On Medicare for All As a Single-Payer System, B.S. Jobs, Agriculture, and the Physician Shortage

This is from an email I wrote to friends discussing Medicare for All as a single-payer system, bullshit jobs, agriculture, and the physician shortage.

I have endorsed Medicare for All (M4A) as a single-payer system rather than public option. I think it would be harder to raise revenue for it as a public option. Companies offering subsidized private insurance probably would not be asked to pay the 7.5% employer payroll tax that Bernie Sanders has proposed, for instance. I’m largely endorsing Bernie Sanders’s version which is universal healthcare for all. Clint (my Democratic primary opponent for Florida’s 6th Congressional district) has “Medicare Available to All” on his website so I presume that means a public option?

Basically, M4A single-payer is like a huge self-insurance program backed by the full faith and credit of the United States. Medicaid seems comparable, but even then you still have to pick 1 of 4 plans in our area (UnitedHealthcare Community Plan, Molina, etc.). Bernie’s plan has no co-pays, co-insurance, deductibles, or premiums, except for a small co-pay on prescription drugs. There would still be out-of-pocket doctors such as most plastic surgery and orthodontic treatment. Doctors could still opt out of M4A entirely like they do now with insurance. (I have not double-checked this but I can’t see them being forced to participate if they just want customers willing to pay out-of-pocket such as those who cater to the rich.)

Our healthcare system can be framed so many ways. I think it should be emphasized that this is a domestic humanitarian crisis that has been going on for decades now but is getting worse. Some estimates are that 50,000 Americans die a year due to lack of healthcare access. Many more are financially disadvantaged. With Medicare for All, we can really help the American people and take away one of the great burdens of living in this country. It’s also a golden opportunity to increase the focus on preventative medicine including exercise, nutrition, and routine checks. I would even like to see farm bills come out of Congress that stop or reduce subsidies (about $15 billion a year) to massive farms growing unhealthful foods such as corn and soy. Only 3% of American cropland is used for fruits, nuts, and vegetables, which is much less than would occur without the bizarre subsidy system encouraging outrageous amounts of corn being grown as feed, ethanol, and high fructose corn syrup.

Shenkar Vedantam did an interesting episode of the Hidden Brain podcast on “bullshit” jobs. The guest, David Graeber, has gained a lot of traction writing about jobs that are often well-paid, but basically pointless. It’s not employees’ fault that they get roped into this sort of uninspiring, unfulfilling, nonsensical work, but that doesn’t mean it can go on forever. This kind of work is a drain on the economy. I also advocate for the IRS pre-filling tax returns for people based on incoming data (W2s, 1099s, etc.), and offering a competing online tax filing platform, for free. TurboTax and H&R Block receive a lot of unnecessary payments from the American people, and until recently TurboTax was tricking people into using the wrong version and then forcing them to pay or make a new account through the free-file link and re-key all data.

I know this will make a lot of people very upset, but the sprawling insurance / billing industry has a parasitic impact on our overall economy. Bernie Sanders’s plan includes a high level of funding to temporarily pay people working in this industry and help them transition to some other line of work. At least they won’t have to worry about health insurance. I know many readers will fire back that the government has lots of bullshit jobs, and I think those should be cut wherever they are. Some argue Trump is doing this, but of course he’s not—he cuts many jobs that are quite necessary and fires competent people to replace them with sycophants. The State department has been sacked, which is quite short-sighted. The CDC isn’t prepared for coronavirus due to key funding and personnel having been cut. Also, there are plenty of unnecessary jobs in large corporations as well. As an aside, I would hit back at the McKinsey-sponsored view that middle management should be sacked and control consolidated in favor of a special class of CEOs and other high-paid executives that float around between businesses in many different industries. I would also mention that more rural hospitals are closing in states that refused the ACA expansion of Medicaid. M4A could be a net benefit to the healthcare industry. I think we need to address the whole educational pipeline too—it’s crazy that we have only 1.1 million MDs/DOs compared to 1.35 million lawyers in this country, and that I was fully taxpayer funded as a PhD student but medical students must pay huge amounts and then endure grueling, low-paid residencies. Advanced nurses should also be allowed more autonomy to practice without a doctor present.

Statement on Myself and Candidacy, February 27, 2020

My positions are pretty far left including Medicare for All and the Green New Deal. I teach future teachers at UCF and am a 28-year-old husband and father to a 1-year-old boy. I started running at the beginning of the year and have been all over the district at Democratic and nonpartisan events, as well as online. After Nancy Soderberg lost, there is not a whole lot of interest in trying again but I’m getting out to support our local Democratic candidates as well as our presidential nominee and to raise issues and inform people. I am running against Clint Curtis but we are friends and will work together, whomever wins. In the general election we are trying to unseat Michael Waltz.

Video of Ambassador Nancy Soderberg at Building a Better Community Event, Ormond Beach, FL, February 25, 2020

Nancy was the Democratic nominee for Florida’s 6th Congressional district in 2018. I’m running for the same seat in 2020.

Building a Better Community, One Word at a Time, was an interactive conversation sponsored by Bank of America / Merrill Lynch at the Ormond Beach Regional Library on February 25, 2020 with:

Ambassador Nancy Soderberg, former U.S. Ambassador to the United Nations, left
Rabbi Kurt Stone, Author, Professor, Historian, et cetera, 2nd from left
Yael Hershfield, Deputy Regional Director for Anti-Defamation League, 3rd from left
Gina Duncan, Director of Transgender Equality for Equality Florida, 4th from left

Moderated by Mark Kallick

Ormond Beach event on 2/25/2020

On Corporate Privilege, Share Buybacks, Trickle-Down Economics, Taxation, and Anti-Competitive Actions

My response to a commentator arguing for trickle-down economics and against corporate taxation, and claiming he could not think of examples where a large corporation bullied small businesses, and claimed not to recall or understand instances when Walmart would sell at a loss to drive small businesses under:

Dr. Lt. Col. [Name], a scholar, helicopter pilot, military tactician, and financial advisor, can’t think of an example of big companies bullying small companies? Doesn’t understand markets? I’m having a hard time believing this.

Your questions and statements can be easily researched online and answered or discredited. Corporations avoid taxes all the time.

The Walmart story is well-known and you must have been living under a rock if you didn’t hear about it. It goes back to 1993 at least. They would sell certain items at a loss until local shops went out of business, and then raise their prices back up. This isn’t capitalist, but rather anti-competitive and unfair.

Corporations do not go to their customers directly to raise additional funds to pay taxes. They have the money, and the successful corporations do something with it. Being flush with cash, many are buying back shares… and executives coordinate the share buybacks so they can sell their shares at a high price, and this is legal. Meanwhile, many such corporations are paying low wages and bullying cities like Deltona (Amazon warehouse) into tax breaks when they could be paying higher wages or at least covering their employees’ Medicaid and food stamps. Wouldn’t it be nice if we could unionize cities, counties, and states nationwide to say no to bullying for tax breaks like Amazon having a phony competition for their 2nd headquarters on who can offer them the most taxpayer subsidies?

The idea that tax breaks lower costs to consumers is pretty rich. If consumers are willing to pay a certain price for an item or service, the price won’t come down either way.

“More money to give to their employees and stock holders”—really? They will raise pay to employees only if they must to compete for labor. You can’t argue for trickle-down economics, which is the idea that the market is fair and will take care of itself benefitting the 99% by eliminating taxes for the 1% and top corporations (which is corporate welfare for them as they are still benefiting from the USA’s many resources and public items such as financial markets, roads, natural resources, education, and so forth). Trickle-down economics has been empirically discredited.

If anything, the stock holders benefit the most, and it’s really getting tacked onto the national debt as the Tax Cuts & Jobs Act of 2017 was a total robbery to benefit big corporations and share holders. And, as you know, I’m a big advocate for owning pieces of the big corporations via index mutual funds, but half of Americans own no stocks, and you shouldn’t need to just to get a rebate from the U.S. Treasury.

Also, your idea that more consumption is good is under severe pressure in light of the climate crisis, which you cannot discount as a retired lieutenant colonel in the U.S. Army. The U.S. military knows the climate crisis is happening and they are making all sorts of preparations.

It’s pretty crazy that the United States is only 4% of the world population yet is home to 55% of publicly traded corporations by valuation. Given our immense wealth and prosperity, it’s crazy we are not investing in the American people by funding their medical care and education, at the very least. When you wonder why the young people are upset, or scoff at their preferred presidential candidate (Bernie Sanders), try to see things from our perspective and question the underlying assumptions that we have all been inculcated with.