AS if single payer doesn’t screw anyone. The only difference is that the liberal media won’t feel bad for you if the health service tells you no.
The health service guarantees you will have at least a reasonable level of care available to you; if you want something above and beyond, you can pay above and beyond. Moreover, if the politicians are not funding the health service at what you consider the appropriate levels, you have a voice at the ballot box.
With pre-ACA health care, you had no guarantees whatsoever of anything beyond strictly emergency care. If you needed chemo, for example, that’s not emergency care, and in many states (including mine), a single working-age adult is not eligible for Medicaid until and unless their condition is so bad that they are approved for disability.
What you are buying with the ACA is the guarantee that you will always be able to purchase insurance, which is something you didn’t have before. The fact that you are generally healthy now doesn’t guarantee you will remain so until you hit 65 and Medicare eligibility; at 57, you are moving into an age bracket where lots of things can start to go catastrophically wrong with little warning.
In the absence of a guaranteed-issue/no-exclusion-for-preexisting-conditions rule, what happens if you have a medical crisis at 58, and then lose your insurance (for any reason from recission to your insurer exiting your market)? Finding yourself at 60, uninsured and uninsurable, could have some really unfortunate effects on your retirement plans, and if you end up bankrupt at 60 or 62 due to medical bills, you don’t exactly have a lot of time to recover financially even if you recover physically. Now, what are you prepared to pay for that guarantee of coverage? It’s a benefit you don’t seem to have figured into your calculations at all, but is it really worthless to you? The insurers are finding that it costs them quite a lot to be able to offer it, which is one reason that rates have been going up so quickly.
That is a complete straw man, Adaher. The media in Canada is quick to run with stories that highlight problems in the single-payer system, from issues of coverage of particular procedures or therapies to big-picture issues about how a particular health region is carrying out its duties, wait times, etc. That kind of media attention, as well as political pressure from opposition parties, is one of the reasons governments are continually updating Medicare.
And as for single-payer screwing people, I will just repeat what I have said before:
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I have never met, heard of, or been, a person who was denied medical care in our system.
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I have never met, heard of, or been, a person who went bankrupt because of medical bills in our system.
Can you say the same?
You’re overlooking its popularity, when the name “Obama” is not included. Even most Trump voters don’t want it repealed.
I sort of miss you “explaining” to us repeatedly how people who want it to go further and be better are actually against it. Something must have happened.
The “stupid” way, as you have called it yourself, is to get rid of coverage and screw people without having a better replacement immediately behind it. As your team is getting ready to do, IOW. But your premise does seem to include that the Democrats, by comparison, won’t be stupid, which is something.
Starting from nothing, after the team you cheer for gets finished with their tantrum, it would probably be better to go with a phased expansion of Medicare eligibility. You’re asking the same questions we’ve gone over here for years.
Now wouldn’t a more appropriate, and immediate, question be “What will the Republican replacement plan actually be? Will they have to pass it for us to see what’s in it? And will the Democrats’ input be invited, unlike in ACA? ;)”
They’d have to change the filibuster rules because the dems will not have 60 senate seats anytime soon.
I guess the best thing would be adding medicare and medicaid to the state exchanges in all 50 states. Let people buy into those programs because they are cheaper than private insurance plans.
however we need to totally restructure our health care system to make it efficient and cost effective. Nobody has the political will to do that, so it won’t happen anytime soon.
I’d just like to clarify some of the details about the tax penalty for not carrying health insurance … there are exemptions to paying this penalty and these are outlined in 2016 Instructions for Form 8965 {PDF} “Health Coverage Exemptions …”
Do consult with a tax professional … each individual tax return is different … but there may be savings to be had far in excess of the fees this tax profession would charge …
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Another thing I never see in these conversations is when we convert to a single payer system … what happens to the equities invested in our current “for profit” health insurance companies? … it’s easy for the poor to say “fuck the rich” … but we have many hard working middle-class folks who scrimp and save their whole working lives to enjoy a comfortable retirement … they depend on this dividend income … and just sweeping it away forces them into food stamps, SS, Section 8 housing and hitting up the local charities for basic sustenance …
I understand not caring about what’s fair for the top one percent … but we do need to care about what’s fair for the top 50% … if a working stiff drives junker cars for seven years so they can buy $10,000 of Anthem, Inc. … then they’re entitled to the $20,000 they’d get today … we just can’t take that money away …
Try to imagine the Single Payer System Law … amendments, riders, ear-marks, graft … this sucker will make the Tax Code seem small … trusting Congress to do what’s right? …
There will be plenty of notice time to reinvest in *productive *sectors of the economy. So what’s the problem again?
Or, if it really is true what the bathtub-drowner ideologues insist (can’t we get Grover Norquist committed to the Old Fools Home yet, please?), that the private sector can always do things more efficiently and effectively than government, they should have nothing to worry about.
Please note that Britain’s NHS, just for instance, has not killed off private insurance after generations of existence. There is room in the market for it still.
Unlike what happens now when they are driven into destitution by uninsured catastrophic medical issues, right?
You would if that’s what you were being told. It’s really more about getting rent-seeking parasites off our backs. If they significant added value at all, much less in proportion to what they cost us, the anger wouldn’t be there.
Thanks for this. I may be quoting this post to Democrats over the next several years.
AFAIK, many if not most countries with UHC don’t have single payer. I’m not sure why American liberals focus on single payer so much.
Healthcare costs will continue to spiral out of control. Given the incompetence of the Democrats and the bootstrap mentality of the Republicans this has the potential to get really ugly.
Progressive types will have to do some actual politics. That is, convincing other people to change their position. Pointing out that countries with UHC have better outcomes for less money probably won’t work. Your propaganda has to be more sophisticated than that. Maybe try to work patriotism in there or something. Failing that, maybe if things get bad enough the capitalist class will intervene to prevent the system from going belly up or to maintain a productive labor force. Probably not, though.
From outside the USA it’s interesting to observe the debate has shifted now; back before the ACA, town hall debates raged and an awful lot of people seemed properly propagandised to believe the proposal was unAmerican and socialised: it was as if the commies were taking over government.
Whatever else happens, Obamacare has largely taken the propaganda out of the issue, and the general population has had a glimpse of a saner world.
Sometimes you can’t get straight to where you need to be, you have to go via somewhere else first and then complete the journey from there … which may be what the OP is talking about …
Yep. The NHS is right at the opposite end of the spectrum of possibilities and the least likely - far better to look at Germany, Australia, all the countries that one way or another include an element of personal insurance.
I think the focus on single payer is because both the UK and Canada have single-payer, and those are two countries that are very familiar to Americans.
Single-payer also has some examples in the US already: Veterans Admin, Medicare and Medicaid. That means there are home-grown examples that come into the discussion. (And I’ve seen proposals here on these boards that gradual expansion of Medicare/Medicaid might be a way to approach the issue)
Humana’s stock price was less than $20 early in 2009 and is now over $200. Aetna and CIGNA have done almost as well. Are there any health industry stocks that are hurting?
One feature of ACA is that insurance premiums are supposed to be capped to some multiple of health spending, right? What’s the status on that? Of course this cost-plus arrangement just increases the industry’s desire for unnecessarily expensive care. 
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Instead of single-payer, a “public option” would greatly ease the problems of ACA. This would be independent of the subsidies, so the government insurance could be profitable — it needn’t try to underbid the private insurers, just provide an insurer of last resort to help keep the private insurers faithful.
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According to Moore’s documentary Sicko, citizens of Canada, France, etc. believe that providing health care for all their citizens is their humane duty — is this a fair summary? Even the right-wing parties support universal health care in all but one of the developed countries. Yet even now, on this Board, we hear from Dopers complaining bitterly that their tax dollars are needed to provide health care for the poor. As long as Americans persist with such uniquely uncharitable views, do not expect smooth-sailing for any universal health care plan.
Well, there are basic human rights as conferred by the European Convention on Human Rights (incorporated into UK law as The Human Rights Act). Then there’s a whole group of rights emanating from Magna Carta (1215).
On top of that there are matters considered a basic human right in developed societies, like basic education - and health care. These are enforced through the electoral mechanism.
If a rich modern democracy doesn’t look after the people how the hell do we call ourselves civilised. It’s under 10% of GDP. FFS, who can’t afford it.
It’s also simple to understand. But it certainly has its drawbacks, and there hasn’t been a new single payer system implemented in a long time. Single payer was much more politically feasible in places where most people didn’t already have good insurance.
In the US, it’s fair to ask the question, “What problem are you trying to solve that single payer is the solution?” If you want to deliver health care to people who don’t have it, you don’t need single payer, you need a program for the minority without health insurance. We have two programs for that, Medicare and Medicaid.
Let me get this straight … the government announces Anthem, Inc. will be dissolved in five years … yes, I have plenty of time to sell … but who the hell is going to buy? … who would give me $140 for a share of stock guarantied to be worthless in the near future? … and where do I invest where the risk of default is comparable? … anything like a reinsurance program is quite rare in the USA … strictly illegal in most all other sectors …
Walk me through this step-by-step … preferably not using Treasuries … unless driving up the National Debt is okay with you …
What’s a “bathtub-drowner ideologue”?
I admit to being a free market advocate … that this usually brings about the best solutions … but not always … health care is an excellent example of an industry where straight capitalism fails … “A pence of prevention is worth a pound of cure” … just that margins are much better on cure, no financial incentive to prevent …
What does California’s system look like if all the dollars stayed in California? … What does Britain’s system look like providing equal services to The Ukraine and Bessarabia? …
“Maximum out-of-pocket expenses” … one of us isn’t clear on what that means …
This I don’t understand at all … doctors are parasites who don’t add enough value for the cost? … are you suggesting doctors make too much money, Anthem, Inc.'s 2% return on investment is too much or that universal health care for the third largest nation on Earth is more expense than everyone thought it would be?
What is the alternative? Prices would be about the same had the ACA never been passed.
You guys are blaming the ACA for the fact that our health system is dysfunctional. The ACA didn’t cause the dysfunction, our system was twice as expensive as every other system on earth before the ACA became law.
You guys are blaming the band aid for the gushing bullet wound it poorly covers, and then pretending if you get rid of the band aid, it will get rid of the wound underneath. It won’t, it’ll just make a bad situation worse.
Grover Norquist: “I don’t want to abolish government. I simply want to reduce it to the size where I can drag it into the bathroom and drown it in the bathtub.”
Interview on NPR’s Morning Edition, May 25, 2001
That’s only for people who have reasonable insurance, and even right now there are people who don’t. If the ACA gets abolished without a reasonable replacement, there’s going to be some 24 million or so additional people who will have uncapped out-of-pocket medical expenses.
Not doctors, but all of the people who design, market, and administer health insurance plans. At many medical practices, there are more people processing insurance claims than there are doctors–how does the value added by all of this paperwork compare to the value added by, you know, real doctors?
Wow, I thought the bathtub quote was older than that…?