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Why BernieCare won’t happen

Sure, there’s lots to like about it – no paperwork, see any doctor you want, no cost for any services, covers nursing home and long term care, dental, vision, you name it.

It will cost a good bit more – at least initially, but over a decade we’d actually spend a couple trillion dollars less than if we stick with the current clustermess. Despite the initial sticker shock, as voters get increasingly scared and frustrated by the crappy “health system” we have today, the balance may well tip towards BernieCare.

Except it won’t, and here’s why.

Infrastructure – There is no current wholly-government infrastructure in place that would be a platform to handle BernieCare. Much of Medicare and Medicaid is administered by private or not-for-profit organizations. It would take years and tens of billions to build that infrastructure. Sure it may well be more cost-effective than using private entities, but I just don’t see us collectively agreeing to spend the sums needed to make it happen.

Impact on employment – BernieCare would essentially eliminate 99% of private insurance. The 540,000 people employed in that business would no longer have a business to employ them. I don’t see Congress voting to vaporize over a half million jobs; and that’s only to start. As things got more automated, many more admin roles would be eliminated.

Big money’s control over politicians – Citizen’s United killed the last faint hopes we could keep dirty dark money out of politics. Fact is, healthcare is by far the biggest political contributor, led by big pharma. Add in device manufacturers, healthplans, physician groups and health systems – all in healthcare collectively pumped about $650 million in cash into political coffers last year alone.

Recall what makes our healthcare so damn expensive is that for-profit entities are heavily involved in healthcare services, devices, drugs, and everything else – BernieCare would crush their profits if not eliminate them altogether.

If you think the healthcare industry contributes a lot now, wait to see what happens if BernieCare gets just a bit of traction.

What does this mean for you?

If we were starting from scratch, BernieCare is by far the best model. We aren’t, so it won’t get off the ground.

That’s not to say some form of MFA/Single Payer isn’t viable. More on that in a future post.

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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