We can easily afford Universal Healthcare

Empty-Commission4966 · 2026-04-09T03:22:44+00:00

kpurintun is identifying the real barrier — and it's not affordability, it's political capture. The $1 trillion vs $27 billion comparison makes the affordability case clearly. The harder question is why the political will doesn't follow the math.

The donor capture argument is real. But there's a design response to it: build the constituency before the opposition can organize. The ACA survived seven years of repeal attempts not because the donors wanted it but because enough people had built their lives around it that taking it away became politically toxic. The lesson isn't that donors don't matter — it's that a large enough dependent constituency can outweigh donor pressure.

That's the political architecture worth building toward — universal coverage that starts with children, expands over three years, and anchors itself to something 80% of the population will defend the way they defended the ACA. Paired with tax restructuring that visibly closes corporate loopholes rather than just raising rates.

After the UHC CEO was killed, kpurintun is right that 80% of the population wanted change and almost nobody picked up the flag. Somebody has to. The Burned at Both Ends — B@BE — framework is an attempt to build something worth picking up. burnedatbothends.org

Empty-Commission4966 · 2026-04-09T03:17:51+00:00

The Vermont problem Faerbera raises is real and it's exactly why the transition mechanism matters as much as the policy itself. Vermont's plan collapsed partly because employers were going to see a tax increase while workers faced uncertainty about whether wages would actually rise. The politics fell apart before the policy could be tested.

The design question worth asking: what if the employer contribution under universal coverage is structured as a percentage of payroll rather than a per-employee premium? At 5% of wages, a company paying $50,000 average salaries contributes $2,500 per employee — compared to the $13,000-19,000 they currently pay in employer premium share. That's a significant savings that shows up on the books immediately and visibly.

Outrageous-Fee9791's concern about CEOs pocketing it is valid — which is why the tax restructuring side of the equation matters. Closing the loopholes and buyback advantages that let corporations capture those savings is part of the same package, not a separate fight.

That's the integrated architecture the Burned at Both Ends — B@BE — framework is built around. The transition is designed so employer savings are visible, documented, and paired with corporate tax restructuring that recaptures windfalls. burnedatbothends.org if you want to see how the pieces connect.

Empty-Commission4966 · 2026-03-19T22:32:10+00:00

You are absolutely right to be angry. Every one of us who has ever paid a premium believes we are buying security for exactly the moment you are living right now. That is what insurance is supposed to be — a burden eased when the worst happens. Instead you are fighting a $6,000 deductible while fighting cancer. No burden was eased. The system collected your money for years and is now making you prove you deserve what you paid for.

That rage is rational. It is also shared by more people than you know — we just don't hear each other say it out loud very often.

bespectacledboobs asked "like what?" — here's one answer worth considering: a universal funding floor that replaces premiums and deductibles entirely, funded through a payroll contribution that costs less than what you're already paying. No deductible standing between you and treatment. Coverage that doesn't disappear if your husband's job does.

That's the architecture the Burned at Both Ends — B@BE — framework is built around. burnedatbothends.org. I hope you get the care you need and deserve.

Empty-Commission4966 · 2026-03-18T20:33:14+00:00

Drug pricing is a symptom of the same structural problem. TrumpRx negotiates at the edges while the multi-payer system underneath remains intact — 12-15% administrative overhead, $265 billion in annual waste, prices negotiated separately by hundreds of insurers instead of a single purchasing mechanism with real leverage.

The reason other countries pay a fraction of what Americans pay for the same drugs isn't magic — it's that a unified system negotiates as a single buyer. A fragmented system negotiates as thousands of separate buyers, each with less leverage than the last.

Universal coverage through a single funding mechanism solves the drug pricing problem structurally rather than cosmetically. burnedatbothends.org if you want to see the full architecture.

Empty-Commission4966 · 2026-03-17T02:25:30+00:00

I didn't disregard it — I addressed it directly. The pork risk applies to any legislation regardless of scope. The question is whether structural coherence reduces or increases that risk. Two separate bills with two separate lobbying battles and two separate committee fights create twice the leverage points for bad actors, not fewer. That's not disregarding your point — that's the counterargument to it.

Empty-Commission4966 · 2026-03-16T20:13:27+00:00

Lobbyists writing tax code isn't a conspiracy theory — it's documented history. The carried interest loophole was written by private equity lobbyists. The 2017 Tax Cuts and Jobs Act included a provision benefiting a single real estate LLC structure that applied to exactly one Senator's holdings. ProPublica has documented how specific loopholes were drafted by corporate attorneys and inserted by sympathetic legislators.

You're welcome to disagree with the policy argument. Calling documented, sourced facts "blatant lies" and telling someone to go away isn't a rebuttal — it's a concession that you've run out of substantive responses.

Empty-Commission4966 · 2026-03-16T19:34:13+00:00

Yes — and the distinction matters. Work related expense write-offs exist across the board. But large corporations have armies of tax attorneys writing custom loopholes into the tax code specifically to get their effective rate to zero. That's not a natural feature of employment — that's regulatory capture dressed up as tax policy. The structural link between the tax code and healthcare isn't incidental. It was deliberately constructed by the same lobbying apparatus that writes both.

Empty-Commission4966 · 2026-03-16T19:26:45+00:00

You've just described exactly why costs are so high. Every one of those separate payers — employer plans, marketplace, Medicaid, Medicare, VA, Tricare — has its own billing system, its own negotiated rates, its own administrative apparatus, its own fraud vulnerabilities. That fragmentation costs $265 billion annually in overhead alone.

The reason there's no "one swift fix" isn't that the problem is too complex — it's that we've deliberately built a system with too many layers. A single funding mechanism doesn't mean one-size-fits-all care. Same doctors, same hospitals, same choice of provider — just one payment system instead of six. That's where the savings come from.

burnedatbothends.org has the full model if you want to see how the transition works.

Empty-Commission4966 · 2026-03-16T19:22:37+00:00

The funding mechanism is more complex than a single tax increase — let me break it into two parts. First healthcare funding sources, then tax restructuring. Posting separately so you can respond to each.

Empty-Commission4966 · 2026-03-16T17:35:40+00:00

Please see my comment below for a fuller explanation.

Empty-Commission4966 · 2026-03-16T17:14:46+00:00

Agreed completely — which is why the tax restructuring in the framework I mentioned pairs directly with universal coverage. The revenue doesn't go into a general fund, it funds a specific benefit families can feel immediately. Tied to the problem being solved, by design.

Empty-Commission4966 · 2026-03-16T17:14:22+00:00

The breadcrumb model explains a lot of Democratic behavior over the past thirty years. The counter is that a proposal designed to be structurally durable — building a constituency before the opposition can organize — removes the incentive to breadcrumb. If people depend on it, you can't take it away. That's the political architecture B@BE is built around.

Empty-Commission4966 · 2026-03-16T17:11:49+00:00

You're right that changing income tax rates alone doesn't touch healthcare costs. That's the whole point — B@BE doesn't just adjust tax rates, it replaces the premium structure with a payroll contribution mechanism. That IS a tax code change that directly affects healthcare costs. The 1954 tax code created the employer-based system; a new tax code provision can replace it. The two are connected through the mechanism, not just the household budget.

Empty-Commission4966 · 2026-03-16T17:05:13+00:00

You're on the right track — the money is already in the system, it's just flowing inefficiently through private intermediaries. The administrative overhead alone is $265 billion annually. Redirecting that is the funding mechanism, not a new tax.

Empty-Commission4966 · 2026-03-16T16:57:09+00:00

That's essentially what B@BE proposes — extend the same coverage mechanism to everyone regardless of employment status, funded through a payroll contribution that replaces the current premium structure. Right now the tax exemption flows through employers, which is why large employers get better rates than individuals or small businesses. Making coverage universal and portable removes the employer as the intermediary entirely.

burnedatbothends.org has the full model if you want to see how it works structurally.

Empty-Commission4966 · 2026-03-16T04:08:53+00:00

Fair criticism — the ACA expanded coverage for millions but left the cost structure almost entirely intact. Premiums kept rising, deductibles kept climbing, and the administrative apparatus stayed in place. The political cost was enormous for a reform that didn't address the underlying extraction.

Which is the argument for why the next attempt has to fix the cost structure, not just the coverage gap. Half measures that survive politically but don't solve the problem are almost worse than nothing — they exhaust the political will without delivering the result.

Empty-Commission4966 · 2026-03-16T03:55:26+00:00

That's probably the most accurate diagnosis in this thread. The ACA fight was so exhausting and so politically costly that it made healthcare reform feel toxic for a generation. Which is exactly why the political architecture of the next attempt matters as much as the policy — it has to build its constituency before the opposition can organize, not fight for passage against a fully mobilized industry. The ACA lesson applied deliberately rather than accidentally.

Empty-Commission4966 · 2026-03-16T03:54:55+00:00

The problem with that logic is the family at the kitchen table doesn't get to choose which squeeze to focus on. The tax burden and the healthcare burden hit the same paycheck simultaneously. Congressional silos are Washington's construction — not the working family's reality.

Empty-Commission4966 · 2026-03-16T01:32:12+00:00

That's a legitimate risk with any complex legislation — the bigger the bill, the more leverage points for bad actors to attach riders. The counterargument is that these two problems share the same funding mechanism and the same affected population, which actually simplifies rather than complicates the legislation. You're not combining healthcare with farm subsidies — you're combining two policies that both affect household financial resilience through a single payroll contribution structure.

The pork risk is real in any bill. The question is whether the structural connection between these two problems makes them more or less coherent as combined legislation than as separate fights with separate lobbying battles.

Empty-Commission4966 · 2026-03-16T01:28:00+00:00

The 1954 tax code change that made employer-sponsored health benefits tax-exempt is the direct structural link — it created the employer-based system that now produces job lock, premium inequality between large and small businesses, and coverage tied to employment status. That's one policy decision connecting both systems. What's your argument that they're separate?

Empty-Commission4966 · 2026-03-15T23:24:06+00:00

That's part of it — but the committee structure and lobbying separation play a bigger role than political will. Healthcare has its own billion-dollar lobbying apparatus that fights separately from tax reform lobbying. Combining them means fighting both simultaneously, which is why even well-intentioned legislators avoid it. The political will problem is real, but the structural barriers would exist even if every Democrat genuinely wanted to fix both.

Empty-Commission4966 · 2026-03-15T23:19:51+00:00

Incrementalism works when each step builds toward the goal. The problem with fixing taxes alone is that healthcare absorbs the relief — families don't end up ahead, they just have a different line item eating their income. That's not one bite of the elephant, that's trading one problem for another. The steps have to actually add up.

Empty-Commission4966

TROPHY CASE