News on Youtube Feb 18 2019

Today we're going to talk about ICOs, STOs,

TGEs and Vegas. One of the most popular questions I get asked at Blockchain

Rookies is exactly how much should I invest in cryptocurrency? And my standard

answer the three-day Vegas rule. How much would you spend on airfare and hotels

and at the roulette tables on a trip to Vegas gambling your life away now there

are some people that say not me I don't gamble

other people say ten thousand pounds count me in I'm off for a weekend at the

end of the day going to Vegas you're gonna meet a whole lot of really crazy

people you're gonna have a whole lot of fun you're probably gonna lose

everything but you might win big and the same is true for the majority of ICOs

STOs and TGEs but we have acronyms initial coin offerings security token

offerings and token generation events at the end of the day when someone else

asks you how much you invest in crypto tell them the answer is easy

it's the three-day Vegas rule the second thing I want to talk about when it comes

to Vegas is people say I'm buying these tokens and what are these tokens look at

it again from Vegas what I tell them is you're buying a poker chip for a casino

that hasn't been built by people that you don't know who don't have a license

to sell poker chips or to run a casino and it's probably being built in a

neighborhood that doesn't gamble and you're hoping you can sell that poker

chip for more than you paid for it before the casino opens another example

is when you talk about an ICO and someone says ah but ours are not

securities ours our utility tokens what's a utility token an example of a

utility token in real life happens in America in a laundromat when you go to a

laundromat you put a dollar bill into a machine on the wall and it spits out

little tokens and those tokens could only be used in the laundromat where you

put them in the wall they can only be used on the

washers and the dryers in that specific laundromat a utility token through an

ICO is very much in the same way you're investing and buying tokens on a project

that you will be able to use those tokens to operate that project at some

point in the future so the question is when you buy an ICO token has the

laundromat been built or has it not been built and who are the team behind the

laundromat do they actually have a legitimate business model and can they

actually build a laundromat so here are three examples that I always tell people

when I talk about ICOs, STOs, TGEs and Vegas one how much did you invest the

three-day Vegas rule. 2. Are you buying poker chips hoping to sell them before

the casino opens or three are you buying tokens for a laundromat that may not

even been built I'm Troy from blocking rookies this has been blocking

essentials we've been talking about ICOs STOs TGEs and Vegas thanks for watching

For more infomation >> How Much Shall I Invest in Cryptocurrencies? - Duration: 3:16.

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How to get free Psn codes - how to get free ps plus - playstation card - ps4 gift card - Duration: 3:18.

How to get free Psn codes - how to get free ps plus.

You

you

For more infomation >> How to get free Psn codes - how to get free ps plus - playstation card - ps4 gift card - Duration: 3:18.

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How Long Do I Study? | How to Study the Bible with Joyce Meyer - Duration: 3:27.

GINGER: WHAT ABOUT HOW LONG I NEED TO SPEND?

WHEN I SIT DOWN, DO I NEED TO HAVE A GOOD HOUR FREE

OR CAN I START SMALLER? WHAT SHOULD I DO?

JOYCE: WELL, I'M REALLY GLAD YOU ASKED THAT QUESTION

BECAUSE IT KIND OF HAS A TWO-FOLD ANSWER.

YOU KNOW, I THINK IN THE BEGINNING, IF SOMEBODY HAS NEVER

STUDIED, THEY PROBABLY ARE GONNA HAVE TO HAVE

SOME KIND OF DISCIPLINARY GUIDELINE.

YOU MIGHT WANT TO SAY, "I'M GONNA START WITH 15 MINUTES"

OR "I'D LIKE TO EVENTUALLY GET UP TO STUDYING AN HOUR A DAY

BUT I'VE NEVER STUDIED AT ALL SO--"

I MEAN, UNLESS THERE'S A SPECIAL GIFT OF GOD ON YOU

TO JUST START STUDYING,

THEN YOU NEED TO JUST START WITH 15 MINUTES A DAY

OR START WITH PRAYING, YOU KNOW, JUST KEEP IT SIMPLE.

START BY JUST TALKING TO GOD IN THE MORNING.

BUT EVENTUALLY WHERE I WOULD LIKE TO SEE PEOPLE GET TO

IS WHERE THEY DON'T COUNT HOW LONG THEY STUDY,

THEY DON'T COUNT HOW LONG THEY PRAY.

I DON'T COUNT HOW LONG I DO ANYTHING ANYMORE

BECAUSE AFTER A NUMBER OF YEARS,

I GOT REPRIMANDED BY THE HOLY SPIRIT FOR IT

THAT I DON'T NEED TO COUNT.

BECAUSE SOMETIMES WHEN WE COUNT,

"I STUDIED AN HOUR AND I READ THIS AND SO MANY CHAPTERS."

WE CAN ALMOST GET INTO A PRIDEFUL,

WHERE WE LIKE TO FEEL GOOD ABOUT OURSELVES

AND WE CAN GET AWAY FROM EVEN DOING IT

FOR THE RIGHT MOTIVATION.

SO I LIKE TO SAY I STUDY 'TIL I'M FULL--

JUST LIKE WHEN I SIT DOWN TO EAT A MEAL, I EAT 'TIL I'M FULL.

AND WHEN I PRAY, I PRAY 'TIL I FEEL LIKE I'M FINISHED.

AND WHEN I STUDY, I REALLY DON'T KNOW HOW TO EXPLAIN IT,

I CAN JUST TELL WHEN I'M FINISHED.

AND SO I DON'T WANT TO SOUND OVERLY SPIRITUAL.

WHAT ABOUT YOU, WHAT DO YOU DO?

GINGER: YOU KNOW, I FIND THAT IT REALLY DEPENDS

ON THE SEASON THAT I'M IN.

AND I THINK A LOT OF US WHO'VE BEEN STUDYING THE BIBLE

FOR YEARS AND YEARS,

DO SEE KIND OF EBBS AND FLOWS IN NOT ONLY THE TIME WE SPEND

WITH GOD, BUT EVEN WHAT WE GET OUT OF IT,

WHICH IS NOT GOD CHANGING, IT'S US CHANGING.

JOYCE: WE HAVE WHAT THEY CALL DRY SEASONS WHERE

YOU JUST--YOU'RE HAVING TO DO IT MORE STRICTLY JUST BY FAITH

THAN WHAT YOU'RE GETTING OUT OF IT.

GINGER, A LOT OF PEOPLE READ THE BIBLE THROUGH

EVERY YEAR AND, YOU KNOW, I THINK THAT'S AWESOME

IF THAT'S THE WAY GOD LEADS A PERSON.

IT HASN'T WORKED FOR ME SIMPLY BECAUSE I'M A TEACHER

AND SO--AND I PROBABLY SHOULDN'T SAY IT LIKE THAT

BECAUSE THERE'S PROBABLY A LOT OF TEACHERS

THAT DO READ THE BIBLE THROUGH EVERY YEAR.

MAYBE IT'S SOMETHING WRONG WITH ME, I DON'T KNOW,

BUT I GET IN HERE AND I FIND, YOU KNOW, "DON'T BE ANGRY,"

AND THEN I'M LIKE, "OH, YEAH, HOW COULD I TEACH PEOPLE

NOT TO BE ANGRY?"

SO RIGHT AWAY I'M WANTING TO DIG THAT OUT

AND I'M RUNNING ALL OVER THE PLACE

LOOKING UP THE WORD "ANGER" AND READING DEFINITIONS

AND MAKING A MESSAGE.

SO I HAVE A LITTLE BIT OF A DIFFERENT SITUATION.

I JUST REALLY WANT TO RECOMMEND THAT PEOPLE FIND

WHAT'S GOOD FOR THEM.

THERE'S LOTS OF GOOD BIBLE STUDY COURSES THAT

WILL TAKE YOU THROUGH CERTAIN CHAPTERS EVERY DAY

AND THEY WANT YOU TO DO IS CERTAIN AMOUNT EVERY DAY

AND I'M NOT AGAINST THAT AT ALL.

THAT'S A GREAT PLACE TO START AND IT MAY BE A

GREAT PLACE FOR SOME PEOPLE TO FINISH,

BUT I ALSO WANT PEOPLE TO

KNOW THAT IT DOESN'T HAVE TO BE A LEGALISTIC BONDAGE WHERE THEY

HAVE TO DO A CERTAIN AMOUNT OF SOMETHING EVERY DAY OTHERWISE

THEY GOTTA GO FEEL GUILTY.

For more infomation >> How Long Do I Study? | How to Study the Bible with Joyce Meyer - Duration: 3:27.

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This Is How Much Celebs Really Get Paid For Private Events - Duration: 5:01.

In addition to whatever celebs get paid for just doing their jobs, they also rake it in

by attending private events and parties.

Planning your next blowout and want a really spectacular act or special guest?

Here's what kind of moolah you'll need to book your favorite star.

Scott Disick

Keeping Up with the Kardashians cast member Scott Disick may not top your list of most-wanted

A-listers, but as GQ revealed in 2016,

"Scott Disick, the runt of the Kardashian litter, the f---up father of Kourtney's three

children, makes more money doing nothing than most Americans earn in an entire year."

"Look at you, this is what you do during the day, you lay in the sun and you tan?"

The mag explained that the celeb gets paid seventy to eighty grand a night in appearance

fees, and at one point, he earned a whopping $250,000 for a set of appearances in the U.K.

GQ noted Disick was contracted to appear eight times a year at 1OAK Las Vegas in 2016, saying,

"He says a few hoarse words on the mic, sits back down, and sips slowly from a water bottle

at his VIP table, out of the crowd's sight."

Jennifer Lopez

Considering her ongoing A-lister status, it's not surprising that Jennifer Lopez pulls in

hefty fees.

But that didn't stop her from catching bad press in 2013, when Us Weekly reported she'd

earned $1.5 million to sing at a birthday party for the President of Turkmenistan, a

dictator who has been accused of human rights violations.

Per Us Weekly, Lopez's reps later released a statement saying,

"The event was vetted by her representatives, had there been knowledge of human [rights]

issues of any kind, Jennifer would not have attended."

"When I heard it like that, I was like, are we crazy?"

In 2016, Lopez made headlines again for a high-profile private appearance at the wedding

of the son of a Russian billionaire.

According to Elle, Lopez earned a whopping $5 million to perform at the nuptials.

Kim Kardashian

These days it seems like the Kardashians can spin anything into money, so it's not too

shocking that they're big players in the private appearances game.

As far back as 2010, Glamour UK reported Kim Kardashian was earning major money for club

appearances, estimating that she earned more than $500,000 for a series of 30th birthday

appearances in Vegas.

And by 2016, Page Six reported that her fee for showing up to party in the Hamptons was

a whopping $700,000.

"I have warned everyone that I will come for them if they even dare try to copy anything

that I'm doing"

But according to leaked emails obtained by Radar Online in 2014, Kardashian demands even

more on top of her appearance fee, including:

"5 first class tickets, plus 1 coach, first class hotel accommodations […] first class

exclusive ground transportation, airport greeter service, security, glam fee […] and a per

diem."

"Mom, she's always late."

"No I'm here!"

"Oh come on…"

"Really?"

Beyonce

Beyoncé found herself in hot water when news broke that she'd performed at a 2009 New Year's

Eve party hosted by the Gaddafi family.

The big deal?

Libya's Muammar Gaddafi was an infamously repressive dictator, until his death in 2011.

According to The Guardian, Beyoncé reportedly received $2 million to perform five songs.

In March 2011 Beyoncé's publicist released a statement via Entertainment Weekly that

explained,

"All monies paid to Beyoncé […] were donated to the earthquake relief efforts for Haiti.

[…] Once it became known that the third party promoter was linked to the [Gaddafi]

family, the decision was made to put that payment to a good cause."

Paris Hilton

"So I'm just so honored and excited for foam and diamonds again this year.

It's gonna be incredible"

By 2013, Paris Hilton's heyday as a private appearance high-earner was waning, with a

source telling Radar Online that the reality star's fees for a club appearance had dropped

from seven hundred and fifty, to five hundred grand, to "the much lower fee of $250,000."

Cut to 2014, and the tide had turned for Hilton, with The Sun reporting that she'd earned $2.7

million for just four nights of DJ-ing.

When Page Six asked Hilton to confirm the rumored rate of $1 million per appearance,

she replied,

"My mother always told me it's not polite to discuss money, but it's true."

By 2017, the Daily Mail reported that Hilton's club appearance fees had settled somewhere

closer to $300,000.

Mariah Carey

"Is this a normal outfit for people to wear?

I don't know.

But I'm at home and this is what I wear"

As The Guardian reported in 2013, Mariah Carey came under fire when it came to light that

she had accepted $1 million to perform at a benefit for the Angolan Red Cross.

Carey reportedly posed for pictures with the then Angolan president, who stood accused

of major corruption.

According to The Guardian, Carey's appearance came on the heels of another controversial

private appearance in 2008 at a New Year's party for the Gaddafi family, for which the

celeb reportedly got paid $1 million.

She later released a statement saying,

"I was naive and unaware of who I was booked to perform for.

I feel horrible and embarrassed to have participated in this mess."

But none of the bad press stopped Carey from booking a private appearance at a Brazilian

New Year's party in 2015, for which TMZ reported she'd be receiving between $2 million and

$5 million.

For more infomation >> This Is How Much Celebs Really Get Paid For Private Events - Duration: 5:01.

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Mom Who Left Daughter Reveals Her Own Struggles - Duration: 2:54.

For more infomation >> Mom Who Left Daughter Reveals Her Own Struggles - Duration: 2:54.

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Kevin Friend salary revealed: How much does Chelsea vs Man Utd referee get paid? - Duration: 2:16.

 Kevin Friend issued two yellow cards during his Premier League refereeing debut between Wolves vs Fulham, and handed out his first red three months later to Sunderland captain Lorik Cana

 The 47-year-old has gone on to dictate play in 196 Premier League fixtures in total, showing 696 yellow and 2 red cards during that time, but how much does he earn? Premier League referees are salaried so they get paid a regular wage with match fees on top of that

 Referees in the top-flight of England can earn as much as £7, per year. They are paid a basic yearly retainer of between £3,5 and £42, based on experience, and then are paid £1,15 per match on top of that

 The Bristol-born ref will take charge as Chelsea take on Manchester United in the FA Cup this evening

 Friend has taken charge of 25 Chelsea games during his career, with the Blues winning 13 and losing just four of those matches

 The refereeing veteran has been involved in 2 United fixtures, with the Red Devils winning 14 and losing just twice

 Friend began he refereeing career at the age of just 14 in home county of Leicestershire

 He was promoted to the Select Group of Referees prior to this 29-1 season where he then made his debut in the top-flight

 A notable season for Friend was the 27– season, when he showed an incredible 11 red cards across just 41 games and dished out 1 yellows

 Friend has taken charge of several high-profile matches during his career, including the 212 Community Shield at Villa Park and the 213 League Cup final at Wembley

For more infomation >> Kevin Friend salary revealed: How much does Chelsea vs Man Utd referee get paid? - Duration: 2:16.

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We Now Know How Much Brothers Were PAID to FAKE the "Hate Crime" on Smollett - Duration: 2:27.

CBS has reported that the two brothers who police believe staged the fake hate crime

against Jussie Smollett were paid $3500 and promised an additional $500 from Smollett

upon their return from Nigeria.

CNN: Chicago Police believe Jussie Smollett paid two men to orchestrate the assault.

The sources tell CNN that the two men are now cooperating fully with law enforcement.

Per CBS, two brothers who were questioned and released by Chicago police investigating

the Jussie Smollett attack did play a role in the crime.

Sources say at least one of the brothers bought the rope used in the incident at Smollett's

request.

The sources also say the "Empire" actor paid for the rope, which was purchased at

the Crafty Beaver Hardware Store the weekend of Jan. 25.

The brothers were paid $3,500 before leaving for Nigeria and were promised an additional

$500 upon their return.

They left for Nigeria later in the day on Jan. 29 after the attack.

The sources say plain red hats worn by the brothers were bought at an Uptown beauty supply

store and that the attack was supposed to happen before Jan. 29.

Smollett claims two men attacked him in Streeterville early Jan. 29 as he was heading to his apartment.

He said they yelled racial and homophobic slurs at him, poured a chemical on him and

put a rope around his neck.

A lot of Democrats in Hollywood owe MAGA voters an apology.

It had a lot of them chastising me for not buying Jussie's story.

Those of us who were skeptical were right.

Now @CNN reports Jussie paid the two Nigerian brothers to stage the attack.

As law enforcement has continued to probe the story, items such as shoes, electronic

devices, and bleach have reportedly been seized from Smollett's home as emerging details

proved that the two suspects formerly worked with the actor on Empire.

By Saturday, unconfirmed reports speculated that attorneys for the two arrested Nigerians

have stated that the brothers knew and worked with Smollett, as well as additional rumors

that the actor may have paid the men to stage the attack.

whether Smollett made up the story after police threatened to charge them with battery.

The brothers attorney said both brothers knew Smollett.

There are unconfirmed reports that Smollett paid the two brothers to perform the alleged

scheme.

For more infomation >> We Now Know How Much Brothers Were PAID to FAKE the "Hate Crime" on Smollett - Duration: 2:27.

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Daytona 500 Purse 2019: How Much Prize Money Does Winner Make? | Heavy.com - Duration: 6:52.

Daytona 500 Purse 2019: How Much Prize Money Does Winner Make? | Heavy.com

The Daytona 500 is one of the most exciting and followed events in sports and draws the most attention of any single NASCAR race.

Not surprisingly, this also means the eventual winner takes home a big payday.

But the way that NASCAR has done things in recent years makes gauging how much money is paid out a tough task.

The decision was made previously for NASCAR to not publicly reveal how much teams and drivers earn during the events.

So while we can make a general guess and use previous years, there are many things that get factored into this.

As FOX Sports revealed during an article back in 2016, they will no longer reveal how much money teams earn.

"One thing that will become less transparent this year is purse money.

NASCAR will no longer disclose how much money teams earn in a given race.

That was negotiated in as part of the Charter deal.

In terms of NASCAR and the teams, the Charter system appears to be a big win for the sport.

But in terms of transparency for the fans, not disclosing purse money is a step backward.".

With that said, Top Bet did reveal that the increases in prize money from the sport come every five years.

In turn, this means that the 2019 purse for the Daytona 500 should be close to what it was last year, although it's purely an estimate at this point.

Daytona 500 Projected Purse & Structure.

*Note: The numbers are estimated based on 2018 and not official from NASCAR.

These are projected off last year's numbers due to a potential increase in prize money coming every five years (next coming in 2020).

Numbers are courtesy of Top Bet and data from past years.

In an interesting breakdown, the way that the money is paid out isn't quite how you'd typically expect.

The projections point to the top-nine looking as follows but can vary, as we'll explain below.

Finish Payment Amount 1st $1,581,453 2nd $1,157,470 3rd $857,245 4th $680,758 5th $616,232 6th $470,640 7th $437,870 8th $405,297 9th $389,308.

As Jamie Page Deaton of How Stuff Works detailed, things aren't quite as cut-and-dry as you'll find in many other sports.

It's even pointed out that the money outside of the top spot can vary, a lot based on a few different things.

"Shares of the race purse are handed out not only based on where a driver finishes, but also on the specific products the team uses — as in the case of the contingency money we talked about earlier in this article — how well the team is doing this season, how well the team did last season, and what type of prize money "plan" the team participates in.

" Deaton writes. Bonus Money for Races.

To make things even more interesting, Deaton explains that certain teams will get bonus money no matter how they finish the race in the "Winner's Circle plan." This plan is made up of the previous season's top 10 teams and two "wild card" positions.

From there, you'll find that there are a few other plans as well.

"The remainder of the plans — the Cup Series Car/Champion Owner Program, Plan 1 and Plan 1c — each have their own system for payout.

Basically, we can tell you that they're all based on the number of points a team has, how long they've been in the sport and how well they've done.

NASCAR doesn't publicize exactly how each of these plans pays out prize money.".

Beyond this, there is bonus money awarded for things like leading laps and best lap times depending on race and sponsor, among other things.

Overall, it's a situation that's brutally tough to gauge, and it's probably best to just enjoy the race and know that the winner is going to take home a nice sum of money.

READ NEXT: Highest Paid AAF Players Not Near Colin Kaepernick's Reported Request.

For more infomation >> Daytona 500 Purse 2019: How Much Prize Money Does Winner Make? | Heavy.com - Duration: 6:52.

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How Much Does Full Coverage Auto Insurance Cost? - Duration: 1:11.

How Much Does Full Coverage Car Insurance Cost?

Because the cost of car insurance can vary dramatically from driver to driver, the best way

to find out how much full coverage insurance costs in your area is to enter your zip code

into our QuoteScout™ search engine.

It's completely free to use and will help you quickly find and compare accurate auto

insurance quotes for your unique driving situation.

Your key to finding the best full coverage policy is not to adapt your budget to the

market, but to adapt the market to your budget.

There are plenty of insurance offers to choose from. It's just a matter of finding the

right policy and right price for you.

Generally speaking, the more quotes you gather, the better chance you'll have to find the

lowest price available.

As you request quotes, you will select the types of coverage you would like to have

and those you think you can do without.

The goal is to design an insurance policy that works best for you in your specific situation,

both in terms of the amount of coverage you have and affordability.

For more infomation >> How Much Does Full Coverage Auto Insurance Cost? - Duration: 1:11.

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Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times - Duration: 3:33.

Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times

A battle is looming over universal health care. Politicians and voters will have to decide whether the trade offs are worth it.

The editorial board represents the opinions of the board, its editor and the publisher. It is separate from the newsroom and the Op Ed section.

Its been nearly 10 years since the passage of the Affordable Care Act — one of the most sweeping health care overhauls in the nations history. The law has brought the number of uninsured people in America to an low, secured protections for people with pre existing conditions and advanced the notion that .

But the system was never perfect, and its fractures and stress points have become too great to ignore. The number of people who are uninsured or underinsured is , after two years of sabotage to the current law by the Trump administration. A Republican led lawsuit that once seemed like is Obamacares protections for pre existing conditions. And high out of pocket costs, absurd hospital billing practices and ever rising prescription drug prices have forced too many people to skip crucial treatments, avoid and life sustaining medications.

America may be a country rich in medical innovation — a place where robots perform surgery — but its also one where tens of thousands of people die every year because they cant afford basic care.

Both parties seem certain to make health care a significant election issue over the next two years. There are no fewer than bills floating through Congress that would address these problems. And Medicare for all — a concept that describes only some of those proposals — has become both a rallying cry and a test of progressive credentials.

Voters, however, appear more ambivalent. Though health care has long topped the electorates list of concerns, , surveys suggest that most Democrats want their party to focus on fixing the Affordable Care Act rather than on starting a long shot bid for a single payer health care system. In a recent poll, some 56 percent of Americans, including nearly a quarter of Republicans, supported the idea of a new federal program; but when trade offs like higher taxes or the loss of private insurance options were factored in, that support evaporated.

As the 2020 race heats up, heres a primer to help citizens sort out where they stand.

The plans currently in play differ in their particulars: Senator Bernie Sanderss Medicare for All Act would scrap private insurance and create a new federal system to cover everyone; a plan from the Center for American Progress, a think tank, would create an optional public program that anyone could buy into; and a plan from Senator Debbie Stabenow would give all Americans the option to buy into Medicare when they turn 50. But these plans would extend coverage to more people and would increase the federal governments role in providing and policing health insurance.

The proposals fall into two broad categories: universal and incremental. On the universal side, Medicare for all would largely eliminate the need for private insurance and for other public programs like Medicaid and the Childrens Health Insurance Program. Its coverage would also be more expansive than current Medicare: It would include eye and dental care as well as prescription drugs, and it would eliminate premiums, deductibles, copays and surprise medical bills.

A single federal payer — as such proposals envision — may well eliminate the waste, inefficiency and corruption that make the current system so expensive and inaccessible; the experience of countries like Canada and Britain that rely heavily on one government payer suggests as much. But such a system would require dramatic changes from the status quo and would be a tough political sell. Whats more, single payer is not the only way to achieve universal coverage.

On the incremental side, several different proposals would allow certain people to buy into existing public plans. Some would enable older Americans who are not yet eligible for Medicare to buy into that program — at age 50 or 55 or 60. One would let people who dont have other insurance coverage buy into Medicaid as long as their state opted into the program .

Because these programs dont rely on a single payer, they would not do as much to clean up the existing system. But they have a better chance of being adopted by Congress, and some could bring the country very close to achieving universal coverage.

A recent Kaiser poll found that the potential loss of private insurance was what turned most people off the concept of Medicare for all. Thats not surprising. About half of all Americans — some 156 million people — get their health insurance through employer based plans, and rely on other forms of private coverage, including the A.C.A. marketplace and Medicare Advantage plans. The of those people say that they like their coverage. And so far, the majority of Americans seem loath to give up what they have, no matter how good the alternative is made to sound.

Thats too bad. The idea of forcing more than half the country off existing programs might sound scary, but the majority of those people are at constant risk of losing their health coverage — for instance, if they lose or leave their jobs, if their employers change plans or if their insurers change their terms in ways that increase out of pocket costs.

Still, the choice between universal health care and private insurance will very likely prove to be a false one. Most of the six plans leave ample room for private options to play a role, and the ones that dont — the true Medicare for all proposals — will almost certainly change as they are negotiated. As , no other country has managed to achieve universal health care without including some form of private insurance.

Proponents of Medicare for all say that total health care spending would remain roughly the same, but that more of that spending would be shouldered by the federal government and less of it would be wasted.

A single payer system would mean fewer administrative costs. Eliminating other government programs would free up billions of dollars for the new plan. And eliminating private insurers would bring billions more dollars worth of profits and employer taxes back into the health care system. Businesses currently enjoy a tax break on the money they spend covering their employees.

But there would also be new taxes. Proponents say that, to the extent those taxes fell on consumers, they would be offset by the elimination of premiums, deductibles and copays. But that may not be enough to assuage voters. In Vermont and Colorado, legislators dropped bids for a state run single payer system when it became clear that people would not support the tax increases needed to sustain such a program.

Taxes are not the only trade off. Increased efficiency and less profiteering should mean that more people would be covered and could afford the care they needed. But a single payer system could also mean the elimination of many thousands of health care jobs and lower pay for providers, both of which could impede access to, and the quality of, care. Those impediments could be small — slightly longer wait times, for example. Or they could be substantial — much longer wait times and far fewer doctors.

There are two basic ways for insurance programs to curb costs. One is to cover fewer things; the other is to negotiate on prices.

Medicare for all would forgo the first option, meaning that it would cover everything. But it would use the massive bargaining power of so many users — the entire United States population — to negotiate far better deals on prescription drugs, hospital stays and more. The different incremental programs would use both levers: Most would not cover vision or dental, for example. But all of them would also direct the secretary of health and human services to negotiate costs with providers.

Most other countries use negotiating power to control health care costs; thats why prescription drugs cost so much less elsewhere than they do in the United States. But those countries accept a trade off, inherent in this approach, that the United States has so far resisted: They forgo access to certain innovations, like pricey new drugs and medical devices whose benefits are found to be minimal.

A plan that results in higher taxes but skimps on cutting edge medicine may seem unfair — and may well be unpopular. But many Americans are already being denied essential services every day. It may make sense to forgo innovations that a growing number of people cant benefit from anyway in exchange for a program that sets fair prices at the outset and doesnt leave people low tech essentials or for donations to cover basic costs.

The fight to once again remake American health care will almost certainly be brutal. Before voters can if they want to have that fight, candidates will need to clarify what they are selling. Only then can the nation have an honest dialogue about the risks, benefits and trade offs ahead.

The Times is committed to publishing to the editor. Wed like to hear what you think about this or any of our articles. Here are some . And heres our email: .

Follow The New York Times Opinion section on , and .

For more infomation >> Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times - Duration: 3:33.

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Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times - Duration: 3:38.

Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times

A battle is looming over universal health care. Politicians and voters will have to decide whether the trade offs are worth it.

The editorial board represents the opinions of the board, its editor and the publisher. It is separate from the newsroom and the Op Ed section.

Its been nearly 10 years since the passage of the Affordable Care Act — one of the most sweeping health care overhauls in the nations history. The law has brought the number of uninsured people in America to an low, secured protections for people with pre existing conditions and advanced the notion that .

But the system was never perfect, and its fractures and stress points have become too great to ignore. The number of people who are uninsured or underinsured is , after two years of sabotage to the current law by the Trump administration. A Republican led lawsuit that once seemed like is Obamacares protections for pre existing conditions. And high out of pocket costs, absurd hospital billing practices and ever rising prescription drug prices have forced too many people to skip crucial treatments, avoid and life sustaining medications.

America may be a country rich in medical innovation — a place where robots perform surgery — but its also one where tens of thousands of people die every year because they cant afford basic care.

Both parties seem certain to make health care a significant election issue over the next two years. There are no fewer than bills floating through Congress that would address these problems. And Medicare for all — a concept that describes only some of those proposals — has become both a rallying cry and a test of progressive credentials.

Voters, however, appear more ambivalent. Though health care has long topped the electorates list of concerns, , surveys suggest that most Democrats want their party to focus on fixing the Affordable Care Act rather than on starting a long shot bid for a single payer health care system. In a recent poll, some 56 percent of Americans, including nearly a quarter of Republicans, supported the idea of a new federal program; but when trade offs like higher taxes or the loss of private insurance options were factored in, that support evaporated.

As the 2020 race heats up, heres a primer to help citizens sort out where they stand.

The plans currently in play differ in their particulars: Senator Bernie Sanderss Medicare for All Act would scrap private insurance and create a new federal system to cover everyone; a plan from the Center for American Progress, a think tank, would create an optional public program that anyone could buy into; and a plan from Senator Debbie Stabenow would give all Americans the option to buy into Medicare when they turn 50. But these plans would extend coverage to more people and would increase the federal governments role in providing and policing health insurance.

The proposals fall into two broad categories: universal and incremental. On the universal side, Medicare for all would largely eliminate the need for private insurance and for other public programs like Medicaid and the Childrens Health Insurance Program. Its coverage would also be more expansive than current Medicare: It would include eye and dental care as well as prescription drugs, and it would eliminate premiums, deductibles, copays and surprise medical bills.

A single federal payer — as such proposals envision — may well eliminate the waste, inefficiency and corruption that make the current system so expensive and inaccessible; the experience of countries like Canada and Britain that rely heavily on one government payer suggests as much. But such a system would require dramatic changes from the status quo and would be a tough political sell. Whats more, single payer is not the only way to achieve universal coverage.

On the incremental side, several different proposals would allow certain people to buy into existing public plans. Some would enable older Americans who are not yet eligible for Medicare to buy into that program — at age 50 or 55 or 60. One would let people who dont have other insurance coverage buy into Medicaid as long as their state opted into the program .

Because these programs dont rely on a single payer, they would not do as much to clean up the existing system. But they have a better chance of being adopted by Congress, and some could bring the country very close to achieving universal coverage.

A recent Kaiser poll found that the potential loss of private insurance was what turned most people off the concept of Medicare for all. Thats not surprising. About half of all Americans — some 156 million people — get their health insurance through employer based plans, and rely on other forms of private coverage, including the A.C.A. marketplace and Medicare Advantage plans. The of those people say that they like their coverage. And so far, the majority of Americans seem loath to give up what they have, no matter how good the alternative is made to sound.

Thats too bad. The idea of forcing more than half the country off existing programs might sound scary, but the majority of those people are at constant risk of losing their health coverage — for instance, if they lose or leave their jobs, if their employers change plans or if their insurers change their terms in ways that increase out of pocket costs.

Still, the choice between universal health care and private insurance will very likely prove to be a false one. Most of the six plans leave ample room for private options to play a role, and the ones that dont — the true Medicare for all proposals — will almost certainly change as they are negotiated. As , no other country has managed to achieve universal health care without including some form of private insurance.

Proponents of Medicare for all say that total health care spending would remain roughly the same, but that more of that spending would be shouldered by the federal government and less of it would be wasted.

A single payer system would mean fewer administrative costs. Eliminating other government programs would free up billions of dollars for the new plan. And eliminating private insurers would bring billions more dollars worth of profits and employer taxes back into the health care system. Businesses currently enjoy a tax break on the money they spend covering their employees.

But there would also be new taxes. Proponents say that, to the extent those taxes fell on consumers, they would be offset by the elimination of premiums, deductibles and copays. But that may not be enough to assuage voters. In Vermont and Colorado, legislators dropped bids for a state run single payer system when it became clear that people would not support the tax increases needed to sustain such a program.

Taxes are not the only trade off. Increased efficiency and less profiteering should mean that more people would be covered and could afford the care they needed. But a single payer system could also mean the elimination of many thousands of health care jobs and lower pay for providers, both of which could impede access to, and the quality of, care. Those impediments could be small — slightly longer wait times, for example. Or they could be substantial — much longer wait times and far fewer doctors.

There are two basic ways for insurance programs to curb costs. One is to cover fewer things; the other is to negotiate on prices.

Medicare for all would forgo the first option, meaning that it would cover everything. But it would use the massive bargaining power of so many users — the entire United States population — to negotiate far better deals on prescription drugs, hospital stays and more. The different incremental programs would use both levers: Most would not cover vision or dental, for example. But all of them would also direct the secretary of health and human services to negotiate costs with providers.

Most other countries use negotiating power to control health care costs; thats why prescription drugs cost so much less elsewhere than they do in the United States. But those countries accept a trade off, inherent in this approach, that the United States has so far resisted: They forgo access to certain innovations, like pricey new drugs and medical devices whose benefits are found to be minimal.

A plan that results in higher taxes but skimps on cutting edge medicine may seem unfair — and may well be unpopular. But many Americans are already being denied essential services every day. It may make sense to forgo innovations that a growing number of people cant benefit from anyway in exchange for a program that sets fair prices at the outset and doesnt leave people low tech essentials or for donations to cover basic costs.

The fight to once again remake American health care will almost certainly be brutal. Before voters can if they want to have that fight, candidates will need to clarify what they are selling. Only then can the nation have an honest dialogue about the risks, benefits and trade offs ahead.

The Times is committed to publishing to the editor. Wed like to hear what you think about this or any of our articles. Here are some . And heres our email: .

Follow The New York Times Opinion section on , and .

For more infomation >> Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times - Duration: 3:38.

-------------------------------------------

Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times - Duration: 4:06.

Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times

A battle is looming over universal health care. Politicians and voters will have to decide whether the trade offs are worth it.

The editorial board represents the opinions of the board, its editor and the publisher. It is separate from the newsroom and the Op Ed section.

Its been nearly 10 years since the passage of the Affordable Care Act — one of the most sweeping health care overhauls in the nations history. The law has brought the number of uninsured people in America to an low, secured protections for people with pre existing conditions and advanced the notion that .

But the system was never perfect, and its fractures and stress points have become too great to ignore. The number of people who are uninsured or underinsured is , after two years of sabotage to the current law by the Trump administration. A Republican led lawsuit that once seemed like is Obamacares protections for pre existing conditions. And high out of pocket costs, absurd hospital billing practices and ever rising prescription drug prices have forced too many people to skip crucial treatments, avoid and life sustaining medications.

America may be a country rich in medical innovation — a place where robots perform surgery — but its also one where tens of thousands of people die every year because they cant afford basic care.

Both parties seem certain to make health care a significant election issue over the next two years. There are no fewer than bills floating through Congress that would address these problems. And Medicare for all — a concept that describes only some of those proposals — has become both a rallying cry and a test of progressive credentials.

Voters, however, appear more ambivalent. Though health care has long topped the electorates list of concerns, , surveys suggest that most Democrats want their party to focus on fixing the Affordable Care Act rather than on starting a long shot bid for a single payer health care system. In a recent poll, some 56 percent of Americans, including nearly a quarter of Republicans, supported the idea of a new federal program; but when trade offs like higher taxes or the loss of private insurance options were factored in, that support evaporated.

As the 2020 race heats up, heres a primer to help citizens sort out where they stand.

The plans currently in play differ in their particulars: Senator Bernie Sanderss Medicare for All Act would scrap private insurance and create a new federal system to cover everyone; a plan from the Center for American Progress, a think tank, would create an optional public program that anyone could buy into; and a plan from Senator Debbie Stabenow would give all Americans the option to buy into Medicare when they turn 50. But these plans would extend coverage to more people and would increase the federal governments role in providing and policing health insurance.

The proposals fall into two broad categories: universal and incremental. On the universal side, Medicare for all would largely eliminate the need for private insurance and for other public programs like Medicaid and the Childrens Health Insurance Program. Its coverage would also be more expansive than current Medicare: It would include eye and dental care as well as prescription drugs, and it would eliminate premiums, deductibles, copays and surprise medical bills.

A single federal payer — as such proposals envision — may well eliminate the waste, inefficiency and corruption that make the current system so expensive and inaccessible; the experience of countries like Canada and Britain that rely heavily on one government payer suggests as much. But such a system would require dramatic changes from the status quo and would be a tough political sell. Whats more, single payer is not the only way to achieve universal coverage.

On the incremental side, several different proposals would allow certain people to buy into existing public plans. Some would enable older Americans who are not yet eligible for Medicare to buy into that program — at age 50 or 55 or 60. One would let people who dont have other insurance coverage buy into Medicaid as long as their state opted into the program .

Because these programs dont rely on a single payer, they would not do as much to clean up the existing system. But they have a better chance of being adopted by Congress, and some could bring the country very close to achieving universal coverage.

A recent Kaiser poll found that the potential loss of private insurance was what turned most people off the concept of Medicare for all. Thats not surprising. About half of all Americans — some 156 million people — get their health insurance through employer based plans, and rely on other forms of private coverage, including the A.C.A. marketplace and Medicare Advantage plans. The of those people say that they like their coverage. And so far, the majority of Americans seem loath to give up what they have, no matter how good the alternative is made to sound.

Thats too bad. The idea of forcing more than half the country off existing programs might sound scary, but the majority of those people are at constant risk of losing their health coverage — for instance, if they lose or leave their jobs, if their employers change plans or if their insurers change their terms in ways that increase out of pocket costs.

Still, the choice between universal health care and private insurance will very likely prove to be a false one. Most of the six plans leave ample room for private options to play a role, and the ones that dont — the true Medicare for all proposals — will almost certainly change as they are negotiated. As , no other country has managed to achieve universal health care without including some form of private insurance.

Proponents of Medicare for all say that total health care spending would remain roughly the same, but that more of that spending would be shouldered by the federal government and less of it would be wasted.

A single payer system would mean fewer administrative costs. Eliminating other government programs would free up billions of dollars for the new plan. And eliminating private insurers would bring billions more dollars worth of profits and employer taxes back into the health care system. Businesses currently enjoy a tax break on the money they spend covering their employees.

But there would also be new taxes. Proponents say that, to the extent those taxes fell on consumers, they would be offset by the elimination of premiums, deductibles and copays. But that may not be enough to assuage voters. In Vermont and Colorado, legislators dropped bids for a state run single payer system when it became clear that people would not support the tax increases needed to sustain such a program.

Taxes are not the only trade off. Increased efficiency and less profiteering should mean that more people would be covered and could afford the care they needed. But a single payer system could also mean the elimination of many thousands of health care jobs and lower pay for providers, both of which could impede access to, and the quality of, care. Those impediments could be small — slightly longer wait times, for example. Or they could be substantial — much longer wait times and far fewer doctors.

There are two basic ways for insurance programs to curb costs. One is to cover fewer things; the other is to negotiate on prices.

Medicare for all would forgo the first option, meaning that it would cover everything. But it would use the massive bargaining power of so many users — the entire United States population — to negotiate far better deals on prescription drugs, hospital stays and more. The different incremental programs would use both levers: Most would not cover vision or dental, for example. But all of them would also direct the secretary of health and human services to negotiate costs with providers.

Most other countries use negotiating power to control health care costs; thats why prescription drugs cost so much less elsewhere than they do in the United States. But those countries accept a trade off, inherent in this approach, that the United States has so far resisted: They forgo access to certain innovations, like pricey new drugs and medical devices whose benefits are found to be minimal.

A plan that results in higher taxes but skimps on cutting edge medicine may seem unfair — and may well be unpopular. But many Americans are already being denied essential services every day. It may make sense to forgo innovations that a growing number of people cant benefit from anyway in exchange for a program that sets fair prices at the outset and doesnt leave people low tech essentials or for donations to cover basic costs.

The fight to once again remake American health care will almost certainly be brutal. Before voters can if they want to have that fight, candidates will need to clarify what they are selling. Only then can the nation have an honest dialogue about the risks, benefits and trade offs ahead.

The Times is committed to publishing to the editor. Wed like to hear what you think about this or any of our articles. Here are some . And heres our email: .

Follow The New York Times Opinion section on , and .

For more infomation >> Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times - Duration: 4:06.

-------------------------------------------

How much you have been losing when you are buying from traders and brokers - Duration: 7:42.

For more infomation >> How much you have been losing when you are buying from traders and brokers - Duration: 7:42.

-------------------------------------------

Update | Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times - Duration: 3:46.

Update | Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times

A battle is looming over universal health care. Politicians and voters will have to decide whether the trade offs are worth it.

The editorial board represents the opinions of the board, its editor and the publisher. It is separate from the newsroom and the Op Ed section.

Its been nearly 10 years since the passage of the Affordable Care Act — one of the most sweeping health care overhauls in the nations history. The law has brought the number of uninsured people in America to an low, secured protections for people with pre existing conditions and advanced the notion that .

But the system was never perfect, and its fractures and stress points have become too great to ignore. The number of people who are uninsured or underinsured is , after two years of sabotage to the current law by the Trump administration. A Republican led lawsuit that once seemed like is Obamacares protections for pre existing conditions. And high out of pocket costs, absurd hospital billing practices and ever rising prescription drug prices have forced too many people to skip crucial treatments, avoid and life sustaining medications.

America may be a country rich in medical innovation — a place where robots perform surgery — but its also one where tens of thousands of people die every year because they cant afford basic care.

Both parties seem certain to make health care a significant election issue over the next two years. There are no fewer than bills floating through Congress that would address these problems. And Medicare for all — a concept that describes only some of those proposals — has become both a rallying cry and a test of progressive credentials.

Voters, however, appear more ambivalent. Though health care has long topped the electorates list of concerns, , surveys suggest that most Democrats want their party to focus on fixing the Affordable Care Act rather than on starting a long shot bid for a single payer health care system. In a recent poll, some 56 percent of Americans, including nearly a quarter of Republicans, supported the idea of a new federal program; but when trade offs like higher taxes or the loss of private insurance options were factored in, that support evaporated.

As the 2020 race heats up, heres a primer to help citizens sort out where they stand.

The plans currently in play differ in their particulars: Senator Bernie Sanderss Medicare for All Act would scrap private insurance and create a new federal system to cover everyone; a plan from the Center for American Progress, a think tank, would create an optional public program that anyone could buy into; and a plan from Senator Debbie Stabenow would give all Americans the option to buy into Medicare when they turn 50. But these plans would extend coverage to more people and would increase the federal governments role in providing and policing health insurance.

The proposals fall into two broad categories: universal and incremental. On the universal side, Medicare for all would largely eliminate the need for private insurance and for other public programs like Medicaid and the Childrens Health Insurance Program. Its coverage would also be more expansive than current Medicare: It would include eye and dental care as well as prescription drugs, and it would eliminate premiums, deductibles, copays and surprise medical bills.

A single federal payer — as such proposals envision — may well eliminate the waste, inefficiency and corruption that make the current system so expensive and inaccessible; the experience of countries like Canada and Britain that rely heavily on one government payer suggests as much. But such a system would require dramatic changes from the status quo and would be a tough political sell. Whats more, single payer is not the only way to achieve universal coverage.

On the incremental side, several different proposals would allow certain people to buy into existing public plans. Some would enable older Americans who are not yet eligible for Medicare to buy into that program — at age 50 or 55 or 60. One would let people who dont have other insurance coverage buy into Medicaid as long as their state opted into the program .

Because these programs dont rely on a single payer, they would not do as much to clean up the existing system. But they have a better chance of being adopted by Congress, and some could bring the country very close to achieving universal coverage.

A recent Kaiser poll found that the potential loss of private insurance was what turned most people off the concept of Medicare for all. Thats not surprising. About half of all Americans — some 156 million people — get their health insurance through employer based plans, and rely on other forms of private coverage, including the A.C.A. marketplace and Medicare Advantage plans. The of those people say that they like their coverage. And so far, the majority of Americans seem loath to give up what they have, no matter how good the alternative is made to sound.

Thats too bad. The idea of forcing more than half the country off existing programs might sound scary, but the majority of those people are at constant risk of losing their health coverage — for instance, if they lose or leave their jobs, if their employers change plans or if their insurers change their terms in ways that increase out of pocket costs.

Still, the choice between universal health care and private insurance will very likely prove to be a false one. Most of the six plans leave ample room for private options to play a role, and the ones that dont — the true Medicare for all proposals — will almost certainly change as they are negotiated. As , no other country has managed to achieve universal health care without including some form of private insurance.

Proponents of Medicare for all say that total health care spending would remain roughly the same, but that more of that spending would be shouldered by the federal government and less of it would be wasted.

A single payer system would mean fewer administrative costs. Eliminating other government programs would free up billions of dollars for the new plan. And eliminating private insurers would bring billions more dollars worth of profits and employer taxes back into the health care system. Businesses currently enjoy a tax break on the money they spend covering their employees.

But there would also be new taxes. Proponents say that, to the extent those taxes fell on consumers, they would be offset by the elimination of premiums, deductibles and copays. But that may not be enough to assuage voters. In Vermont and Colorado, legislators dropped bids for a state run single payer system when it became clear that people would not support the tax increases needed to sustain such a program.

Taxes are not the only trade off. Increased efficiency and less profiteering should mean that more people would be covered and could afford the care they needed. But a single payer system could also mean the elimination of many thousands of health care jobs and lower pay for providers, both of which could impede access to, and the quality of, care. Those impediments could be small — slightly longer wait times, for example. Or they could be substantial — much longer wait times and far fewer doctors.

There are two basic ways for insurance programs to curb costs. One is to cover fewer things; the other is to negotiate on prices.

Medicare for all would forgo the first option, meaning that it would cover everything. But it would use the massive bargaining power of so many users — the entire United States population — to negotiate far better deals on prescription drugs, hospital stays and more. The different incremental programs would use both levers: Most would not cover vision or dental, for example. But all of them would also direct the secretary of health and human services to negotiate costs with providers.

Most other countries use negotiating power to control health care costs; thats why prescription drugs cost so much less elsewhere than they do in the United States. But those countries accept a trade off, inherent in this approach, that the United States has so far resisted: They forgo access to certain innovations, like pricey new drugs and medical devices whose benefits are found to be minimal.

A plan that results in higher taxes but skimps on cutting edge medicine may seem unfair — and may well be unpopular. But many Americans are already being denied essential services every day. It may make sense to forgo innovations that a growing number of people cant benefit from anyway in exchange for a program that sets fair prices at the outset and doesnt leave people low tech essentials or for donations to cover basic costs.

The fight to once again remake American health care will almost certainly be brutal. Before voters can if they want to have that fight, candidates will need to clarify what they are selling. Only then can the nation have an honest dialogue about the risks, benefits and trade offs ahead.

The Times is committed to publishing to the editor. Wed like to hear what you think about this or any of our articles. Here are some . And heres our email: .

Follow The New York Times Opinion section on , and .

For more infomation >> Update | Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times - Duration: 3:46.

-------------------------------------------

Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times - Duration: 3:33.

Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times

A battle is looming over universal health care. Politicians and voters will have to decide whether the trade offs are worth it.

The editorial board represents the opinions of the board, its editor and the publisher. It is separate from the newsroom and the Op Ed section.

Its been nearly 10 years since the passage of the Affordable Care Act — one of the most sweeping health care overhauls in the nations history. The law has brought the number of uninsured people in America to an low, secured protections for people with pre existing conditions and advanced the notion that .

But the system was never perfect, and its fractures and stress points have become too great to ignore. The number of people who are uninsured or underinsured is , after two years of sabotage to the current law by the Trump administration. A Republican led lawsuit that once seemed like is Obamacares protections for pre existing conditions. And high out of pocket costs, absurd hospital billing practices and ever rising prescription drug prices have forced too many people to skip crucial treatments, avoid and life sustaining medications.

America may be a country rich in medical innovation — a place where robots perform surgery — but its also one where tens of thousands of people die every year because they cant afford basic care.

Both parties seem certain to make health care a significant election issue over the next two years. There are no fewer than bills floating through Congress that would address these problems. And Medicare for all — a concept that describes only some of those proposals — has become both a rallying cry and a test of progressive credentials.

Voters, however, appear more ambivalent. Though health care has long topped the electorates list of concerns, , surveys suggest that most Democrats want their party to focus on fixing the Affordable Care Act rather than on starting a long shot bid for a single payer health care system. In a recent poll, some 56 percent of Americans, including nearly a quarter of Republicans, supported the idea of a new federal program; but when trade offs like higher taxes or the loss of private insurance options were factored in, that support evaporated.

As the 2020 race heats up, heres a primer to help citizens sort out where they stand.

The plans currently in play differ in their particulars: Senator Bernie Sanderss Medicare for All Act would scrap private insurance and create a new federal system to cover everyone; a plan from the Center for American Progress, a think tank, would create an optional public program that anyone could buy into; and a plan from Senator Debbie Stabenow would give all Americans the option to buy into Medicare when they turn 50. But these plans would extend coverage to more people and would increase the federal governments role in providing and policing health insurance.

The proposals fall into two broad categories: universal and incremental. On the universal side, Medicare for all would largely eliminate the need for private insurance and for other public programs like Medicaid and the Childrens Health Insurance Program. Its coverage would also be more expansive than current Medicare: It would include eye and dental care as well as prescription drugs, and it would eliminate premiums, deductibles, copays and surprise medical bills.

A single federal payer — as such proposals envision — may well eliminate the waste, inefficiency and corruption that make the current system so expensive and inaccessible; the experience of countries like Canada and Britain that rely heavily on one government payer suggests as much. But such a system would require dramatic changes from the status quo and would be a tough political sell. Whats more, single payer is not the only way to achieve universal coverage.

On the incremental side, several different proposals would allow certain people to buy into existing public plans. Some would enable older Americans who are not yet eligible for Medicare to buy into that program — at age 50 or 55 or 60. One would let people who dont have other insurance coverage buy into Medicaid as long as their state opted into the program .

Because these programs dont rely on a single payer, they would not do as much to clean up the existing system. But they have a better chance of being adopted by Congress, and some could bring the country very close to achieving universal coverage.

A recent Kaiser poll found that the potential loss of private insurance was what turned most people off the concept of Medicare for all. Thats not surprising. About half of all Americans — some 156 million people — get their health insurance through employer based plans, and rely on other forms of private coverage, including the A.C.A. marketplace and Medicare Advantage plans. The of those people say that they like their coverage. And so far, the majority of Americans seem loath to give up what they have, no matter how good the alternative is made to sound.

Thats too bad. The idea of forcing more than half the country off existing programs might sound scary, but the majority of those people are at constant risk of losing their health coverage — for instance, if they lose or leave their jobs, if their employers change plans or if their insurers change their terms in ways that increase out of pocket costs.

Still, the choice between universal health care and private insurance will very likely prove to be a false one. Most of the six plans leave ample room for private options to play a role, and the ones that dont — the true Medicare for all proposals — will almost certainly change as they are negotiated. As , no other country has managed to achieve universal health care without including some form of private insurance.

Proponents of Medicare for all say that total health care spending would remain roughly the same, but that more of that spending would be shouldered by the federal government and less of it would be wasted.

A single payer system would mean fewer administrative costs. Eliminating other government programs would free up billions of dollars for the new plan. And eliminating private insurers would bring billions more dollars worth of profits and employer taxes back into the health care system. Businesses currently enjoy a tax break on the money they spend covering their employees.

But there would also be new taxes. Proponents say that, to the extent those taxes fell on consumers, they would be offset by the elimination of premiums, deductibles and copays. But that may not be enough to assuage voters. In Vermont and Colorado, legislators dropped bids for a state run single payer system when it became clear that people would not support the tax increases needed to sustain such a program.

Taxes are not the only trade off. Increased efficiency and less profiteering should mean that more people would be covered and could afford the care they needed. But a single payer system could also mean the elimination of many thousands of health care jobs and lower pay for providers, both of which could impede access to, and the quality of, care. Those impediments could be small — slightly longer wait times, for example. Or they could be substantial — much longer wait times and far fewer doctors.

There are two basic ways for insurance programs to curb costs. One is to cover fewer things; the other is to negotiate on prices.

Medicare for all would forgo the first option, meaning that it would cover everything. But it would use the massive bargaining power of so many users — the entire United States population — to negotiate far better deals on prescription drugs, hospital stays and more. The different incremental programs would use both levers: Most would not cover vision or dental, for example. But all of them would also direct the secretary of health and human services to negotiate costs with providers.

Most other countries use negotiating power to control health care costs; thats why prescription drugs cost so much less elsewhere than they do in the United States. But those countries accept a trade off, inherent in this approach, that the United States has so far resisted: They forgo access to certain innovations, like pricey new drugs and medical devices whose benefits are found to be minimal.

A plan that results in higher taxes but skimps on cutting edge medicine may seem unfair — and may well be unpopular. But many Americans are already being denied essential services every day. It may make sense to forgo innovations that a growing number of people cant benefit from anyway in exchange for a program that sets fair prices at the outset and doesnt leave people low tech essentials or for donations to cover basic costs.

The fight to once again remake American health care will almost certainly be brutal. Before voters can if they want to have that fight, candidates will need to clarify what they are selling. Only then can the nation have an honest dialogue about the risks, benefits and trade offs ahead.

The Times is committed to publishing to the editor. Wed like to hear what you think about this or any of our articles. Here are some . And heres our email: .

Follow The New York Times Opinion section on , and .

For more infomation >> Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times - Duration: 3:33.

-------------------------------------------

Alan Shearer salary revealed: How much does Chelsea vs Man Utd pundit earn from the BBC? - Duration: 2:24.

 Alan Shearer has been a regular alongside Gary Lineker on Match of the Day since joining in 214

 The ex-England skipper is worth an estimated £4million according to The Richest, but how much does he earn from the BBC per year? Shearer earned between £4, and £449,999 for the 216/17 financial year - over a million less than his on-screen colleague Lineker

 The Premier League's all-time top-scorer's wage was revealed by his employer in 21 after a Freedom of Information request was made to the publicly-funded broadcaster

 Shearer made his professional football debut whilst a Southampton player in 19 - and played for the club for the next four seasons

 Forty-three goals in 15 appearances for the Saints caught the eye of newly-promoted Blackburn - who paid around £3

6million to acquire his services. The powerful striker scored an incredible 13 goals in 171 fixtures for Blackburn, and helped them to their only ever Premier League title in 1995

 After a blistering 37 goals in the 1995/96 season, Shearer was purchased for a world-record transfer fee of £15m by title-challengers Newcastle United

 Shearer played for England throughout his career, scoring 3 goals across 63 appearances

 The 4-year-old made his debut in 1992 under the late Graham Taylor. Shearer was appointed captain by Glenn Hoddle for the 199 FIFA World Cup, where England crashed out to Argentina during the last 16 via a penalty shootout

 The Newcastle-local tried his hand at management in 29, but failed to save his beloved club from relegation to the Championship

For more infomation >> Alan Shearer salary revealed: How much does Chelsea vs Man Utd pundit earn from the BBC? - Duration: 2:24.

-------------------------------------------

Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times - Duration: 3:38.

Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times

A battle is looming over universal health care. Politicians and voters will have to decide whether the trade offs are worth it.

The editorial board represents the opinions of the board, its editor and the publisher. It is separate from the newsroom and the Op Ed section.

Its been nearly 10 years since the passage of the Affordable Care Act — one of the most sweeping health care overhauls in the nations history. The law has brought the number of uninsured people in America to an low, secured protections for people with pre existing conditions and advanced the notion that .

But the system was never perfect, and its fractures and stress points have become too great to ignore. The number of people who are uninsured or underinsured is , after two years of sabotage to the current law by the Trump administration. A Republican led lawsuit that once seemed like is Obamacares protections for pre existing conditions. And high out of pocket costs, absurd hospital billing practices and ever rising prescription drug prices have forced too many people to skip crucial treatments, avoid and life sustaining medications.

America may be a country rich in medical innovation — a place where robots perform surgery — but its also one where tens of thousands of people die every year because they cant afford basic care.

Both parties seem certain to make health care a significant election issue over the next two years. There are no fewer than bills floating through Congress that would address these problems. And Medicare for all — a concept that describes only some of those proposals — has become both a rallying cry and a test of progressive credentials.

Voters, however, appear more ambivalent. Though health care has long topped the electorates list of concerns, , surveys suggest that most Democrats want their party to focus on fixing the Affordable Care Act rather than on starting a long shot bid for a single payer health care system. In a recent poll, some 56 percent of Americans, including nearly a quarter of Republicans, supported the idea of a new federal program; but when trade offs like higher taxes or the loss of private insurance options were factored in, that support evaporated.

As the 2020 race heats up, heres a primer to help citizens sort out where they stand.

The plans currently in play differ in their particulars: Senator Bernie Sanderss Medicare for All Act would scrap private insurance and create a new federal system to cover everyone; a plan from the Center for American Progress, a think tank, would create an optional public program that anyone could buy into; and a plan from Senator Debbie Stabenow would give all Americans the option to buy into Medicare when they turn 50. But these plans would extend coverage to more people and would increase the federal governments role in providing and policing health insurance.

The proposals fall into two broad categories: universal and incremental. On the universal side, Medicare for all would largely eliminate the need for private insurance and for other public programs like Medicaid and the Childrens Health Insurance Program. Its coverage would also be more expansive than current Medicare: It would include eye and dental care as well as prescription drugs, and it would eliminate premiums, deductibles, copays and surprise medical bills.

A single federal payer — as such proposals envision — may well eliminate the waste, inefficiency and corruption that make the current system so expensive and inaccessible; the experience of countries like Canada and Britain that rely heavily on one government payer suggests as much. But such a system would require dramatic changes from the status quo and would be a tough political sell. Whats more, single payer is not the only way to achieve universal coverage.

On the incremental side, several different proposals would allow certain people to buy into existing public plans. Some would enable older Americans who are not yet eligible for Medicare to buy into that program — at age 50 or 55 or 60. One would let people who dont have other insurance coverage buy into Medicaid as long as their state opted into the program .

Because these programs dont rely on a single payer, they would not do as much to clean up the existing system. But they have a better chance of being adopted by Congress, and some could bring the country very close to achieving universal coverage.

A recent Kaiser poll found that the potential loss of private insurance was what turned most people off the concept of Medicare for all. Thats not surprising. About half of all Americans — some 156 million people — get their health insurance through employer based plans, and rely on other forms of private coverage, including the A.C.A. marketplace and Medicare Advantage plans. The of those people say that they like their coverage. And so far, the majority of Americans seem loath to give up what they have, no matter how good the alternative is made to sound.

Thats too bad. The idea of forcing more than half the country off existing programs might sound scary, but the majority of those people are at constant risk of losing their health coverage — for instance, if they lose or leave their jobs, if their employers change plans or if their insurers change their terms in ways that increase out of pocket costs.

Still, the choice between universal health care and private insurance will very likely prove to be a false one. Most of the six plans leave ample room for private options to play a role, and the ones that dont — the true Medicare for all proposals — will almost certainly change as they are negotiated. As , no other country has managed to achieve universal health care without including some form of private insurance.

Proponents of Medicare for all say that total health care spending would remain roughly the same, but that more of that spending would be shouldered by the federal government and less of it would be wasted.

A single payer system would mean fewer administrative costs. Eliminating other government programs would free up billions of dollars for the new plan. And eliminating private insurers would bring billions more dollars worth of profits and employer taxes back into the health care system. Businesses currently enjoy a tax break on the money they spend covering their employees.

But there would also be new taxes. Proponents say that, to the extent those taxes fell on consumers, they would be offset by the elimination of premiums, deductibles and copays. But that may not be enough to assuage voters. In Vermont and Colorado, legislators dropped bids for a state run single payer system when it became clear that people would not support the tax increases needed to sustain such a program.

Taxes are not the only trade off. Increased efficiency and less profiteering should mean that more people would be covered and could afford the care they needed. But a single payer system could also mean the elimination of many thousands of health care jobs and lower pay for providers, both of which could impede access to, and the quality of, care. Those impediments could be small — slightly longer wait times, for example. Or they could be substantial — much longer wait times and far fewer doctors.

There are two basic ways for insurance programs to curb costs. One is to cover fewer things; the other is to negotiate on prices.

Medicare for all would forgo the first option, meaning that it would cover everything. But it would use the massive bargaining power of so many users — the entire United States population — to negotiate far better deals on prescription drugs, hospital stays and more. The different incremental programs would use both levers: Most would not cover vision or dental, for example. But all of them would also direct the secretary of health and human services to negotiate costs with providers.

Most other countries use negotiating power to control health care costs; thats why prescription drugs cost so much less elsewhere than they do in the United States. But those countries accept a trade off, inherent in this approach, that the United States has so far resisted: They forgo access to certain innovations, like pricey new drugs and medical devices whose benefits are found to be minimal.

A plan that results in higher taxes but skimps on cutting edge medicine may seem unfair — and may well be unpopular. But many Americans are already being denied essential services every day. It may make sense to forgo innovations that a growing number of people cant benefit from anyway in exchange for a program that sets fair prices at the outset and doesnt leave people low tech essentials or for donations to cover basic costs.

The fight to once again remake American health care will almost certainly be brutal. Before voters can if they want to have that fight, candidates will need to clarify what they are selling. Only then can the nation have an honest dialogue about the risks, benefits and trade offs ahead.

The Times is committed to publishing to the editor. Wed like to hear what you think about this or any of our articles. Here are some . And heres our email: .

Follow The New York Times Opinion section on , and .

For more infomation >> Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times - Duration: 3:38.

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Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times - Duration: 3:36.

Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times

A battle is looming over universal health care. Politicians and voters will have to decide whether the trade offs are worth it.

The editorial board represents the opinions of the board, its editor and the publisher. It is separate from the newsroom and the Op Ed section.

Its been nearly 10 years since the passage of the Affordable Care Act — one of the most sweeping health care overhauls in the nations history. The law has brought the number of uninsured people in America to an low, secured protections for people with pre existing conditions and advanced the notion that .

But the system was never perfect, and its fractures and stress points have become too great to ignore. The number of people who are uninsured or underinsured is , after two years of sabotage to the current law by the Trump administration. A Republican led lawsuit that once seemed like is Obamacares protections for pre existing conditions. And high out of pocket costs, absurd hospital billing practices and ever rising prescription drug prices have forced too many people to skip crucial treatments, avoid and life sustaining medications.

America may be a country rich in medical innovation — a place where robots perform surgery — but its also one where tens of thousands of people die every year because they cant afford basic care.

Both parties seem certain to make health care a significant election issue over the next two years. There are no fewer than bills floating through Congress that would address these problems. And Medicare for all — a concept that describes only some of those proposals — has become both a rallying cry and a test of progressive credentials.

Voters, however, appear more ambivalent. Though health care has long topped the electorates list of concerns, , surveys suggest that most Democrats want their party to focus on fixing the Affordable Care Act rather than on starting a long shot bid for a single payer health care system. In a recent poll, some 56 percent of Americans, including nearly a quarter of Republicans, supported the idea of a new federal program; but when trade offs like higher taxes or the loss of private insurance options were factored in, that support evaporated.

As the 2020 race heats up, heres a primer to help citizens sort out where they stand.

The plans currently in play differ in their particulars: Senator Bernie Sanderss Medicare for All Act would scrap private insurance and create a new federal system to cover everyone; a plan from the Center for American Progress, a think tank, would create an optional public program that anyone could buy into; and a plan from Senator Debbie Stabenow would give all Americans the option to buy into Medicare when they turn 50. But these plans would extend coverage to more people and would increase the federal governments role in providing and policing health insurance.

The proposals fall into two broad categories: universal and incremental. On the universal side, Medicare for all would largely eliminate the need for private insurance and for other public programs like Medicaid and the Childrens Health Insurance Program. Its coverage would also be more expansive than current Medicare: It would include eye and dental care as well as prescription drugs, and it would eliminate premiums, deductibles, copays and surprise medical bills.

A single federal payer — as such proposals envision — may well eliminate the waste, inefficiency and corruption that make the current system so expensive and inaccessible; the experience of countries like Canada and Britain that rely heavily on one government payer suggests as much. But such a system would require dramatic changes from the status quo and would be a tough political sell. Whats more, single payer is not the only way to achieve universal coverage.

On the incremental side, several different proposals would allow certain people to buy into existing public plans. Some would enable older Americans who are not yet eligible for Medicare to buy into that program — at age 50 or 55 or 60. One would let people who dont have other insurance coverage buy into Medicaid as long as their state opted into the program .

Because these programs dont rely on a single payer, they would not do as much to clean up the existing system. But they have a better chance of being adopted by Congress, and some could bring the country very close to achieving universal coverage.

A recent Kaiser poll found that the potential loss of private insurance was what turned most people off the concept of Medicare for all. Thats not surprising. About half of all Americans — some 156 million people — get their health insurance through employer based plans, and rely on other forms of private coverage, including the A.C.A. marketplace and Medicare Advantage plans. The of those people say that they like their coverage. And so far, the majority of Americans seem loath to give up what they have, no matter how good the alternative is made to sound.

Thats too bad. The idea of forcing more than half the country off existing programs might sound scary, but the majority of those people are at constant risk of losing their health coverage — for instance, if they lose or leave their jobs, if their employers change plans or if their insurers change their terms in ways that increase out of pocket costs.

Still, the choice between universal health care and private insurance will very likely prove to be a false one. Most of the six plans leave ample room for private options to play a role, and the ones that dont — the true Medicare for all proposals — will almost certainly change as they are negotiated. As , no other country has managed to achieve universal health care without including some form of private insurance.

Proponents of Medicare for all say that total health care spending would remain roughly the same, but that more of that spending would be shouldered by the federal government and less of it would be wasted.

A single payer system would mean fewer administrative costs. Eliminating other government programs would free up billions of dollars for the new plan. And eliminating private insurers would bring billions more dollars worth of profits and employer taxes back into the health care system. Businesses currently enjoy a tax break on the money they spend covering their employees.

But there would also be new taxes. Proponents say that, to the extent those taxes fell on consumers, they would be offset by the elimination of premiums, deductibles and copays. But that may not be enough to assuage voters. In Vermont and Colorado, legislators dropped bids for a state run single payer system when it became clear that people would not support the tax increases needed to sustain such a program.

Taxes are not the only trade off. Increased efficiency and less profiteering should mean that more people would be covered and could afford the care they needed. But a single payer system could also mean the elimination of many thousands of health care jobs and lower pay for providers, both of which could impede access to, and the quality of, care. Those impediments could be small — slightly longer wait times, for example. Or they could be substantial — much longer wait times and far fewer doctors.

There are two basic ways for insurance programs to curb costs. One is to cover fewer things; the other is to negotiate on prices.

Medicare for all would forgo the first option, meaning that it would cover everything. But it would use the massive bargaining power of so many users — the entire United States population — to negotiate far better deals on prescription drugs, hospital stays and more. The different incremental programs would use both levers: Most would not cover vision or dental, for example. But all of them would also direct the secretary of health and human services to negotiate costs with providers.

Most other countries use negotiating power to control health care costs; thats why prescription drugs cost so much less elsewhere than they do in the United States. But those countries accept a trade off, inherent in this approach, that the United States has so far resisted: They forgo access to certain innovations, like pricey new drugs and medical devices whose benefits are found to be minimal.

A plan that results in higher taxes but skimps on cutting edge medicine may seem unfair — and may well be unpopular. But many Americans are already being denied essential services every day. It may make sense to forgo innovations that a growing number of people cant benefit from anyway in exchange for a program that sets fair prices at the outset and doesnt leave people low tech essentials or for donations to cover basic costs.

The fight to once again remake American health care will almost certainly be brutal. Before voters can if they want to have that fight, candidates will need to clarify what they are selling. Only then can the nation have an honest dialogue about the risks, benefits and trade offs ahead.

The Times is committed to publishing to the editor. Wed like to hear what you think about this or any of our articles. Here are some . And heres our email: .

Follow The New York Times Opinion section on , and .

For more infomation >> Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times - Duration: 3:36.

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Meghan Fashion - Meghan Markle letter: How much of the news do the Royals REALLY read? - Duration: 4:03.

 Last week, five of Meghan Markle's closest friends spoke to PEOPLE magazine to stand up against the "global bullying" and speak the truth about their pal

And the week before that, Kensington Palace appealed to social media firms to help stem the level of vitriol directed towards both Meghan and Kate, Duchess of Cambridge

Then Meghan's father leaked that letter and suddenly even more of Meghan's personal life was exposed

 But is all of this concern justified? How much of the news and comments do the royals actually read? Of course, the Royals are all protected from the comments and remarks to some extent

 They have teams around them who will surely try filter out the most unnecessary of remarks

 And none of the key British Royals are on social media - no Facebook, no Twitter, no Instagram

 READ MORE: The interview Meghan's best friends gave PEOPLE - 'Meg has silently sat back and endured the lies and untruths' But Marlene Koenig, an expert on British and European royalty, told Express

co.uk she would be surprised if Meghan didn't know what was going on. She said: "I cannot speak for the Duchess of Sussex but I suspect she is very aware of what is being written, as there is no doubt her staff sees basically everything

Her friends see it. "I would hope that she does not see half the nasty, racist tweets, but certainly the press coverage - and no doubt that other members of the Royal Family do as well

" When Express.co.uk approached Kensington Palace to try find out more, they declined to comment

 The palace referred back to the comments made by Meghan during her and Prince Harry's engagement interview in November 2017

 In the interview, she said: "We were just hit so hard at the beginning with a lot of mistruths that I made the choice to not read anything, positive or negative

 "It just didn't make sense and instead we focused all of our energies just on nurturing our relationship

" But the Duchess is surely aware of some of the content out there and indicated such in the letter to her father

 She wrote about the claims Thomas Markle made to the press about his daughter and pleaded with him to "please stop lying"

 READ MORE: Meghan's letter to her father IN FULL - 'Daddy, you broke my heart'  Meghan also said she found out about his heart attack around the time of her wedding through the tabloids, which she described as "horrifying"

 But she added: "I pleaded with you to stop reading the tabloids. "On a daily basis you fixated and clicked on the lies they were writing about me

" But the Royal Family usually weather storms by remaining silent and waiting for the storm to pass

 With Meghan and Harry expecting their first baby in the spring, here's hoping they're still choosing to shut out the noise and focus on nurturing their relationship and this new phase of their lives

For more infomation >> Meghan Fashion - Meghan Markle letter: How much of the news do the Royals REALLY read? - Duration: 4:03.

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Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times - Duration: 3:32.

Opinion How Much Will Americans Sacrifice for Good Health Care? The New York Times

A battle is looming over universal health care. Politicians and voters will have to decide whether the trade offs are worth it.

The editorial board represents the opinions of the board, its editor and the publisher. It is separate from the newsroom and the Op Ed section.

Its been nearly 10 years since the passage of the Affordable Care Act — one of the most sweeping health care overhauls in the nations history. The law has brought the number of uninsured people in America to an low, secured protections for people with pre existing conditions and advanced the notion that .

But the system was never perfect, and its fractures and stress points have become too great to ignore. The number of people who are uninsured or underinsured is , after two years of sabotage to the current law by the Trump administration. A Republican led lawsuit that once seemed like is Obamacares protections for pre existing conditions. And high out of pocket costs, absurd hospital billing practices and ever rising prescription drug prices have forced too many people to skip crucial treatments, avoid and life sustaining medications.

America may be a country rich in medical innovation — a place where robots perform surgery — but its also one where tens of thousands of people die every year because they cant afford basic care.

Both parties seem certain to make health care a significant election issue over the next two years. There are no fewer than bills floating through Congress that would address these problems. And Medicare for all — a concept that describes only some of those proposals — has become both a rallying cry and a test of progressive credentials.

Voters, however, appear more ambivalent. Though health care has long topped the electorates list of concerns, , surveys suggest that most Democrats want their party to focus on fixing the Affordable Care Act rather than on starting a long shot bid for a single payer health care system. In a recent poll, some 56 percent of Americans, including nearly a quarter of Republicans, supported the idea of a new federal program; but when trade offs like higher taxes or the loss of private insurance options were factored in, that support evaporated.

As the 2020 race heats up, heres a primer to help citizens sort out where they stand.

The plans currently in play differ in their particulars: Senator Bernie Sanderss Medicare for All Act would scrap private insurance and create a new federal system to cover everyone; a plan from the Center for American Progress, a think tank, would create an optional public program that anyone could buy into; and a plan from Senator Debbie Stabenow would give all Americans the option to buy into Medicare when they turn 50. But these plans would extend coverage to more people and would increase the federal governments role in providing and policing health insurance.

The proposals fall into two broad categories: universal and incremental. On the universal side, Medicare for all would largely eliminate the need for private insurance and for other public programs like Medicaid and the Childrens Health Insurance Program. Its coverage would also be more expansive than current Medicare: It would include eye and dental care as well as prescription drugs, and it would eliminate premiums, deductibles, copays and surprise medical bills.

A single federal payer — as such proposals envision — may well eliminate the waste, inefficiency and corruption that make the current system so expensive and inaccessible; the experience of countries like Canada and Britain that rely heavily on one government payer suggests as much. But such a system would require dramatic changes from the status quo and would be a tough political sell. Whats more, single payer is not the only way to achieve universal coverage.

On the incremental side, several different proposals would allow certain people to buy into existing public plans. Some would enable older Americans who are not yet eligible for Medicare to buy into that program — at age 50 or 55 or 60. One would let people who dont have other insurance coverage buy into Medicaid as long as their state opted into the program .

Because these programs dont rely on a single payer, they would not do as much to clean up the existing system. But they have a better chance of being adopted by Congress, and some could bring the country very close to achieving universal coverage.

A recent Kaiser poll found that the potential loss of private insurance was what turned most people off the concept of Medicare for all. Thats not surprising. About half of all Americans — some 156 million people — get their health insurance through employer based plans, and rely on other forms of private coverage, including the A.C.A. marketplace and Medicare Advantage plans. The of those people say that they like their coverage. And so far, the majority of Americans seem loath to give up what they have, no matter how good the alternative is made to sound.

Thats too bad. The idea of forcing more than half the country off existing programs might sound scary, but the majority of those people are at constant risk of losing their health coverage — for instance, if they lose or leave their jobs, if their employers change plans or if their insurers change their terms in ways that increase out of pocket costs.

Still, the choice between universal health care and private insurance will very likely prove to be a false one. Most of the six plans leave ample room for private options to play a role, and the ones that dont — the true Medicare for all proposals — will almost certainly change as they are negotiated. As , no other country has managed to achieve universal health care without including some form of private insurance.

Proponents of Medicare for all say that total health care spending would remain roughly the same, but that more of that spending would be shouldered by the federal government and less of it would be wasted.

A single payer system would mean fewer administrative costs. Eliminating other government programs would free up billions of dollars for the new plan. And eliminating private insurers would bring billions more dollars worth of profits and employer taxes back into the health care system. Businesses currently enjoy a tax break on the money they spend covering their employees.

But there would also be new taxes. Proponents say that, to the extent those taxes fell on consumers, they would be offset by the elimination of premiums, deductibles and copays. But that may not be enough to assuage voters. In Vermont and Colorado, legislators dropped bids for a state run single payer system when it became clear that people would not support the tax increases needed to sustain such a program.

Taxes are not the only trade off. Increased efficiency and less profiteering should mean that more people would be covered and could afford the care they needed. But a single payer system could also mean the elimination of many thousands of health care jobs and lower pay for providers, both of which could impede access to, and the quality of, care. Those impediments could be small — slightly longer wait times, for example. Or they could be substantial — much longer wait times and far fewer doctors.

There are two basic ways for insurance programs to curb costs. One is to cover fewer things; the other is to negotiate on prices.

Medicare for all would forgo the first option, meaning that it would cover everything. But it would use the massive bargaining power of so many users — the entire United States population — to negotiate far better deals on prescription drugs, hospital stays and more. The different incremental programs would use both levers: Most would not cover vision or dental, for example. But all of them would also direct the secretary of health and human services to negotiate costs with providers.

Most other countries use negotiating power to control health care costs; thats why prescription drugs cost so much less elsewhere than they do in the United States. But those countries accept a trade off, inherent in this approach, that the United States has so far resisted: They forgo access to certain innovations, like pricey new drugs and medical devices whose benefits are found to be minimal.

A plan that results in higher taxes but skimps on cutting edge medicine may seem unfair — and may well be unpopular. But many Americans are already being denied essential services every day. It may make sense to forgo innovations that a growing number of people cant benefit from anyway in exchange for a program that sets fair prices at the outset and doesnt leave people low tech essentials or for donations to cover basic costs.

The fight to once again remake American health care will almost certainly be brutal. Before voters can if they want to have that fight, candidates will need to clarify what they are selling. Only then can the nation have an honest dialogue about the risks, benefits and trade offs ahead.

The Times is committed to publishing to the editor. Wed like to hear what you think about this or any of our articles. Here are some . And heres our email: .

Follow The New York Times Opinion section on , and .