Sighhh …

Now we have the moderates proposing M4A WWI ..  the latter an abbreviation for “whoever wants it.”  Sadly both M4A and the WWI variant are frauds unless they make huge cost cuts.

For Bernie, M4A focuses on insurance profits.  It is easy to demonize execs making 10 million a year, but nonprofit and profit health plans in the US cost pretty much the same.  This is because real profits in insurance programs go to the underwriters.  Underwriters make their profit from investing premiums.

So why does American medicine cost so damn much?  Many studies show three sources of cost .. 1. High administrative overhead, 2. High costs for services, 3., High costs for drugs.

Drugs are the relatively easy target, although this may create huge gaps in the willingness of drug companies to fund the development of low-profit drugs like vaccines ar very risky drugs like drugs for congestive heart failure or Alzheimers.  A simple trial of such a drug can cost well over a billion dollars!   Interestingly China is now getting into the drug trials business!  I wonder how Americans will feel about outsourcing the next drug to treat kids’ behaviors to China?

The bigger issue, however is labor.  Private insurance .. subsidizes all other streams including existing Medicare and welfare programs that cap charges to the plan but do not usually reduce administrative costs. The same is true for services.  The number of staff required to run an American hospital are so big that in many states, health services is the #1 employer!  To make matters worse, a massive part of these costs are hidden as a  result of cost transfers.

To cut costs you will need to hugely reduce staffing in admin and services.

The politics of that are ugly. Massive layoffs!  That prospect means an effective M4A can only happen if …