I honestly never understood the "they're gonna take away your choice" argument. Not just for the reasons outlined here, but I didn't understand what there is to choose. If we get the kind of healthcare we should, then all medical expenses will be covered. As in, everything. If all the insurance companies die because of that and you no longer have the option to choose between healthplan A, B, or C, who cares, medicare for all means getting you A, B and C all at once.
If anything, choice as experienced by the normal person would actually expand, since you no longer have to worry if any particular doctor is in your insurance network. Everyone is, other than maybe a handful of ultra-high price specialists doing elective procedures and other things that have been deemed too high cost to cover. No proposal is going to create some government board of assigning you a doctor without your consent.
Bernie's theory is that if you ask for a golden yacht you might get a sail boat, and sail boats are better than not having sail boats. I'm not 100% sure I agree with the political assessment but he thinks if you start asking for a nice ship rather than the golden yacht then you'll be negotiated down to a rowboat.
I dunno why I'm going with a boat metaphor here. Most use loaves of bread. Some say if you ask for a whole loaf then you'll maybe get half. If you start asking for a more reasonable half then you'll actually get a quarter. That sort of theory. It sort of does ignore the swaths of people you immediately turn off by demanding an entire loaf, though.
Yeah, Bernie is right on legislative negotiating tactics (but that's a separate question from electoral tactics — voters could still, in theory, punish you for the maximalist ask), though there are definitely some out there who have taken the negotiating position as received gospel. I don't think it'll be a big issue in the grand scheme of things, so long as Bernie is around the sell his people on the eventual compromise, but there will definitely be some people out there who have claimed that single-payer with $20 copays would be murder who will have to flip to actually it's fine and will control wait times.
There's gold on the other side of the rainbow and unicorns are real.
The countries that do have universal healthcare all practice some form of rationing. The Scandavian countries won't do organ transplants on people above a certain age. I remember Denmark was often noted for not giving kidney transplants to people over 50.
Universal healthcare is a good idea, but don't make false promises.
I almost blame the opposition to universal healthcare for this problem more than the people promising the moon. They spent so long on the "how will we pay for it" line that when people woke up and were like "wait, or course we can fucking pay for it" all the actual questions of real policy choices about real limited resources were so far out of the public conscious that we don't even think about them anymore.
You have to pray that John Robert's votes to keep it around because it would definitely make it to the SC. I'm not sure Roberts would be convinced to kill of private health insurance.
The real issue there is there's no way for Roberts to kill single-payer without ruling that federal direct provision of literally any service is illegal. He's have to blow up not just Medicare for All, but the original Medicare for Olds too. It would be a full-blown return to the constitution of the 1920s. Which, maybe he'd be willing to do if he though the conservative stranglehold on the courts was solid enough to protect from any blowback, but there at least his little-c conservatism to not completely blow up the legal order will weigh against his capital-C ideological Conservatism.
Wait lists in other country are a problem, especially for trans individuals that need to get what they need ASAP. Often times people have to crowd fund and get it hormones or surgery with a private doctor. So, I hope that in M4A they have these sorts of things readily available for people that need it.
There's not really a good way to not increase wait times though. More people can see the doctor, but you're not making more doctors, or adding more hours to doctors days. You can do things around the edges, like pushing more basic services to nurses, and get rid of the need for a doctors involvement where it's safe to do so, and have free med school for anyone who can get in to expand the pool of doctors in coming years, and offer incentives for foreign doctors to immigrate here, but at the end of the day, you're going to create a huge surge in demand with only a limited ability to increase supply. Waits will happen. But wait by first-come-first-serve is better than excluding people completely for inability to pay so that waits are manageable for the portion of the population that's left.
While it's true that the US would have to cover more than any other single payer nation, I'm not sure that argument really holds weight. If you look at per capita spending, just private spending alone would eclipse a lot of other countries. More recent statistics have shown total expenditures over 10k.
The US also spends more as a percentage of GDP with the
OECD showing the US spending 16.9% of it's GDP vs the closest next country, Switzerland at 12.2%.
So I don't buy that we can't do it at scale. As Oliver mentioned, the biggest hurdle for the US is upturning an industry that employees millions of people, and I'm not sure anyone has a good answer how to accomplish that. I don't think we should wait any longer to implement a change, but I also don't think you can flip a switch overnight. The US built up a gigantic pile of shit over the years, and unfortunately it's going to take time to dig through it to get us to a better place.
I think his point is less about the US having to cover more people — that's pretty easily solved by also having more doctors and more tax dollars because of having all those people — and more about Bernie's plan being literally more generous than any other nation's. No other country covers dental and vision and long-term care all with zero copay cost. And like people have mentioned, most of those are probably there to be sacrificed to moderates in the eventual compromise, but it is true that the plan Bernie is running on is wildly more generous in what it offers to each person than any other country in the world.
