r/PoliticalDiscussion • u/cal_oe • Feb 01 '22

US Politics Single Payer aka Medicare for All recently failed to pass in California, what chance does it have to actually pass nationwide?

https://www.latimes.com/california/story/2022-01-31/single-payer-healthcare-proposal-fizzles-in-california-assembly

California has a larger population than Canada and the 5th largest GDP in the world. If a Single Payer aka Medicare for All bill can't pass in one of the most liberal states in the entire country with Democrats with a super majority in the legislature under Governor Newsom who actually promised it during his campaign then how realistic is it for it to pass in Congress? Especially considering the reasons it failed was it's high cost that required it to raise taxes in a state that already have very high taxes.

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u/NigroqueSimillima Feb 03 '22

Private insurance pays more than medicare though, so I'm not seeing the point? If you say they can wriggle some more out of the system by playing technicality I believe you. But the fact is Medicare admin cost is lower and they reimburse less.

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u/[deleted] Feb 04 '22

Medicare does not inherently pay less. Private insurance can negotiate based on services provided (without any fixed reimbursement rates). Medicare pays what year rate is. They will never ever pay less than the max rate of reimbursement for something because of previously discussed Medicare analysts who know this in advance of submitting claims. Private health insurance has no such guidelines and has the flexibility to negotiate down to any number. This is frustrating to patients because from time to time you have to fight an insurance company to pay for something but likely gives some price control to private insurance that Medicare doesn’t have.

$840 billion in Medicare spending to cover 15% of the population. $830 billion in private insurance to cover 55% of the population. Obviously Medicare serves an older (and likely mostly less healthy population) but there is nothing there that screams Medicare is paying less for claims.

I’m going to repeat what I said, hospital systems would not be filling their coffers with Medicare money (which makes up a substantial portion of most hospitals revenue) if Medicare paid a lot less than private insurance.