Glad they're taking off the gloves a little, but it's always been a non-option to just make our lives significantly and irrevocably better like M4A or the PRO act and although they're good at trying and failing, they never talk about the consequences as dire as they actually are with few exceptions.
Way to sidestep the fact that her proposal still allows the following:
Privatized Medicare: those insurance companies still get money, in fact even more because now tax dollars are funneled directly to them.
No change for administrative complexity: because there will still be 10,000 private Medicare plans, all with their own rules, we would still spend 20-30 cents of every dollar (see Woolhandler, Campbell, & Himmelstein (2003), Health Affairs (2014) off the top of my recent tabs for the numbers from my first post here but numerous other studies have pegged the number between 25-35% from 2003-2021) where other countries spend 7-10.
Collective price setting power would shift, but only slightly: again, the vast majority of people would be under privatized Medicare plans the government would have little to no control over negotiating for. This would essentially increase the Medicaid population and roll them into medicare which would give Medicare more bargaining power to be fair, but likely not by as much as you think. Additionally this is only of concern to major providers, smaller specialist networks will simply opt out. If I can fill my practice with Aetna medicare patients that reimburse at $150 for a typical cpt code that medicare reimburses at $97, I will just do that.
You are oversimplifying the issue and further you are appealing to some magic made up bullshit. “Based on every study ever”, “based on all data ever collected” is obvious overgeneralization. “Proven fact” is meaningless. Weasel words from a lib without substance that insists they are right and demands that everyone yields.
To your point single payer systems can absolutely improve costs through collective bargaining. What Harris proposed was in no way a single payer system, nor was there a path to one. It was a system designed to shield the private insurance industry from a single payer system. This takes us back to what the system really is: a return of the individual mandate, eg forcing individuals who do not have insurance that are typically young and healthy to have it so you can have them fund the care of the disabled and elderly that have significantly higher utilization. This is a necessary evil of any insurance system but it is unjust to demand participation when the options given are classist in nature and once again are exploiting lower socioeconomic classes to give a higher quality of care to the higher classes at the lower classes expense.
Waiting times being a non issue for you implies you are privileged. This will not be the case if you are diagnosed with cancer in an emergency room, have a child with autism and want to begin early intervention, etc. A 6-12 month waiting period in these scenarios could mean the difference between your child being verbal or nonverbal, or you literally dying.
This also brings up another domain of the substandard care I only touched upon. Another big problem in controlling costs is shifting people away from emergency care to preventative care. A two lane system again does little to help here. Getting a cancer diagnosis in the ER generally (but not always) means you’ve been ignoring issues and routine primary care for some time. Just looking at medicare data around 23% of cancer diagnosesoccur in the ER, with a broader review showing 12-32%. This generally means these people don’t have a primary care relationship, that they only can seek care once it is debilitating (and unfortunately for them far more likely to be seriously complex or fatal) and tremendously more expensive. This is where you get into the barriers to primary care, which are plentiful, and once again nothing of substance is done on this front to alleviate the issue
The plan is all sizzle, no steak. Libs like you eat it up because you have a job and insurance. Your material conditions will not change, your Aetna plan will become Aetna medicare and you will still pay crazy amounts for healthcare and wonder “why didn’t this work?” Just like Obamacare didn’t work, and if anything hastened the problem as costs have dramatically risen in the decade since.
Finally, opposing your plan does not mean opposing socialized medicine. It means opposing a shitty plan that won’t help