An interesting discussion on the issues surrounding paying for any "Medicare-for-all" plan in America.
Surfacing the questions on utilization, and changing the way taxes are collected open up some really interesting mechanics of how our healthcare system works (or doesn't work).
This is so much easier than everyone is pretending. Two words: "COBRA Medicaid." The Consolidated Omnibus Budget Reconciliation Act of 1985 allows you to buy your healthcare coverage if you've been laid off. You get to pay what it costs your employer. In the case of my employer, that's $48k a year (I know!). For the state of Washington, under Medicaid, that's $6k per year for adults, $2k per year for children. Medicaid is currently not available for individuals making over $1400 a month. You don't think a TechBro wouldn't happily pay $500 a month for medicaid if he could get a payout from his employer instead of a health plan? On the private market the insurance companies get to play whatever hijinx they feel like; on the public market they're heavily proscribed by law. For me? I could be saving $30k a year if I could buy medicaid. Which means every insurer has a $30k a year incentive to compete for me on price. 'cuz thing is, there's six different insurers administering Medicaid in WA state and they all get paid the same. If you can sell me "Medicaid Plus" for an additional $50 a month, I'll probably jump for it because that's what consumers do. You know what medicare-for-all needs? Fuckin' free-market participation. Problem solved.