AP FACT CHECK: Sanders spins savings in Medicare plan

Bernie lies to us too!

Of course we all know all politicians lie and all try to at least paint a rosier picture when they can, and Feel the Bern isn't immune.

Sen. Bernie Sanders is skimming over the facts in claiming that his “Medicare for all” plan will lead to big reductions in what Americans spend for health care.

In a recent tweet, the Vermont independent insists the plan will cut $2 trillion from the nation’s health care bill.

But that’s based on a scenario in which hospitals and doctors accept significantly lower payments for many patients. It’s a big asterisk, and one that Sanders fails to disclose.

Associated Press

Once again, I invite people to try to debunk AP's fact checking if they want to, so far we haven't been able to here on ATS. Although, I don't know of anyone so emotionally invested into Bernie at the moment to try to discredit AP or their fact checking.

Thougt id drop in to add some info...
This was taken from a facebook page called “The meme policeman” which i highly recommend....

“A recent study from George Mason University’s Mercatus Center made headlines when it projected that Bernie Sanders’ Medicare For All (M4A) plan would cost the government an additional $32 trillion over 10 years. Many on the left countered by saying the study also showed a reduction in total healthcare spending, so we’d still be better off under M4A. Let’s take a look at this claim.

-It’s true that the study lists a slight decrease in projected total healthcare costs under M4A. In 2022, personal spending is estimated at $3.86 trillion vs. $3.85T under M4A, a reduction of $10 billion. By 2031, the projection is $6.49T vs. $6.40T, a difference of $90 billion. In this regard, the meme is correct, but it leaves out plenty.

-The Mercatus study repeatedly explains how their projections are conservative, and the actual costs of M4A are likely to be far greater in reality. To understand this, we need to look deeper into the study.

-Under M4A, there would be a projected $5.7T increase in healthcare spending over 10 years, as more people use their newfound “free” healthcare services. So how could total healthcare spending go down? Because of a supposed $6.1T reduction in costs. How, one might ask, will government dramatically cut costs? In a few ways, but primarily through decreasing payments to healthcare providers.

-Medicare pays healthcare providers substantially less than private insurance does. Hospital payment rates under Medicare are about 60% of private rates. Essentially, healthcare providers must charge higher rates to private insurers to make up for their Medicare patients. By 2019, over 80% of hospitals will lose money treating Medicare, and this shortfall is projected to worsen into the future. Yet, M4A will attempt to force all providers to accept these low Medicare payments.

-While on paper it appears to save money, it’s highly doubtful it would work. Its just not realistic to expect hospitals, doctors and nurses to work for substantially less. It’s likely the government would need to raise Medicare reimbursements, or providers would restrict services and patients would still pay out of pocket for timely and desired care. Either would increase total spending substantially.

-The study notes that with more realistic Medicare payments, the cost would rise from $32.6T to $38T.

-The other supposed savings from reduced prescription drug costs, and administrative savings were also called into question by the study, although they still used the rosy projections in their cost assessment.

-The M4A plan also relies on an unrealistic funding mechanism. The study notes that to pay for the $32.6T price (let alone the more likely $38T) even doubling the corporate and income tax collections wouldn’t pay for it. Some of this would be offset by the benefit of people trading higher taxes for medical care, but even by their conservative estimate M4A would increase federal spending by $4.24T per year by 2031! This is more than the ENTIRE federal budget now, and just for one program.

-It’s unrealistic to assume that the tax increases required to pay for this wouldn’t have vast unforeseen effects on taxpayer behavior and the economy. And even those tax increases wouldn’t pay for it.

www.mercatus.org...”

a reply to: Kharron

a reply to: SteamyJeans

Interesting read, thanks.

I am of the opinion that whatever the numbers are, we get the real non-sugar coated and non-demonized numbers and they are presented to us as they are.

From that point the people and the reps can decide whether an extra $500b or a trillion or 4 trillion dollars is worth it to us as a country. Is that peace of mind worth the extra cost over a decade?

And how much is saved once no one ever has to file for bankruptcy due to medical bills again, for example? The repercussions are so vast, a good starting point for debate would be clear and accurate numbers from everyone, on both sides, and obviously the independents too.

Thanks for reading.

a reply to: SteamyJeans

Makes you wonder how all the countries in Europe keep their NHS to under 10% of their GDP doesn't it? UK is currently 7.1% and yet the USA seems to think it's going to blow it's entire income on a national health service... if there is any scare mongering buddy I would suggest it's more to do with miss information.

National health is NOT cheap, we know this but it is a worthwhile concept. More work needs to be done to reduce what things cost (such as the scam with PreP medication for HIV patients) and preventative measures along with education. Private health care worldwide not just in the US is a runaway phenomenon and sadly what people don't seem to realise is with little government spending on it (do to it being mostly private) the costs have continued to rise expodentially for silly things like bandages.. aspirin... for years.

Either-way, I am truly grateful for living in a forward thinking country (UK) that keeps me safe, treats my illnesses, my injuries, my eyes and my teeth for a simple and small contribution weekly (less than £20 for most) and makes me pity those that are in pain simply because they can't afford treatment. ON Monday I go for my free STI check and God forbid there comes back anything that 2 paracetamol won't cure I will be treated again for free. Safe knowing that I won't make anyone else ill should I not be able to afford the medication.. Seems like a win to me.

It’s a tough one for me because I don’t believe healthcare to be a god given / universal / undeniable right. Unfortunately.

Would be real nice if it was.
But because it is not, it’s tough to support heavy taxation just to pay for it.

Not to mention one persons healthcare is another persons luxury.

Not to open another can of worms but contraceptives, tampons and abortion come to mind... I say no way should my tax dollars pay for that it’s a luxury and an extra item more or less... other would say that it’s a women’s right and it’s an attack to withhold that... so who knows?

Maybe if we cut the military budget by a few billion and relaxed on the drone strikes we could all get what we want but we all know that ain’t happening.

Time will tell.

Me thinks something like Bernie’s plan will eventually pass because the youth are being pushed so hard to far left/socialist ideas they will eventually vote it in.

Pray for us all.

a reply to: Kharron

You make good points and while I am far from an expert my understanding is that USA size geographically and population wise make it an entirely different and unrelatable animal.

Not to mention also (again, as I understand it, could
Be wrong) the USA tax payers and private corps alike are doing the bulk of medical research thus figuratively and literally subsidizing many other countries health care becus they are using our advances and not funding them.

Am I way off base here?



a reply to: ChristianParr

I have a feeling the people who were trying to discredit the AP when they fact checked Trump won't make a peep in this thread because they probably all of a sudden agree with the AP. Either that or Trump and Bernie are all of a sudden on the same side since the "biased" AP are calling both of them out.

a reply to: SteamyJeans

I think in some respects with the research yes but equally no. Medication even on the NHS is heavily licences. Equally a lot of the research is done right across the world with the licences then purchased by the US pharmaceuticals who massively inflate the prices and sell it back (We have the same issue even with charity organisations like cancer research in the UK) who have made huge steps forward globally in the fight against this disease but sadly even though the research is paid for by the UK population through donations it is still purchased by US pharmaceuticals (We find it ridiculous as it's us that have paid for the research) Equally, a lot of Universities like Keele (I went there) do medical research where again the same issue happens.

As for the size of the country, I don't personally think it matters, it is still based on the statistical need for treatment as a percentage of the population and the contributions each person pays. In essence the funding structure for national health is actually quite simple, the problem is all the government quangos that get involved taking their slice of the pie (such as computer systems, ordering etc) A few years back we had a brand new 'online' system installed for the NHS it cost so many billions and didn't even work, it was scrapped a few years later.

So in essence I think what would be more helpful is for the US to work out the installation costs rather then lumping it all together with so many mysterious trillions. If you could see the breakdown you would know where they are going wrong. Of course that would stifle the whole Corporations vers common sense debate lol

When has ANY government program's budget NOT been significantly underestimated? Doesn't matter if it's the cost of a new bridge, a ship, a building, an entitlement program. The projections are always wrong. The government is fundamentally incapable of staying within a budget.

a reply to: 3NL1GHT3N3D1

It's a conundrum when you can't trust any of the media or any of the politicians.

originally posted by: schuyler
When has ANY government program's budget NOT been significantly underestimated? Doesn't matter if it's the cost of a new bridge, a ship, a building, an entitlement program. The projections are always wrong. The government is fundamentally incapable of staying within a budget.

This 1000%. It has always amazed me that people seem to distrust the government in pretty much every conceivable way, yet somehow trust them to run their healthcare completely........

Democrats have the right idea, but as usual, attempting to shove it down every American's throat, BACKFIRES on them big time.

If Bernie (or any Democrat) would simply say that they want to "adjust" the Medicare law to enable anyone who wants to, to buy into the program, that Democrat would have a WINNER in their bag of promises.

originally posted by: carewemust
Democrats have the right idea, but as usual, attempting to shove it down every American's throat, BACKFIRES on them big time.

If Bernie (or any Democrat) would simply say that they want to "adjust" the Medicare law to enable anyone who wants to, to buy into the program, that Democrat would have a WINNER in their bag of promises.

yeah... sure... and if I like my Doctor I can keep my doctor with DNC Care as well right?

Here's more on the report by this MSM "fact checker":

On July 30, the Mercatus Center at George Mason University released a working paper on the 10-year fiscal impact of the Medicare-for-all plan sponsored by Sen. Bernie Sanders (I-Vt.). The report was written by Charles Blahous, a former economic adviser to George W. Bush and a public trustee for Social Security and Medicare from 2010 through 2015.

Continued...

In doing his research, Blahous decided to follow the text of the Sanders plan and assume that providers — doctors, hospitals, drug companies and the like — would face an immediate cut of 40 percent in their payments. That in theory would reduce the country’s overall level of health expenditures by $2 trillion from 2022 to 2031. But he makes clear that it’s a pretty unrealistic assumption.

Read more

How does Medicare work for physicians?

Medicare reimburses office visits at around $85 per visit [1], though precise reimbursements vary by region. At $85 per visit, a primary care physician seeing nothing but Medicare patients could expect to receive $293,760 in annual reimbursements. Subtracting out the physician’s annual overhead provides an estimate of the physician’s salary. According to this physicians’ overhead spreadsheet, 50% is a good target for a primary care physician’s overhead. Overhead cannot fall below 100-150k for most physicians, as many expenses are fixed. This would leave our example physician with net income of roughly $147,000 annually.

This isn’t a terrible income, as it’s more than triple the average American income, but it is slightly less than primary care physicians’ average pay nationwide. These numbers do show conclusively that it is possible for a family practice physician to make a living on Medicare patients alone!

Source2

Some obviously aren't too happy about that-can't afford such, etc.

To add more to the discussion:
. (not included in the above source discussion) Physicians that have college debt are not allowed to accept Medicare patients. As the above info may leave a shortage, event bigger than it is now, of physicians available if the plan being discussed was to happen.

References:
. "Why No One on Medicaid Can Find a Doctor (and Why ERs Are Busier than Ever)"- Source Prior to the ACA

A big problem, even for those who do live in Medicaid expansion states, is that there are not enough primary care physicians to treat people on the government insurance plan. This was a problem even before the expansion.

. "CMS Blacklists Doctors that Default on Student Loans"-
Source

Over ten percent of all doctors and nurses on the CMS blacklist end up on it because they defaulted on government-backed student loans. Medical workers on the blacklist are barred from treating Medicare and Medicaid patients or receiving federal reimbursements for a predesignated time period.

You have to do two things in order to get costs down. Move to Medicare for all, and government mandated salaries for doctors (which does not cap the salary).
One of the reasons we have such a huge percentage of our GDP going to healthcare is that doctors get a cut of all their tests, and of course insurance pays for it. This leads to unnecessary testing (you can verify this by the fact that patient outcomes in similar countries that have socialized medicine, are actually marginally better).

a reply to: Kharron

I don't know if I can fully 'debunk' the AP fact-check, but I can point a couple of glaring omission in their analysis.

The basic claim in the fact check is that Sander's numbers only work if Medico's will reduce their income, and the implication is that they would not do that. Why then does the Physicians For a National Health Program (PNHP) propose EXACTLY that: Single Payer FAQ?

Do U.S. doctors support this concept?

Surveys show most doctors would welcome it.

Yes. Doctors are increasingly fed up with the bureaucratic hassles, paperwork and meddling imposed on them by today’s private-insurance-based system. They want to regain autonomy over patient care – to do what they were trained to do. They are also acutely aware of the human suffering caused by the lack of access to care under our existing arrangements.

National and state surveys of physician attitudes have shown a marked shift over the past few decades toward support for a single-payer plan.

A national survey published in Annals of Internal Medicine in 2008 showed that 59 percent of U.S. physicians support national health insurance, an increase of 10 percentage points from five years before.

In August 2017, a survey conducted by Merritt, Hawkins and Associates, a physician recruiting firm, found that 56 percent of U.S. physicians either strongly support or somewhat support a single-payer system.

Even the AMA is getting on board: Doctors Used to Be the Greatest Opponents of Universal Health Care. Now They’re Embracing It

When the American Medical Association — one of the nation’s most powerful health care groups — met in Chicago this June, its medical student caucus seized an opportunity for change.

Though they had tried for years to advance a resolution calling on the organization to drop its decades-long opposition to single-payer health care, this was the first time it got a full hearing. The debate grew heated — older physicians warned their pay would decrease, calling younger advocates naïve to single-payer’s consequences. But this time, by the meeting’s end, the AMA’s older members had agreed to at least study the possibility of changing its stance.

“We believe health care is a human right, maybe more so than past generations,” said Dr. Brad Zehr, a 29-year-old pathology resident at Ohio State University, who was part of the debate. “There’s a generational shift happening, where we see universal health care as a requirement.”

However, what is missing from the AP analysis altogether is that malpractice insurance is a BIG part of the current Medico's payment scheme. Doctors have huge insurance costs that have to be reflected in their billings.

Malpractice insurance varies from state to state and from speciality to speciality, but I can find estimates that anywhere from 5% to 10% of the doctors bill is for malpractice. In addition, 'defensive medicine' (for example ordering too many tests, just to be sure nobody can claim they didn't do enough) adds more than $50 billion per year to the US health care spend.

How Much Do Doctors Pay for Insurance?
Evaluating the Medical Malpractice System and Options for Reform

Under a single payer system most of the costs of a malpractice insurance system goes away. For example, if there is universal health care, a patient damaged by malpractice would not need to sue for future medical costs - the health care system covers everything anyway.

(From the PNHP link above

What will happen to malpractice costs under single payer?

They will fall dramatically.

First, about half of all malpractice awards go to pay present and future medical costs (e.g. for infants born with serious disabilities). Single-payer national health insurance will eliminate the need for these awards. Second, many claims arise from a lack of communication between doctor and patient (e.g. in the Emergency Department). Miscommunication/mistakes are heightened under the present system because physicians don’t have continuity with their patients (to know their prior medical history, establish therapeutic trust, etc.) and patients aren’t allowed to choose and keep the doctors and other caregivers they know and trust (due to insurance arrangements). For these and other reasons, malpractice costs in three nations with single payer are much lower than in the United States, and we would expect them to fall dramatically here.

So if doctors don't need to pay for Malpractice, or at least much less than currently, then their actual income may not actually be any lower than it is now.

a reply to: Kharron

Bernie's statements don't even add up to common sense.

We're told that proposing "Medicare for All" is going to cost $32 Trillion over 10 years, but doing that is going to save us $2 Trillion over 10 years from what we're currently spending or are expected to pay over the next 10 years?

How much do we spend each year already for our ENTIRE government operations each year? Around $4 Trillion? How does spending $3.2 Trillion each year just on health care going to save us money? Can you imagine what our yearly spending would be if we spent just that amount on health care? I don't think you can raise taxes enough to try and make up that kind of addition to the budget. It only means more borrowing and we definitely can't afford to keep doubling that!

Am I missing something on these spending projections?

a reply to: ChristianParr

Christian, what is the amount of time and cost spent on going to medical school in the UK? How much do doctors make in comparison?

a reply to: ChristianParr

So in essence I think what would be more helpful is for the US to work out the installation costs rather then lumping it all together with so many mysterious trillions. If you could see the breakdown you would know where they are going wrong. Of course that would stifle the whole Corporations vers common sense debate lol

That makes it worse when we look back at all of the startup costs for Obamacare that far exceeded projected costs, and then too, some of it got scrapped because they couldn't even figure out how to make it work right.

If there is one thing the U.S. has learned, is that our government has NO ability to administer anything with competence and reasonable controls.

originally posted by: WhateverYouSay
You have to do two things in order to get costs down. Move to Medicare for all, and government mandated salaries for doctors (which does not cap the salary).
One of the reasons we have such a huge percentage of our GDP going to healthcare is that doctors get a cut of all their tests, and of course insurance pays for it. This leads to unnecessary testing (you can verify this by the fact that patient outcomes in similar countries that have socialized medicine, are actually marginally better).

I thought "uneccesary testing" already got axed as part of the ACA law for all health care plans.