Midwest Moderate

Rockefeller Republican - Midwest Supremacist - Politics & Econ enjoyer - Hater of DSA & MaGa clowns - ✝️ - 🌐 -🗽- ↙️↙️↙️ - 🥑 - 🔰 - 🏗️ - ⚛️ - 🚂 - 🇺🇸

[Midwest Moderate @ModerateIndy]

@Jerry_C__ Ok but why did he have to do the ramp in the first place? Illinois constitutional law prevented Thompson and Edgar from editing the COLA

It’s also not Edgar’s fault that Thompson chose to continually short the fund

[Midwest Moderate @ModerateIndy]

Listen I would like a fiscally responsible center right government, but let’s not pretend like the pension crisis we have today isn’t partially because of Jim Thompson and Jim Edgar

[Slats Grobnik @MissinRoyko]

You would have a hard time convincing Indiana residents of that …..

[Midwest Moderate @ModerateIndy]

@KEL0818 @rgoldson @realTomSlayton *** said OBM and mean CBO

[Midwest Moderate @ModerateIndy]

Being a “doctor” doesn’t actually mean you know anything about healthcare systems.

Medicare for all is bad policy. It doesn’t actually fix the underlying problems

We will still end up spending ~18% of GDP on healthcare, 50% more than the next highest in the OECD.

[Dr. Abdul El-Sayed @AbdulElSayed]

Democrats will have a 56-seat majority in the US Senate. We need to use it. Pass Medicare for All.

[Midwest Moderate @ModerateIndy]

@KEL0818 @rgoldson @realTomSlayton You’re correct! But while M4A does get you universal coverage, we actually still end up paying the same amount for healthcare through taxes!

The OBM studies has shown that funding mechanisms for M4A would be fairly extreme like a 20% Vat tax or national sales tax. Not ideal!

[Midwest Moderate @ModerateIndy]

@rgoldson @KEL0818 @realTomSlayton No that’s part of a study.

There’s new savings and new expenditures

In some studies they cancel out, in many it costs us even more

[Midwest Moderate @ModerateIndy]

@heathpicker This is, everyone born before 1964 keeps Medicare or their ability to use it.

This is a highlight of a large plan that involves funding and reimbursement glide downs over 20 years

[Midwest Moderate @ModerateIndy]

@UrbanCourtyard I’m almost always with you here but maybe we let this one go? It’s kinda sweet

[Midwest Moderate @ModerateIndy]

@Will51812643 @Jackattack20204 https://t.co/ixSJM733h5

[Midwest Moderate @ModerateIndy]

@Jackattack20204 Of course it being Illinois you’d have to require that funding levels from other sources have to remain within their 10 year averages.

Otherwise they’ll just proportionally drop pension funding with the income tax increase and the tax will end up permanent

[Polymarket @Polymarket]

JUST IN: Developer abandons $10B Michigan data center project after residents reject the proposal, despite promises of $54 million in annual tax revenue & a $20 million community investment fund.

[Michael McLean @cornoisseur]

It took CTA and the feds 12.9 YEARS to do the environmental review for the Red Line Extension!

BAAJA would be a boon for public transit projects that have a federal nexus. Could shrink timeline down to just 2.1 years!

Call your senators and congress members!

[Midwest Moderate @ModerateIndy]

@heathpicker In my opinion we’d do something like this

https://t.co/uGLNpjRoQx

[Midwest Moderate @ModerateIndy]

I would prefer that we implement a U.S. Singaporean hybrid system.

Every gets an HSA with a mandatory match from you and your employer kinda like FICA. The median American spends about 8-12% of their paycheck on HC today and I would like to make it 4-6% with your employer matching ~5% and paying another 4% to a general trust for the first 20 years of the program. If you reach ~250k in real dollars in your account, you no longer have to contribute and your employer just has to maintain it at inflation. There is a max amount you can hold as well so it doesn’t become a tax exemption vehicle for the wealthy.

The government would run a universal catastrophic coverage plan. Premiums for that plan would be progressive based on income and no premium if you make under 50k indexed to inflation. There would still be 5% coinsurnace. For this structure we can cut and convert Medicare.

The third pillar is a medical trust fund. This we fund with Medicaid outlays and there’s an investment structure for it. The fund is used to top off low income HSAs and elder accounts. When the fund gets over a certain amount the independent board governing the fund has the ability to disperse dividends back to Congress, to low income accounts, or greater seeding of under 18 accounts. They have discretion there.

There’s a number of cost saving measures that have to be included in this as well like upfront cash pricing, broader negotiations with the rest of the OECD on balancing drug costs and implementing reference pricing. There are hospital savings we have to get through charting and coding streamlining. Licensure for PAs, NPs and really all medical personnel needs to be streamlined across the states.

I’m working on a paper for this plan, there’s a lot involved with fixing healthcare in the U.S. but this is a high level overview without getting into glide downs on reimbursement or rural hospital or specialty clinic subsidies.

[Midwest Moderate @ModerateIndy]

@sneakysalmom My preference would be this

https://t.co/uGLNpjRoQx

[Midwest Moderate @ModerateIndy]

I would prefer that we implement a U.S. Singaporean hybrid system.

Every gets an HSA with a mandatory match from you and your employer kinda like FICA. The median American spends about 8-12% of their paycheck on HC today and I would like to make it 4-6% with your employer matching ~5% and paying another 4% to a general trust for the first 20 years of the program. If you reach ~250k in real dollars in your account, you no longer have to contribute and your employer just has to maintain it at inflation. There is a max amount you can hold as well so it doesn’t become a tax exemption vehicle for the wealthy.

The government would run a universal catastrophic coverage plan. Premiums for that plan would be progressive based on income and no premium if you make under 50k indexed to inflation. There would still be 5% coinsurnace. For this structure we can cut and convert Medicare.

The third pillar is a medical trust fund. This we fund with Medicaid outlays and there’s an investment structure for it. The fund is used to top off low income HSAs and elder accounts. When the fund gets over a certain amount the independent board governing the fund has the ability to disperse dividends back to Congress, to low income accounts, or greater seeding of under 18 accounts. They have discretion there.

There’s a number of cost saving measures that have to be included in this as well like upfront cash pricing, broader negotiations with the rest of the OECD on balancing drug costs and implementing reference pricing. There are hospital savings we have to get through charting and coding streamlining. Licensure for PAs, NPs and really all medical personnel needs to be streamlined across the states.

I’m working on a paper for this plan, there’s a lot involved with fixing healthcare in the U.S. but this is a high level overview without getting into glide downs on reimbursement or rural hospital or specialty clinic subsidies.

[Kareem Rifai 🌐 @KareemRifai]

Extinction-level community note

[Bill Scher @billscher]

The Hamilton agenda:

End Iran war
Rollback tariffs
Bipartisan health care reform
Unspecified immigration reform
Shore up Social Security trust fund
Reduce national debt

[Midwest Moderate @ModerateIndy]

@heathpicker I’m not saying we shouldn’t have universal healthcare. I’m saying we shouldn’t do Medicare for all.

There are better systems. People don’t understand how different this plan is than even European single payer systems

[Midwest Moderate @ModerateIndy]

@dastardlydre @RocCityBuilt I’m not aware of that study and would be genuinely curious to read it because the effects of M4A on medical innovation will be terrible

[Polymarket @Polymarket]

JUST IN: Democrats propose requiring AI companies to obtain federal government permission before training AI models, with up to 20 years in prison for violations.

[Midwest Moderate @ModerateIndy]

@barista_ta27411 No those are the two moderates I said could win.

Their missteps aren’t something anyone should endorse and yes anyone with a brain would have wanted to try and do pension reform back at the inception of this mess

[Midwest Moderate @ModerateIndy]

They are not commensurate with the increase in consumption

look at European models, the best ones have some sort of cost share. It’s behavioral economics.

No one is saying the savings this does accomplish don’t affect expenditures. They don’t address the whole system tho and they aren’t sufficient

[Midwest Moderate @ModerateIndy]

@u60cf28 @RocCityBuilt Reducing costs in one or two areas doesn’t mean you reduce overall spending.

And yes the second order effect would be awful

[Midwest Moderate @ModerateIndy]

There’s like 8 different analyses of this plan and almost all of them say this will cost an insane amount, bankrupt hospitals or create shortages

I’m in favor of the government being involved in healthcare. The market requires it in my opinion. I’m not arguing for some free market Romney/Ryan plan

[Midwest Moderate @ModerateIndy]

I’m not disputing that there are efficiencies gain from really any single payer. That’s true. But when you have a zero deductible, zero premium, zero copay, zero coinsurance plan, youre going to have to address the system wide costs, not just drug prices and admin costs because you’re paying for everything now. Universal coverage is a great aim. One we should pursue but spending the same or probably more on healthcare as we do today is bad policy

I’m arguing it doesn’t tackle a lot of the underlying costs and yes I am arguing that the savings aren’t commensurate with increased expenditures.