Op-Ed: Follow the Science—An Open Letter to Anna Eshoo

Rep. Anna Eshoo,

I am in receipt of your Dec. 18 weekly report, wherein you describe the enormity of the Covid-19 calamity we are confronting.

You note that Covid-19 cases in California alone now surpass caseloads in whole nations like the United Kingdom, Germany and India. You go on to encourage people who don't have insurance for whatever reason to get it through the state-based health care exchange—Covered California—and nonchalantly note that almost 90 percent of those insured through Covered California qualify for a subsidy to help pay for the private health insurance plans sold through the exchange.

The ironic implication here, in case you missed it, is that about 90 percent of people who have no alternatives, and who therefore buy private health insurance through the exchanges, can't fully afford it. This is another way of saying that 10 years after the passage of the Affordable Care Act (ACA) and six years after its rollout, private health insurance affordability for millions of Americans remains dubious, to say the least.

In order to further promote this relatively high-cost insurance option, you have written a letter to the Administrator of the Centers for Medicare and Medicaid, which organize and regulate the ACA insurance exchanges nationally, to request an extension by at least two weeks of the enrollment period for 2021.

That letter states, in part, that “[m]illions of Americans have lost their jobs, upending their ability to access employer-based health insurance. … During this unprecedented health and employment crisis ... enrollment beyond Dec. 15 ... ensures fewer uninsured people will be hit by devastating health care bills.”

So, in the face of seismic disruptions in the lives of your constituents and the country, and in these unprecedented times, you are still incapable or unwilling to put forward solutions as momentous as the crisis you describe in your letter.

You may recall that in April 2019, I was part of a constituent delegation to your office advocating for universal, guaranteed and publicly-financed health care, referred to in the shorthand as “Medicare for All.” In that meeting, you spoke favorably of the predominant employer-based health insurance plans and the ACA, despite their ever-accelerating expense, ever-rising employee shares of costs and their restricted networks of providers.

Despite years of holding key positions in the Health Sub-Committee of the Energy and Commerce Committee, a strategic sub-committee you have chaired since January 2019, you feigned ignorance about the significance, or even the basic definition of, Medicare for All, despite the existence of pending bills in both the House (HR 1384) and the Senate (SB 1129). Indeed, you sounded like an onlooker or a bystander in health care debates, rather than a key policymaker and gatekeeper.

In order to wash your hands of the matter, you even falsely claimed to us that the Energy and Commerce Committee has no jurisdiction over Medicare.

Even after we presented the latest expert research showing that a Medicare for All-type system would lower overall projected health care costs, while covering all presently uninsured Americans, you indicated no interest but did say that the Medicare for All bills should be “scored”  by the Congressional Budget Office (CBO) because as you noted “it is our duty as legislators to know.”

Well, the CBO has finally scored those bills and just last week issued its report.

The CBO estimates that, were a system very similar to that proposed in HR 1384 adopted today, total U.S. health care expenditures in 2030 would be about $340 billion below what they would be under current laws and arrangements.

But reduced cost is only half the story: the CBO calculations are for a system that would cover the 30 plus million Americans who currently have no insurance; fully insure the 40 plus millions Americans who currently are under-insured; and include services not currently provided by Medicare such as mental health care, vision care, dental care and, significantly, long term care services.

In other words, the CBO estimates that, as compared to current arrangements, a Medicare for All-type system would give 30 million Americans full coverage for the first time, 40 million others better coverage and give all of them more comprehensive services and still reduce total health care expenditures by several hundreds of billions of dollars per year in the next decade.

This is what your own Congressional research arm is telling you.

Now you know, Rep. Eshoo.

The CBO confirms what we told you, what many other constituents have consistently told you at every opportunity and what other studies show definitively.

More than 90 percent of U.S. households and businesses would see significant health cost savings under such a rational public plan. The science tells us this is low-hanging fruit, a slam dunk as a public policy prescription. We get more and better while spending less. (You know, like shopping at Costco.)

The establishment Democratic leadership, of which you have been a part for more than a quarter-century, has in the Covid-19 era strongly and relentlessly emphasized the importance of science, especially in their rhetoric directed at the White House.

But, as anyone who has been paying attention can tell you, for more than a half-century, that leadership has consistently put wealthy donor and corporate interests ahead and above good public policy and the public good.

Your own record as the currently sitting all-time, all-star congressional recipient of drug, medical device and health product lobbyists’ money is a case in point. It pits you squarely against the type of health care reform that would so greatly benefit hundreds of thousands of District 18 constituents and tens of millions across the country.

Your affiliations and allegiances to donors first and foremost is why you and House Speaker Nancy Pelosi are alone among the 10-person, all-Democrat Bay Area congressional delegation who have not yet co-sponsored HR 1384. It also places you squarely against science on the matter.

Patriotism is the last refuge of scoundrels and “we can’t afford a single-payer system” is the last hideout of compromised politicians.

As tens and hundreds of millions struggle with inadequate health care coverage and its unbearable human and financial costs, the mounting evidence tells us unambiguously that a universal, guaranteed, publicly-financed health care system, i.e. improved and expanded Medicare, is the least costly and most humane path forward.

The CBO report clearly supports such a conclusion.

Anyone not on the payroll, or under the influence of, insurance companies, for-profit hospitals, drug and medical device companies or ideologically-motivated neoliberals, will tell you the real question is: “how can we afford not to adopt a single-payer system?”

Salem Ajluni, a San Jose resident, is an economist and a member of both the Santa Clara County Single Payer Health Care Coalition and the Silicon Valley Democratic Socialists of America. Opinions are the author’s own and do not necessarily reflect those of San Jose Inside. Send op-ed pitches to [email protected].

38 Comments

  1. This fool has absolutely no clue how much to Medicare for All will cost.

    Can the author even research the costs and publish?

    ….

    crickets.

  2. I pay 930 per month for a mediocre Kaiser plan, for just me (60), and at my income level — pretty comfortable doing software engineering work as an experienced contractor — I ran the numbers
    comparing the tax increase in Bernie Sander’s proposed single payer plan and I found out that even at my income level, I’d save based on what I pay in premiums, and that is not accounting for not having to deal with deductibles and co-pays and all the other crap they hit you with… And not taking into account the fact that I pay for new glasses every couple of years as my eyes decay… But that is not the reason I support M4A — I support M4A because I believe health care should be a human right — and that we can afford it in a country that spends 3/4 trillion a year on defense (and that’s just the non-secret part). How about instead of bombing countries around the world we take care of our own citizens ?! I’m tired of seeing 1/2 a million of my fellow citizens go bankrupt every year due to medical bills.. And in a time of pandemic, wouldn’t we all be safer if anyone with Coronavirus concerns could get a quick, rapid results test, and high quality treatment no matter where they live in the US ?

  3. If John Doe Crickets has the ability to read and process written text, he would follow one of the links in the article that takes you to the following source: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003013.

    The summary in that source reads as follows:

    “As the US healthcare debate continues, there is growing interest in ‘single-payer’ also known as ‘Medicare for All.’ Single-payer uses a simplified public funding approach to provide everyone with high-quality health insurance. Public support for provision of universal health coverage through a plan like Medicare for All is as high as 70%, but falls when costs are emphasized.

    “Economic models help assess the financial viability of single-payer. Yet, models vary widely in their assumptions and methods, and can be hard to compare. We found and compared cost analyses of 22 single-payer plans for the US or individual states. Nineteen (86%) of the analyses estimated that health expenditures would fall in the first year, and all suggested the potential for long-term cost savings. The largest savings were predicted to come from simplified billing and lower drug costs. Studies funded by organizations across the political spectrum estimated savings for single-payer.

    “There is near-consensus in these analyses that single-payer would reduce health expenditures while providing high-quality insurance to all US residents. To achieve net savings, single-payer plans rely on simplified billing and negotiated drug price reductions, as well as global budgets to control spending growth over time. Replacing private insurers with a public system is expected to achieve lower net healthcare costs.”

    I’m no expert but, unlike Crickets, I can follow a link and read what a team of experts has put together. What they say, I think, is that a single payer system is cheaper and more effective than what we have now.

  4. People love to use cost as a reason to oppose Medicare For All but they never address the abysmal medical debt Americans struggle with as a result of the system we are in now. Healthcare must be a human right, period. It’s shameful our country doesn’t agree. Thanks for this insightful article.

  5. the problem isnt cost, the problem is the DLC branch of the party is bought and paid for, so it wont happen, not under the current configuration.

    Progs, thats on you for blindly obeying.

  6. The funny thing about Rights: they aren’t something the government gives you.

    Rights are specific limitations on how far the government can intrude into your lives.

    Allowing the government to run anything is nothing but license to raid the public coffers and allow for Zero accountability to those who seek proper medical care.

  7. > I support M4A because I believe health care should be a human right

    So, if health care is YOUR RIGHT as a human, do you believe that people should be enslaved to to provide you your human right?

    You want someone to be enslaved to change your bedpans?

    Or, you want someone to be enslaved to earn the money to pay the taxes to pay people to change your bedpans?

    I’m not willing to be your slave. Find someone else.

    Have Bernie change your bedpans with his own little socialist hands.

  8. It’s true that federal spending on health care will go up. This is because Medicare for All shifts the burden of paying for health care from individuals, families, businesses, and local governments to the federal government. But overall spending on health care goes down, as the many studies and the CBO conclude.

    What other evidence do we have that Medicare for All would reduce health care spending? We look for concrete examples. For years, the Organization for Economic Cooperation and Development has compiled annual statistics on health care spending in most countries. From this data, we see that the United States annually spends about twice the amount on health care (per person) as most other “developed” countries. These other countries provide some type of universal or guaranteed health care for all of their people, while the United States does not.

    Under a Medicare for All program, Americans would no longer have to worry that they would lose their health insurance if they lose their jobs, as what happened to millions of Americans due to the Covid-19 pandemic: https://www.commonwealthfund.org/publications/issue-briefs/2020/oct/how-many-lost-jobs-employer-coverage-pandemic.

    No longer would Americans have to decide between medical bankruptcy or possible Covid-19 death: https://wkow.com/2020/10/11/shock-anger-depression-family-reflects-after-black-earth-woman-dies-from-covid-19/.

    The compassionate and financially prudent course of action for Rep. Eshoo is to co-sponsor and actively support Medicare for All.

  9. > > I support M4A because I believe health care should be a human right

    “If you don’t make the stuff, there is no stuff”.
    — Elon Musk

    So, who’s going to make the health care stuff?

  10. Some government “anythings” that I appreciate: Interstate Highway System, National Parks, Social Security, Medicare . . .

  11. Under Medicare for All, health care stuff (e.g. medical equipment, drugs) are still produced by private industry.

    Our Defense Department is run by the federal government, so who makes the defense stuff? Answer: Lockheed Martin, Boeing, Raytheon, Northrop Grumman . . .

  12. “Allowing the government to run anything is nothing but license to raid the public coffers and allow for Zero accountability to those who seek proper medical care.” –Ashbless

    “Or, you want someone to be enslaved to earn the money to pay the taxes to pay people to change your bedpans?” –Bubble

    If all you have is a hammer, everything looks like a nail.

    If all you have is a libertarian obsession, all (toll) roads lead to Grafton, NH (https://washingtonmonthly.com/magazine/september-october-2020/libertarians-took-control-of-this-small-town-it-didnt-end-well/)

  13. The new CBO study on SinglePayer Health Care Systems is HUGE! The conclusion of this exhaustive 209 page study is NOT surprising. The big news — CBO (the agency that provides economic analysis to Congress) has confirmed what most other studies have found for decades.

    One of the links in the op-ed is to a January meta-analysis led by a UCSF researcher that analyzed 22 SinglePayer studies from the past 30 years. All 22 studies showed SinglePayer would reduce healthcare costs within a decade. Nineteen showed savings starting the first year. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003013

    The CBO evaluated 5 options. It also considered studies by centrist (Urban) and right-wing (Mercatus) think tanks. But in its findings, the CBO option most similar to the current Medicare for All bills (HR1384 and S1129) will save $300 BILLION a year while providing more care per person and cover more people (everyone!). 

    Since the 2016 Bernie Sanders campaign escalated this to a prominent national issue, the depth of the debate among corporate politicians and media has been mostly limited to “How can we afford it?”

    The CBO makes it clear that their question is backwards. It should be “How can we NOT afford it?”

    Case closed (or should be).

  14. 48 years ago I passed the CPA exam and 90 days later I was diagnosed with insulin dependent diabetes. 48 years treating a chronic health condition without side effects of a trained financial analyst adds credibility to my comments. I analyzed national health expenditures from 1957 to 2007, during the period Medicare & Medicaid services was publishing those reports before the Affordable Care Act was passed in 2009. The private health insurance industry was spending 36% of their premium dollars on non-medical overhead, marketing, and profit. During that same period the Medicare administration was spending 4% of their funding dollars on overhead because they are a public service entity. The private health insurance industry is not focused on cost containment because that reduces their profit margins. You may not believe the CBO or Salem, but I have researched the numbers. Only a publicly accountable, not-profit financial entity like Medicare can contain the Medical services industry’s multitude of profit generating layers. My financial training and analysis supports the CBO’s reports.

  15. In three years, with a Kaiser Bronze Plan through Covered California, my monthly premium costs have tripled. It is assumed that I can pay more since there is one fewer dependent, and the remaining just started a part-time job (while a full-time college student).

    I would love to ask Rep Eshoo to explain to me how I’m supposed to pay 300% more in insurance premiums with an 11% increase in income. And how it’s considered affordable to pay 13% of one’s income in health care premiums not including another 13% if we maxed out the deductibles.

    And like so many other people, I have stories of delaying care, calling the financial services offices, and debating with my doctor if I really need a certain test or procedure.

    Medicare for All is simple for patients, will cost less for most people and the system as a whole, and will create more freedom since healthcare will not be tied to one’s employment.

  16. Facendo Guaio:

    “I’m no expert but, unlike crickets, I can follow a research link and read what a team of experts have put together.”

    Did you read it?

    Four of your ‘experts’ received Summer Student Research Grants from ‘Physicians For A National Health Program’ for their participation in this research.

    These four are experts in their field that also qualify for summer student grants?

    I stayed at a Holiday Inn last night. Can I provide any more ‘expert’ medical advice to support your views? If you are really nice, I might help you out.
    If, you give me a summer grant.

    The study lead is an Executive Board Member of ‘Students For A National Health Program’.

    Agenda much?

  17. It would help a lot if more people understood Medicare and the players before making statements about it. Sure, it’s simpler and makes health care easier to get for an ocean of people, but there is no instant, painless, magic pony here.

    Cambridge, MA (Boston area, Harvard) is the biggest center of Medicare for All, “single-payer” (weasel words; who’s the payer?), public health and other activism people. That includes Steffi Woolhandler’s PNHP, related student groups, the New England Journal of Medicine (often liberal), and so on. (There are activists at most other medical schools and in academia, including but not limited to public health, the best known. They aren’t limited to medicine but embrace gun control, the “climate” political movement, and other pet liberal causes.)

    Do you proponents here and others now know what Medicare pays for and what it doesn’t? Do you know that typical payment is 80% of approved care? Do you know what the “Medigap” is? Do you know what it would cost to end that, which is a reasonable first start to incremental expansion of the program? Do you know how it’s financed? Do you know how the program is financed now, or how bad its future is ready going to be? When the Bush people wanted to change Social Security and move it effectively to Wall Street, you failed to seize your best opportunity to change it in a liberal way, instead playing the coward’s game of diversion, shouting that Medicare was much worse, fix it first. You’re always silent about the problems with Medicare when you argue for expanding Medicare, more liberal hypocrisy, your norm.

    No, you cannot magically extend Medicare to everyone without thought and work, can’t just say “do it and make funding for all of it mandatory. Poof!” You can’t do as Conyers would do, take from existing providers without full compensation. Never mind adding benefits of all kinds like vision, dental, and all the rest that way, nor any legitimate way, instead, without a lot of thought and work first.

  18. > This is because Medicare for All shifts the burden of paying for health care from individuals, families, businesses, and local governments to the federal government.

    The federal government doesn’t have any money. It can pay for anything. It only has a printing press.

    Primitive people, i.e. socialists, do NOT know how money works.

    A dollar is just a chit to get stuff.

    If there are a hundred things, and there are a hundred chits, it takes a dollar to get a thing.

    Printing more dollars does create more things.

    DUH!

    If there are a million doctors to provide healthcare, tripling the number of “Medicare for All” dollars doesn’t change the number of doctors.

    Primitive people just think the spirit world will conjure up more doctors.

    This is not “science”; it’s superstition.

    It’s the cargo cult.

  19. This is the usual “progressive” politics, not research or science, as with so many Great Causes and small ones alike on the Left.

    There is no fundamental “right” to health care, human or otherwise. It can made a legal right in this country, as with Medicare and other programs already.

    Jayapal has been on record before as not knowing many details but knowing that what she wants simply “has to be not for profit,” and her bill prohibits payment for, among other things, “the profit or net revenue of the provider, or increasing the profit or net revenue of the provider” consistent with this view. Consider the results. (Two-tier private-too care is fought by prohibiting duplication of private coverage for items covered by Medicare.)

  20. > I support M4A because I believe health care should be a human right
    . . . .
    > Healthcare must be a human right, period.

    Well, If healthcare is your right as a human, you should just go up to any human and demand your rights.

    Get your healthcare from antifa or Black Lives Matter or from the Southern Poverty Law Center.

    They’re humans, right!

  21. NO MAGIC GENIE, OR PONY makes excellent points:
    ‘Do you know that typical payment is 80% of approved care? Do you know what the “Medigap” is?’

    We agree these are big problems for many Americans! But many people don’t understand that “Medicare for All” is about improving the coverage and closing those very gaps. These improvements are included in both the House (HR1384) and Senate (S1129) bills. These points are good arguments for Medicare for All.

    Then NMGorP asks:
    ‘Do you know what it would cost to end that, which is a reasonable first start to incremental expansion of the program? Do you know how it’s financed? Do you know how the program is financed now, or how bad its future is ready going to be?’

    Yes, we know. It would cost much less than what we pay now. The big news mentioned in the op-ed: the new CBO analysis confirms decades of economic studies that conclude SinglePayer saves money. The CBO analysis concludes it would save $300 Billion a year while expanding care (closing those gaps) and covering everyone (12% of Americans under 65 are uninsured, and a similar amount are underinsured). Another good argument for Medicare for All.

  22. > The CBO analysis concludes it would save $300 Billion a year while expanding care . .

    The CBO analysis doesn’t explain where the money is coming from and that someday, someone will bear the costs. (That would be future generations.)

    The CBO (“Congressional Budget Office”) assumes the money will come from the “Taxpayer Fairy”.

    If the Taxpayer Fairy is paying for it, it doesn’t matter to the CBO how much it costs; it’s just free money.

    Why not Medicare for All, for everyone, anywhere on planet earth. And don’t cut corners, buy the deLuxe plan.

  23. Medicare For All!
    Okay. Fine.
    But how about a little gratitude or at least an acknowledgement of those who were forced to pay into Medicare over their entire career with the promise that they were earning something special.

  24. SJOUTSIDETHEBUBBLE is concerned about tax increase. Yes, SinglePayer will increase taxes, but taxpayers will more than offset these taxes by reduced out-of-pocket expenses. To extend the op-ed Costco analogy, it is good to pay the $60 Costco membership “tax” as long as you save more than $60/year in out-of-pocket shopping. The CBO projects 20-65% savings! from SinglePayer!

    From the CBO report:
    “The payments that people make out of pocket for health care would, on average, decline under
    all five of CBO’s illustrative single-payer options. Those out-of-pocket payments include cost-sharing payments, spending on services not covered by insurance, and payments covered by
    health savings accounts, but they exclude all payments for insurance premiums. CBO projects
    that out-of-pocket spending would total $721 billion in 2030 under current law. Under the
    illustrative single-payer options, total out-of-pocket spending would range from $255 billion
    under Option 5 to $579 billion under Option 1 (see Exhibit 13-1). Those changes represent
    reductions in total out-of-pocket spending ranging from 20 percent (or $142 billion) under
    Option 1 to 65 percent (or $466 billion) under Option 5. Average out-of-pocket spending per
    person in 2030 would fall from $2,062 under current law to amounts ranging from $729 under
    Option 5 to $1,655 under Option 1, CBO estimates.”

  25. Apparently Mr. John Doe didn’t read the article. It cites the study of the CBO that concludes rather decisively that Medicare for all would represent a huge savings for the country. And it would cover vitrually everyone.

  26. Ajluni focuses on health insurance coverage and total health care expenditures under two scenarios:

    Scenario 1: The continuation of the status quo with a fragmented, mish mash of insurance providers–private insurance through employers; private insurance through the Affordable Care Act exchanges (Obama Care); and public insurance via government entities (Medicare; Medicaid; federal, state and local government employees’ insurance; TRICARE for active duty military and Veterans’ Affairs (VA) for previous military; Indian Health Service (IHS); and Children’s Health Insurance Program (CHIP)). This scenario assumes that about 12% of the U.S. adult population would remain without health insurance and another 12% of the adult population would remain under-insured (i.e. having insurance plans but unable to fully afford deductibles, co-payments and co-insurance);

    Scenario 2: A single-payer health care insurance system that replaces private insurers; Medicare; Medicaid, CHIP and federal, state and local government employee insurance with a single administration. The private premiums and taxes presently paid to these insurers would be pooled into a single fund administered by the federal Department of Health and Human Services (HHS) that currently administers Medicare and Medicaid. HHS would thereafter become the single payer for all health care services and products provided to the American population (excluding TRICARE, VA and IHS) by private hospitals, physicians, drug companies and medical device makers, as well as providers of long term care services. All Americans would be automatically enrolled in the new national health care insurance plan.

    Ajluni correctly points out that Scenario 2 results in expanded and improved health care coverage for the vast bulk of the American population at a cost that is lower than the costs associated with Scenario 1. (The above commenters who ask “where will the money come from to pay for single-payer?” now have their answer. What is currently paid in private premiums to insurance companies and taxes to Medicare, Medicaid, CHIP and public sector employees will be redirected to the HHS-administered funds. That’s the money, and it is an enormous pile of money at that. Get it now? And will you stop asking sophomoric questions intended to deceive readers and deflect attention?)

    What Ajluni doesn’t say, and the whole point of fighting for a single-payer system, is the impact it will have on the health outcomes of the American people. If you follow one of the links provided in the opinion piece (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)33019-3/fulltext), you arrive at a summary of results from a study conducted by an expert team of researchers which estimates that a publicly-financed, single payer system would save an estimated 68,000 lives and 1.7 million life-years every year for the next decade and beyond. Not only is a single-payer system less expensive, it saves and extends lives and improves the quality of health for the U.S. population.

    Lord knows we could use it. Bloomberg recently reported on research results comparing health care and economic systems’ responses to the COVID-19 pandemic in 57 wealthy countries (https://www.bloomberg.com/news/articles/2020-12-18/asia-trounces-u-s-in-health-efficiency-index-amid-pandemic). In other words, they wanted to see which countries could manage the COVID-19 pandemic most effectively with the least damage to economic conditions. Here are the abysmal results:

    “…The U.S. ranks among the bottom 10% under this method as well as the formula used before Covid-19, which simply measured spending against life expectancy. America’s low scores reflect a middling average lifespan, the world’s biggest outlays on medical care along with the largest Covid-19 caseload…

    “…Using the formula adjusted for the pandemic, eight of the world’s 10 most-efficient health systems are in Asia Pacific. Singapore and Hong Kong top the list, while Taiwan, New Zealand, South Korea and Thailand leapfrogged many territories based on their Covid-19 statistics…

    “…The average lifespan in the U.S. is 78.5 years, having decreased for several consecutive years, according to the latest data. That is at near-parity with those in the U.A.E. and Cuba, where per-capita spending on health care is less than a tenth of the U.S.’s $10,246. Only Switzerland’s $9,956 expenditure is close — yet the average Swiss lives five years longer than their American peers.”

  27. > Cubans gets lifespans equal to the U.S. with less than one-tenth in per capita health spending?

    Bernie is not going to like hearing you say that.

    Your going to cause a reverse boatlift from Miami to Cuba.

  28. > Yes, SinglePayer will increase taxes, but taxpayers will more than offset these taxes by reduced out-of-pocket expenses.

    Or, maybe not.

    Progressives are notoriously bad at arithmetic.

    They NEVER account for the full costs of things. They imagine that they are living in a vast Garden of Eden where all the good things are free for the taking.

    The Leninists confiscated the “means of production” in the Ukraine and caused a horrific famine. Their ideology forget to tell them that the “means of production” were no damn good without the producers.

    Memo to commies: the producers must be paid.

  29. This is not a left or right issue. Single Payer will save money for ALL taxpayers (except maybe for some of the richest of the rich).

    Inflammatory accusations that the 30 years of economic analysis are distorted by “progressives” and “commies” is misguided. The CBO is neither progressive nor Communist.

    Additionally studies from the RAND Corp, the corporate funded Urban Institute, and even the Koch-funded Mercatus Center have shown Single Payer will save money. I doubt any of these have photos of Lenin on their walls.

    So readers, don’t be persuaded by name calling and red-baiting. Read the analysis. Study the facts. Single Payer will be like giving us all a raise (unless you’re a health insurance CEO).

  30. > Additionally studies from the RAND Corp, the corporate funded Urban Institute, and even the Koch-funded Mercatus Center have shown Single Payer will save money.

    Oh, now the progressives are into “saving money!

    Why don’t we do this in the customary Democrat bait and switch way. Let’s cut taxes NOW for all the money we’re going to save in the future? Yes?

    And, if we for some reason don’t get around to saving that money in the future, oh well. We tried.

    Progressives absolutely do not understand money. The utility of money is that it can be SAVED or SPENT.

    There is a time to save, and a time to spend.

    It should be spent when INDIVIDUALS see an opportunity for future benefit. It should be SAVED when Congress sees justification for spending the money of many for the benefit if the few, or for spending the money of the few for the benefit of the many,

  31. SJOutsidetheBubble may be outside “the” bubble, but he/she is definitely inside “a” bubble. Since the days of Reagan, we have been told that cutting taxes and shredding the social safety net–a project undertaken with great zeal equally by Republicans and Democrats for nearly half a century–would produce top-heavy wealth creation that would result in downstream trickling of benefits such that everyone would be better off. Only half of this fairly tale has been achieved, of course. We are still waiting for the downstream part of the story, 50 years later.

    But Bubble can only blather about the meaning of money and protecting those who have it from those who don’t. Like the other local Trumpist/libertarian sophists (e.g. Kulak, Ashbless, Hoapres, John Doe, HB), Bubble rushes to “flood the zone” with twaddle and bunkum, a strategy taken directly from Steve Bannon: “The opposition party is the media…they’re dumb and they’re lazy, they can only focus on one thing at a time..They won’t do the basic, what are the core things that are going on in the country…[A]ll we have to do is flood the zone. Every day we hit them with three things. They’ll bite on one, and we’ll get all of our stuff done, bang, bang, bang. These guys will never—will never be able to recover. But we’ve got to start with muzzle velocity (https://www.pbs.org/wgbh/frontline/interview/steve-bannon-2/; https://time.com/5860215/domestic-disinformation-growing-menace-america/).

    We’re on to you charlatans.

  32. > Since the days of Reagan, we have been told that cutting taxes and shredding the social safety net–a project undertaken with great zeal equally by Republicans and Democrats for nearly half a century . . . .

    So, tell us what this mythical “social safety net” is supposed to look like?

    Where on the planet can we see a real, live example of this social safety net in all of it’s equitable and sustainable glory?

    People must be flooding into social-safety-net-land in vast caravans. We need to tell Mexico where to send their caravans so they aren’t disappointed by the oppression and racism that awaits them when they cross the border into Trump’s America.

  33. Apparently, Bubble’s search engine is in the shop for repairs. Otherwise, he could have revved it up and used it to ask a basic question about human beings in the world: “who among them are the most happy and why?” It turns out international organizations conduct regular surveys of people all over the world to ask such questions and to measure their levels of content with their own situations.

    From these, happiness rankings are created like this one: https://worldhappiness.report/ed/2020/social-environments-for-world-happiness/#figure-21-ranking-of-happiness-20172019-part-1 The “happiest people” in the world (using 2017-2019 data) live in Finland. The U.S. is 18th in that ranking behind Germany and Ireland. The top 10 countries on the list are what Trumpist libertarians and neoliberals would refer to as “socialist” countries because they have publicly-financed, usually universal, social services and robust social safety nets for the relatively poor among them.

    The social services include universal, guaranteed health care with little or no out of pocket payments at the point of service delivery (with no such thing as medical bankruptcy https://www.cnbc.com/2019/02/11/this-is-the-real-reason-most-americans-file-for-bankruptcy.html) and publicly financed schools, universities and graduate schools (with no such thing as student debt https://www.forbes.com/sites/zackfriedman/2020/02/03/student-loan-debt-statistics/?sh=1d675fd281fe)

    The social safety net in most of these countries include relatively generous income supports for the poor; relatively generous unemployment compensation; usually about one month of paid vacation each year for most workers; maternity/paternity leaves of up to 18 months with up to 80% of regular salaries and a maximum of 35-40 hour work weeks. Relatively generous retirement benefits and systems. Of course, these social services and benefits were attained through decades of mass organizing and struggles led mostly by labor unions and socialist and communist parties.

    Here is an excerpt from the latest study: “In a longitudinal study of 18 industrial countries from 1971-2002, Pacek and Radcliff examine welfare state generosity by using an index capturing the extent of emancipation from market dependency in terms of pensions, income maintenance for the ill or disabled, and unemployment benefits, finding that welfare state generosity exerts a positive and significant impact on life satisfaction. Another study that examined OECD countries found that indicators such as the extensiveness of welfare benefits and degree of labor market regulation had a significant positive association with life satisfaction. This study also found that this effect is not moderated by people’s income, meaning that both poor and rich individuals and households benefit from more extensive government. Income security in case of unemployment plays a strong role in determining life satisfaction, as both unemployment and fear of unemployment strongly affect quality of life. Furthermore, using Gallup World Poll data, Oishi et al. demonstrate that the positive link between progressive taxation and global life evaluation is fully mediated by citizens’ satisfaction with public and common goods such as health care, education, and public transportation that the progressive taxation helps to fund” (https://happiness-report.s3.amazonaws.com/2020/WHR20.pdf, p. 132).

  34. > Of course, these social services and benefits were attained through decades of mass organizing and struggles led mostly by labor unions and socialist and communist parties.

    1. generous social services and benefits for people who produce less than the consume is non-sustainable. Entropy increases. Second Law of Thermodynamics.

    2. “struggles led mostly by labor unions and socialist and communist parties” simply coerce producers into violating the laws of thermodynamics and increase entropy faster.

    3. Of course people who live off of the resources produced by others are happy. But happiness ends when starvation sets in.

    Oh, and speaking of socialists and communists, Marxism should probably be called “famine politics”.

    Societies that have Marxism imposed on them seem to experience on awful lot of famine, a. k. a. “crop failures”: Ukraine. China. North Korea. Ethiopia. Africa.

    Many college professors seem to be unaware of this. But many college professors also don’t seem to know where their food comes from.

  35. And yet the people of Finland, Denmark, Switzerland, Iceland, Norway, Netherlands, Sweden, New Zealand, Austria and Luxemboug (the top 10 on the list of happiest peoples) don’t experience famine–not by a long shot–while all of them have been led by labor, socialist and/or communist parties, among others, for most of the past century. I’ve been to half of those countries and they all seem prosperous and the people in each of them looked healthy and unstressed. But who needs evidence and facts when you’ve got a perfectly serviceable, and obsessively repeated, all-purpose social Darwinist/libertarian ideology (https://www.history.com/topics/early-20th-century-us/social-darwinism)? When all you have is such a Weltanschaaung, all that matters is getting to Galt’s Gulch (https://en.wikipedia.org/wiki/Atlas_Shrugged; https://www.motherjones.com/politics/2014/02/libertarian-expat-communities-chile/) by any means necessary. Poor Bubble is taking his talking points and aspirations straight from that malcontent SJKulak and will never find happiness it seems.

  36. Just a quick read of page 2 of the CBO report and I was done.

    “CBO projects that federal subsidies for health care in 2030 would increase by amounts ranging from $1.5 trillion to $3.0 trillion under the illustrative single-payer options”

    “National health expenditures in 2030 would change by amounts ranging from a decrease of $0.7 trillion to an increase of $0.3 trillion”

    So Federal subsidies would go up by $1.5 to $3.0 trillion annually to pay for Medicare for All. Where do we think that money will come from?

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