This is a prime opportunity if the Democrats are bold enough to take it. With Manchin, Sinema and Lieberman gone, they may just. And given that we know that over the next two years (at least) Trump and his flunkies will be doing everything they can to undermine the ACA, Medicare and Medicaid. Thune and Johnson have already said they have no interest in extending the subsidies when they come up for renewal, instantly making health insurance unaffordable for millions. This is the time for Democrats to go for all the gusto - Medicare for All - expressing it in simple terms that even the dullest MAGA can understand. And make it clear that there will be no networks, no denial of claims, that everyone can choose the provider they want and he/she will be the sole decider, with the patient, of what the treatment plan is. And be clear, the health insurance companies are leeches, parasites, that add no value.
…seriously, what democrats did in four years they been in WH to stop this orange motherfucker ? …they didn’t even produce a viable candidate with a real platform for REAL CHANGES, instead they came up with a gimmick of Kamala and spiked emotional response from the crowd doing SAME THING trump was doing in his rallies - no issues, no platform and no real plan… well now you have it, sure if you’re looking for excuses, it’s not that “trump won” it’s democrats FAILED, they LITERALLY gave trump every reason to believe he’s invincible, we could put motherfucker away FOUR YEARS AGO for fucking treason, but instead democrats PUT HIM ON THE BALLOT !
…the reason is in the system itself, it DID NOT happen overnight, consumerism, political ignorance and lack of proper education made this country a politically impaired nation where propaganda runs wild and people choosing to believe false promises about economy afraid to lose stuff they never owned in a first place, while losing their rights and freedoms, country that allows a dictator to become a dictator after he said he will be dictator DESERVES A DICTATOR
A quicker solution would be for the DNC to finance hits on another 6-8 health insurance CEOs. I guarantee that would lower the claim denial rate to near zero. These assholes deserve nothing less. And if you disagree you've clearly never been a cancer patient fighting to have your chemo treatments paid for like I was.
My mom just spent 10 days in the hospital: CAT scans, specialist visits, occupational and physical therapists. After discharge she also got follow-up home health visits and (rented) medical equipment. No bills. None. This is with medicaid plus a $200/mo supplemental policy. The medical system was falling all over itself to provide all necessary coverage (I guess because they know they'll get paid?)
I was flabbergasted. This is not the medical system I know. I pay close to $1000/month to United Health Care and still have to pay $100 for my one and only medical visit for the year to a Nurse Practitioner (I can't even see an MD or get a real "physical" hands-on exam). My medications are covered no more than 30 days at a time, and three 30-day-supply co-pays are more than what I pay out of pocket for a 90-day supply. Yeah, I'm pissed off.
"Subsidies" is the wrong way to go. It's insurance, If people pay for their own medical insurance the way they pay for their own old age insurance..flat rate enough to cover the medical care of everyone...some people will need more care than others, but everyone is subject to the same risks. And it is better to pay for "more than you need" while young so that you will already have paid for what you need when you are old and need it more. This should not cost you more than current private insurance. And while Obamacare helps the poor it does so by making "the government" pay for it...it does not lower costs. This turns out to be a noticeable tax on the rich and is one reason they hate it. But their idea of fixing it is to throw people on the mercies of the private market, instead of using the government to oversee a program with leverage to control costs, and paid for at a reasonable flat rate (per income, not per person) that will be less than current private programs. As you suggest there is no reason the rich can't buy their own "better" insurance on the private market... but there is no reason they should not pay for a guaranteed government program that will be there in case something happens to their private insurance or their income by the time they need the care.
Meanwhile.. "Biden shelved it" (and Obama caved and gave us Obamacare also known as Romneycare). This means we can't trust Democrats. But if you can get a lot of ordinary people to speak up and demand "Medicare for all" we might have a chance.
The key is getting people to understand "we need to pay for it ourselves," just like we pay for Social Security ourselves.
Just curious, what's the case in your mind for a hybrid health insurance system rather than full single-payer? Why do we HAVE to leave "gold-plated" policies (i.e. broader coverage, right?) for the wealthier Americans only?
The case for single-payer is simple: middlemen don't get to profit handsomely off of Americans' basic need for medical care, high regressive premiums are replaced by lower progressive taxes, and the nation as a whole saves HUGE amounts of money.
Does a hybrid system confer some kind of benefit that I'm missing? Or is it simply a matter of what feels possible/expedient at the moment?
I got there through a combination of policy and political considerations. Of course, even a transition to a hybrid system will be a huge political lift, but there's a path to it that is easier to sell to people, which starts with just letting people buy into Medicare or Medicaid. I can live with rich people getting concierge care if as part of the bargain I have insurance that is secure and not such a nightmare to deal with. I think most Americans would agree, and given that everyone thinks they're eventually going to be rich, maybe it would go down easier.
i understood the hybrid system to mean Medicare For All, with the rich free to buy gold plated in the private market...but still pay for Medicare because by the time they need healthcare they may no longer be rich. i am sure the private market could find a way to cut its premiums for gold plated services by letting medicare pay for the low cost services.
re low progressive taxes...they would not be low for everyone if progressive. what kills medicare and social security is the Left's unquenchable need for "welfare." a flat percent of income tax would cover all of our needs at a price less than the current market... or the current "progressive" tax on Medicare for high earners.
i'm not sure what middlemen you mean. insurance companies meet a need. what hurts is high prices for care and profit seeking by providers including insurance companies.
Medicare For All could fix that, but not because of "middlemen." always demanding "the rich" pay will guarantee you never see Medicare for all...or Social Security for much longer. [I have no special love for the rich..i think a progressive tax is just fine for what the government needs. but i don't think all of us need to be on welfare for all of our ordinary needs, insurance is an ordinary need.
I know what "progressive" means - obviously some people's taxes would be relatively lower and some would be relatively higher. My point was that OVERALL spending on healthcare would be lower, like by about half. It's insane that Americans and/or their employers pay through the nose, at rates orders of magnitude higher than other developed countries, so that insurance company shareholders can rake in billions. And yes, they're the middlemen I'm speaking of. By and large, providers are not the issue.
i did not mean to imply that you don'tknow what progressive taxes means; i meant to point out that progressive is not cheap for higher income people. i have no special love for high income people, but it is the wrong approach to Medicare and Social Security if anyone still cares about that. It almost insures that :the rich" will oppose it, and tey have more power than you do/ it lso means that workers can no longer say "we paid for it ourselves. and a flat 9per income) tax would be cheaper for all income groups than they are currently paying for private insurance and the progressive rates for Medicare. "overall spending" would be reduced by government leverage to control prices. provider prices are what drive insurer profits. your dismissing provider prices tells me you don't know much about health care pricing. Medicare paid my bill for a triviial injury i had treated at a hospital,,, four thousnd dollars for six stitches. the bill was padded for numerous xrays the doctor lied about, and iv's "to prevent infection". I told Medicare they were being cheated. they did not care.
"about half" is correct. that is not "orders of magnitude." insurers are not middlemen. people need insurance so that they are protected from the high costs of a rare (ish) event. that is not "middleman" that is a legitimate service/need. Medicare is insurance. the difference is that Medicare would not be driven by profit seeking...but might have some problem with dishonest congress protecting providers profits.
i guess i am trying to find a polite way to say you have not thought this through.
I think you have the "provider prices drive insurer profits" part backwards. Yes, provider prices are out of control, but that problem would largely solve itself under a single-payer system. Currently, provider prices are heavily distorted by insurers' need to generate profits (which, counterintuitively, they can do even when they pay inflated costs for services). ProPublica explains all of that here: https://www.propublica.org/article/why-your-health-insurer-does-not-care-about-your-big-bills
Insurers ARE middlemen, just as government would be in a single-payer system. The difference is that government would not be driven by the need to generate obscene profits.
I also know that "about half" is not "orders of magnitude." I was referring to two different things. First, I said that total American healthcare spending under a single-payer plan would go down by about half compared to now. Then I said that total American healthcare spending is higher by orders of magnitude compared to other developed nations. However, fact-checking myself now, I'll concede that that IS an exaggeration: apparently our spending is "merely" double to triple that of other developed nations.
A 9% flat tax would be extremely onerous for the lowest-income Americans. "Less than they're paying now for premiums" does not equal "manageable."
Gonna leave the chat at this point, but I do sincerely thank you for challenging my assumptions, which forced me to delve a little deeper into them.
hate to leave you with the last word, so for the sake of anyone else listening.
i cant follow your reasoning re insurance companies v providers re high costs. the providers are the first line of price gougers. insurance companies don't mind high prices... that is what drives people to buy insurance, and even a small margin on a lot of money is a lot of money. where they get really criminal is in denying coverage. medicare for all would fix that (given an honest congress); i am with you there. where i am not with you is on progressive tax. i don't think the flat tax needed would be nine percent, but even nine pecent of a small wage is not a lot of money...check your arithmetic. less than we are paying now is a damn good start, and as i can tell you being a low income person all my life it is very manageable. we do not need to turn medicare or social security into welfare. the rich wil not let us, and if they did they would own it; and "we have the will but not the wallet" would become the new motto of America. "we paid for it ourselves" has worked pretty well for ninety years. also, you would find..even though the rich say it...that depending on welfare is demoralizing..and something like being locked in debt slavery.
This is a prime opportunity if the Democrats are bold enough to take it. With Manchin, Sinema and Lieberman gone, they may just. And given that we know that over the next two years (at least) Trump and his flunkies will be doing everything they can to undermine the ACA, Medicare and Medicaid. Thune and Johnson have already said they have no interest in extending the subsidies when they come up for renewal, instantly making health insurance unaffordable for millions. This is the time for Democrats to go for all the gusto - Medicare for All - expressing it in simple terms that even the dullest MAGA can understand. And make it clear that there will be no networks, no denial of claims, that everyone can choose the provider they want and he/she will be the sole decider, with the patient, of what the treatment plan is. And be clear, the health insurance companies are leeches, parasites, that add no value.
…democrats a pathetic losers !
…seriously, what democrats did in four years they been in WH to stop this orange motherfucker ? …they didn’t even produce a viable candidate with a real platform for REAL CHANGES, instead they came up with a gimmick of Kamala and spiked emotional response from the crowd doing SAME THING trump was doing in his rallies - no issues, no platform and no real plan… well now you have it, sure if you’re looking for excuses, it’s not that “trump won” it’s democrats FAILED, they LITERALLY gave trump every reason to believe he’s invincible, we could put motherfucker away FOUR YEARS AGO for fucking treason, but instead democrats PUT HIM ON THE BALLOT !
…the reason is in the system itself, it DID NOT happen overnight, consumerism, political ignorance and lack of proper education made this country a politically impaired nation where propaganda runs wild and people choosing to believe false promises about economy afraid to lose stuff they never owned in a first place, while losing their rights and freedoms, country that allows a dictator to become a dictator after he said he will be dictator DESERVES A DICTATOR
Tall order for party leadership not accustomed to fighting back
A quicker solution would be for the DNC to finance hits on another 6-8 health insurance CEOs. I guarantee that would lower the claim denial rate to near zero. These assholes deserve nothing less. And if you disagree you've clearly never been a cancer patient fighting to have your chemo treatments paid for like I was.
And some Wall Street Banksters, groc rub execs and oil barons while they’re at it
United health makes you buy supplemental cancer coverage for anything government and above just the basics
My mom just spent 10 days in the hospital: CAT scans, specialist visits, occupational and physical therapists. After discharge she also got follow-up home health visits and (rented) medical equipment. No bills. None. This is with medicaid plus a $200/mo supplemental policy. The medical system was falling all over itself to provide all necessary coverage (I guess because they know they'll get paid?)
I was flabbergasted. This is not the medical system I know. I pay close to $1000/month to United Health Care and still have to pay $100 for my one and only medical visit for the year to a Nurse Practitioner (I can't even see an MD or get a real "physical" hands-on exam). My medications are covered no more than 30 days at a time, and three 30-day-supply co-pays are more than what I pay out of pocket for a 90-day supply. Yeah, I'm pissed off.
Unfortunately if anything it will just be more middling nibbling around the edges rather than sweeping bold reforms
Current democratic leadership doesn’t know how to do anything else Bipartisanship with our good friends across the aisle and all that
Waldman
I'll vote for that, but please listen:
"Subsidies" is the wrong way to go. It's insurance, If people pay for their own medical insurance the way they pay for their own old age insurance..flat rate enough to cover the medical care of everyone...some people will need more care than others, but everyone is subject to the same risks. And it is better to pay for "more than you need" while young so that you will already have paid for what you need when you are old and need it more. This should not cost you more than current private insurance. And while Obamacare helps the poor it does so by making "the government" pay for it...it does not lower costs. This turns out to be a noticeable tax on the rich and is one reason they hate it. But their idea of fixing it is to throw people on the mercies of the private market, instead of using the government to oversee a program with leverage to control costs, and paid for at a reasonable flat rate (per income, not per person) that will be less than current private programs. As you suggest there is no reason the rich can't buy their own "better" insurance on the private market... but there is no reason they should not pay for a guaranteed government program that will be there in case something happens to their private insurance or their income by the time they need the care.
Meanwhile.. "Biden shelved it" (and Obama caved and gave us Obamacare also known as Romneycare). This means we can't trust Democrats. But if you can get a lot of ordinary people to speak up and demand "Medicare for all" we might have a chance.
The key is getting people to understand "we need to pay for it ourselves," just like we pay for Social Security ourselves.
Just curious, what's the case in your mind for a hybrid health insurance system rather than full single-payer? Why do we HAVE to leave "gold-plated" policies (i.e. broader coverage, right?) for the wealthier Americans only?
The case for single-payer is simple: middlemen don't get to profit handsomely off of Americans' basic need for medical care, high regressive premiums are replaced by lower progressive taxes, and the nation as a whole saves HUGE amounts of money.
Does a hybrid system confer some kind of benefit that I'm missing? Or is it simply a matter of what feels possible/expedient at the moment?
I got there through a combination of policy and political considerations. Of course, even a transition to a hybrid system will be a huge political lift, but there's a path to it that is easier to sell to people, which starts with just letting people buy into Medicare or Medicaid. I can live with rich people getting concierge care if as part of the bargain I have insurance that is secure and not such a nightmare to deal with. I think most Americans would agree, and given that everyone thinks they're eventually going to be rich, maybe it would go down easier.
Paul
i understood the hybrid system to mean Medicare For All, with the rich free to buy gold plated in the private market...but still pay for Medicare because by the time they need healthcare they may no longer be rich. i am sure the private market could find a way to cut its premiums for gold plated services by letting medicare pay for the low cost services.
michael
re low progressive taxes...they would not be low for everyone if progressive. what kills medicare and social security is the Left's unquenchable need for "welfare." a flat percent of income tax would cover all of our needs at a price less than the current market... or the current "progressive" tax on Medicare for high earners.
i'm not sure what middlemen you mean. insurance companies meet a need. what hurts is high prices for care and profit seeking by providers including insurance companies.
Medicare For All could fix that, but not because of "middlemen." always demanding "the rich" pay will guarantee you never see Medicare for all...or Social Security for much longer. [I have no special love for the rich..i think a progressive tax is just fine for what the government needs. but i don't think all of us need to be on welfare for all of our ordinary needs, insurance is an ordinary need.
I know what "progressive" means - obviously some people's taxes would be relatively lower and some would be relatively higher. My point was that OVERALL spending on healthcare would be lower, like by about half. It's insane that Americans and/or their employers pay through the nose, at rates orders of magnitude higher than other developed countries, so that insurance company shareholders can rake in billions. And yes, they're the middlemen I'm speaking of. By and large, providers are not the issue.
michael
i did not mean to imply that you don'tknow what progressive taxes means; i meant to point out that progressive is not cheap for higher income people. i have no special love for high income people, but it is the wrong approach to Medicare and Social Security if anyone still cares about that. It almost insures that :the rich" will oppose it, and tey have more power than you do/ it lso means that workers can no longer say "we paid for it ourselves. and a flat 9per income) tax would be cheaper for all income groups than they are currently paying for private insurance and the progressive rates for Medicare. "overall spending" would be reduced by government leverage to control prices. provider prices are what drive insurer profits. your dismissing provider prices tells me you don't know much about health care pricing. Medicare paid my bill for a triviial injury i had treated at a hospital,,, four thousnd dollars for six stitches. the bill was padded for numerous xrays the doctor lied about, and iv's "to prevent infection". I told Medicare they were being cheated. they did not care.
"about half" is correct. that is not "orders of magnitude." insurers are not middlemen. people need insurance so that they are protected from the high costs of a rare (ish) event. that is not "middleman" that is a legitimate service/need. Medicare is insurance. the difference is that Medicare would not be driven by profit seeking...but might have some problem with dishonest congress protecting providers profits.
i guess i am trying to find a polite way to say you have not thought this through.
I think you have the "provider prices drive insurer profits" part backwards. Yes, provider prices are out of control, but that problem would largely solve itself under a single-payer system. Currently, provider prices are heavily distorted by insurers' need to generate profits (which, counterintuitively, they can do even when they pay inflated costs for services). ProPublica explains all of that here: https://www.propublica.org/article/why-your-health-insurer-does-not-care-about-your-big-bills
Insurers ARE middlemen, just as government would be in a single-payer system. The difference is that government would not be driven by the need to generate obscene profits.
I also know that "about half" is not "orders of magnitude." I was referring to two different things. First, I said that total American healthcare spending under a single-payer plan would go down by about half compared to now. Then I said that total American healthcare spending is higher by orders of magnitude compared to other developed nations. However, fact-checking myself now, I'll concede that that IS an exaggeration: apparently our spending is "merely" double to triple that of other developed nations.
A 9% flat tax would be extremely onerous for the lowest-income Americans. "Less than they're paying now for premiums" does not equal "manageable."
Gonna leave the chat at this point, but I do sincerely thank you for challenging my assumptions, which forced me to delve a little deeper into them.
hate to leave you with the last word, so for the sake of anyone else listening.
i cant follow your reasoning re insurance companies v providers re high costs. the providers are the first line of price gougers. insurance companies don't mind high prices... that is what drives people to buy insurance, and even a small margin on a lot of money is a lot of money. where they get really criminal is in denying coverage. medicare for all would fix that (given an honest congress); i am with you there. where i am not with you is on progressive tax. i don't think the flat tax needed would be nine percent, but even nine pecent of a small wage is not a lot of money...check your arithmetic. less than we are paying now is a damn good start, and as i can tell you being a low income person all my life it is very manageable. we do not need to turn medicare or social security into welfare. the rich wil not let us, and if they did they would own it; and "we have the will but not the wallet" would become the new motto of America. "we paid for it ourselves" has worked pretty well for ninety years. also, you would find..even though the rich say it...that depending on welfare is demoralizing..and something like being locked in debt slavery.