I am assuming for the sake of argument that the GOP does this the stupid way instead of the smart way and Democrats win everything in 2020.
So if that comes about, how should Democrats approach health care? Campaign on reimplementing ACA? That sounds like a quick path back to the minority to me. Campaign on single payer? That sounds even worse. “See, this’ll be great. First, we’ll take away your private health insurance… Hey, wait, come back! I wasn’t finished!”
Perhaps single payer lite, something that either takes care of catastrophic costs only, or perhaps something that does take care of basic insurance but is lean enough to not impact taxpayers much who already have insurance? Say, a revamp of Medicaid that makes it a little better?
Or just forget health care(at least anything big) and focus on climate change, income inequality, other Democratic issues?
JMO, but I never thought the ACA was a good idea, though while it was first being pushed, I appreciated that since the Republicans idea of how to deal with the rapidly rising cost of health care was to do absolutely NOTHING AT ALL, I was willing to give it a shot.
I would HOPE that if the ACA is repealed, that someone would come up with an ACTUAL plan to deal with the mess.
It would have to involve something other than leaving the Insurance-Profits-Mean-Everything-Poor-sick-people-are-garbage concept that both parties have followed, and set up some kind of recognition that the health of the entire nation is a good way to build human resources, and reduce the cost of doing business here.
What exactly, I’m not sure, but I do assume it would be a lot more complicated than either a simplified “single payer” idea, or the even worse “screw it, let poor people die in the street” idea that the GOP continues to adamantly support.
Take away your private health insurance? Adaher don’t you realize that only 10% or so have had their own health insurance for the last few decades? The overwhelming majority either get it via their employer or the government (Medicare/Medicaid/Veterans…). Do you really think your boss is going to select the best insurance–or is he going to go with the cheapest–so he can maximize his profit?
I suggest mandatory insurance, either from an expanded Medicare/Medicaid system or a private insurer of the individual’s choice.
The Democrats have to wait. Everything is in Trump’s court. He’s not a generic Republican. Look how he criticized the cost of the new Air Force One. I predict the drug companies are in for world of hurt. Better start selling your stocks now. He’s going to bring the prices down to what Canada pays. Some form of single payer will be part of his agenda.
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or perhaps something that does take care of basic insurance but is lean enough to not impact taxpayers much who already have insurance?
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They’d presumably have to sell that by saying if you like your plan, you can keep it.
Single payer that just adds to Medicare and Medicaid does mean people can keep their insurance, but it also means much higher taxes for those who already have insurance as well.
Well, the reasoned response to this is… boo-the-fuck-hoo. Americans might just have to let the higher-income earners pay higher taxes for the benefit of the population overall. The evidence available from virtually ever other post-industrial democracy is that this would be an overall improvement.
Perhaps, but we’re talking about what the Democrats should do, which presumably would be what they could actually do politically. Raising taxes on all Americans with insurance would mean a quick path back to the minority again, which means what they did just gets repealed again.
What next? Oblivion, either way. The Democratic Party isn’t what it used to be. It will embarrassingly lose several more elections, then join the Whigs in the cold, cold ground.
•splat•
Hey! That tomato’s rotten!
•splat•splut•
OK, OK, fine. Seriously, I suspect the Democrats, like UK Labour, are going to go through a period of internal fighting and restructuring, which may take a few years. One danger is that Trump will be disastrous enough that they can coast to victory as a unified big tent in 2018 and 2020 without fixing–or even trying to fix–the deep and dividing problem, that they kept putting Ivy League elitists in charge of a nominally populist party.
Once there’s actually a “New New Deal with America” or whatever, that may involve a full version of Medicare instead the ridiculous retirees-only model. But the private insurers, and maybe many of the Bourbon Democrats who took their money, will have to be run out of the party to get there.
The Democrats need to stop trying to meet the Republicans half way. All that happens from these attempts at compromise is the Republicans get everything they wanted and then get to blame the Democrats for the problems that result.
The Democrats should draw a clear line and explain which side of it they’re on and why. They should tell people the Republicans want a health plan that benefits the AMA and insurance companies - and those groups in turn finance the Republicans. And the Democrats should point out how much our private health care system costs.
Then the Democrats should role out a public health care system. They should explain that this system will actually cost less because nobody will be making billions of dollars of profit off it. And they should explain how this system will be designed around the needs of patients not the desires of corporations.
The Republicans will of course demonize this. But the Democrats need to back the Republicans into a corner and force them to try to defend themselves. This is an issue where the Republicans are screwing over the majority of the voters in order to protect special interests. This is a battle the Democrats can win if they’re just willing to fight it.
Or like his other promises, he could retreat when faced with the reality of actually needing to deliver. Which of course he’s already done with healthcare, which was originally going to be repeal + replace with “something great”.
Anything big costs big money. That’s why Vermont had to abandon their plan, because of how much they would have to raise taxes. There’s a reason we fund our biggest entitlements through payroll taxes that hit every worker, no matter how poor. It’s the only way to do it. Every nation with single payer does it through taxation that reaches every person, rich and poor alike. There is no path to single payer that doesn’t involve higher taxes on everyone.
Although let’s not forget that Americans pay much more for their healthcare per capita than any other nation (wiki), implying, at the least, that other systems are not inherently more expensive.
But yes, if you’re saying no path to single-payer, i.e. no way for the US to transition to such a system without at least temporarily incurring higher costs, you’re probably right.
But what your constant harping about taxes ignores is, if you did have a true UHC system paid for by taxes, you wouldn’t have to be paying for your health insurance on top of that.
I live in the Socialist Hellhole of Canada, and have a pretty good job. My monthly taxes (both federal and provincial combined) run about $1700. And that pays for everything, including my healthcare, and the healthcare of all those people I’m “subsidizing via my higher taxes”. Every time I see a thread here with Americans discussing the costs of their insurance, I see them quoting monthly costs that sound astronomical in comparison to my typical tax load.
I suspect that if every employed American just paid in extra taxes exactly what they’re currently paying in insurance costs, you’d have an absolutely kick-ass UHC system that could not only serve everyone, but serve everyone better than* the current system does, with zero impact on how much money you have at the end of the month.
*Because that’s the other problem with your system - aside from the costs, and the problems of covering everyone, it also is engineered to screw over the customers every chance it gets - ridiculous co-pays and deductibles, in-network vs. out-of-network providers, routine denial of treatments, or denial of claims, all that junk. All of it an artifact of the for-profit system you have.