I believe you could describe the ACA as a step closer to the German system, which is not a bad one.
Obviously, I’m resorting to hyperbole here, as advances could make the notion of needing to pay lots of money for health care obsolete. If you can print your own organ at home and have your robot that knows everything the human race knows put it in for you, then insurance isn’t really going to be a thing anymore.
But as long as insurance is something people need, we’re sticking with multi-payer.
The problem with the idea of lowering Medicare eligibility is that the trust fund is already near insolvency. What Congress could do is allow anyone to enroll in Medicare if they pay the full cost.
As a brief aside, there was this little exchange on Twitter recently:
Boom.
I saw that. I work with several Trump supporters. When I showed it to them they told me that The National Review isn’t really a conservative publication. It’s part of the Republican Globalist wing of the party that George W belonged to and that I can’t trust it. They say the same thing about David Frum, Mitch McConnell John McCain… Anyone who disagrees with them.
It’s a crazy world.
Then we’re sticking with something cruel, inefficient, and demonstrably inferior to what the rest of the civilized world is doing.
I’ve yet to get a good answer to why the US can’t go single-payer UHC like the rest of the world other than “we’re stupid, stubborn, and cruel”.
This story gets better! Chaffetz uses an iPhone that was paid for out of his campaign donations! That isn’t illegal if he used it for campaign business, and the GOP has made it legal for him to use such a phone for Congressional business as well — but not for personal business. (Chaffetz’ office was unavailable for comment on the rumors that he had illegally used his campaign-donated iPhone for personal business.)
What’s their position on the sugaring of porridge?
the states will start covering everyone* and, gradually, everyone will be able to see this works and all the arguments against it are bogus. or, since I am channeling the Car Talk Guys, booooooooooooooooooogus.
this is easily fixed, as Bernie showed us.
so: will California be first? or is MA already covering everyone? I’ve lost track. :o
*not the same as UHC, I know, but it’s what we will get
UHC based on states should work even if we can’t get Federal level UHC. After all, most US states have more people than a lot of actual sovereign nations. It’s better if your risk pool is as large as possible and 300 million is a very nice size, but a mere several million should work.
Places like Wyoming might want to ally with other nearby low-population states, though.
If every state did it, sure. But even California would have a hard time making it work alone.
States cannot run deficits.
Moving people and businesses out of the state is a lot easier than moving out of the country.
Any state move will not reduce federal tax burdens. California (using them as an example) supports poorer states already.
It’s not about the size of the state. It’s about the financing structure and how it differs from a separate country. The differences are significant.
Only in the sense that if I take one step eastward I’m a step closer to China, but I’m still nowhere near it. The German system is a very good one, but the differences between it and the ACA are vast and fundamental. Much is sometimes made of the fact that it’s a multi-payer system, plus it includes private insurance, but at its core it’s a universal system premised on egalitarian social principles and is nothing like the US model.
Private insurance is only available to those in a high salary bracket under strict conditions, or visitors, and only about 10% of the population opts in. The multi-payer aspect is pretty much irrelevant because in the statutory (public) system costs are community rated and not risk rated and essentially everyone has the same coverage at the same cost, everyone is guaranteed coverage regardless of income, provider fees are standardized, and the whole thing is highly regulated.
For all practical purposes, the statutory system that serves the vast majority may as well be single payer. The thing that makes it work well is precisely the kind of regulatory intervention that some like to refer to as “socialized medicine”. The sort of thing that would send American Republicans to their fainting couch in panic over incipient communism, and send health insurance lobbyists straight to their pet Congressmen with some very strict orders to make sure it never saw the light of day. Yet as long as “free markets” govern health care, the thing will continue to be an exorbitantly costly, inhumane, hopeless mess.
As much as I usually disagree with adaher, this assertion is on the money. Although I think that Trumpcare is a terrible and inhumane policy, its mere existence proves that the paradigm has permanently shifted and that the Democrats have won the foundational philosophical argument:
It is the responsibility of the federal government to ensure that the population has health insurance.
Clearly, the GOP differs wildly from the Dems in terms of (a) how many people the government should assist (as few as possible), and (b) how generous such assistance should be (as stringent as possible), but the Republicans know that the actual responsibility for the government to fulfill these functions now exists.
Meh. Just tell them that you’re disappointed to learn that they hate everything that makes (or could make) America good, and bid them good day.
I happened to lunch with Malcolm Wright, the Chief Executive of NHS Grampian, today. He said that the NHS budget per person is £1850 per year (~$2250). That equates to US$700B for the whole of the US. Add in additional private insurance, and you’d still be less than $1T.
Business Insider says that US spending is expected to surpass US$10,000 per person. Four times what we spend. Do the maths: $3.35T vs $1T. I know I’m preaching to the converted here but some facts might help.
The Republicans goal with this bill is not to have a bill that passes, it’s to have a bill that fails that they can blame on someone else (hopefully Democrats) and use to win reelection; if you want to repeal Obamacare, we need more Republicans elected.
What?.. :dubious:
According to the LA Times, the vast majority of Californians will not be eligible for the tax credits of the proposed plan, regardless of age or income.
Essentially, the issue is this:
The plan proposed by Republicans does not allow tax credits for any plan that pays for abortions.
California state law requires all health plans to pay for abortions, with very limited exceptions.
Have any Republicans acknowledged this little problem?
I strongly suspect that Republicans don’t see this as a problem. For them, it’s more of a feature than a bug.
Ding ding ding. We have a winner.
In a nutshell, this is the problem. Look, forget everything else. Forget it. Forget the seven pages devoted to lottery winners. Here’s how health insurance works:
- If everyone is forced to get it, it works. It has a chance of working, anyway.
- If people aren’t forced to get it, it does not work.
This is Economics 101. If there is no “individual mandate” then people are inclined to buy insurance only when they feel they are likely to need it, and, as a result, insurers are automatically suspicious of anyone who wants to buy insurance. The only way this ridiculous “health” insurance system will last six weeks is with a network of tent poles in fifty different places desperately trying to keep adverse selection from collapsing down upon it.