Court puts U.S. on path to single payer,0,49509.story

Care to post a little more, bahia hombre? Do you agree or disagree with the editorial? Would single-payer be a good thing or a bad thing?

I don’t get that article.

That is an oxymoron. Health plans done through the private sector are not public options. The public option was a public plan tied to medicare. A big reason it was taken out is medicare reimburses at lower rates than private insurance, so the storyline described in the OP was likely to happen. I saw studies showing close to 50% of people would be on the public option plan by the 2020s since it was 20-30% cheaper than private insurance (I think the quotes were $5000 a year for a private insurance plan, $3900 for a public option tied to medicare for coverage for a single adult).

I think the article in question is describing Co-ops, which are not the same as a public option tied to medicare.

It may happen eventually, but because of public impatience with being forced to subsidize the grossly-inefficient and under-regulated insurance companies, in comparison with the highly-effective and easily-expanded Medicare. Blocking that will be the massive contributions (of those same taxpayer dollars) to the campaign chests of the key legislators, of course.

For what it’s worth, there’s a grain of truth in the article. My wife (who is an employee benefits outsourcing analyst) notes that the general feeling in the industry is that small-to-medium employers will end up dumping all of their employees on the state exchanges with a check for whatever amount they used to pay to underwrite their health insurance directly.

Which, oddly enough, is what Republicans want to do anyway. The centerpiece of John McCain’s health care plan was to eliminate the tax break for employer-provided health insurance in an attempt to decouple health insurance from employment. That would result in almost exactly the same situation as this, except worse (since there wouldn’t be the highly regulated exchanges that let individuals purchase insurance as though they belonged to larger groups).

It won’t lead to single payer. Unless the ACA is repealed, that’s our health care system for the next 100 years. Inertia is powerful when it comes to entitlements. No country with a national health care system has ever gone from multi payer to single payer. And only one, the Netherlands, has ever gone from single payer to multi payer. Once a nation creates a universal system, they tend to stick with it for the most part.