller each armed with perfect information come together in a voluntary transaction. But from the get-go, the patient-as-consumer faces a knowledge asymmetry almost impossible to overcome. Americans' general deference to physicians isn't just a cultural trait, it simply reflects the expertise and training regarding diagnoses, possible treatments, and likely outcomes doctors possess and their patients do not. For some cases and for some conditions, the layman can narrow that yawning information gap. But WebMD or no, it can't be eliminated. "Health" is not a commodity. Those who believe that choosing a health care product or service is no different than buying a car, television, or cell phone might feel differently after, say, developing colon cancer.

But even if the diagnoses, treatments and cures for heart disease, diabetes or depression could be purchased in a free market, in the United States the buyer simply doesn't--or--can't know what price he or she will pay. As Stephen Brill documented in March ("Bitter Pill: Why Medical Bills Are Killing Us"), hospital prices for drugs, supplies, and procedures are completely opaque. The answer from the so-called "charge master" about what anything costs depends on whether the patient is insured or uninsured (the latter often forced to pay multiple times more than the former) and who the insurer is. As it turns out, that mystery pricing is one of the hallmarks of the American model that spends $2.8 trillion a year (over 17 percent of GDP) on health care, more than Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain, and Australia combined….

Perrspectives
Why the U.S. Should Treat Health Care Like a Utility, Not a Market
John Perr

Valerie Bauman — Gen. Colin Powell calls for universal health care in the U.S.

“I am not an expert in health care, or Obamacare, or the Affordable Care Act, or however you choose to describe it, but I do know this: I have benefited from that kind of universal health care in my 55 years of public life,” Powell said. “And I don’t see why we can’t do what Europe is doing, what Canada is doing, what Korea is doing, what all these other places are doing.”

Puget Sound Business Journal

Gen. Colin Powell calls for universal health care in the U.S.

Valerie Bauman | Staff Writer

Interesting that this has not hit the mainstream media, although it all over rightwing blogs criticizing Powell as a RINO, as well as Daily Kos on the left.

John Perr — The Real Reason for the GOP's All-Out War on Obamacare

At its core, the Republicans' scorched-earth opposition to Obamacare has never been so much about "freedom" or "limited government" or any other right-wing ideological buzzword as it has been about political power, pure and simple. Now as for the past 20 years, Republicans have feared not that health care reform would fail the American people, but that it would succeed. Along with Social Security and Medicare, successful health care reform would provide the third and final pillar of Americans' social safety net, all brought you by the Democratic Party. To put it another way, the GOP was never really concerned about a "government takeover of health care", "rationing", "the doctor-patient relationship" or mythical "death panels," but that an American public grateful for access to health care could provide Democrats with an enduring majority for years to come.

But what Utah Senator Orrin Hatch called a "holy war" to block health care reform didn't start when Barack Obama took the oath of office in January 2009, but instead when Bill Clinton was inaugurated in 1993. It was then that former Quayle chief of staff and Republican strategist William Kristol warned his GOP allies that a Clinton victory on health care could guarantee Democratic majorities for the foreseeable future. "The Clinton proposal is also a serious political threat to the Republican Party," Kristol wrote in his infamous December 3, 1993 memo titled "Defeating President Clinton's Health Care Proposal," adding:

"Its passage in the short run will do nothing to hurt (and everything to help) Democratic electoral prospects in 1996. But the long-term political effects of a successful Clinton health care bill will be even worse--much worse. It will relegitimize middle-class dependence for 'security' on government spending and regulation. It will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests. And it will at the same time strike a punishing blow against Republican claims to defend the middle class by restraining government."

And that, for Kristol, meant it had to be stopped at all costs:
"The first step in that process must be the unqualified political defeat of the Clinton health care proposal. Its rejection by Congress and the public would be a monumental setback for the president; and an incontestable piece of evidence that Democratic welfare-state liberalism remains firmly in retreat."

PERRspectives
The Real Reason for the GOP's All-Out War on Obamacare
John Perr

The market state versus the welfare state. 

In this endeavor, the right worked very diligently to recast the framing so that welfare state would be perceived as living on the dole instead of its original meaning of public purpose being oriented toward the "general welfare," in the words of the Preamble to the US Constitution. Even if you were not taken in by the framing, many people have been.

The strategy in this endeavor was to use wedge issues and inter-group conflict to dupe the rubes into voting against their economic and social interests by creating a tribal mindset of "us versus those people." They even frame it in terms of "the real Americans" versus those people who aren't real Americans.