Medicare for all. National, every person living in the country, and of the Health Professional in the country, is in the system. It is more comprehensive and there are no upfront outofpocket costs like copays or deductibles. Then medicare for all, everybody pays into it through a preventive tax, and everybody is covered for the care they need. That is certainly an expansive definition, and it gives us some to work with, but it is much more expansive than National HealthInsurance Programs in other countries, which do include outofpocket expenses which often have secondary payers working alongside the governmentrun market. This would be much more expansive than perhaps anywhere in the world. Host lets look at the idea of pros and cons for such a system. Michael tanner, the idea of singlepayer what are the pros and cons as far as that program is concerned . Guest it would certainly give everybody a piece of paper saying they have Health Insurance, more than what some people have today. But it would be enormously expensive here at look at the california proposals, 400 billion more than the entire state budget for a year. There is the Bernie Sanders proposal, medicare for all, which have caused 30 trillion over 10 years. We are not willing to make the sort of tradeoffs that other countries are willing to make an terms of access and outofpocket expenses in order to expand coverage. What we would end up with is a hugely expensive program that tries to do something and when alls does, which is provide everyone with unlimited care. Guest a National Improved Medicare for all system is the only way to save money on health the costs and start to bend cost curve. If you look at the other industrialized nations, most are spending less than half of what we spent per person for health care, causing High Satisfaction raise, much better outcomes, improving where the u. S. Is declining. Numerous studies show when we do a National Medicare for all system, it will save us money and we can cover every Single Person with comprehensive coverage for the amount of money we are currently spending. I do not think this can be done at a state level. There are too many federal barriers. No state has achieved a true singlepayer state system. That, you cannot do the cost savings you need to cover everybody. Host he mentioned the california example and the expected price tag. It came up in legislation. That is on a state system. How do you make it work on a National System . Guest the problem with a state system as we have a lot of pieces to the Healthcare System, multiple payers, and you cannot create a state system that puts those all in a single risk pool. With national law, just like we in 1965, wherere we set on this certain day every person over 65 in the country is included on the medicare system, date, say, ok, on this every Single Person is in the system. That is how it has been done and other countries, and it has been a smooth system. They have been able to control costs. Host medicare is 58 trillion in the red going forward. You have the titanic going under, suggesting everybody is a passenger. This is a program that is unaffordable as it stands now. Adding every american would raise the cost of the program. This program already has deductibles and copayments that people have to pay out. On longer you are sick medicare, the less it actually reimburses you, which is why people in Nursing Homes going medicaid. Medicare is an example of everything wrong with health care in this country, simply trying to cram more people onto it would be a bad idea. What is the closest example to singlepayer . What we callf National Healthcare systems and other countries are actually multipayer systems with private insurance and so on your there are very few systems in which a government is the only payer. Medicare is a good example. Has beendicare consistently under attack for decades now. When we brought in the Medicare Advantage plans come a private insurance plans that seniors choose, those act like private Insurance Companies. They choose the healthiest seniors, and when the sinews get sick, they and send buys them to leave and go into a traditional medicare plan. So it is a more expensive server more expensive medicare. The reason people going to medicaid is because medicare does not cover longterm care. Only medicaid covers that. Under a National Improved Medicare for all system, if you look at legislation we have, it is comprehensive and includes longterm care. We know that by doing that and being able to incentivize communitybased care, homebased care, some countries are looking at reimbursing family members for staying home to take care of their sick people in a family, we can save money that way. So the best way to protect and preserve medicare, which people in this country do love, is to expand it to everyone and improve it so it is not operating in the current toxic and expensive environment. Host you have heard our two guests this morning, dr. Margaret flowers and michael tanner. If you want to ask questions about this idea of singlepayer, we divided the lines differently. If you support the program, 2027488000. If you oppose it, 2027488001. Mr. Tanner . Guest look, 58 trillion in medical debt in medicare debt. The average couple will pay hundreds of thousands of dollars into it, and they will take out about 450,000 and benefits. What dr. Flowers is talking about is losing money in every transaction and trying to make it up in value. Guest i say what we are doing right now is losing a lot of money in every transaction. We have the most complex Health Care System because we have hundreds of different payers spirit we are paying onethird of our Health Care Dollars just on paperwork. That adds up to almost 500 billion a year that we are wasting on paperwork that could be going to health care. In fort collins, colorado, you support this idea of singlepayer. Caller thank you, and i would have to agree with ms. Flowers. If somebody gets sick, the hospitals should not turn them away. Time i checked with a think tank, they said it would cost each american 6,000 a year just to take care of people who do not have health care insurance. Aca is onent on the of the big issues is that not makeh kids are in this to the actuarial pool large enough for affordability. Singlepayer would spread the actuarial pool against everyone. Is charles in colorado. Mr. Tanner, what about the idea that people will ultimately be in the hospital anyway . Guest youre right. It does get passed on to the on toers or gets passed people with private insurance and pay higher premiums. But what takes place in Government Programs like medicare and medicaid exceeds the costs from uncompensated care. Those programs under reimburse physicians significantly. Onicare is around 70 cents the dollar of actual cost. What you are actually doing is those costs are passed on to people with private insurance, as well. Guest the caller makes a good point, that the basic idea of insurance is sharing the risk, spreading the risk around. The bigger you have the group of people in the pool, the more that risk gets spread. When you look at population dynamics, you know about 20 of the population uses about 80 of our Health Care Dollars, but any one of us could be in that 20 at any time and our life if you have an accident or illness. 50 of our population use very healthcaree dollars. But you had that security that when you get sick, the money is there to cover the care. That is what is experienced in other countries. Other countries have private insurance on top of the public system, adding an extra is the public system may not cover. That is fine. Efficient want an system where everyone is covered, you need to have comprehensive provided through a singlepayer system. Guest in medicare, basically everyone under 65 is paying into the system and taking nothing out, and the program is still 58 trillion in the red. So if there were taking out in addition to paying an, that would only make medicare work. To thein addition problems with Medicare Advantage, medicare is operating in a toxic environment. In the u. S. , we pay the highest prices for Health Services and for pharmaceuticals because we do not have a Natural Health system designed to lift up our health. So we do not have the ability to negotiate. There is no rational basis for the prices we have for pharmaceuticals or Health Services. In the system, you can bring some saturday sanity to our pricing. Guest about what that half of all pharmaceutical products are patented in the United States because that is where the research and development is done. 80 of nonpharmaceutical s, wehroughs, such as mri would not want to have price control to limit medical availability. Imagine if you put price 1900,ls on health care in so we have no advances in Health Care Quality since that time, no new products, no new drugs it would be terrible. Guest the majority of our Research Done on health in the u. S. Is sent to the National Institutes of health, the ones who do the upfront research with the breakthroughs, and that then goes on to pharmaceutical companies. A lot of our innovation in the United States when it comes to pharmaceuticals, because it is a forprofit model, it is taking the medication, tweaking it, giving it a new name, patenting and making a lot of money. We can prioritize what our health needs are and direct research towards areas with needs. Taylor from kansas city, missouri, opposes this idea. Say that i am to opposed to the singlepayer system because i have seen what happens in england. In england, they have a baby there that is sick, and yes, it life is but that babys being taken short because the doctors there in the government feel that that they be should just go ahead and die. They want to take it off of life support. To brings. , we want the baby here and give that baby some life with its parents as long as it can. If we do a singlepayer system, were going to end up with a system or the government and whoever is in charge is going to die a situation of you because you dont have qualityoflife. You are healthy and you have qualityoflife. I do not want to see that in the United States. I want to see that everybody has qualityoflife. Host dr. Flowers . Guest it is sad that the situation in the u. K. Has been politicized the way it has to in the u. S. , we have tens of millions of families with no Health Insurance at all, so they cannot access the care they need. Death rates from others and for infants are many times higher than they are and other countries. A lot of people in the u. S. Do not have the ability to get health care they need, including children. Families will go into debt because they have an unexpected complication with a child. The united in states, if we do a national approved medicare for all system, it is a different thing from the u. K. , a truly government owned and operated system. Taking a private Health Insurance industry out of the picture, because they are the and that want to deny care, were putting the decisions back in the hands of the patients and physicians. Guest i will say, in fairness, that this, as tragic as it is in the u. K. , has more to do with the u. K. Court system and the legal right to parents of than it does with the National Health service, although the doctors did make a costbenefit analysis originally. Then it had to do a lot with the legal system in britain after that. But it does set up the fact that every Health Care System in the world rations health care in some way. Lists. Ssian by waiting some ration by waiting lists. Unlimited care is unaffordable. Host this is a recent headline from the guardian about the National Health service. Longer delays for operations cut onee nhs decided to of its most important requirements, relaxing the requirement for hospitals to treat with an 18 weeks. Mean that there are problems with the Current System that they are making these kind of decisions . Guest the u. K. Has been under severe austerity for a long time now, so we are seeing cuts to the National Service there appeared people and physicians are fighting to restore that because they are in the system together. They fight together to make it a better system. That is what we need in the u. S. Here it when were all in, it is social solidarity, and it raises at the bar in the system, and that is what we see around the world. When we are all in it, we have an incentive, including the members of congress being in the same system. Guest it is called the magic money tree system of health care. Health care is a commodity like any other. There is a finite amount of money and a finite amount of hospitals and doctors. There will have to be allocation decisions and we can retain there is a unicorn farm and we can give everything to everybody, but the reality is we have to allocate decisions. The American People want to make those decisions for themselves, not let an arbitrary body make those decisions about who gets karen who does not care. Agree thatlutely people want the choice of the doctors. In our Current System, we do not have those choices. The private Insurance Companies dictate who we can say, where we can go, what treatment we get. Their incentive is to charge premiums as high as they can get away with, shift the costs onto the people. Since the Affordable Care act became law, Insurance Company stocks are booming. United health care is up almost 500 . No reason we should have that element in our Health Care System. What national approved medicare for all, that puts health care back into the hands of patients and their health care professionals. Host joseph in florida, hi. Caller ok, so have a little spiel, as my friends in new york would say, regarding health care. I am a veteran. My three brothers are all veterans. We served during three different wars. After world war ii, we did not destroy the powers, we build them up into great economies, and we also help them rewrite the constitutions. Rewrite the constitutions. In those, health care for systems in those countries guaranteed some type of Health Insurance program. Hello why have we not done the same thing for our own people . Guest a very good reason why we have not done it for our own people, we have an industry here in the United States that is making tremendous amounts of money off of the system the way it is. Theyre the same ones who have lobbyists on capitol hill. This is really a democracy issue if you think about it. In the u. S. , the majority of people support a medicare for all system. We know that these systems work and we can spend less and have Better Health outcomes. But our members of congress, because of the financial interest, locations, are not going in this direction. That is why it is so important that we continue to build this movement to fight for National Health care for all system. Gett i disagree that you Better Health outcomes from some of these interNational Systems. Can alwayslook, we give people a piece of paper that says they have Health Insurance. Goingality is we are not to provide unlimited care for everyone. No Health Care System in the world does that. Many of these countries that say you have a right to health care, the reality is it you do not. Example, in britain, they have the National Institute for clinical effectiveness that looks at the price ratio, makes a costbenefit termination, and they say that the treatment that might save your life costs too much, so you do not get the treatment unless you can supply the market and provided for yourself. If you look at the studies, it is very consistent, International Studies looking at Health Outcomes in this country compared to other countries, looking at the and we have in our country. We arecent studies show failing and serious areas of chronic disease, problems from medical errors am a because we have a system that is not about care. I disagree, health care is not a commodity. Health care is something every Single Person needs. We need roads to drive on, schools, health care. When we get sick, if we make it a commodity, a gets more expensive and more unequal. Guest but it is a commodity and we have so many hospitals, so many doctors, so much money it physically is a commodity. It is the same laws of economics as any other commodity. Guest the problem with that is you cannot put health care and to the marketplace. People do not have the same choice that they have when buying something on the market that i would consider a commodity, like a telephone or Television Set where you can save up and shop around and cho