Are we waiting now for the media to come out and actually say it?; to say, "Our job is to see that this President fails," Mitch McConnell style. If so, we'll be waiting a long time.
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Mass media seems intent on making sure Trump fails
- Thread starter Greenie
- Start date
Jem never claimed that GOP wanted single payer. However jem is quite correct in his assertions about the formation of Obamacare and the Obama administration taking the side of insurance lobbyists to ditch the single payer option favored by most Democrats in Congress.
As I have outlined in this forum before, if universal health coverage is a desired option for U.S. society then single payer is the only proper route to go. There are plenty of good examples of single payer systems in other western countries (U.K., Germany, Canada, etc.). All of them have some downsides such as wait lists, etc. -- but all are vastly better than Obamacare.
Obamacare was written by lobbyists to be a give-away to the healthcare & insurance industries. it backfired on the insurance industries when Congress rejected paying over $25Billion yearly in bailout money (i.e. risk corridors).
No, we did not get single payer because of one thing. The fucking GOP. You are also seriously ignorant and deluded. But we knew that already.
No, we did not get single payer because of one thing. The fucking GOP. You are also seriously ignorant and deluded. But we knew that already.
And you like to re-write history and are always devoid of the actual facts.
For those who actually want to read the facts here is the detailed history of the public option during the passage of Obamacare.
The Origins And Demise Of The Public Option
http://content.healthaffairs.org/content/29/6/1117.full
I know you won't read it since you don't actually want to learn the actual facts about how the Obama administration caved into corporate lobbyists and torpedoed the public option desired by many Democrats in Congress (at a time they held the majority and could pass whatever they wanted).
I suppose what we are struggling with is whether free market capitalism is fundamentally incompatible with everyone having affordable access to a common standard of routine medical care at a level consistent with that of other industrialized countries. If we could answer that question, then we could get on with it one way or the other. (No matter what, if costs are brought down, nearly impossible, or the rate of increase contained (much more probable) someone is going to make less money. They will fight any change that threatens profit.)
Logic would have it that a bone would have had to be tossed to the insurance industry to keep them from opposing the ACA. Certainly single payer was a none starter. Thus the idea of the 'public option' was born. But this, in the end, also proved too threatening to the insurance industry, particularly a public option that would, unlike medicare, cover the young and healthy.**
By leaving McCarran Ferguson intact, eliminating the public option, keeping employer linked insurance, and permitting States to opt out of medicaid expansion -- a Court decision -- the ultimate failure of the ACA seems assured regardless of which party heads our government. I believed from the beginning that the success of any broad new plan would be contingent on cost control, and the final form of the ACA gave me no hope that costs could be contained to grow no faster than the GDP.
Probably single payer, which we know works better than the U.S. system*, is where we will end up, but not of course within the next four to eight years. We will limp along in the meantime. Of course I am hoping that the Republicans prove that free market capitalism is not incompatible, but I'll not hold my breath for the proof to arrive...
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*One has to assume the goals of the ACA here. Certainly the U.S. system works reasonably well for people of means, and very well indeed for those of considerable means. I have had direct experience with healthcare outside of the U.S. and found it better, in the sense of much less red tape and much easier, quicker access than what is readily available to me here. And it goes without saying, trivial cost compared to what the same care would have cost here. (I am a person means.)
**I am hitting the core issue underlying all of the sundry objections raised at various points in the debate. For example, the philosophical opposition of conservatives is incorporated fundamentally within the concerns of the free market advocates. The democrat opposition waxed and waned according to the chances of passing a bill without a single Republican vote, etc. The article gwb posted a link to above is excellent in its detailed description of the battle from start to finish..
Logic would have it that a bone would have had to be tossed to the insurance industry to keep them from opposing the ACA. Certainly single payer was a none starter. Thus the idea of the 'public option' was born. But this, in the end, also proved too threatening to the insurance industry, particularly a public option that would, unlike medicare, cover the young and healthy.**
By leaving McCarran Ferguson intact, eliminating the public option, keeping employer linked insurance, and permitting States to opt out of medicaid expansion -- a Court decision -- the ultimate failure of the ACA seems assured regardless of which party heads our government. I believed from the beginning that the success of any broad new plan would be contingent on cost control, and the final form of the ACA gave me no hope that costs could be contained to grow no faster than the GDP.
Probably single payer, which we know works better than the U.S. system*, is where we will end up, but not of course within the next four to eight years. We will limp along in the meantime. Of course I am hoping that the Republicans prove that free market capitalism is not incompatible, but I'll not hold my breath for the proof to arrive...
__________________
*One has to assume the goals of the ACA here. Certainly the U.S. system works reasonably well for people of means, and very well indeed for those of considerable means. I have had direct experience with healthcare outside of the U.S. and found it better, in the sense of much less red tape and much easier, quicker access than what is readily available to me here. And it goes without saying, trivial cost compared to what the same care would have cost here. (I am a person means.)
**I am hitting the core issue underlying all of the sundry objections raised at various points in the debate. For example, the philosophical opposition of conservatives is incorporated fundamentally within the concerns of the free market advocates. The democrat opposition waxed and waned according to the chances of passing a bill without a single Republican vote, etc. The article gwb posted a link to above is excellent in its detailed description of the battle from start to finish..
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This is a great question!How about medicaid and a government catastrophe policy? What else would anybody need?
Let suppose we had medicaid for everyone who could not afford medical care. That in my opinion would be a huge step forward. But we don't! Republican Governors blocked expansion of medicaid in their States. If you make too little to qualify for a federally subsidized medical insurance policy under the ACA, and you have no dependents, you won't qualify for medicaid in the States with Republican governors that blocked expansion of medicaid. (It is a lot of States!) There are people dead today because "treat and street" emergency room doesn't cut it for some conditions. And why should the tax payer be on the hook for $600 bucks to treat a kid with a runny nose? Does that make any sense?
So yes, if we expanded access to medicaid in all the States, that would take care of the indigent! Part one solved.
Now the problem becomes the cost of medical care. if federal catastrophic coverage could keep the cost of insurance down to something affordable, that would be swell. But that does nothing to address the overall cost, which is the real problem. The way single payer addresses this problem is straight forward. Coercion. You either agree to the government price or you starve. This works beautifully in all other industrialized countries except ours. And in those countries healthcare workers make a fine living! But they can afford only his and her Mercedes, none for the kids.
In the U.S. regulatory capture in medicine is extreme and the entire system is a government protected cartel. Whenever you you have a cartel offering a service that can't be refused you no longer have a free market and therefore you have a price problem on your hands. So whatever you come up with will have to address that problem. Single payer is the way most countries have dealt with this. It works.
I laugh when I hear people say if we had single payer our physicians would all leave and go somewhere else. Yeah right, pay every else in the world is much less! Where are they going to go? France? I hope their French is up to speed.
I suppose what we are struggling with is whether free market capitalism is fundamentally incompatible with everyone having affordable access to a common standard of routine medical care at a level consistent with that of other industrialized countries. If we could answer that question, then we could get on with it one way or the other. (No matter what, if costs are brought down, nearly impossible, or the rate of increase contained (much more probable) someone is going to make less money. They will fight any change that threatens profit.)
Logic would have it that a bone would have had to be tossed to the insurance industry to keep them from opposing the ACA. Certainly single payer was a none starter. Thus the idea of the 'public option' was born. But this, in the end, also proved too threatening to the insurance industry, particularly a public option that would, unlike medicare, cover the young and healthy.**
By leaving McCarran Ferguson intact, eliminating the public option, keeping employer linked insurance, and permitting States to opt out of medicaid expansion -- a Court decision -- the ultimate failure of the ACA seems assured regardless of which party heads our government. I believed from the beginning that the success of any broad new plan would be contingent on cost control, and the final form of the ACA gave me no hope that costs could be contained to grow no faster than the GDP.
Probably single payer, which we know works better than the U.S. system*, is where we will end up, but not of course within the next four to eight years. We will limp along in the meantime. Of course I am hoping that the Republicans prove that free market capitalism is not incompatible, but I'll not hold my breath for the proof to arrive...
__________________
*One has to assume the goals of the ACA here. Certainly the U.S. system works reasonably well for people of means, and very well indeed for those of considerable means. I have had direct experience with healthcare outside of the U.S. and found it better, in the sense of much less red tape and much easier, quicker access than what is readily available to me here. And it goes without saying, trivial cost compared to what the same care would have cost here. (I am a person means.)
**I am hitting the core issue underlying all of the sundry objections raised at various points in the debate. For example, the philosophical opposition of conservatives is incorporated fundamentally within the concerns of the free market advocates. The democrat opposition waxed and waned according to the chances of passing a bill without a single Republican vote, etc. The article gwb posted a link to above is excellent in its detailed description of the battle from start to finish..
The "level" of healthcare we get up in Canada is pretty shit. Not sure what you're going on about. As if you're missing out on something.
Unless you suffer from cancer, heart disease, blunt trauma, or an empty bank account, Canada is 2nd rate all the way.
ACA eliminated the cap on the maximum insurance would pay. In the typical 'single payer' system, like medicare, which is termed 'single payer' but is actually a dual payer system with optional third party payer. The way these systems are intended to work is entitlement contributions pay for a major fraction, and the patient pays for a lesser fraction, say 20%. The patient has the option of taking out insurance to cover the 20%. When everyone is covered there are no unpaid hospitals (in theory).As I understand it ACA eliminated catastrophic policies. Correct me if I am wrong. A single payer catastrophic policy would protect the hospital from large unpaid bills.
The situation in the U.S. is unique among developed countries, because the U.S. system amounts to a blood sucking cartel. Before the ACA, all manner of measures against the sucking arose in the form of ungodly amounts of paper work piled on top of an ungodly amount of government regulations and still more paperwork (one third, or more?, of the cost of care is paperwork cost), hospital admission pre-clearance, 'out of network' stuff, pre-existing conditions stuff, out patient vs. in patient stuff, pharmaceutical tiers, approved supplier stuff, and on and on and on, blah, blah, blah forever and ever, amen. And the ACA only managed to do away with some of this! Unbelievably high costs, 7$/ box of kleenex, 15$/aspirin tablet, etc., resulted in astronomical bills and rampant bankruptcies. Even with insurers paying 80% of costs, 20% of a quarter of a million was difficult for some families to come up with. And the rates for supplemental insurance to cover the additional 20% were (are) high.
So the real problem is out of control costs. Any proposal that doesn't address cost in a serious way won't do much to solve the healthcare problem in the U.S.
One approach that has been proven to work is coercion. The two main economic classes in modern social democracies are Capital and Labor. While the American medical cartel serves Capital splendidly, from Labor's point of view it sucks. Capitalism does not work for Labor unless there is a free market. And pure free markets, other than on a local scale, seldom exist in modern America, and they don't exist at all in U.S. healthcare. Denying this is like denying that the Earth is round.
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