I was under the impression that this isn’t accurate. The exchanges will operate on partial community rating - they can only take into account demographic information (and smoking status) when determining your rates.
How realistic is single payer on the national level anytime soon?
I see it being realistic 10 years out, but only in a handful of things all occur at the same time.
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Various states implement it and find it is 20-30% cheaper than regular insurance health care, like the studies say it will. That will give proof of concept that it works in the US. Vermont predicts their health care will be about 25% cheaper (compared to keeping the current system) in the 2020s due to their new health model.
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A public option tied to medicare or modeled after the VA’s recent reforms, or some other option is eventually added that does the same thing, offers national health insurance option that is 20-30% cheaper and as high quality or higher quality than private insurance. Medicare is rated more highly than private insurance by respondents, I believe the VA system is now rated highest of all in the US due to recent reforms. Both are cheaper than private insurance.
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Demographic shifts actually continue with the Fox news audience and tea party members dropping off and being replaced by more open minded young voters. This assumes millennials maintain their center left policy views in the 2020s, when they are 35-40% of the electorate and the majority of fox news and talk radio viewers (who are 70 years old on average) are gone.
To me it seems possible, but it’ll be a decade or more before the convergence happens and a meaningful, pragmatic health policy is enacted on a national level. For the time being I think just keeping the ACA alive is most important, because it moves the overton window to the left and allows reforms to the ACA (like a public option modeled after medicare or the VA) to be added.
New York has guaranteed issue and community rating. It has high health insurance rates, but there are plenty of insurance companies. Massachusetts has guaranteed issue, community rating and a mandate. Premium growth has slowed since the trifecta was instituted.
Takes a while to the spiral to have its full effect.
- Rates go up.
- Some healthier persons decide they cannot afford it. They cancel.
- Remaining persons in pool are sicker, on average, than before.
- Rates increase to cover higher cost of insuring sicker persons. Go to 1.
Taken to extreme, eventually the insurance pool is no longer financially viable. Companies stop offering policies that they cannot make a profit on.
Wash. Rinse. Repeat.
In reference to point number 3:
I’ve been echoing that sentiment for a while. Basically, we all just need to wait until the folks from my generation - your typical 20-something’s of today who were born near the end of or after the Cold War - to become the majority of the electorate and subsequently start taking over the political scene and running the government. You’re absolutely right; we generally have center-left leanings and don’t have this absolutely irrational fear of socialism that has stymied the health care debate up until now.
In the meantime, I also endorse point number 1:
I’ve been saying this for a while; the most likely route to true UHC in this country will come in the form of state-by-state adoption of single-payer. A lot - and I mean a lot - of that prediction is reliant upon the degree to which Vermont’s system proves to be successful. Assuming it is, I foresee many of the more liberal states emulating the Vermont model; Montana would probably do it next, then California, then maybe Massachusetts, etc. Eventually, that might pave the way for a national model.
But yeah, in the short term, ensuring that the ACA is allowed to be completely implemented is probably the most important thing to do right now.
Don’t the republican’s have to have 2/3 majority in the house & senate to overide an Obama veto at a congressional attempt to repeal ObamaCare? How many seats in each house are up for grabs and will we it be enough to reach the two thirds majority? If, not is it likely that some democrats may support the repeal attempt and jump side.
I’m assuming the Supreme Court will not revisit the law; Is that correct?
If Obama wins, there’s no other way to repeal the law except to wait for 2014 or 2016 elections or is there?
California is unlikely IMO to be an early adopter of the single-payer system as long as they’re stuck in their fiscal tar pit. Plus with their loose direct-democracy rules, you’d get proposition after proposition every year to reverse or replace whatever was approved the year before.
Kvorka: Still, if the GOP gets majority in one or both houses they can seek to deny funding through reconciliation and/or hold the debt ceiling or defense spending or the continuing budget resolution hostage to a scaleback in the program.
The penalty is will be A LOT many than $695 for most people, and the basic plans should cost around 5k/person. The penalty is up to 2.5% of income above around 10k. So a family with a household income of 100k will pay around $2250. After around 200k, you are fined at the cost of the bronze insurance package. So even though you may initially save money forgoing insurance, it often doesn’t make sense to. Why pay $2250 for nothing, and pay your regular health care costs (which will likely be billed at a higher rate), rather than paying for a cheap plan?
Thanks, I found this article:
http://suite101.com/article/killing-obamacare-through-the-congressional-power-of-the-purse-a307705
Sounds like really dangerous politics. Teddy Roosevelt’s solution was innovative!
I am amazed at how little attention is paid to this fact.
In a few years, I expect to see the talking heads on TV slamming the ACA for those poor idiots who can’t game the system and buy insurance immediately after getting sick.
Medicare has always had a similar enrollment period, how many people skip that until they get sick?
This is one reason I wouldn’t support rolling back Social Security.
If we removed the self-funded pension tier of the Social Security system, and kept the other parts, we’d basically have a wealth transfer from working upper middle class people to retired former minimum wage earners. We’d get major complaints of “Grandma Jones is too frail to work and her completely free government pension of $500 a month is too low!” despite the fact that she would have had an opportunity to save for her retirement with the extra money-- a couple thousand a year spread over decades – from eliminating SS taxes on the poor.