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[Fenderputty]

That's fine. Why doesn't she do what Sanders is doing and creating a bill that's more of symbolism? .

She's currently trying to get a DACA bill passed and is prepping for a battle on tax reform and a spending bill. She may even have to deal with the debt ceiling again if Turtle doesn't stall until next April. She also successfully got a public option through the house when the ACA passs that died in the Senate. She's not an enemy to healthcare

I do agree that Bernie bringing up these issues is good for national dialog though

 

[VendettaRed07]

Why do you think Pelosi should be doing this when Bernie's part of the same party and already doing it?

I would caution you against assuming that Bernie and Pelosi are not coordinating. They're part of the same leadership team.

Basically

I don't really think Bernie expects Pelosi to come out and advocate for this right now. They are almost certainly talking. People should chill

 

[AcceptableGhost]

This and ... there's sentiment on the left that for profit companies shouldn't exist in healthcare, period.

The people who run American health insurance companies and people responsible for propping it up should probably be put on trial for crimes against humanity honestly. Like I can barely express how negative I feel about the American "healthcare" setup and I am definitely not alone. I think a growing amount of people want this shit gone completely. I don't want the existing people responsible for this mess anywhere near the future of American healthcare.

 

[Aaronrules380]

She's currently trying to get a DACA bill passed and is prepping for a battle on tax reform and a spending bill. She may even have to deal with the debt ceiling again if Turtle doesn't stall until next April. She also successfully got a public option through the house when the ACA passs that died in the Senate.

I do agree that Bernie bringing up these issues is good for national dialog though

Yeah, I think she has way higher priorities right now then trying to draft and/or propose a bill everyone knows will fail

 

[Unknown Soldier]

No, they are not called single-payer, and that is not the definition of a single-payer system.

They are government/public health care/insurance plans.

Single-Payer is when one entity does all of the baseline coverage for everyone in the market. You can have supplemental plans in a single-payer system, but everyone is mandated to be part of the baseline system. It is called single payer because only one organization is paying for the bills.

The definition of single-payer is straightforward and Medicare in the US qualifies as an example of it.

https://en.wikipedia.org/wiki/Single-payer_healthcare

Medicare is paid for by the government through collecting taxes, the government is the only payer, the health care is provided to everyone (over 65), and while it may be administered by private insurance companies the funds come solely from the government.

Medicare is single-payer. It's just restricted to 65 years of age and older.

 

[Fenderputty]

The people who run American health insurance companies and people responsible for propping it up should probably be put on trial for crimes against humanity honestly. Like I can barely express how negative I feel about the American "healthcare" setup and I am definitely not alone. I think a growing amount of people want this shit gone completely.

Sweeden, for example, restricts how much profit can be made by for profit health providers. They also control plan details some and restrict public payment to these providers if they're not approved.

There's zero reason we couldn't regulate for profit healthcare while also providing a robust public option to achieve UHC

 

[kirblar]

The definition of single-payer is straightforward and Medicare in the US qualifies as an example of it.

https://en.wikipedia.org/wiki/Single-payer_healthcare

Medicare is paid for by the government through collecting taxes, the government is the only payer, the health care is provided to everyone (over 65), and while it may be administered by private insurance companies the funds come solely from the government.

Medicare is single-payer. It's just restricted to 65 years of age and older.

Sure, fine, it's single-payer with a really big asterisk.

If you think that a move to single payer wouldn't cause a recession, wouldn't cause the Democrats to be kicked out of office en masse, and wouldn't likely be undone nearly immediately by the GOP (for good reason!) you really, really do not understand the depth of the problems with trying to implement this as a solution for universal coverage.

This has nothing to do with being "corporate" and everything to do with the vast majority of working people being willing to accept a giant tax hike and the impending loss of their employer-sponsored care.

Sweeden, for example, restricts how much profit can be made by for profit health providers. They also control plan details some and restrict public payment to these providers if they're not approved.

There's zero reason we couldn't regulate for profit healthcare while also providing a robust public option to achieve UHC

All-Payer Rate Setting (where you must charge everyone the same price) is a much better way of accomplishing this via a multi-payer system. Maryland's hospitals operate like this, and either France or Germany uses it as well.

 

[Zoe]

In that sense the bill could have been more accurately named Medicaid for All since Medicaid is the program which covers all Americans who have an economic need for subsidized health care regardless of age.

I think they want to divorce it from economic status though. So opening up Medicare while keeping Medicaid for more specialized purposes.

 

[Fenderputty]

Sure, fine, it's single-payer with a really big asterisk.

If you think that a move to single payer wouldn't cause a recession, wouldn't cause the Democrats to be kicked out of office en masse, and wouldn't likely be undone nearly immediately by the GOP (for good reason!) you really, really do not understand the depth of the problems with trying to implement this as a solution for universal coverage.

This has nothing to do with being "corporate" and everything to do with the vast majority of working people being willing to accept a giant tax hike and the impending loss of their employer-sponsored care.

All-Payer Rate Setting (where you must charge everyone the same price) is a much better way of accomplishing this via a multi-payer system. Maryland's hospitals operate like this, and either France or Germany uses it as well.

If single payer uses the private infrastructure we currently have, why do you think it would cause a recession?

 

[Unknown Soldier]

Sure, fine, it's single-payer with a really big asterisk.

If you think that a move to single payer wouldn't cause a recession, wouldn't cause the Democrats to be kicked out of office en masse, and wouldn't likely be undone nearly immediately by the GOP (for good reason!) you really, really do not understand the depth of the problems with trying to implement this as a solution for universal coverage.

This has nothing to do with being "corporate" and everything to do with the vast majority of working people being willing to accept a giant tax hike and the impending loss of their employer-sponsored care.

What are you even talking about now? I simply answered the other poster's question. You tried to tell me I was wrong. I demonstrated why I was right. Now you're going off on a bunch of random tangents unrelated to what started as a simple answer to another poster's question.

Anyways, I've answered his question, which was

I was under the impression that Medicare for All isn't necessarily single payer, but that's because I heard the name and assumed it meant a public option. Was I wrong?

And the answer is that Medicare for All is single-payer, because Medicare is single-payer. So I'm done.

 

[AcceptableGhost]

Sweeden, for example, restricts how much profit can be made by for profit health providers. They also control plan details some and restrict public payment to these providers if they're not approved.

There's zero reason we couldn't regulate for profit healthcare while also providing a robust public option to achieve UHC

I know this, logically. But I really don't want any of these nightmare factories around in any capacity, even declawed. It's like being forced to live with someone who abused you. They don't deserve to exist. I know it's irrational but I can't help it. I'll still vote for whatever moves us forward but I fully understand the dream.

 

[kirblar]

If single payer uses the private infrastructure we currently have, why do you think it would cause a recession?

Because "private infrastructure" here refers to existing insurance companies that would be massively reduced in size or go out of business entirely in the wake of losing 140m people worth of business?

If you have a single-payer UHC system, that infrastructure has been destroyed and rebuilt inside the government.

 

[shinra-bansho]

That's fine. Why doesn't she do what Sanders is doing and creating a bill that's more of symbolism?

She doesn't have to. Rep Conyers does this like every couple of years.
https://www.congress.gov/bill/115th-congress/house-bill/676/
It dies in committee and nobody notices or cares.

 

[Fenderputty]

I know this, logically. But I really don't want any of these nightmare factories around in any capacity, even declawed. It's like being forced to live with someone who abused you. They don't deserve to exist. I know it's irrational but I can't help it. I'll still vote for whatever moves us forward but I fully understand the dream.

I get that to some extent. We're just very entrenched in our system. What do you do with all this infrastructure? What about jobs in the private industry? What if I really like the service I get from Kaiser?

 

[Cipherr]

Yiiiikes. That's not a good way to start. The first talking point shouldn't be "who pays for it?!"

He's said outright that he knows the bill has literally zero chance of passing and he's only putting it forth to start a discussion. I don't think that having a foolproof budget-feasible proposal is something that's relevant to his aims.

I mean yeah. This is him 100%. Some people love it, some people don't. To me its the literal fucking definition of political theatre. Acting.

Acting acting acting.

You know its going nowhere but lets act. Because it looks good.

"How are we going to pay for it!?"

"That's not important right now, figure that out later".

I hate this form of politics.

When will democrats learn: we don't want fucking incremental change!

Probably about the point that you learn that we want actual policy and not empty gestures for show.

The Democratic party is a joke. I hope Bernie dumps this jokers and forms a legitimate progressive party.

By all means, I hope he does. And take his 'for show' bills with him.

I don't really mind that Bernie is bringing up this bill, I think, but I'm not a fan of the way its currently being set as the "with us or against us" fulcrum

I don't think anyone would care if it wasn't being used to anchor some sort of divide in the only progressive party in the U.S. But this is Bernie fucking Sanders we are talking about here. This IS his playbook. It wasn't ever going to be anything other than this.

 

[Grug]

The universal health care problem seems a bit like the gun control issue in a way.

If you get in early, you can make them work really well. However if you come to the party late, and you wait until the health system is almost entirely commercialised and everyone has a gun already, it's too late. If it's not impossible at this point, it's still very fucking difficult... politically and practically.

 

[OceanBlue]

What are you even talking about now? I simply answered the other poster's question. You tried to tell me I was wrong. I demonstrated why I was right. Now you're going off on a bunch of random tangents unrelated to what started as a simple answer to another poster's question.

Anyways, I've answered his question, which was



And the answer is that Medicare for All is single-payer, because Medicare is single-payer. So I'm done.

Oh yeah thanks. I'm definitely learning I need to learn more about different health care systems lol.

 

[Fenderputty]

Because "private infrastructure" here refers to existing insurance companies that would be massively reduced in size or go out of business entirely in the wake of losing 140m people worth of business?

If you have a single-payer UHC system, that infrastructure has been destroyed and rebuilt inside the government.

No, I mean like everything stays as is and we add cost controls and fund payments to these already existing entities through public taxation.

 

[Unknown Soldier]

I get that to some extent. We're just very entrenched in our system. What do you do with all this infrastructure? What about jobs in the private industry? What if I really like the service I get from Kaiser?

In a "Medicare for All" system, you would still get care from Kaiser. Nothing changes except the government pays for it instead of your employer. And now even if you weren't employed, you could still get care at Kaiser.

Kaiser is actually a fantastic example of what a "Medicare for All" system might look like because they are a vertically integrated health care system which owns and operates all their clinics and hospitals and directly employs their doctors and other health care staff.

 

[kirblar]

The universal health care problem seems a bit like the gun control issue in a way.

If you get in early, you can make them work really well. However if you come to the party late, it's almost impossible. The health system is almost entirely commercialised and everyone has a gun already. If it's not impossible at this point, it's still very fucking difficult.

Yes. It's not as difficult as gun control, because no one owns a doctor and nurse and keeps them under their bed. Because it's a service you can move forward with changes over time, but because it's a life and death service, you must maintain continuity at all times. There is a limit to the disruption the system and the people using it will tolerate.

 

[Somnid]

You can ask for incremental changes and they'll fight you to the death, or you can ask for the moon and they'll fight you to the death. Given both are equally unlikely the incremental route is even more a distraction because if it pulls through will not yield value worth that battle that has to be fought. The climate is too partisan and she's still playing with an outdated rulebook.

 

[Foffy]

Why do you think Pelosi should be doing this when Bernie's part of the same party and already doing it?

I would caution you against assuming that Bernie and Pelosi are not coordinating. They're part of the same leadership team.

It's not that I think they're opposing forces on this matter. I guess I'm saying why is she opposed to a gesture on the matter, which is what this bill ultimately comes down to. Like, if I were to be specific, Sanders bill is more of a dialog on "is health care a right to a citizen" and I'd assume those who believe in that idea should be able to get behind that idea. For example, does Al Franken even support this idea as is? I believe he's averse to the specificity of it, but is on board as a gesture for what it symbolizes. I may be wrong but I recall him challenging parts of this type of proposal on Twitter in the last week or so.

If the gesture is massive health care reform for a universal system, shouldn't any symbolic bill get a yes? It's not going to pass, and you only risk being seen by some who assert your aversion as rejection, and probably the reason Pelosi had to "defend" herself with her stances prior to being in office as a reminder of her position. Look at how the GOP ran on repeal plans when Obama was in office; they were all symbolic, and it helped create a narrative and thus a movement to actually try and tinker when it came time when they have majority power. It brought the party together under a narrowed direction, albeit one where the goal was to use the destruction of the ACA for something else. One of the failings the Democratic Party had was to defend even the ACA for a good long while, for their motivation came in the form of Orange Con Man. They need a message beyond defend to start unifying around.

At the same time however, it would probably mean more if one of the leaders of your party did something like this, as there's still the narrative that Sanders is "the outsider" and "the thorn in the side" to the party itself. Isn't it a bit damning that an Independant is making a deeper gesture on this matter than Minority Leader of the Democratic Party, especially when that Independent is defined as an unwelcome intruder by some of the people in that same party? How many, even on this forum, want him to go away? Where does that leave the Dems on messaging in this moment? Just back at defence, to defend the ACA. You need to defend and push. The platform can support X or Y, but you need a narrative and a movement to build the social capital, and in this sense, Sanders is currently the best asset they have for universal care as an agent for the narrative and movement. You can see that as hopeful or damning, and that's primarily on what you think of Sanders himself.

 

[Jeels]

Itt people don't know the difference between single payer and universal healthcare.

Same issue in the Vox Hillary thread with people saying she's not for universal healthcare.

 

[kirblar]

No, I mean like everything stays as is and we add cost controls and fund payments to these already existing entities through public taxation.

I'm all for public subsidies and cost controls, but that's still a multi-payer system if people are still free to pick their own baseline coverage insurer.

 

[Fenderputty]

I'm all for public subsidies and cost controls, but that's still a multi-payer system if people are still free to pick their own baseline coverage insurer.

It's multiplayer if the government is the only source of funding?

 

[kirblar]

It's multiplayer if the government is the only source of funding?

Yes. If they're subsidizing the competing insurers on the market, it's still a multi-payer system.

If the government is handling the insurance itself it's single-payer.

Btw- w/ the Kaiser example? They're an HMO organization. They don't do normal Medicare. They do Medicare supplementary plans - https://medicare.kaiserpermanente.org/wps/portal/medicare/plans/links-help/questions# They would not be covered under a hypothetical government basic coverage plan, you'd still have to pay extra for access.

Q. If I join a Kaiser Permanente Medicare health plan, will I lose my Medicare coverage?

A. No. You do not lose Part A and Part B coverage. When you become a member of our plan, Kaiser Permanente will provide your Medicare benefits to you. You must maintain your Part B Medicare enrollment in order to keep your coverage in our Medicare health plan.

 

[Kenai]

They should really teach kids their vote doesn't matter and it's all about how much money you have to purchase influence.

The American political system is a well-protected monopolistic system ensuring the ignorance and docility of anyone who is a class below the sons and daughters of engineers.

There should be urgency to correct the bad things destroying our democratic system, but the power mechanisms in place ensure correction is unlikely.

So, I will dream as young people do.

It's nice to want things. But throwing up one's hands and doing nothing is a huge part of the reason Trump is in office now. The game isn't going to stop being played because you choose not to participate. So I hope you keep trying to do stuff even if it doesn't work every time. I know I will.

 

[Fenderputty]

Yes. If they're subsidizing the competing insurers on the market, it's still a multi-payer system.

If the government is handling the insurance itself it's single-payer.

Btw- w/ the Kaiser example? They're an HMO organization. They don't do normal Medicare. They do Medicare supplementary plans - https://medicare.kaiserpermanente.org/wps/portal/medicare/plans/links-help/questions# They would not be covered under a hypothetical government basic coverage plan, you'd still have to pay extra for access.

The terminology is confusing here, but it's not really important if we're understanding each other.

To your second point. You think in this hypothetical where the government funds all healthcare, kaiser would just settle for supplemental plans? They would lose 80% of their customer base overnight.


Kaiser is great. When I was young, it wasn't as good because there were fewer hospitals and medical offices. Their infrastructure is humongous now though. They're also good with tech. I had to leave Kaiser for about 10 years when I got off my parents plan. I rejoined several years ago and they have an iPhone app. I download the app and they have all my medical history from my childhood still available to me. I'm ordering prescriptions from my phone and setting appointments as well.

Any bill that takes my Kaiser away is going to give me pause

 

[kirblar]

The terminology is confusing here, but it's not really important if we're understanding each other.

To your second point. You think in this hypothetical where the government funds all healthcare, kaiser would just settle for supplemental plans? They would lose 80% of their customer base overnight.

Kaiser's entire model is built on exclusivity. They're an HMO, not a regular insurer like Aetna.

You'll still be able to pay for it, but there's zero chance of them opening their doors to the world.

 

[Unknown Soldier]

Yes. If they're subsidizing the competing insurers on the market, it's still a multi-payer system.

If the government is handling the insurance itself it's single-payer.

Btw- w/ the Kaiser example? They're an HMO organization. They don't do normal Medicare. They do Medicare supplementary plans - https://medicare.kaiserpermanente.org/wps/portal/medicare/plans/links-help/questions# They would not be covered under a hypothetical government basic coverage plan, you'd still have to pay extra for access.

They do employer-sponsored health plans as the majority of their business and in a "Medicare for All" system where the government pays for everything (single-payer), their employer-sponsored health plans would convert to health plans paid for by the government. This goes for all private insurers, the government would simply replace employers in the short term.

The terminology is confusing here, but it's not really important if we're understanding each other.

To your second point. You think in this hypothetical where the government funds all healthcare, kaiser would just settle for supplemental plans? They would lose 80% of their customer base overnight.


Kaiser is great. When I was young, it wasn't as good because there were fewer hospitals and medical offices. Their infrastructure is humongous now though. They're also good with tech. I had to leave Kaiser for about 10 years when I got off my parents plan. I rejoined several years ago and they have an iPhone app. I download the app and they have all my medical history from my childhood still available to me. I'm ordering prescriptions from my phone and setting appointments as well.

Any bill that takes my Kaiser away is going to give me pause

Kaiser Permanente is now the country's largest vertically integrated not-for-profit health care organization, serving 9 states plus DC and over 11 million members. Big isn't even the right description. They have enough scale and resources to be a government-sponsored health care entity of a small country.

 

[kirblar]

They do employer-sponsored health plans as the majority of their business and in a "Medicare for All" system where the government pays for everything (single-payer), their employer-sponsored health plans would convert to health plans paid for by the government. This goes for all private insurers, the government would simply replace employers in the short term.

No. No they would not.

Medicare for All means that Medicare replaces whatever your current baseline coverage is with Medicare. That is what a single payer system looks like.

A multi-payer system subsidized by the government, on the other hand, would just hand people cash and tell them to buy whichever coverage on the marketplace they like. That setup WOULD allow for maintenance of primary care via Kaiser w/o complications.

edit: "Medicare Available To All" would mean that on the market/exchange, the government is providing a public option to compete against private options like Kaiser.

 

[pigeon]

They do employer-sponsored health plans as the majority of their business and in a "Medicare for All" system where the government pays for everything (single-payer), their employer-sponsored health plans would convert to health plans paid for by the government. This goes for all private insurers, the government would simply replace employers in the short term.

That's not in any sense how Medicare works.

This is a great example of how the great thing about "Medicare for all" is that people can just make up their own plans that they like and project them onto your slogan.

 

[Fenderputty]

Kaiser's entire model is built on exclusivity. They're an HMO, not a regular insurer like Aetna.

You'll still be able to pay for it, but there's zero chance of them opening their doors to the world.

I'm it following this at all, man. Why can't my employer plan be covered by the Feds? Why do you say "the world"? They already can't deny coverage based on preexisting conditions so they're open as is.

 

[And_Gignac]

She is part of #TheResistance after all.

 

[kirblar]

I'm it following this at all, man. Why can't my employer plan be covered by the Feds? Why do you say "the world"? They already can't deny coverage based on preexisting conditions so they're open as is.

It can in a multi-payer system with competing entities. Presumably, the subsidies provided by the government would be able to pay for Kaiser. It's possible you might have to pay extra, but Kaiser would be providing your baseline coverage.

It can't in a single-payer system like the UK where the national insurance group is paying for your basics up front. You would have to pay extra for access to Kaiser here. In the UK private supplementary insurance exists.

edit: I missed the meaning of the "the world" question. Kaiser is a closed HMO. They generally do care only for their members. They generally do not accept external patients. This is not inherently a bad thing, they're incredibly well-regarded and viewed as a model. But it also means that they do not cover Medicare patients unless they bought into their supplementary plans.

 

[Armaros]

She is part of #TheResistance after all.

Because that means following in lockstep with Bernie?

 

[Unknown Soldier]

No. No they would not.

Medicare for All means that Medicare replaces whatever your current baseline coverage is with Medicare. That is what a single payer system looks like.

A multi-payer system subsidized by the government, on the other hand, would just hand people cash and tell them to buy whichever coverage on the marketplace they like. That setup WOULD allow for maintenance of primary care via Kaiser w/o complications.

I think we're saying the same thing but in a different way.

I'm not speaking specifically about coverage though, but about who the underlying source of the funding is. Kaiser or any other health care organization would continue to exist and serve patients, but the government now pays directly instead of employers.

However I think you would be correct in that the actual baseline coverage would become uniform and follow whatever Medicare follows in terms of what is covered, how much is paid for this service, and that sort of thing. But private insurance and health care would not cease to exist, at least not in the short term. Those things exist today even though that's how Medicare works with people over 65 right now.

 

[Fenderputty]

It can in a multi-payer system with competing entities. Presumably, the subsidies provided by the government would be able to pay for Kaiser. It's possible you might have to pay extra, but Kaiser would be providing your baseline coverage.

It can't in a single-payer system like the UK where the national insurance group is paying for your basics up front. You would have to pay extra for access to Kaiser here. In the UK private supplementary insurance exists.

edit: I missed the meaning of the "the world" question. Kaiser is a closed HMO. They generally do care only for their members. They generally do not accept external patients. This is not inherently a bad thing, they're incredibly well-regarded and viewed as a model. But it also means that they do not cover Medicare patients unless they bought into their supplementary plans.

Yeah I think we're just confusing terminology here. Using your definition my hypothetical was a multiplayer system. Like I said "everything as is just with the funding coming from federal taxation"

 

[The Technomancer]

Yeah I think we're just confusing terminology here. Using your definition my hypothetical was a multiplayer system. Like I said "everything as is just with the funding coming from federal taxation"

"Everything with the funding coming from taxation" probably shouldn't be what we actually want though right? Like, in that model aren't insurance companies still wildly profitable? That's why I like the public option honestly, just establish the baseline and drive them out via inability to match the government's lack of need for high margins

 

[Helznicht]

In a "Medicare for All" system, you would still get care from Kaiser. Nothing changes except the government pays for it instead of your employer.

Cool, so the employers wont mind paying the money they saved back to the employees to help pay for the their increased health-tax right?

Sounds like the working middle class will be left with more healthcare costs and the rich get richer to me.

 

[kirblar]

I think we're saying the same thing but in a different way.

I'm not speaking specifically about coverage though, but about who the underlying source of the funding is. Kaiser or any other health care organization would continue to exist and serve patients, but the government now pays directly instead of employers.

However I think you would be correct in that the actual baseline coverage would become uniform and follow whatever Medicare follows in terms of what is covered, how much is paid for this service, and that sort of thing. But private insurance and health care would not cease to exist, at least not in the short term. Those things exist today even though that's how Medicare works with people over 65 right now.

So the language matters a lot here. As do the details.

I am in favor of universal healthcare coverage as a right.

I am in favor of government-subsidized healthcare coverage.

I am in favor of severing the employment-based insurance link and moving to a system more like car insurance, but I have lots of apprehension about the ability to actually do this given that a country like France has things like All-Payer rate setting and strong government subsidies...but also recently established an employer mandate for health insurance. A big part of the problem here is that people are vastly unaware of just how much their employers pay in premiums and how much they're really earning and really paying to their health insurance company. (Hence, sticker shock on the Obamacare Exchanges.) Getting companies to start paying that part of people's salaries to them instead of pocketing it...seems impossible?

I am in favor of updating the exchanges w/ a competitive public option that may one day backdoor into a single-payer system if a critical mass of people eventually start paying into it. I'm in favor of having the government provide subsidies that people can use on these exchanges to buy their preferred public or private option.

I am not in favor of establishing a single-payer system cold, given that our nation's infrastructure is already built in the private structure and that tearing it down would be bad. It'd send us into a recession from the lost jobs/business/etc., and we'd be rightfully thrown out of office for our hubris.

If you say "I'm for single payer" you are saying the government should establish a singular entity that pays for the baseline coverage for all Americans. I cannot support that. I want the government paying for it, yes, but I do not want the government trying to "seize the means of paying the medical professionals."

 

[Fenderputty]

"Everything with the funding coming from taxation" probably shouldn't be what we actually want though right? Like, in that model aren't insurance companies still wildly profitable? That's why I like the public option honestly, just establish the baseline and drive them out via inability to match the government's lack of need for high margins

My hypothetical also means we control profit a la sweeden. It was just spread out over multiple posts in a vague fashion. Sort of like Bernies bill lol


Also (not in posts) ... I would want a public option as a stepping stone to my hypothetical

 

[Fenderputty]

Cool, so the employers wont mind paying the money they saved back to the employees to help pay for the their increased health-tax right?

Sounds like the working middle class will be left with more healthcare costs and the rich get richer to me.

The assumption is that this would be mainly paid via a payroll tax to your employer so ... you wouldn't see much difference at A paycheck level. I have issues going this route as well though

 

[kirblar]

Cool, so the employers wont mind paying the money they saved back to the employees to help pay for the their increased health-tax right?

Sounds like the working middle class will be left with more healthcare costs and the rich get richer to me.

This is generally the big problem with trying to move off of employer-based coverage, yes.

The GOP's suggestion to start taxing medical benefits as income...was actually a good step in figuring out a way to make this transition happen!

The assumption is that this would be mainly paid via a payroll tax to your employer so ... you wouldn't see much difference at A paycheck level. I have issues going this route as well though

If you're not actually reducing the marginal cost to hire a new employee, you're losing one of the major benefits of moving off the employer-based health care model.

 

[Fenderputty]

If you're not actually reducing the marginal cost to hire a new employee, you're losing one of the major benefits of moving off the employer-based health care model.

That's why I said I had issues with a payroll tax. It's just easier to get public support.

Ideally it's a progressive income tax and companies have to give their current healthcare contributions to their employee as taxable income

 

[AmayaPapaya]

Is it possible for a well crafted bill to be unpopular? I think that that's what's probably going to happen, something gets through and we face blowback for it

Yes, depends on how it's framed. Dems are usually terrible at it, case in point, their own leader won't endorse the issue. I bet that looks good for Medicare for all.

Republicans are stubborn and almost always dominate the media with their talking points. Doesn't matter the popularity of it.

Dems let themselves get ran over, every time. This bill, and why it's so important the party gets behind it, is the first look that the public has at some single-payer legislation. If the party was forceful on the issue, with the leaders pushing others to support it, they could be the ones defining it. The more people behind, and the more established people who vouch for it, the better off we are. Problem is, it's clear the party isn't unified on it, and it's just a Bernie Sanders proposal (which is pretty powerful, but not as strong as it could be).

If Dems hailed it as their alternative to what the Republican's proposed, and as an immeasurable improvement to Obamacare, that would generate extremely positive buzz. Forget how much it costs, forget the negatives, just have everyone praise the thing to death for all the good it does. That's good politics. Do that before the taxes even come. When the taxes eventually come up, be honest and don't even let it be a story, while your on stage, for more than a second. "Anderson, I hear you, but the positives are immeasurable and will offset any costs you would have paid otherwise. 60% of bankruptcies are caused by medical emergencies, and that disappears overnight. Kids in poor areas can go to the dentist and receive quality care, whenever they need it. Your mom who has cancer no longer has to worry if she can't pay for care or die, she gets coverage etetcetc"

They don't think like that, though. And it's part of why I feel the leadership is incompetent. They go for the money first, and it doesn't work. The strategy above isn't new. It's what the Republicans do, and kinda what Sanders drew upon in the primary. It works tremendously well. Instead, the Pelosi strategy is to quiet down, on what could be an incredibly popular issue that makes Republicans look like fools, and collect money from the Drug companies instead. As far as I'm concerned, it's been a failure. This is why this story bugs me. It more of the same ideas that got us here. Yes Pelosi should endorse, because that's the strong and competent thing to do. But she chose the drug and insurance money instead. That didn't work for Hillary or the Obama years in congress. Republicans would mount strategies like this, and the Dem response would always be incredibly dull. The Republican message is always the ones that dominates the media, and that's a sign of competent leadership on their side, and something wrong, here at home. Thank goodness Obama was great at marketing himself, at least.

EDIT: LOL. This thread died. I didn't realize I knocked out for so long.

 

[excelsiorlef]

And people go off on me for saying Pelosi shouldn't be minority leader. Progressives, even.

Pelosi's been in her position since 2007 and has overseen the destruction of the Democratic Party from elected offices at the state and federal level.

I'm not saying Tim Ryan was the answer, but more Pelosi definitely isn't. She boasts about how much of a liability she is, it's so annoying that no Democratic took a serious stand against her.

Do you know what her job actually is?

 

[Muppet of a Man]

The people who run American health insurance companies and people responsible for propping it up should probably be put on trial for crimes against humanity honestly. Like I can barely express how negative I feel about the American "healthcare" setup and I am definitely not alone. I think a growing amount of people want this shit gone completely. I don't want the existing people responsible for this mess anywhere near the future of American healthcare.

I've done a bunch of web systems work on a consulting basis for giant medical insurance companies. I know how they operate internally and how they frivolously throw around and waste money. They are the definition of a "useless middle man" to a T. The amount of money they extract from the healthcare equation is baffling to say the least and is completely nauseating.

Their existence should have been terminated a long time ago. There is a reason that comparable care in Europe is, on average, 4 times less expensive: the removal of multitudinous private insurers from the equation who inflate the price of healthcare to get their cut and have less leverage to limit the costs demanded from pharmaceutical companies and medical providers themselves.

 

[Unknown Soldier]

So the language matters a lot here. As do the details.

I am in favor of universal healthcare coverage as a right.

I am in favor of government-subsidized healthcare coverage.

I am in favor of severing the employment-based insurance link and moving to a system more like car insurance, but I have lots of apprehension about the ability to actually do this given that a country like France has things like All-Payer rate setting and strong government subsidies...but also recently established an employer mandate for health insurance. A big part of the problem here is that people are vastly unaware of just how much their employers pay in premiums and how much they're really earning and really paying to their health insurance company. (Hence, sticker shock on the Obamacare Exchanges.) Getting companies to start paying that part of people's salaries to them instead of pocketing it...seems impossible?

I am in favor of updating the exchanges w/ a competitive public option that may one day backdoor into a single-payer system if a critical mass of people eventually start paying into it. I'm in favor of having the government provide subsidies that people can use on these exchanges to buy their preferred public or private option.

I am not in favor of establishing a single-payer system cold, given that our nation's infrastructure is already built in the private structure and that tearing it down would be bad. It'd send us into a recession from the lost jobs/business/etc., and we'd be rightfully thrown out of office for our hubris.

If you say "I'm for single payer" you are saying the government should establish a singular entity that pays for the baseline coverage for all Americans. I cannot support that. I want the government paying for it, yes, but I do not want the government trying to "seize the means of paying the medical professionals."

The thing is, there is already a singular entity which pays for the baseline coverage for all Americans...over the age of 65. It's Medicare! The government already controls the means of paying the medical professionals who are serving Americans over the age of 65. Nothing is being established cold here, it's been around this whole time!

So I don't really think this argument is that good when there is already a single-payer system, it has existed for decades, and it is the system in place which pays for the basic health care coverage of all Americans over the age of 65. It already has a funding structure through payroll taxes, it already administers benefits, it already has a coverage map for services, and it already has an existing organizational structure and bureaucracy. All these things were established so that all Americans over the age of 65 can have a universal, baseline, cost-managed health care plan and it exists today.

Now can Medicare just be suddenly extended to cover the entire country without driving the US Government into bankruptcy? No, it cannot. Medicare has many problems of it's own and it would need significant reorganization before it could become a program that covered all Americans. I think everyone, including Bernie, knows this. It's not really even about getting it done tomorrow. It's about laying the groundwork, getting people involved, understanding that single-payer health care already exists in the US and has for decades and your retired parents have it right now.

This is the basis from which a conversation can start. Knowing that we already have Medicare, warts and all, and that Americans over 65 not only generally like it and are happy to see it expanded and will fight tooth and nail to prevent it from being rolled back as we already saw with the GOP's failed Obamacare repeal. Knowing that single-payer exists today, right now, and we haven't become communist overnight. Most importantly the opposition is in disarray right now because they failed to roll back Obamacare so talking about expansion now, mounting a counter-attack, is just seizing an opportunity.

So yes, I support single-payer. Because it already exists, it seems to work just fine even though it's for the segment of the American population which uses the most health care services per capita (over 65), so why can't we talk about expanding it without doomsday scenarios of economic depression and massive unemployment and communist seizing the means of production? I don't get it.

 

[Fenderputty]

Getting companies to start paying that part of people's salaries to them instead of pocketing it...seems impossible?

Why though? Legislative? I can't imagine any company would complain if they were made to do so. It wouldnt cost them anything in the immediate calendar year and would save them money in each of the following.