IPAB is right there in the third entry, actually.
I agree that the cost containment measures may or may not work, though as I recall the CBO’s overall scoring of the bill simply assumed minimal success, while their separate assessment of the cost savings expected moderate success.
IIRC, CMS’s independent auditor was among the most pessimistic of the non-partisan assessments, and even they saw savings in the hundreds of billions over ten years.
Looks like this bill is getting more and more likely to end up on the President’s desk. Feinstein has just come out in support, which I believe is the first Democrat whose job is not under threat to back the bill.
The “so what” is that the insurance aspect of ACA can be, and should be, considered as separate from the welfare aspect of ACA. Sure, for this one person, the after-subsidy and after-credit is what matters. But from the country’s standpoint, the cost of the welfare that brings the price down matters a great deal, as it has to be paid for either by current taxes taken from taxpayers or added to the debt burden we’re racking up.
We can’t entrust the decision for what medications are covered to a single person, so there would be group of wise citizens, a panel if you will, deciding which patients can be treated, and which must go without?
And what if it was revenue neutral, and the tax credits were fully paid for at current revenue levels without increasing the debt?
I have not consumed (used?, partaken?) medical care in other countries, but the Spanish exchange student we hosted was amazed at how fast he got to see a doctor when he had a medical issue. He said it’s typical to wait days for an appointment, and then hours to see a doc in Spain. He also said he has an uncle who is a doctor, and the uncle complains about how little he gets paid.
Are there positives to socialized medicine? No doubt, but you can’t ignore the typical inefficiencies and lousy service associated with any government program.
To be honest, I don’t know what the answer is. I’m not sure that socialized care might not be better than the horrible ACA monstrosity.
An interesting example. As I’m sure you know, Spain has a lot less in the way of a thriving economy that we do, as many other nations do. The cold equations apply, of course, but medical care you have to wait for is a vast improvement over medical care you cannot get. The outcome of such medical practices as we advocate are dependent on where they are practiced, of course, it can hardly be otherwise.
But we can do a damn sight better than we are.
Um, what was so wrong with our system that we needed a major overhaul like ACA?
You’d rather see US healthcare be reduced to the level of the other countries you stated earlier than continue to be the worldwide leader?
Obama care will level the playing field for everyone, that it will do. I suspect that’s what you want to see. Now we all get to have somewhat decent insurance instead of most of us getting excellent insurance.
And we’ll all have to pay dearly for it.
I’m not sure it can be done. Maybe they should call this the “Put the Toothpaste Back in the Tube Act”.
To answer elucidator, our health care is vastly superior to other countries while our health care costs are outrageously high. How much can we trim from health care costs first of all. Then after that how much are you willing to trade of one in favor of the other?
Not compared to other industrialized nations, it’s not.
Seriously?
People don’t get preventive care. Then, by law, every hospital has to treat the most serious and complex illnesses for free. All the patient has to do is walk into the emergency room and decline to pay. We have (until next year, and even then only in states accepting medicaid expansion) socialized treatment without having a system of paying for it. It makes for by far the world’s most expensive health care system, without outcomes to match.
We have over a million personal bankruptcies every year, most medical-care related. And who pays for that?
Differences in wait time do not have to do with how socialist the system is, but with how well organized it is and how many resources are devoted to health care.
Taiwan has single payer with short wait times, according to our son who is cared for by that system.
A few years ago, we switched family medicine practices (following our long-time physician), and the change was remarkable – long waits and appointments delayed for hours are no more. All in the US, and both are non-profit, non-governmental, group practices.
Twenty years ago Veterans Affairs healthcare was mostly bad; now it is generally good. My link explains what changed, and it has nothing to do with socialism.
Universal care is a given in all first world nations, at least for the most expensive sorts of care. The question is how to rationally organize it. And the last people I want organizing it are people who think goodness and badness are measured by how socialist it is.
Well, of course our health care technology is excellent, we are rich as fuck. Duh.
How can we trim such costs? Well, how much can be gained by treating illness and injury early on, when our cures are more effective? Some reason we cannot trim the costs by trimming the necessity for those costs?
For years, we were told by hard-headed realists of the conservative persuasion that providing such health care would ruin us, not even a country as rich as we could do it, road to ruin, for sure. (From my earliest dim awareness of politics, I’ve been reading about how Sweden was going to collapse any minute now, because of all that destructive socialism. When first I read that, I believed it. I got over it.)
If this cannot be reasonably done, how come other countries are doing it? Countries that have nowhere near our resources and wealth. Years ago, it had not been demonstrated, now, worldwide, it has. It works. As a simple, practical, hard-headed and realistic fact: it works.
And, of course, what is the benefit in terms of productivity gained by a healthy population? How much of those costs could be paid for?
For these reasons as well as others, I don’t see why I should think that we will somehow be forced to trade quality away. The rich will always be able to afford it, and someone will always be willing to supply it to them. I seldom worry for the well-being of the rich, I am assured they will be fine.
Not quite the last. The last would be people who make more money denying such care than they do providing it.
All the plans still exist, so it shouldn’t be too hard. After Jan. 1, of course, then the toothpaste will actually be out of the tube.
We trade quality away because there’s no accountability in such systems. When an insurance company denies treatment, the media covers it. When the government denies treatment, only the right-wing media covers it. and since decisions like this are made in the deepest bowels of the bureaucracy, there’s no democratic accountability either.
Sez who?
Now, here you are on firm ground. No doubt about it, the media covered both of those stories with lavish attention. Or was it four? Six stories, tops? People broken on the wheel of bankruptcy because some guy at Blue Double Cross wants to be regional sales manager. We could check on them, see how things turned out, if only we knew exactly which bridge…
With time traveling reporters? Political science fiction? Perhaps you can just give us your top ten most damning stories?
Not touching it. Nope.
If you want NHS stories of denied treatment, they are easy to find. On the Telegraph’s site. Not so much the BBC or the Guardian.
As for accountability, when has a party in Britain lost Parliament due to dissatisfaction with NHS?
even if they grandfather it to Dec 2030 it doesn’t help the insured. You have to have an Obama approved policy to qualify for welfare subsidy. So it was always a big “fuck you” from the WH.
Jeff Merkley is now a “Yes”.