If this factionalism continues in the GOP (gotta love the “Freedom Caucus” - it ain’t hateful enough, so we are agin it!) will they have the votes to impeach and convict Trump, leading to “President Pence” - a TRUE right-winger and a competent politician to boot.
I was amazed how compliant the “Never Trump” faction became once Pence was named as VP.
The only way for that to have been rational is if the “Never Trump” folks knew Trump was a necessary fool who would soon be gone, replaced by a member of the True Religion of the Right.
That the most rabid right-wingers in the House chose to torpedo Trump’s biggest Bill would indicate they are ready to move past a “President Trump”.
They want
[ol][li]The best health care in the world[/li][li]Available to everyone, and[/li][li]At a reasonable price.[/ol][/li][/QUOTE]
The problem (well, a problem, at least) is that we have piecemeal, half-assed approaches to each of these. Medicare is available to everyone…over 65, and costs the government more than $650 billion per year for patients who are the most expensive and the least economically useful to cover. Emergency rooms are available to everyone…but are subsidized by people who do have insurance and can afford it, since doctors inexplicably refuse to work for free. We have the best health care in the world…if you have extraordinarily good insurance, which is determined (unless you’re independently wealthy) by your employer. And so on.
At the very least, I’d want a health care system that’s competently and coherently designed. By historical accident and the niceties of the tax code, insurance is heavily tied up with employment; I want to be able to buy my own insurance (at a reasonable price). Want a free market system? Fine; I’ll take the money I give to the government to spend on keeping 80-year-olds alive for another few months, and spend it on my own care. (Or, hell, spend it on education, infratstructure, reducing the deficit, etc.) What a fully socialist system? That’s cool, I’ll actually get some use out of the taxes I pay. Honestly, if you throw a dart at a map of comparable first-world countries and take the health-care system of wherever it lands, you’ll probably come up with a better result than what we’re stuck with.
Telegraph = the Barclay Brothers ( previously Conrad Black )
Express = Richard Desmond (ex-pornographer)
Daily Mail = DMG Media > Viscount Rothermere, founded by Alfred Harmsworth ( Viscount Northcliffe, mad as a hatter ) and Harold Harmsworth ( Viscount Rothermere, lover of nazis preWWII )
Independent = Evgeny “Don’t call me an oligarch” Lebedev
The Guardian and the Daily Mirror, the only major papers owned by people not far to the right of old Ronnie are owned by separate trusts.
* According to the data, ‘research finds 95% of tabloid’s editorials in runup to election have been anti-Labour, with most of those directly vilifying the Labour leader‘*
Most continental press is equally narrowly owned, if less rabid than the British.
I would like to avoid having to decide between the health of My Beloved, who has already already survived cancer and is now trying to survive the high cost of medicine, and paying the mortgage. I would like to not have to choose between the anti-seizure medication I need and the bus pass I need to continue working. I would like to know that if an emergency comes up involving either of us we won’t end up homeless because we couldn’t pay for both. I would like to avoid silly discussions about special medical savings accounts that would be wiped out after a day or two in the hospital.
Out of curiosity, has there been any economic anaysis of the effect on labour markets, or business efficiency and flexibility more generally, of employer-based health insurance? Seems to me it builds in some rigidities and burdens on employers they might prefer to do without.
Yes, but I’ll leave it to someone with a background in macroeconomics to discuss the details. My understanding is that everyone hates it except for insurance companies, but I’d like to see actual data (as opposed to a few anecdotes and case studies) to back that up.
Actually, not everybody hates it. This Forbes article (linked by JKellyMap in another thread) contains the following paragraph:
That paragraph confused me, at first. Wait, haven’t I spent my whole life hearing that Americans are so much more mobile than we are? As far as I can remember I’ve been hearing how Americans are the entrepreneurs, the zigzaggers, the people who will uproot to go where the jobs are or change companies for their next promotion. Us Europeans, with our multiple languages and educational systems and so forth are a bunch of provincial snails whose worn-on-the-back houses might as well be stapled to the floor, we need to be more mobile! Like the Americans!
But, not all. For those Americans who are mobile, having health insurance linked to employment can feel like a set of manacles. But that’s mainly upper-middle urban classes, what you guys call professionals, artsy types… in the US like in Colombia, Italy or the Solomon Islands there is a lot of people who want to stay where they are and who’d be perfectly happy to spend their whole working life doing the same job day in and day out.
And because of historical reasons, for those particular Americans having their healthcare be linked to their employment truly feels like a benefit. What to me stinks of 19th century factory villages which were barely above indentured peonage, to them is perfectly fine as long as the company store is always the same single one.
I am not an economist, but I would expect it imposes a competitive disadvantage versus foreign businesses. Exactly how much of the job losses to foreign markets are due to this extra cost for employers I can’t guess, but I would be interested in seeing numbers.
However, most businesses don’t compete much with foreign markets, their main competitors are national. And I think to them, there are considerable benefits to this… economic serfdom.
I work with a lot of start-ups and new businesses, here in Norway and one common denominator I have noticed is that outside of the IT business most people who start their own business are people in their 30s and 40s who feel they have mastered their trade and come as far as they can working for someone else, or have a strong business idea. This is the age range where people normally start to lose the notion that they are indestructible, have a family and dependents, etc.
So I suspect the current setup heavily discourages new business formation, to the advantage of the large old-growth businesses, who do not have to worry much about their employees taking off with their customers and starting lean new competitors.
This does not lead to a healthy business ecology. The concept of markets is heavily reliant on new business regrowth and failing businesses being outcompeted. However in the US, it seems to me that a healthy business ecology is often considered synonymous with having large companies, with the economies of scale working for them, pulling in immense profits.
Are they, though? The 2016 Republican standard-bearer said:
[ul]
[li]“Everybody’s got to be covered. This is an un-Republican thing for me to say, I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody is going to be taken care of, much better than they’re taken care of now.”[/li][li]“We’re going to have insurance for everybody. There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.”[/li][li]“As far as single payer, it works in Canada. It works incredibly well in Scotland.”[/li][li]“A friend of mine was in Scotland recently. He got very, very sick. They took him by ambulance and he was there for four days. He was really in trouble, and they released him and he said, ‘Where do I pay?’ And they said, ‘There’s no charge.’ Not only that, he said it was like great doctors, great care. I mean we could have a great system in this country.”[/li][/ul]
It works because the US is starting from a higher baseline of spending, and the factors that cause increase in health care costs (aging populations, new technologies and drugs, etc.) are the same in both the US and Europe.
The US spends a lot, and the cost is going up. The UK spends less, and the cost is going up. The UK has a lot further to go but the increases are there, and they are also going to increase in the US for the same reasons.
The idea is always that we implement single-payer and then health care costs in the US will be reduced by a large amount, so that we spend the same as the UK does now.
And I doubt very much if we can reduce spending overall if our expectations are this -
This list is much more specific than what I said originally, but it’s the same thing - “I want the best health care in the world, available to everyone, and at a reasonable cost”. If we tried to implement anything like this list, we would have the first two options.
So we implement singe-payer, and we save a lot of money. We then spend it all and more expanding coverage. That might be a good idea, but it doesn’t cut costs at all.
The parallel phenomenon in the UK sees its sense of community and place-bound identity tied up with… the National Health Service. That’s why there was so much emphasis in the Brexit campaign on how much more there would be for the NHS if we didn’t pay so much to the EU, and a constant drumbeat about foreigners - perceived not to be contributing to the community - taking advantage of the NHS. Whatever the actual statistics, it’s a powerful chord in the mood music. (It’s also a potential drag on reforming care management, since people will fight to the death to keep their local facilities more or less as they are).
It tends to be the people in better-off managerial positions in the UK whose job perks include private health insurance.
AFAIK, virtually no-one was particularly sorry to see the pre-NHS employment-based insurance schemes superseded; but circumstances were rather different in the 40s.
You keep saying this, although nothing in this thread comes close to that statement. Why do I get the feeling that this stock dismissal is going to be the way you translate what people want, no matter what they say?
Do you believe we can implement the things on the list, while simultaneously cutting health care spending such that the US spends the same percentage of GDP as the UK?
