I despise Trump but would vote for him over someone who wants to take my family's insurance away

Politics & Elections
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How is voting for a “pro business democrat” any different than voting for that “other” party? That’s how ya lost last go 'round, and let’s not forget that Don failed on HIS healthcare promises.

Maybe because a majority of the public supports a 21st century healthcare system like all the other advanced post-industrial nations enjoy. We pay more for much worse outcomes. While other advanced nations invest in their own societies with healthcare and education, we would rather engage in endless wars of aggression and occupation across the globe. It is the stiff of empires in decline throughout history; this economic cannibalization at home to project empire and militarism abroad.

Ranking 37th — Measuring the Performance of the U.S. Health Care System
https://www.nejm.org/doi/full/10.1056/NEJMp0910064

World Health Organization’s Ranking of the World’s Health Systems
Some people fancy all health care debates to be a case of Canadian Health Care vs. American. Not so. According to the World Health Organization’s ranking of the world’s health systems, neither Canada nor the USA ranks in the top 25.

Improving the Canadian Healthcare System does not mean we must emulate the American system, but it may mean that perhaps we can learn from countries that rank better than both Canada and the USA at keeping their citizens healthy.
http://thepatientfactor.com/canadian-health-care-information/world-health-organizations-ranking-of-the-worlds-health-systems/

****U.S. Health Care Ranked Worst in the Developed World
****The U.S. health care system has been subject to heated debate over the past decade, but one thing that has remained consistent is the level of performance, which has been ranked as the worst among industrialized nations for the fifth time, according to the 2014 Commonwealth Fund survey 2014. The U.K. ranked best with Switzerland following a close second.
The Commonwealth Fund report compares the U.S. with 10 other nations: France, Australia, Germany, Canada, Sweden, New Zealand, Norway, the Netherlands, Switzerland and the U.K. were all judged to be superior based on various factors. These include quality of care, access to doctors and equity throughout the country. Results of the study rely on data from the Organisation for Economic Co-operation and Development, the World Health Organization and interviews from physicians and patients.

HOW BAD IS U.S. HEALTH CARE? AMONG HIGH-INCOME NATIONS, IT’S THE WORST, STUDY SAYS
As Republicans struggle to agree on a replacement for the Affordable Care Act, the Commonwealth Fund has rated the U.S. health care system as the worst among the 11 developed nations it analyzed as part of an evaluation conducted every three years. The think tank also rated the U.S. health care system as the worst-performing of the nations analyzed when the last evaluation was released in 2014.

**How does the quality of the U.S. healthcare system compare to other countries?
**Bench-marking U.S. quality measures against those of similarly large and wealthy countries is one way to assess how successful the U.S. has been at improving care for its population, and to learn from systems that often produce better outcomes. The OECD has compiled data on dozens of outcomes and process measures. Across a number of these measures, the U.S. lags behind similarly wealthy OECD countries (those that are similarly large and wealthy based on GDP and GDP per capita).In some cases, such as the rates of all-cause mortality, premature death, death amenable to healthcare, and disease burden, the U.S. is also not improving as quickly as other countries, which means the gap is growing.

343

  1. No, I was actually envisioning something like what Switzerland does on penalties. It has to have enough teeth so that everyone understands it’s a mandate. I’m not going to say exactly what the amounts are, but I like how the Swiss will really go after people (garnish wages, for example). I think Germany and Netherlands have similar views to the Swiss on mandates. The key is that the original ACA was too weak, and under Trump, there’s no penalty at all. It has to be strong enough so that everyone is compelled to enroll. It’s not something that’s for the purpose of raising revenue. It’s for being part of the 3-legged stool for UHC.

  2. I’ve said the current system has gaps. A properly designed ACA would not have gaps, because all 3 legs of the stool would exist fully. You’re accusing me of acknowledging something that I didn’t acknowledge. I said it might take a few tweaks to get it totally worked out, but that’s not the same as saying there will be gaps. At the end, there shouldn’t be.

You claim to be arguing for UHC. But I don’t think you are at all.

344

…“private health insurance is **compulsory **for all persons residing in Switzerland.” The insured don’t pay more than 8% of their income.

Your system isn’t compulsory. They aren’t using the same system you propose.

If insurance isn’t compulsory then you are going to have gaps.

Is it possible under your system that people could not have healthcare insurance and not be eligible for Medicaid because you aren’t poor enough?

Your system shouldn’t need tweaking to get to universality. It would need tweaking though because it doesn’t have universality at its core. That’s my entire point. If you start with the premise that “everyone **must **be covered” then why would your starting point be a system that won’t meet its core goal from day one?

UHC is universal healthcare. Everyone is covered. Everyone gets healthcare. Your system doesn’t cover everyone.

345

Your argument is bovine excrement. A UHC that’s not single-payer requires companies to sell, requires people to buy, and requires government to subsidize so that it’s affordable. That is exactly what I would do to the ACA to fix the part that doesn’t subsidize enough and doesn’t mandate enough. It would take some lifting, but the principles behind it are unassailable. The mandate has to hurt enough so that people are compelled to buy (it must be accompanied by a very strong penalty of some type). The subsidies have to be enough so that people can afford. It can be Medicaid, or a heavily-subsidized private policy. And companies must sell to everyone, regardless of their income or their health status.

If you don’t think that can accomplish UHC, then you are arguing against basic healthcare economics. See Krugman for the basic explanation of how it works:

346

…LOL.

It requires everyone to be covered.

Say it with me: UNIVERSAL.

Your system is not universal if the thing that you claim makes it universal is that it is affordable.

“Affordable” is subjective. The Swiss system has three elements that yours does not, its compulsory (hence universal), its tied to a percentage of your income (you don’t pay more than 8%), and the amount that you pay out of pocket is capped.

Can you guarantee that nobody will get 80K bills in your system? Can you guarantee that there will be no people who don’t qualify for medicaid but also can’t afford health insurance?

Except the principles behind it are assailable.

Why a mandate instead of making it compulsory?

If people honestly can’t afford insurance why would you choose to punish them?

How much people can afford is subjective.

It isn’t universal** if everyone isn’t covered.** That’s a pretty basic principle of UHC. Your system allows people to opt out, and if they can’t afford health insurance and if they don’t qualify for Medicaid, or a heavily-subsidized private policy, then your system will punish them by making them pay a very strong penalty of some type. Will this penalty drive people to bankruptcy? What if they can’t afford to pay it?

347

No one pays more than americans for health"care". And no, it ain’t better.

348

Maybe the goal is to keep things such that everyone does not have access to healthcare.

349

OK, let me try one last time with you.

Do you agree that a 3-legged stool exists, such that UHC is achievable if 1)companies must sell to everyone; 2) everyone must buy; 3) government must subsidize so that everyone can afford? Yes or no? Answer that simple question for me, because until you acknowledge this very basic healthcare econ 101 question, I don’t think there’s much else I can do here.

350

That is the goal of the Republicans (and unfortunately a few dems, too). But Krugman understands that the principles of the 3-legged stool work if they’re all properly implemented. The current ACA is too weak, and needs to be strengthened to realize UHC.

351

…“everyone must buy” is very different to what you propose, which is “punishing people who choose not to buy.” The “government must subsidize so that everyone can afford” is not the same as what you have argued in this thread which is “we set an arbitrary figure on who does and doesn’t qualify as ‘poor’ who would be eligible for a subsidy.”

Two of the three of your “legs” don’t match up with the plan that you talk about in this thread. Which plan do you actually endorse, this plan or the plan you have been advocating throughout this and other threads?

You still haven’t answered the questions:

Can you guarantee that nobody will get 80K bills in your system? Can you guarantee that there will be no people who don’t qualify for medicaid but also can’t afford health insurance?

How about you answer the questions I’ve put to you several times in the thread first?

LOL.

The problem isn’t “basic healthcare econ 101.” Its that your plan for UHC won’t get you to UHC.

I’ll keep posting as long as you keep responding to me.

352

I figured you wouldn’t answer the basic question (just like you wouldn’t admit your flawed premise from post 265). If the answer is “yes”, then you have no choice but to admit that a fixed ACA can deliver UHC. If the answer is “no”, then you’d be trying to pretend that Switzerland doesn’t exist.

I’ve already explained my views pretty clearly on this thread and will no longer discuss anything with you on thread, because I can tell what is motivating your posts as I’ve seen on other threads, and I have nothing left to say that wouldn’t run afoul of the moderators.

353

…LOL. My premise wasn’t flawed. And you’ve been ignoring my questions throughout the thread. You still haven’t answered the question would your plan allow for the possibility of people ending up with 80K of debt. I’ve asked you several times. I figured you wouldn’t answer that basic question.

The 3 legs don’t match your plan. Therefore your plan isn’t UHC by your very own definition.

The version of a “fixed ACA” you have presented in this thread does not deliver UHC. It doesn’t even match the 3 legs you presented in the last post.

Your plan and Switzerland’s plan are not the same. Switzerland’s plan is compulsory, yours is not. Its tied to a percentage of your income, yours is not. The amount that you pay out of pocket is capped, yours is not.

The differences are obvious.

BYE!!!