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  #61  
Old 04-22-2019, 01:02 PM
Dr T Non-Fan Dr T Non-Fan is offline
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Medicare isn't all that great of a benefit in the first place.
Average US health cost is $10000 per person, and that is for premiums and out-of pocket medical costs (I'll find a citation soon).
Change everyone's current benefits to Medicare's (sounds like something our fellow Milliman man could do) and there might be a utilization drop due to people actually having to pay something and thinking twice or asking for a cheaper alternative.

Yeah, so someone will pay for that. Who's paying for it now, though? It's mainly a matter of distributing the current payments to others. And that's where it gets political.
Increasing some taxes, and I'd recommend taxing activities that increase medical costs, would have to be done. Consumption taxes would help a lot, as well as reducing subsidies to industries that contribute to higher medical costs (polluters and animal-farming and sugar). Tariffs on these things as well, so that importing what amounts to higher medical costs, can be implemented.

Increasing salaries to make up for eliminating employer-subsidized health insurance will help offset whatever taxes are increased.
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  #62  
Old 04-22-2019, 01:05 PM
Dr T Non-Fan Dr T Non-Fan is offline
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At least 10% savings due to eliminating commissions.
(Just a guess.)
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  #63  
Old 04-22-2019, 01:11 PM
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Originally Posted by Dr T Non-Fan View Post
Medicare isn't all that great of a benefit in the first place.
Average US health cost is $10000 per person, and that is for premiums and out-of pocket medical costs (I'll find a citation soon).
Change everyone's current benefits to Medicare's (sounds like something our fellow Milliman man could do) and there might be a utilization drop due to people actually having to pay something and thinking twice or asking for a cheaper alternative.

Yeah, so someone will pay for that. Who's paying for it now, though? It's mainly a matter of distributing the current payments to others. And that's where it gets political.
Increasing some taxes, and I'd recommend taxing activities that increase medical costs, would have to be done. Consumption taxes would help a lot, as well as reducing subsidies to industries that contribute to higher medical costs (polluters and animal-farming and sugar). Tariffs on these things as well, so that importing what amounts to higher medical costs, can be implemented.

Increasing salaries to make up for eliminating employer-subsidized health insurance will help offset whatever taxes are increased.
Would it be more realistic to make all employers pay a M4A tax or to mandate pay increases for all employees?

Last edited by selectstar; 04-22-2019 at 01:11 PM.. Reason: spelling :)
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  #64  
Old 04-22-2019, 01:32 PM
Dr T Non-Fan Dr T Non-Fan is offline
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Would it be more realistic to make all employers pay a M4A tax or to mandate pay increases for all employees?
When is "realistic" an issue? None of this is going to happen, ever.

But, I'll play along.
Not everyone has an employer. Could probably use a "fair tax" on this and pretty much everything. It does have the problem of enforcement at the smallest-business level, creating a black-market barter system (I think).

Not really a wage increase, but net wages would increase mainly by lowering withholding for health insurance, as most employers require their employees to pay some part of the premium.
And then, increasing the taxes elsewhere. There will be winners and losers, same as whenever the government gets involved in the economy. Potential losers tend to speak up louder than the winners, and tend to sway the votes on such issues.
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  #65  
Old 04-22-2019, 02:15 PM
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At least 10% savings due to eliminating commissions.
(Just a guess.)
Nah. Most sales are direct nowadays, brokers are shrinking as a sales channel.
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Old 04-24-2019, 08:29 PM
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Increasing salaries to make up for eliminating employer-subsidized health insurance will help offset whatever taxes are increased.
Except that Bernie is going to raise the corporate tax rate too so... looks like we will be eating that cost my friend. If you're on an actuarial salary, you are sure as hell netting less income under M4A tax structure.
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Old 04-24-2019, 08:31 PM
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At least 10% savings due to eliminating commissions.
(Just a guess.)
Tell that to traditional Medicare. And I get that it sounds like an appealing argument, but I would urge anyone looking at this to look at the data. Medicare Advantage is able to out compete traditional Medicare because of their management efficiencies, there is no other way to spin it.
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  #68  
Old 04-25-2019, 10:38 AM
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When is "realistic" an issue? None of this is going to happen, ever.

But, I'll play along.
Interesting, Never? I think there is a VERY small chance.
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  #69  
Old 04-25-2019, 10:50 AM
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Tell that to traditional Medicare. And I get that it sounds like an appealing argument, but I would urge anyone looking at this to look at the data. Medicare Advantage is able to out compete traditional Medicare because of their management efficiencies, there is no other way to spin it.
MA got more controls on utilization, which isn't bad, and healthier enrollees than traditional Medicare. Maybe you could get some kind of Public system which allow enrollees to access care through a PCP with incentives based on health of whole population within specified geographic areas. Or you could copy almost anything in other developed country and be better off as you have the most costly healthcare system in the world.
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Old 04-25-2019, 12:28 PM
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Originally Posted by Dr T Non-Fan View Post
Medicare isn't all that great of a benefit in the first place.
Average US health cost is $10000 per person, and that is for premiums and out-of pocket medical costs (I'll find a citation soon).
Change everyone's current benefits to Medicare's (sounds like something our fellow Milliman man could do) and there might be a utilization drop due to people actually having to pay something and thinking twice or asking for a cheaper alternative.

Yeah, so someone will pay for that. Who's paying for it now, though? It's mainly a matter of distributing the current payments to others. And that's where it gets political.
Increasing some taxes, and I'd recommend taxing activities that increase medical costs, would have to be done. Consumption taxes would help a lot, as well as reducing subsidies to industries that contribute to higher medical costs (polluters and animal-farming and sugar). Tariffs on these things as well, so that importing what amounts to higher medical costs, can be implemented.

Increasing salaries to make up for eliminating employer-subsidized health insurance will help offset whatever taxes are increased.
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Originally Posted by selectstar View Post
Would it be more realistic to make all employers pay a M4A tax or to mandate pay increases for all employees?
Employers are the ones currently paying a large portion of the cost for those not in state run programs (Medicare / Medicaid). Easiest solution would be to increase the employer portion of the Medicare payroll tax such that it is (on average) cost neutral for what they pay towards medical benefits today. There would be differences to the extent some employers currently offer richer benefits (winners in this method) or cover more/fewer employees based on their eligibility rules.

I don’t see tax increases on individuals being necessary but, as was said, allocating the cost of coverage is where it gets political. We definitely would NOT see employers increase salaries. It wouldn’t even make sense to do that since employees would essentially be getting the same or similar benefit (medical coverage) through a different source but still largely funded by the employer in the form of higher payroll taxes in my scenario.
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