It is a single payer system funded through taxation. There is no place for insurers in a system in which everyone is already fully covered.

@RoboGraham so who runs this system?

What are you going to do with the around 650,000 newly unemployed insurance workers, btw?

Biden has repeatedly said in the debates and explained on his website..... "The right approach is to build on Obamacare. People can keep their current insurance provider if they want to."

Biden has not reached as far as creating a single payer system yet.

@1of5 Medicare is run by the Centers for Medicare & Medicaid Services.

650,000 people working in the health insurance industry shows you how bloated and inefficient that system is. Likely, some of those people will work for the expanded CMS. The rest can be more productive elsewhere in the economy. For those struggling to transition, Bernie is also planning to implement a jobs guarantee.

@1of5 I doubt there will be be a huge problem with those 650k people becoming unemployed. The govt currently outsources a good chunk of their current Medicare business, and about 1/3 of Medicare recipeinta choose to use a private insurer as it is. CMS has no where near the capacity to run something like MCFA, and while they are building capacity (and lobbyists and court cases are changing how MCFA gets run) private insurers will likely run most everything. Eventually a good chunk of those 650k will become govt employees or contractors, because we will still need most of them, from people who answer the phones, run IT stuff, make decisions about money and care allocation, run audits, and so forth. Sales people and account managers may be one of the only jobs that d9esnt get rolled into the MCFA program

@MarkiusMahamius You make some good points. I would add that some other jobs in the current health insurance industry that will not have a place in medicare for all would include

Advertisers- no need for marketing when everyone is covered under one system.

CEOs- no more fat cats pocketing millions that ought to be spent on care for patients.

Claims Adjusters/Clerks- no need to analyze claims when everyone is fully covered.

This is why med4all will bring down the enormous costs of healthcare in America.

@RoboGraham im not sure what you mean by " no claims adjusters". A big part of every MCFA style plan has been capped payments. Drs. Hospitals and clinics absolutely cannot charge whatever they want, if the system is going to stay solvent. There will be claims adjustors . Someone, be they pivate or public sector, will need to look at claims and match up the diagnosis and services provided (and determine if the services are even covered) with the dollar amounts, and then adjust them, before sending out a check. Medicare fraud and abuse is a huge deal now, and if the program expands in size, even more people will find ways to try to gouge the system. Claims adjusters will be absolutely needed, and they will be key to keeping costs down.

@RoboGraham it's partially paid for by CMS and not administered by them - the state's administer and pick up the rest of the tab which in my state is about 40%. CMS just oversees it. CMS IS going to cover the expanded state costs too, right?

No, it doesn't show me it's bloated, what it shows me is that you seriously have no idea how insurance works regarding health care. Thinking that 6000 CMS employees can replace 650,000 people while tripling the number of people covered is extrodinaraly misinformed, even if CMS sextupled it's staff.

That's a pretty thin answer that's just pure speculation about where over 1/2 a million people are going to find work. "Likely", and "more productive elsewhere" is a complex way of saying "I haven't got a clue". Got a cost for Bernie's job creation program for these folks? Also the 1 extra person, on average per small medical office, that does nothing but deal with insurance? No, I'm not saying we need to keep redundant jobs, but if you flood the market with a skill set those folks will suffer. I guess we should be happy they have health insurance instead of a house.

Advertisers- no need for marketing when everyone is covered under one system.

It doesn't cover everything and there will always be people willing to provide services above and beyond just like there will always be people willing to pay for services above and beyond standard levels.

CEOs- no more fat cats pocketing millions that ought to be spent on care for patients.

Oh look, you played the fat cat card. How droll.

Claims Adjusters/Clerks- no need to analyze claims when everyone is fully covered.

What, you think no ones gonna keep track of where the money's going, or make sure doctors/hospitals/providers aren't doing unnecessary procedures to bill? No one to make sure the patient their billing for exists? No one to track overall treatment of the patient to ensure they're getting what they need? Seriously?

This is why med4all will bring down the enormous costs of healthcare in America.

Health care costs will always be enormous and we need to find the best way to bring them down/manage them responsibly. Medicare for all is a start that might work (If done right), but claiming it's going to be a cure all is a pipe dream. Also It's not going to eliminate insurance companies in healthcare, just the nature of what they insure.

@MarkiusMahamius yup

@1of5 First off, touche in regard to the claims adjusters. My line of thinking was that, if everyone is fully covered, no need for the insurance company to have people who work out what's covered and what's not because everything is covered for everyone. But you're right, there will need to be people making sure that the prices being charged are fair.

You asked me who runs it, not you pays for it. "The Centers for Medicare & Medicaid Services (CMS) is the federal agency that runs Medicare." That is from Medicareinteractive.org. Med4All will be medicare expanded. Of course the 6,000 or whatever CMS employees can't replace them all, it will be expanded meaning more people will work there, some of which will be from the private insurers as I said originally.

Yeah it sucks that these people will be out of work, including the billing specialists in all the hospitals and doctors offices but that's the price we pay for a rational healthcare system. If it will be expensive to provide them with jobs on Bernie's plan fine. Paying them to work on something else will be more worth while than paying the insurance companies to pay them to do redundant unnecessary work.

The current proposal of Med4All does cover everything. Only plastic surgery is not covered. I don't consider getting work done to be healthcare. It's an optional improvement of appearance like getting a tattoo and ought not be covered. If you want that, you can pay for it. This doesn't mean that the actual thing, once it gets through Congress will be that way so okay, there probably will be some room for private insurers. However, I'm arguing about Med4all in it's purest form. The current proposal would eliminate all private insurers.

Yes of course I mentioned fat cats. Don't care how droll you think it is. There are people getting filthy rich taking money that ought to be used for care. If that is unimportant to you, well that says a lot about you.

I do think that medicare for all will fix many of the issues in healthcare. If done right. I hope you are right and that it will be just a start. What do you think needs to be done beyond med4all?

@RoboGraham

My line of thinking was that, if everyone is fully covered, no need for the insurance company to have people who work out what's covered and what's not because everything is covered for everyone. But you're right, there will need to be people making sure that the prices being charged are fair.

Boob jobs for porn actresses, bionic artificial hips for 95 year olds, female genital mutilation for daughters whose parents choose it, experimental back surgeries for paraplegics who will never walk again anyhow, cancer treatments for someone with no cancer diagnosis, unlimited prescriptions for every hypochondriac?

And the govt (meaning us) should pay without question?

Not everything will be covered. Not even close. Hopefully more than current medicare covers, would be a start.

@MarkiusMahamius Right, plastic surgery won't be covered. Why would mutilation, cancer treatments for the cancerless, surgeries for people who don't need them, and unlimited drugs be provided by any doctor? Of course there must be a method to ensure that these frivolous expenditures don't occur. Govt, meaning us, should not pay, yes question.

Everything will be covered that is medically necessary and not ridiculous, meaning,things that are covered now plus dental and hearing aids.

@RoboGraham dude read up on medical fraud. None of those are made up.

Anyhow, again, my point is that claims adjusters will be needed, as well as a big list of whats covered and what's not, and a whole bunch of drs and nurses to make decisions.

@MarkiusMahamius Yeah, you're right. I admitted as much in my comment to 1of5. I don't think many doctors would be willingly to give approval for the things you listed but sure, someone has to keep an eye on it.

@RoboGraham the state's actually do run it - its overseen and evaluated by the feds. Each state is different, has different options, and if memory serves some just contract directly with insurance companies to do the actual nuts and bolts of day to day operation. So the feds don't actually run it, even though it sounds like they do. They dont. The states do the actual work and pick up a nice chunk of the tab.

I'm sensing you don't know how medical pricing works through insurance companies and medical providers. Dont feel like typing it out unless you want it.

...but that's the price we pay for a rational healthcare system.

We? They. They pay, not we. Destroying peoples carriers doesnt sound rational to me. Just assuming they'd be happier doing something else or would make as much or more money is wishful thinking. That you dismiss concerns about them tells me youre ok with an ends justifies the means on these people's suffering - I'm not.

Plastic surgery is pretty importaint to a lot of folks - burn victims and people disfigured by accidents leap to mind. Of course @MarkiusMahamius jumps straight to porn actresses and boob jobs - subjects that are nearly always on his mind.

The only way you'll ever get rid of private insurance is if every medical proffessional works for the government and can't do outside work. Basic healthcare doesnt include everything that people think they want or think they need.

I actually don't have some bright, shinning idea that'll cure everything. What I think needs to be done is to examine how other countries do it successfully and learn from them. This to me feels like we're trying to reinvent the wheel while other countries have been testing thier wheels out on carts, wheelbarrow's, sports cars and trucks, and we're trying to modify a triangle to put on a bike. Let's see what actually works and build on that.

@1of5 ahem, i was speaking to the validity of sex work and the need for women's bodily autonomy in the light of their objectification as a means of wealth transfer. So are you saying insurance shouldnt cover pre-k?

@MarkiusMahamius the heavy breathing during that discussion really showed your passion on the subject. My apologies.

@1of5 The price we pay meaning the price we pay as a society which is a hefty one with so many thousands of people thrown out of the workforce. Sure it's a heavier price for them than the rest of us and I'm not assuming that they'd be happier or just as well off. It will be turmoil for them but I do think that, in the grand scheme of things, a rational healthcare system will be well worth it. There are many economic factors that are constantly putting people out of work, at least this one will save money in healthcare cost for all of us and will literally save lives and reduce the suffering of a large number of people. If you want to label that as the ends justifies the means, fine. But you could say that about any positive thing that has a down side. So basically, you could say that about anything.

You are right, I don't know all the nitty gritty details of how health insurance works. My understanding of med4all is that it will be a single payer system. Everyone pays in and it covers all the costs. The way it's run now doesn't necessarily mean that's the way it will be after the overhaul.

I'm pretty sure that plastic surgery for burn victims and the sufferers of other nasty injuries would be considered medically necessary. At least I hope so, it should be. I'm talking about people getting it done just because they want to look better or reverse the effects of aging. In that case, it's on you.

No it's not required that all medical professionals work for the government to get rid of private insurance. None of them would have to work for the government for that to happen. They would just all have to be paid by a government run single payer system.

The only argument I can see for private insurance continuing to be necessary in a single payer system would be for athletes and other people who need to be extremely physically fit and therefore need specialized medical care that goes above and beyond what the average person would need. In that case, sure buy some insurance to cover that stuff. As long as regular healthcare is guaranteed to everyone, I'm cool with people buying insurance on top of what is already covered as long as what is already covered is everything that the average person would need to get by in life including dental and hearing aids.

It's not about me, it's about us.

@RoboGraham
You as in "voters'. Biden will not change much. He is capable of sleeping with the enemy. He has voted with Republicans against Democrats' interests.

@St-Sinner I don't think that voting with the other party to the detriment of your own is necessarily a bad thing. It shows that you can be pragmatic and are able to put country over party. Unless you are doing it for selfish reasons.