Where Sanders went wrong on MFA and why

[NCProgressive]

Because of Sanders' personal and visceral hatred for corporations, CEOs, insurance companies and pharmaceutical companies, Sanders had a major blind spot to bring the most powerful constituency to his side and that doomed his MFA completely.

Corporations and CEOs: Every product made and service delivered has a health care component in its pricing. An average car contains nearly $2,000 to $3,000 in health insurance for auto-employees and so on. Most corporation would love to get rid of this expense and saddle the government with it. Sanders should have held meetings with the corporate leadership and the chamber of commerce explaining how they could increase profits from his plan.

Insurance Companies: The demonized health insurance companies actually have the infrasturcture, technology, doctors and hospitals to deliver care efficiently and eliminate fraud and waste. When faced with no business at all, they would have absolutely loved to have Medicare act as the funds collector and gate-keeper for payments in exchange for their structure and business remaining in place plus with an opportunity to shift their riskiest insureds to medicare. Sanders should have had them on his side to make his plan work - instead, he chose to malign them.

Pharmaceutical Companies: Let's face it, American pharma and device companies come up with over 90% of the new advances in medicine and healthcare. Those things cost an enormous amount of money to develop and this money has to be amortized in the short lived patent protection. Total patent protection is 17½ years of which as many as 12 years are eaten up by R&D plus regulatory processes leaving just 4-5 years for a pharma company to recoup its investments plus investments in failed drugs and technologies. For every 20 things tried by scientists, only one ends up being successful in the market. Sanders should have met with the Pharma companies and separated their R&D and regulatory expenses in the form of block grants. By adding more years of patent protection, he could then have leveraged the pharma industry to lower the costs of the drugs and technologies without significant upheaval.

There was a clear path to build a consensus but Sanders' own hatred and visceral desire to destroy the existing system came in the way and he lost the war very badly.

[comradebillyboy]

1. Excellent points.

Sanders ideological blinders keep him blind to the real world.

[The Magistrate]

2. Sound Points All, Sir

I confess to a fondness for doing away with the health insurance industry root and branch (viewing them as bookies who take far too much out of the pool of monies on wager), but understand there are difficulties, and a slow wither on the vine in competition with a superior public option would be satisfactory to me. I am aware a number of countries use health insurance corporations under strict regulation in systems that perform very well in bringing universal coverage. Barring companies from profiting on their health division is often a part of such systems. The companies use the quality of their health performance as a selling point for other sorts of insurance they provide, which do bring them profit.





"From Bernie’s perspective, dropping out of a race once you have no chance of winning is peculiar behavior that can only be explained by the work of a hidden hand. For most politicians, though, it is actually standard operating procedure. Only Sanders seems to think the normal thing to do once voters have made clear they don’t want to nominate you is to continue campaigning anyway."





"When things are not called by their right names, what is said cannot make sense. When what is said does not make sense, what is planned cannot succeed. When plans do not succeed, people become uneasy. When people are uneasy, punishments do not fit crimes. When punishments do not fit crimes, people cannot know where to put hand or foot."

[NCProgressive]

5. Actually, agents and middlemen are a part of the capitalist system

The reason is that they add value to whatever is offered and their profits flow into the economy while adding value of supply-chains and easy access for consumers.

Theoretically, GM can eliminate dealerships and sell directly to car buyers on line. Dealers are used and they make as much as 22% of the retail price. The dealers allow the consumers to test drive the vehicles and maintain an inventory so that one can drive off with a car instantly.

All retailers make a profit of 15 to 50% by displaying and selling items in stores. We can walk into Macy's and try out the clothes, accessories, shoes and perfumes before buying. We can also return the goods that we don't end up liking.

We hire real estate agents to seel a house and pay a 6-7% commission instead of selling it ourselves because the agents do the heavy lifting of advertising, marketing, showing the house and negotiating.

Health insurance companies are no different.

[The Magistrate]

8. As You say, Sir, Profits May Flow Back In

But health insurance companies add nothing of value to medical care, and subtract something of value from the pool of monies devoted to medical care.

Insurance is a wager. If you insure, say, against theft, you are betting someone will abscond with your possessions, and the insurance company is betting no one will do that to you. If the company has calculated the odds correctly, the pool of money it collects as premiums will be greater than the sums it must pay out when it loses that bet, and the difference will pay the costs of collecting and administering the pool, and the profit of the firm. The cost of collecting and administering may be considered of value, but save as enticement to invest in the firm, the profit is of no particular use to anyone --- it is simply the bookie's fee.

When this is applied to payment for medical care, it is not possible to argue sensibly that the profit of the firm is anything but a species of surcharge on every payment to a health care provider. Necessarily, either the doctor is being paid too little or the patient is paying too much, for otherwise there could be no profit to the firm. Worse, the health insurance industry have justly gained a reputation as dishonest bookies, as welshers, who attempt to wriggle out of payment when their bet that a policy-holder will not get sick comes a cropper. Firms comb through the policy for the slightest thing they can hang a cancellation on, and people with cancer have their policies cancelled because they did not report a hang-nail twenty years ago on their application. Further, they seek to restrict treatments a patient may receive in their own interests. A harried nurse-practioner at a phone bank may over-rule a doctor concerning treatment of a patient, usually for no better reason than the expense of the treatment to the company, and does so without regard for what may well be a life or limb outcome to the patient denied the treatment the doctor prescribes. And into the bargain, doctors are saddled with appreciable costs of administration in order to deal with various insurance firms, and to ensure they are properly paid, which they cannot honestly expect they will be. These costs, too, are a dead loss, save as they go to clerical salaries, and these costs can be reckoned to include a doctor's time, which he or she may need to devote to considering and directing how the office deals with the firm. There is simply no room for doubt the health insurance industry, as presently constituted in this country, inflates the total costs of health care by an appreciable amount.





"From Bernie’s perspective, dropping out of a race once you have no chance of winning is peculiar behavior that can only be explained by the work of a hidden hand. For most politicians, though, it is actually standard operating procedure. Only Sanders seems to think the normal thing to do once voters have made clear they don’t want to nominate you is to continue campaigning anyway."





"When things are not called by their right names, what is said cannot make sense. When what is said does not make sense, what is planned cannot succeed. When plans do not succeed, people become uneasy. When people are uneasy, punishments do not fit crimes. When punishments do not fit crimes, people cannot know where to put hand or foot."

[Turin_C3PO]

3. Point number one

is the one I think about the most. I’ve long thought that most corporations should support single payer in order to offload their health coverage costs to the government. I’m sure most could be brought on board.

[dansolo]

4. The problem is he never addressed actually reducing costs

His plan was to make the government psy for everything, and then institute fee caps on all services. The problem is that the price caps would only apply to the healthcare providers at the end of the line, but would to nothing to defray their costs, or the costs for their suppliers.

[jaxexpat]

6. Bernie, I never understood why any healthcare proposal was framed as 'Medicare for All'

I mean, does everyone understand that currently, under Medicare, you MUST pay for an additional insurance plan to be reasonably covered? The cost comes off your monthly check. There are out-of-pocket copays and deductibles and that every year the insurers' underwriters adjust coverage to fit the profitability of their business model. Did the candidates actually think that sound-biting the public was preferable to some attempt to educate the public? Most people already agree with the WHY of healthcare reform but no one is sure about the actual HOW. The MFA spiel didn't have the clarity to inform nor did it pass the smell test of frank, honest discourse.
I'm not sure why Sanders' message didn't address how the actual numbers and methodology of his plan would impact those whose livelihood was on the line, much less everybody else. One could never be quite sure if he even had an actual detailed plan. I think if he had, he could have told people just about how much income most citizens would actually save with a single payer system. Educating small business owners (99.9% Republicans) that their payroll would be simplified and their operating costs would NOT go up was never done. That their current provision of employee insurance plans, for which they think employees should feel gratitude, is the single biggest rip off, on so many levels, of the whole stupid system.
His mistrust of corporate interests is understandable because, ultimately, single payer would cut the 20%+ profit currently enjoyed by the healthcare industry. Corporate executives will never agree that their exorbitant compensation levels are a thing of the past.
And while I'm on my soapbox I'd like to remind people that just about ALL legislation goes through what is essentially a corporate approval process (unless its so off-the-wall that the lobbyists haven't figured out how to capitalize on it yet) and somehow we are to think that's okay.

[NCProgressive]

7. It was a simplistic marketing ploy

He hijacked the popularity of medicare to use that in a slogan.

[betsuni]

9. K&R

[Blue_true]

10. One thing that can be done with Big Pharma and medical equipment makers,

is grant them 15 years of exclusivity AFTER final approval of their medicine or medical device or diagnostic equipment. If properly regulated, such an approach should reduce drug and medical device costs for consumers.

[Hortensis]

11. All true, but he went "wrong" on MfA the moment he first

seriously considered making creation of a capitalism-based, for-profit healthcare plan the foundation for a run for the presidency. But he couldn't give socialism away and, even though the plan he could sell was the very thing he despised and rejected all his life, he had a great marketing name for it that test flew rather spectacularly.

Meanwhile, Trump was doing exactly the same thing on the right: promising a wonderfully better healthcare program than Obamacare that would cost far less. Promise! Easy! Just do it!

Neither promise had, or to this day has, either a real plan behind it or a path to making it happen. Didn't matter. For both populist insurgents it harnessed the nation's #1 issue to run on -- and provided a supposed "rationale" for destroying the Democrats' Obamacare.

Instead of just completing the excellent healthcare system already in place.

[NCProgressive]

12. I totally agree.

[oasis]

13. K and R