Medicare for All

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Government Bureaucracy

Regarding Health Care

Health insurance provided to government employees is a large starting point for the tax burden placed on all citizens. There will be a huge cost-cutting occurring among all levels of government when we implement improved Medicare for All and dramatically reduce the cost of health care for citizens AND businesses … and the government (our taxes). As just one example of this topic, refer to the description of the Federal Employees Health Benefits Program (FEHBP).

More examples of the complexity due to government bureaucracy.

  • Medicaid programs in 50 states
  • SCHIP State Children’s Health Insurance Program in 50 states
  • COBRA The U.S. Department of Labor’s management of the program resulting from the Consolidated Omnibus Budget Reconciliation Act (COBRA)
  • The medical component of:
    • Workers compensation programs in all 50 states
    • Auto insurance health insurance component: seen as “coordinated medical benefits”; this does not apply to all states
  • Government cash incentives to health insurance companies
    • Just a few examples so far for this list:
      • Medicare Advantage Plans — this is a huge issue of the spending of our tax dollars that has been in the news a lot. It’s payments of our tax dollars to for-profit health insurance companies. It’s costing us a fortune, as part of the Medicare Modernization Act of 2003.
      • The Medicare Modernization Act of 2003 included a guarantee for the initial period of the Drug Prescription Benefit program that health insurance companies would not lose money. (I’d have to research to confirm if this was a year or longer.)
      • The further privatization of Medicare, scheduled to start in 2010 as per the same Medicare Modernization Act, is also scheduled to pay billions of dollars to for-profit health insurance companies to “encourage” (!) them to participate. Another case of guaranteeing companies that they will not lose.
  • Reductions in taxes for employers who provide health insurance to their employees; this is an indirect payment of private health insurance by the government

  • A variety of additional existing programs are associated with (and/or directly include) an amazing bureaucracy of programs and grants and grant-writing and more activities that have nothing to do with the actual activity of delivering health care; the following list is all that we have gathered so far. If we learn of more, we will add them. It is not our intent to research all of these, nor defend them being on the list or not. It is our intent to give some tiny indication of the massive opportunity for simplicity and efficiency. PART of the following programs might make sense to keep within a health-care-for-all system. That would need to be determined.

    • County-specific programs supported by local millage tax assessments
    • Rural Assistance Center
    • Rural Health Clinics
    • Federally Qualified Health Centers
    • Community Health Centers (CHCs)
    • Migrant Health Centers
    • Health Care for the Homeless programs
    • Public Housing Primary Care programs
    • The SHARE program, operating in 50 states,
      where people can get one-on-one help in their
      attempt to figure out the current Medicare program
    • Urban Indian and Tribal Health Centers

More complexity added by “Obamacare”, the Affordable Care Act of 2010.

The new U.S. health care reform law (March 2010), the Patient Protection and Affordable Care Act (PPACA) and the associated HCERA legislation are now expanding government related to health care.

Examples of the items that are being added to the complexity.

  • New regulations (regulatory requirements) on private health insurance companies, including new reporting requirements
  • New regulations (regulatory requirements) on hospitals
  • Thousands of new government regulators to enforce the expanded regulations; that includes an expansion of the IRS, Internal Revenue Service
  • Expansion of existing programs, such as Medicaid.
  • Over 150 new programs, commissions, positions and departments (sometimes titled “offices” or “agencies” or “institutes”). (Examples: grant programs, demonstration programs and projects, pilot programs, loan programs, loan forgiveness programs, education-related programs, quality assurance programs, facility programs, committees, state exchanges, advisory boards, advisory panels, networks, network review boards, centers of excellence, funds, task forces and councils)
  • Addition of even more government employees across multiple departments required to implement and manage/operate the parts of the law that do not explicitly state as requiring a special program; an example of that is that the government will be development and implementing an extensive subsidies program so that no American will need to pay above a specified percentage of their income on health care premiums
  • Mandated / dictated / forced purchase of health care
    • If you don’t choose, then the government will assign you to a health insurance plan and force you to pay.
    • If you don’t pay the forced premiums, you’ll be fined.
    • If you don’t pay the fine, you could be arrested for tax evasion, an offense which sometimes results in spending time in federal prison.
    • Increased use of the estate recovery program to recover costs; this takes priority over all other claimants and beneficiaries to an estate.


As you think about the above list regarding the March 2010 law, think “Higher Taxes.” and “Higher Costs.”


Additional Information

What will be done to support all those employees who will need to find new jobs?
Go here for the answer.

Obamacare: what is it?


Those seeing this page may also be interested in:
the insurance companies’ bureaucracy
and the supporting bureaucracy

Let’s eliminate the unnecessary administrative functions
within all 3 types of bureaucracy.



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