If the ACA falls, meaningful health care reform in this country will be dead nationally for the next 20 years, minimum, and, at that point, the ONLY solution will be a single-payer system.
But here’s the thing, single-payer will only happen at the federal level when the majority of the population wants a single-payer system, and like I said earlier, that won’t happen until at least another 20 years from now.
What everybody will be left with is health care reform at the state level. Nobody talks about it, but Vermont is actually leading the way here: they will have a single-payer system in 2017. If that’s successful, I definitely foresee the more liberal states (ie Massachusetts, California, Maryland, whatever) adopting similar policies; those of you in the conservative red states are gonna be out of luck.
Still, I wouldn’t even doubt that some of the states that have made headway so far into implementing the ACA already (such as my own state CA) will continue down that path at the state level even if the law is overturned. Again, who knows what the redneck states would do.
But hey, this is still getting way ahead of ourselves. The ACA is still law, and for all we know, the USSC might uphold it.
Remember that ‘single payer’ does not mean “Universal Health Care”. It only means the government would become the only payer, as is the case in Canada (as I understand - Canadians forgive my ignorance if I am not accounting for what the Provinces kick-in). This was the “Public Option” that was stricken from the current law - where the govt would essentially become a national health insurance company to compete with industry health insurance companies. So, with Public Option out, and possibly Mandate out, and then No Pre-existing Conditions out…
What will be left, if anything, to further the cause toward universal health coverage and reducing costs? We are back to where we started. I concur there may not be much progress on this in the forseeable future.
Can I have a cite for the majority of the population not being in favor of a single-payer system? That’s not what the polls I’ve seen said, but, I haven’t seen any very recent polls on the subject.
It completely depends on how you frame the question. “Government-run health-care” gets pretty low marks. “Universal health-care” quite a bit higher. “Single-payer” does pretty well, because a lot of people don’t stop to think who that single payer would be. “Medicare for all” also polls pretty well (and I think that’s actually the second most likely way to get there - state-by-state adoption of single-payer being the most likely).
And on preview: “public option” polled pretty well too, unless it was framed as a government take-over.
Basically, people really like Medicare but hate government-provided health care. Go figure.
The problem with this is that Romney is in favor of an individual mandate, even if his GOP talking points contradict that. He’s having trouble reconciling the obvious need for a mandate with the fantasy that the same mandate when proposed by Obama is tyranny of the highest order.
It’s a loser for him to have to talk about this; much simpler to just shout “Obamacare!” and point. He keeps saying “I will repeal Obamacare”–why is that a reason to vote for him if Obamacare is ruled unconstitutional in full? And if it’s ruled unconstitutional in part, he’s going to have to explain his position on the individual parts that remain; the quote above shows he’s ill-equipped to do that.
The potential problem with that is that you will get people with medical conditions moving to Vermont so they can get coverage. Same problem we have with the national mandate. Unless Vermont has immigration controls to prevent Alabamans from immigrating, perhaps with a fence and laws that require them to prove their legal Vermont citizenship at traffic stops.
But in such a situation, Romney will have little choice but to hit the “it makes sense for states to do it, but Obamacare was an unconstitutional waste of time that could’ve been better spent actually fixing problems” point as hard as he can. And if Romney becomes the nominee, the GOP will have little choice but to hit that same talking point.
Romney, they’ll say, wouldn’t have wasted time on it to begin with; who knows, they’ll add, which unconstitutional overreach Obama will waste time on next? All we know is, Obama doesn’t understand what Presidents can and can’t do, and so squanders his time trying to do the job of a Governor instead of doing his job as President.
I’m sorry, but I’m not quite following you. We have universal health care here, with a single-payer in each province/territory, namely some emanation of the provincial or territorial government. All Canadians and permanent residents are eligible for full coverage under that system.
But it will ensure that more Democrats will get to the polls to prevent another Republican president–with the power to appoint fossils to the Supremes…
And that is an albatross for him. If this primary has shown us anything about Romney, it’s that he’s not a very good at marshaling support, is extremely uncomfortable at political pandering, and gets easily flustered when challenged.
As the public reaction to Clinton’s “it depends on what the meaning of ‘is’ is” shows, voters have no tolerance for hair-splitting arguments, especially when they’re so obviosuly self-serving. The fact is Romney did “waste his time” on this and touted it as a national solution. The Dems will play the video at that link over and over if he tries to say otherwise now.
In the wake of a hypothetical Supreme Court hair-split that Obamacare is unconstitutional, while Romneycare keeps on working for Massachusetts?
You really don’t think Romney is minimally competent to say he figures (a) the national solution would be for each state to follow the example he set in Massachusetts, and (b) Obama never understood why the alternative is unconstitutional? You don’t think he can rehearse that easy one-two before the debates?
It’s going to be an issue but it’s hard to predict who will be on the winning side of it. There are people on both sides who are shocked thinking, “well, of course my side is obviously the right one” but most people are somewhere in the middle.
Will the Republicans be able to convince the public that they saved the country from an expensive new entitlement program? Or will the Democrats be able to convince the public that the Republicans stole their health care?
Agreed. Without the mandate, I would purchase insurance for the day of my doctor’s visit and cancel that afternoon.
Could I keep an application on me with a check for the first month’s premium? That way, if I’m in an accident, the EMTs can mail the completed application and check so I can be covered immediately. Plus, if they give me my hospital discharge date, I can send my cancellation notice effective that day.
It would be like being able to buy fire insurance once your house caught on fire.
Well, this brings to mind a commonly suggested fix. Enrollment periods, perhaps annually. If you buy individual insurance on the exchange you have to do so during this period (very similar to what all employer-based plans have).
You could still game the system a bit by getting insured after you go a cancer diagnosis, of course.
Another thought was to allow insurance companies to increase the price of coverage based on years of non-coverage. Basically a penalty but not one assessed by the government.
Or perhaps more draconian - waive the coverage rules for applicants who choose not to buy insurance. I.e., you can go without if you want (no penalty) but when you apply you no longer get the guaranteed coverage provisions. Basically a “get in the pool now or you may never get in” clause.
Well, I am not sure we want to involve “penalties” in this. The thrust of what must be done is to provide access to basic, preventative care - to everyone. That is how you are going to both save money and have better outcomes for all. We WANT everyone in the pool without exception - that is how a risk pool works best.
Isn’t that the exact problem this bill tries to solve? I mean, honestly, we aren’t going to let people die outside of the ER doors, so this person who foolishly chose not to purchase insurance will bleed his savings dry and then be part of Medicaid.
Same problem, but then you will create new side problems. Take your typical 23 year old who thinks he is immortal and pogo sticks out of bed on his hard dick every morning. He doesn’t pay the $300/mo for health insurance through his job because he doesn’t think he needs it.
Then one day he gets hit by a drunk driver. The drunk’s insurance pays for all of his medical bills, but he has continuous pain in his back. Even though the drunk’s insurance will pay for all follow up back pain visits, what would stop an insurance company from turning him down when he’s 40 for this pre-existing condition (under your plan)?
My personal preference for the entire market was the HSA with a catastrophic insurance plan. If we could transition all young people into those it would do wonders for the market. Routine medical care would be subject to market conditions because you would be paying out of pocket. We’ve all seen these outrageous bills that the doctor submits to the insurance. No way in hell would they be that high if the free market controlled. The prices are so high precisely because you don’t give a damn what the doctor charges. You pay your $20 co-pay and move on. He can bill the insurance company a million for all you care.
