Host this is the chief washington correspondent for Kaiser Health news to talk about a theme that emerged from the debates. Medicare for all versus public option. How would you decide those things . Option. How would you decide those thinks . Guest medicare for all, which is what some democrats have been running on for years, would basically take the Medicare Program that is popular. It serves 60 million seniors and expanded to everyone. In practice, that is not what it would do. It would create a more Generous Program that might or might not be called medicare and extended to the entire population. Is idea of medicare for all the government would pay the Nation Health bills. A public option would create a Government Program like medicare, medicaid and make it more available. Now you have to meet qualifications to get into the Government Health provided programs. A public option would make it easier for people to get into government paid health care. For democrats debating of the issues, why are they firmly at the getting for these positions . What is wrong with the Current System . Guest everyone agrees the Current System is not working. People are paying too much. Most people have insurance but a substantial number do not. People who do have insurance literally cannot afford to use their insurance because they have multithousand dollar deductibles. Everyone agrees we need to fix what is broken. Democrats agree everyone should have health care, that health care should be a basic rights. How you get there is the debate and whether you do it in all one fell swoop like medicare for all, singlepayer or gradually with the public option or whether you give people the choice of keeping their private insurance if they like it or going on a government plan. That is what the democrats are debating. Guest how my test host how are my concerns . Guest you can be put out of business. It is hard to imagine there will not be some role for private insurance, even as the administrator, that a lot of Large Companies now, they selfinsure but higher Insurance Companies to administer benefits. Private companies administer medicare and i am not talking about Medicare Advantage. I am talking about service medicare. Most of those bills are managed by private Insurance Companies. Private Insurance Companies are washing this with rate wariness great where a mess. Wariness. Providers are watching with more panic. Providers say they can afford to take medicare now because private insurance pays them more. Private insurance were to go away in large part, they would repave be paid less. Host we will talk on other themes ursus the public option. If you want to ask questions about it, we divided the lines differently. If you receive insurance through the aca, 202 7488000. For those who get insurance through employers, 202 7488001. If your uninsured, 202 7488002. The current medicare system as it stands, does it have the ability to admit all of these potential people . Guest the Current Program is in financial distress because we have got 10,000 baby boomers a day who are qualified fifth for medicare. Baby boomers are still young in their low spending days as far as medicare. Something has to be done to shore up medicare financing going forward. People except for they could but it would have to be some kind of new financing. Supporters just what supporters are calling medicare for all is not medicare. It might be a brandnew program that the people on medicare would go into the people on medicare would get extra benefits. There is a lot of things not completely ironed out. Host you talked about new proposals being more generous. How generous and who is making these proposals . Guest according to Bernie Sanders, who has been pushing medicare for all since 1993, probably before that. Cosponsor. Wer level under his proposal, people would not have to pay anything outofpocket. There will be no copayments. People on medicare now has to pay. In exchange, you would finance the bills through increased taxes. His argument is everyone would save money. That is probably not the case. Juste who do not consume consume little or no health care and in any given year there is a lot of those people they would have insurance or it when their time came to have help expenditures, they would be covered. Its hard to know. And so you know what is going to be covered and what is paid, you have no idea how much it is going to cost. Host how do the candidates and their proposals still with rings like dental and eye glasses deal with things like dental and eye glasses . Guest those are things that are missing largely from the basic medicare package. Things like dental and eye coverage and foot care, things that are medical but not part of the medicare package. Until 2003 prescription drugs were not part of the medicare package. Under the proposal of medicare for all, everything would be paid. There is a health bill and senate bill and one in longterm care would also be paid. That is a huge threshold decision that would have to be made if and when coverage gets around. We saw Kamala Harris introduced her version of this. What of the main features and how is it different from the others . Guest it is an interesting hybrid. She would have medicare for all and it would be a lot like the current Medicare Program and that you could choose to go into fiserv serve plan. You could go into what is currently called Medicare Advantage, which is managed care and it generally offers more benefits. In exchange you give up the chores of doctors and hospitals. You choose from a network. This popular because of extra benefits and it covers outofpocket cost that medicare does not. A third of Medicare Beneficiaries are in Medicare Advantage. You could choose the public plan of the private version of the public plan. Is not entirely clear but it looks like provider Insurance Employer insurance would go away under Kamala Harris plan. You talked about these proposals since 1993. Lets say a democrat does win. What is the potential as far as making these plans reality . Guest anyone who covered the Affordable Care act knows it was not easy. The democrats had 60 votes in the senate in 2009. It was still hanging by a thread. It almost collapsed any number of times. This, much more dramatic, you would need to get rid of the filibuster have 60 votes. You would need to balance the needs of the conservative string swing district all the things were seeing now on capitol hill. It would not be easy. For those who think, oh it is ok if we elected democratic president and senate, this is going to happen. Youre going to get a debate. What is going to happen from the debate . Guest this is our first caller. This is jim and missouri. You are on with julie rovner. Caller good morning. Like most people, i get my health and science insurance from my employer until i was hired fired at the age of 58. I am in favor of medicare for all. The way i would finance it would be to take the thousand dollar a month premium that my employer put towards my insurance, pay 500 and a new tax to finance the medicare. The other 500 goes in my pocket. To me that is a winwin. A new tax that would be painless. Private insurance through the yearabout 16,000 a provided by the government. No outofpocket costs. To thenot taken spin doctor for years. I have no plans on going to the doctor. If you want to keep your Health Care Cost down, avoid doctors. There is the argument that if the government were to start paying for health care ,ather than private insurance many private Insurance Companies there isofit but profit in the Insurance Industry for sure and the ideas that if supplyrs did not have to insurance and more, some of that money could go back to the workers in higher wages and it could. Most people, 180 Million People, have employerprovided insurance but employers are different in how much of that they pay for. Most of them pay for a substantial part but some employers do not pay for much. Those people would save money with increased packets taxes. People who pay a lot of that portion and if they are making a good salary might pay more in they do not use the Health Care System much would not use. It is always about tradeoffs. Everyone will be affected differently. Host there is a new taxing system to finance this. The middle class would be hit with the tax. If it is as generous as Bernie Sanders would like, it is impossible to finance it without having that tax go down to middle classes. His argument is everyone would be better off. Many people would. Some people would not. We learned this with the Affordable Care act. Notfew people who were screamed really loud. You would expect the same under medicare for all. That is where the candidates are hedging their bets. They do not want to disrupt peoples coverage if they like it. Nobody loves their Insurance Company but if people are afraid of change and sometimes their promised change would be better, and sometimes it is and sometimes it is not. This is from texas, john. Caller thanks for discussing this serious issue. One of the ways we could lower a ost of insurance, is a asa. I am getting a serious discount. It gives us more control over spending. Medicare for all is not about Health Insurance. About control. Once the government has control over your health care, we are no longer a democracy. We are a communist country. What bernie wants to do is illuminate all options and control everything we have to do and no one in their right mind would hand over the health of their family to the government. It would be insane. Thank you. Thet hsas are something republicans have been pushing hard. Triple taxl preferred savings vehicle. You do not pay taxes going in, coming out. You pay taxes on what it earns. If you have enough money to fund your hsa and have few enough medical bills that your hsa will cover it, it is a great thing. A lot of people like them. There are difficulties. If you have an issue, you can negotiate. You can usually get a discount. If you pay cash, you do not have to go through an Insurance Company but it is hard to know how much things cost. That is something that compass working on that is bipartisan more transparency in prices of health care. Sometimes if you call, a provider will not be able to tell you. They literally dont know until bills get processed. Hsa. Are issues with host the Family Foundation did a poll. In favor, 51 percent, opposing 42 . In july, a healthcare care plan among democrats that 72 of supports, republicans 15 . What is meant by singlepayer and what do these numbers suggest . Guest one thing is support for medicare for all is shifting. It sounds great. Everybody likes medicare. It is already socialist. The government is paying for Seniors Health care. It is very popular. When you tell the public you can have medicare and not wait until youre 65, they say great. It means or taxes might go up. Then support starts to drop. It means the government will decide what benefits you get in support drops. We are at the stage of the debate where the terms are being defined. What is interesting is if you read into these polls is not just what the top lines is about support that what it says when you say, what if x, y, z and you see where the real support is. Democrats are more in favor of government run, government paid health care. Republicans are in favor of more and that has been the fight. Host these discussions about expansion, a lot appoint the veterans administration. Are theions cautions of that type of service . Guest medicare is not a government run system in that the providers are all private based. The government pays their bills. The v. A. Is like the British NationalHealth System where the Health Care Professionals are employed by the government. Nationalized system. Of privatefair bit insurance in england so while this discussion of, we are going to get rid of private insurance entirely there is not a single country that has no role for private insurance. The v. A. Is more like the National Health service. Our system is malik canadas canadas more like system in that the government pays the bills but the Health Care Providers are not government. Host are there Cautionary Tales from canada . Guest there are some. If you go to canada, most like their Health Care System. But there are sometimes waiting lines for things and people come to the United States to get care if they do not want to wait come up with hillary particularly for elective care. People for canada by drugs because they are cheaper there. This is ron from New Hampshire host this is ron from New Hampshire. Caller i love this show. You are great. Should mention i did call on the wrong line. I do not have insurance. I did have a ca but i no longer do. I have a couple cap who questions. The middle class is shrinking as forest taxes. In the middle class are not happy. The rich pay little or no taxes. The ultrarich pay zero in taxes. The poor do not pay met much in taxes. That leaves the onerous on the middle class, which is making things difficult on the middle class. If in thise to know next election cycle, we will see the republicans for the last 15 years, trying to get rid of the aca if they are going to defend it now and defend it against medicare for all, which is what the democrats are looking for. And i have to say, i do not believe medicare for all and medical help for our general masses in this country is going to destroy our democracy. I do not see it as socialism. I see it as a socialist program. We need some of those to tamper some of the wealth that the Upper Echelon is amassing. Sorry to cut you there but you put a lot there. Asst medicare is known social insurance. They are pretty popular, whether socialist. They were called socialist at the time they were created. Fdr wanted to health care and did not think he could get through congress. None of these things are new. The colors right about the middle class being unhappy. Both parties want to help the middle class. As to what the republicans will do, what is interesting is there is a court case going on that was argued at the federal euros Appeals Court in new orleans that could limit the desolate entirely. Ca the republicans are scrambling to come up with a plan b. House is trying to put together a health plan even as we speak although it is not clear what would begin it. He would not be via for the correct but they say they would continue to protect people with preexisting conditions. That is the most popular piece of the Affordable Care act and that would go away if this lawsuit prevails. It says congress a limited tax for people who do not have Health Insurance as part of the tax bill in 2017. That renders the entire health unconstitutional and most lawyers on both sides of the issue say that is a dubious claim. It was that lower court judge that found it to be the case and during the oral arguments, two of the three judges seemed sympathetic to that. It may well be back before the supreme court, possibly as early as next year. How do preexisting conditions fit into those plants . Actt the board will care still are protected. One of the Big Questions among the president ial candidates is do you build on the Affordable Care act . Joe biden wants to do that. His plan would take the Affordable Care act and expanded. Expand it. Take away the threshold. Rybody would get out of toss it and start over. That is the crux of the democratic debate. In their island, go ahead. I am a 41yearold africanamerican single woman with three children and we have been on medicaid for 15 years. Sucksy i see it, medicare. I understand from talks about that and people understand. Heir Customer Service sucks if you want to get treatment, you have to be careful how you go into that. I do not know what the argument is about because the service sucks anyway. Thaty seems to trust service. As a single mother who has been dependent on this, i have had a hard time. I made myself sick trying to find out how to get an appointment. They do not take appointments. They do not treat for dental care. They do not do anything besides treat people like guinea pigs, especially black women. Who cares about medicaid for all . It comes to a time where you have to say, there is a major emergency. You get into a car accident or whatever, but on a regular trying to get treatment on a regular basis . They do not care about nobody. Host you major points. I think cullison medicaid, not medicare. Health system is bureaucratic and difficult to navigate and can be difficult. A lot of people with private insurance who have the same feeling about the Health Care System it is a fair point. Medicaid is supposed to cover all the things the color is talking about and it does cover but it can be difficult to get. This is a more fundamental problem with part of it is because we have a multipayer Health Care System. There are some new layers of bureaucracy. If the Public Sector takes over the entire thing, it will get worse. There are people who think if we get the private insurance out of it, there are people on both sides. Getting2 Americans Health care through their jobs. Their average premiums, 600 96 for single coverage, 19,000 dollars for family coverage. Average, workers contributing 18 for the premium of civil coverage. 85 of workers having an annual deductible for single coverage. For single coverage, 1573 dollars. How do those calls change under proposals . Ultimately, no one pays out in a cast to get services . That is the ideal. Guest those big numbers that is not how much insurance costs. That is how much the average private insurance costs. The workers pay a percentage of that, usually a small percentage on average a very is. Some employers are generous and premium. Very little or they pay some premium but leave large deductibles and coinsurance for people to pay when they use the system. It depends. It is not how the system is structured. How much providers get paid. In the United States, we do not use that much more health care than our competitors and other industrialized nations but we pay more for the care we use. Our prices are higher than most other countries. As i mentioned, providers are concerned about having their pay cut. How much of that they could would close their doors and how much of that they like getting paid a lot. Have to bere things straightened out. The buttigieg endorses medicare for all who wanted. Guest that is another word for the public option. There is medicare for all there are variations on expending a medicare like program to more people. Some people are talking about medicaid for all. There are different ways to do this but it is basically saying, they do not want to take anybodys insurance away. Remember back to the failed Clinton Health can plan. Louiseusly had harry and commercials from the Insurance Industry sitting around their Kitchen Table worrying about losing their employerprovided insurance. This is the irony. People do not love the Insurance Industry but they do not want to have it taken away. Of these more gradual programs would give people a choice. If they could see the public plan is better, maybe we should move to that, then it would happen more as an evolution than a revolution. That is the debate sorting itself out. Host lets show you some of that with congressman john delaney and Bernie Sanders talking about their ideas. [video clip] health care for free. We do not have to be the party of subtraction and telling half the country that their Health Insurance is illegal. My dad loved the health care he got. He would never want someone to take that away. Half of Medicare Beneficiaries have Medicare Advantage, which is private insurance or supplemental plans. It is also bad policy. It will underfund the industry and it is bad. Let me go to senator sanders now. The fact of the matter is loseof millions of people their Health Insurance every year when they change jobs, when their employer changes that insurance. If you want stability in the Health Care System, if you want a system which gives you freedom systemce, which is a which will not bankrupt you, the answer is to get rid of the Drug Companies and Insurance Companies and have medicare for all. Host when Bernie Sanders uses that word, stability, can you paint that in . Guest they are both right and wrong. They are both over talking event, which is what candidates do. John delaney backed off his earlier claim that every hospital would close under medicare for all. He is just saying medicare many hospitals would close. Senator sanders is correct that people will lose their insurance when they change jobs. That is true. It is a matter of which do you prefer and what are you more worried about . Are you worried about profiteering in the Health Care Industry . A you worried about the government determining what benefits you get . Who do you distrust the least . Host charlotte, from texas, high. Caller i want to know why medicare for all . People that work pay into it. Medicaid is freebies. If you really want medicare, you have to pay the premium that you have to pay every month. The premium that you have to pay every month goes to supplemental insurance and a premium for drugs. He speaks about the advantage. Most do not want to take it. How medicare, which is really medicaid, for all is a great deal. First of all, it is not medicare. Medicaid you are talking about. They call it medicare for all because medicare is popular. People know what it is. The caller is correct. Medicare has a lot of costsharing for its patience and people do pay. You pay the medicare tax what is withheld from your paycheck you sent to the government. There is a tax for part a of medicare. You get when you become eligible that for free. There is a premium for part b and there is a premium if you have a standalone prescription to them. Sometimes there is a premium if you going to Medicare Advantage. The Medicare Advantage straight off, you get more benefits and fewer outofpocket costs. You do not get to every doctor or hospital. That is the way medicare is that appear that is not the way medicare for all would be set up. It is not really medicaid because medicaid is shared with the state. Medicaid is a different kind of program. You could do medicaid for all and there is talk of that because the medicaid benefit packages much wider and there is less cost sharing because it is for people who do not have a lot of money so they cannot afford to help pay costs. There are variations in how you do this. I agree. It is confusing to call it medicare for all because they stumble over themselves. It is not medicare. Host how do proposals treat prescription drugs . Guest they would be covered in the public option. The idea of freestanding Medicare Prescription Drug plans, because it was the Republican Congress and republican president in 2003, that put the doctrine together and they wanted a role for private insurance, so they created these prescription only drug plans. The administration announcing efforts to import drugs from canada, can you sketch out what that proposal is and how does the canadian government do that proposal . Guest they are not thrilled. There are 37 Million People in canada, smaller than california. There are not enough drugs in canada to provide the drugs for the United States. What it is doing is not supporting canadian drugs as supporting price controls. That is why drugs are cheaper in canada and other places. The government says we are not going to let you make big profits. The and i states is the him the country where the companies can charge what they want. You have people traveling to canada to get going over the border and getting cheaper drugs. That works. If you can go to canada and save money on drugs and have a prescription and bring them back and Border Patrol will let you bring them back you obviously cannot bring large master resell and what the Trump Administration is looking at is some states and pharmacies, bring back drugs at their lower prices and sell them. It is not clear how would work. Theould not cover most of expensive drugs and to would only work if it stayed small. It is not a longterm solution for drug prices and for everybody. It does allow the Trump Administration to say we will let you buy cheaper drugs from canada. Host stan in gainesville, virginia. Caller good morning. I could talk an hour on this. The couple of things when people call in and say going to a universal Health Care System andedicaid for all, communism meant whatever it is, if that is the case then we have to declare israel and japan and canada and germany and all those countries communist countries. They all have universal health care. We are the oddball. When were talking about the my costlook at individually. Does the highest estimated that 10 taxes. W2sook at line 12 on my says how much my employer pays as a benefit that i never received. Towards myg is paid the personurance, can be quite higher. That is paid to the Insurance Company on my behalf. That money moves over to me as payments buthad my i also paid towards my Health Insurance. When you combine that amounts, i get paidsonally 70,000 a year. Income,k at 10 of my people in 23,000 a year, that would imply that i am making 230,000. Which is well above my future employment pay. When we look at the amount of money that i would actually be paying, if they write the bill in such a way that that money would go to the Insurance Company comes to me as income, most people, not making over 150,000 would probably benefit greatly and those people paying private insurance will start seeing their fellow employees making 10,000 more a year. Host thank you. Big if, if is a employers stop providing insurance put that money into wages instead. I am not aware. I do not know that congress can guarantee that. The amount that employers pay towards Health Insurance changes every year. There would be winners. There would be a lot of people who would pay a lot less. There it be some people who would pay more. That getse part brushed aside. Also, it is individual. Everyone has to look at their own paycheck and figure out what is good for them. It is the president s job to figure out the solution to help most people. It is unrealistic to say everybody would be helped by anybodys plan. Host from tennessee, this is richard. Caller good morning. Thank you for the conversation. It is informative for me the visible reason, my daughter enrolled in medical school. She is looking in the neighborhood of 250,000 to 300,000 in school cost. I look at this as medicare for all and everything is free. You are going to have a lot of. Onsumers of medical care either going to be enough provide medical care . And theyat is a good question. There was concern monday Affordable Care act past there would be a shortage of Health Care Professionals. One title of the Affordable Care wenthat nobody talks about towards helping train more Health Professionals, not to stock is Nurse Practitioners and whoand other professionals can provide primary care to winter there were not be a shortage. 20 Million People got insurance as a result of the Affordable Care act and there are issues with shortages in general but the Affordable Care act self does not create a shortage of medicare professionals. That is an issue the debt that medical professionals, not doctors but again Health Care Professionals incur. That is one of the reasons they charge high prices. They have a normas loans to pay off. There is a move towards trying to make Health Professionals school less expensive or tuition free. Loan repayments, you can go and the government will help you pay off your loans. Those types of things can be expanded. You giveissue if everybody Health Insurance coverage and that the caller pointed out, make things free so people will use more health care. Youll get people who needed care who cannot get it before getting it or you might get a necessary care. That will be an issue. Host have you heard formal responses doctors, nurses, medicare for all public options . Guest the Health Care Industry in general is not a fan of medicare for all. The association killed every proposal to expand Health Insurance. Against, they fight its. They did not win. The Affordable Care act they did come into the fold negotiated with the Health Care Industry because the sick the decision was made you cannot fight the Health Care Industry so you better get them on board. Julie rovner talking about medicare for all and public option proposals, darrell from new brunswick. Hello. Caller hello. I have a question about public option. I want to find out if i have private insurance, and i get sick and cannot work and therefore cannot my premium, what kind of Health Insurance what i have . Guest that was the idea of the Affordable Care act. You no longer have a job. For whatever reason, you will by insurance through the government. Now you get a government subsidy but those are private plans under most of the public options being proposed. You would be able to go out. You could buy new insurance. Plan, whatever is best for you. Host from newark, new jersey, james. Aller hi what Bernie Sanders is proposing, i am not going to take. I am not rich. I pay nothing when i go to the doctor. Is. Edical doctor, that because my Health Care Takes care of me, physical eight. So, at the same time the work paid nothing at all. Wiest do that in the 70s. Remember . In this country. Thank you. Thet it is not so much company that provides the insurance. The type of insurance you have. Some people are happy with their private insurance. That is one of the reasons we are debating medicare for all versus the public options. It seems like any candidates, the largest hurdle they may have his winning of the public were the idea of what they want change. Guest is important to have the debate. Everybody is frustrated with the Health Care System. Maybe not this caller. It is not functioning well. We are spending an increasing andnt of gdp as a society not necessarily getting the returns we would. We are way down the list. We are spending a lot of money and getting a lot of value. Everybody agrees me to do something about it. What is it that we as a society want to do . Our system, how to sick that other systems and what of a doing better . Guest almost everything. A lot of our trade competitors do but to have universal Health Insurance. It is run by the government so they pay a tax but at least it doesnt fluctuate. There is more stability in those other countries. They control the prices. Health care of hospitals and doctors, where they do that. Some do a better job than others. Depends where you live. If there is a single Hospital System and the insurers have to take it or if there is a single insurer in the hospital has to take it, so there is difficulty in different parts of the country. If we rationalize it, some people like going to be dislocated. They are going to complain. There a system that relates well to the United States versus the number of people . And why they do it well . Guest what we are bigger than most of the other countries. There are systems in europe that do it well. You can think of them if not communists than socialists. I spent some time in switzerland, which is fairly similar. It has an individual mandate. People have to buy private insurance and private insurance in switzerland is expensive. It took me a lot of figure out why do people like it so much. They paid high taxes in switzerland and it covers everything else. They do not have medical school if they go to medical school. They have paisley. They do not have to save for college. Save forot have to retirement. All these other expensive things that the american middle class a story about, they only have to pay for their Health Insurance. Host scott in georgia, hello. Caller i am an insurance broker. I have been in the business 20 years. In south georgia when we had had three or 45 Insurance Companies to pick from for Health Insurance. Post apa, service for individual , you do not have competition. When you do not have competition , it does not give you a lot of choices. Another thing to come in on, i have noticed how politicians speed up the Insurance Companies and it is always the Insurance Companies fault. Ultimately, the providers are the ones making the money. You never are politicians question the providers themselves. Withworking with a system the providers. They are trying to pay. Host thanks. Guest yeah. This dates back to the Clinton Health plan. It was the Insurance Companies and Drug Companies who were the big enemies. Everybody else was getting off and the caller is correct. The money is openly being made by providers. There are people skimming through it as it goes through, which is another issue. Biggest hospitals make an enormous amount of money and they set the prices for the most are in a mosttals every congressional district. Hospitals are important. You need a hospital. This is the issue here. Get the price and it is hard to get the price. Host and the hospitals in the congressional districts, i how consider this issue. Thats good go to south carolina. David, good morning. Caller good morning. I am 65. It was Kaiser Permanente and Richard Nixon that enabled the aberration and health care that we have in this country. She is going to say not connected with the Kaiser Family was connected. The republicans in my lifetime have always been for the few, not the many. A were always for the bosses, not the workers. They are for Insurance Companies as much as the right wing democrats are. They bought and sold. They followed the money. The profit between Insurance Companies and big pharma are nothing but late blatant usery. As far as the middleman, i do not want the government between me and my doctor. I would rather have a government i could vote out than a ceo of a corporation that can just take me for has much as he could get. Guest that is the debate. As i said, with 20 distrust least which one do you distrust least . Host from livingston in massachusetts, hi. Caller good morning. My questions are, what appropriation is covered or private insurance . What is covered by the Insurance Company . Generally, the is currents companies are the ones the Insurance Companies are the ones that decide the service. And the Insurance Company on the covert mostly company with a lot of employers, employees. Most people as an individual cannot afford insurance. They do not cover individuals. Cannot afford it. Guest the Affordable Care act theyrance company kept the percentage of profits. If that percentage goes up, that percentage could be a larger or smaller number. That could be a big concern. It is hard to say how much the people had predators. There are a lot of people in medicare with Government Insurance who has a private plan. There are people in medicaid on private insurance that is contracted with the government to provide the care and there are the 150 to 180 Million People who have employee provided insurance. The gentleman who loved these Insurance Companies, he loved that insurance. That Company Provides different toues at different rates different employers and segments of the market. We definitely have a hybrid system now, government and private. Which one would you like to squeeze out and which would you like more of . Host a lot of questions about his Health Care Programs what should have been asked or what was not asked that you thought was important to ask of these candidates . Guest i feel like there were a lot of issues that went untouched. They did not talk much about drug prices. That is a huge issue. They did top not talk much about the opioid academic epidemic. There was one brief mention of mental health, which is an issue this week. They were a lot of things that did not happen. Really wish somebody would ask more about the tradeoff. The public versus private and would you rather vote that your congressman than not having any control over this. The ceo that you cannot reach. Those acre issues a lot of the candidates got stuck in the weeds of their own plan rather than looking at the Bigger Picture of how do we want to provide health care as a society . Host from buck in north carolina, go ahead. Caller yes. My situation is complicated. I am retired on disability several years ago. Have medicare i have private insurance from my employer. Medicare sets what the doctors are paid and since i have gotten on medicare, the doctors get a lot less than what they did when i just had the private insurance , but my calls to month was just over 100. My private insurances about 250 a month. The leaking a have to pay for when i go to the hospital i am lucky i live in durham, north carolina. I do not pay anything when i go to the hospital. The other thing i pay outofpocket is my premium. I pay a toll payment from my medication. Most of those are 10, except for the specialty drugs i take which are 90 but that is for a 90 day supply. That works perfectly for me and i do not know why a system like that could not be implemented for everybody. It just seems like it is a winwin situation. Everybody gets medicare once they retire and medicare sets the rates now. And it is usually a lot less than what my private insurance your private insurance paid up until you get the medicare. I do not know how the hospital is staying different. In the hospital for two months and major surgery, and i did not have to say anything. Host thanks. Guest somebody had to pay something and that is the argument it tends to go towards. Private insurance pays more or if you are uninsured, you can see films. The cost gets moved around. The argument that it is great for me so it should be great for everybody best providers say we cannot afford to do that for everybody. We can do it for this subset of people, but if this subset does not pay anything, then some subset of people has to pay with that person didnt. At what point is it sustainable for the Healthcare System that is the balance we have to find . Been a years and the Trump Administration allowed rules to expand skinny healthcare plans. What are they and what is the result of that in the expansion . Big in the Obama Administration. The idea of shortterm plans is if you are between jobs or a College Student graduating and needs before they get a job, they need to talk for a couple months. They tend not to be very generous. They do not cover a lot of things. They can still not sell you based on preexisting conditions. They cannot cover preexisting conditions. They are not compliant with you for the care act requirement. The Obama Administration limited them to three months. They were concerned people were buying them instead of dance. Be Trump Administration reversed that. Lasty these plans and they as long as 364 days. There is a concern people would be rushing to buy these plans instead of compliant plans. It has happened in some places. It happened a lot but we are starting to see stories of people who bought this insurance thinking it was real and they got sick and discovers nothing was covered. There is that part of it. It is not as disruptive. There are a lot of things going on. The Insurance Market has proven to be more stable. Out signed up last year, find out the year before. There has been a little bit of impact but not a lot. Host from massachusetts, catherine. Caller hello. I will try to make this brief. It is compensated. I was injured in may. I fell and hurt my right arm. With an elbow. Since then, now it is august. I still have nothing is get my wrist x rate. I have cross. I pay singlepayer 790 must. No copayment. I have to pay at least 2700 before they will even allow me to pay on the fifth dollars for a visit. Since then i have had primary in july. That is the first time i could be seen. The orthopedic did not want to. O with my wrist now i am told i have to go back to the orthopedic to have another xray on my wrist. When i questioned said, i was told because of the , required that i be saved for one body part at a time. I am paying for the full visit and i am up to five Office Visits and xrays. Had got to the emergency room when i fell, it would have cost me 1000 that would not apply to might do a bull. Is making me go back. Why couldnt i have been saved by the orthopedics for my wrist . Our system does not function well. I hear these stories everyday with hear them with people private insurance and public insurance. Few people who think the system is functioning well for them. That is where we are debating. Host the medicare for all proposal what should people Pay Attention to as these debates go on, as best guest what they think a system would look like that would be fair that would work for them. This question of how realistic want, do we as a society to throw everything up in the air and start over again . Maybe we do. Maybe we want something more gradual. Every system will have its tradeoffs. Some things will be better and some things will be more difficult. You will have to decide as a boat or what appeals to you. Announcer washington journal mugs are available at cspans new online store. To cspanstore. Org. Lives a look at whats thursday. On cspan at 11 30 a. M. Eastern, state forsecretary of International Trade talks about the future of u. S. U. K. Relations. Well have live fairage of the iowa state where president ial candidates are speaking. Day, cato in the institute and Heritage Foundation cohost a debate among interns about libertarianism versus conservatism at 6 30 p. M. Eastern. And more coverage on cspan2 in the center for strategic and International Studies looks at trade relations u. S. And china followed by a discussion on the future of ukraine with two former u. S. Diplomats and