Sigh. Why do people not read the posts before responding?
Here is the context: from my post above "I can name any number of issues where the majority of the voters is for something but what is legislated is another thing. Like making marijuana legal. Or that big majority that think that US government is not aggressive enough in deporting illegal immigrants. Or the majority that support late term abortion bans. Or, for that matter, the big majority that wants ACA repealed or changed. "
The choices were A. Something and B. Nothing. For now, that is still the case.
To put those who want even more in the same category as those who want nothing, as if they opposed getting as much farther along as we did, is absurd.
Do you know what compromise is? Or about politics being the art of the possible? Or about letting the perfect be the enemy of the good? It doesn’t look that way.
I think we can all comfortably say that the salvation of HealthCare.Gov is nothing short of miraculous, given the flurry of states who dropped the ball last year and are now opting to lean on the federal website. For the latest on that development:
Nevada transitioning to HealthCare.Gov for the 2015 enrollment period
Seriously, color me surprised on this one. By all early accounts, NV seemed to be one of the states that truly had its act together in terms of building a state-based marketplace. Apparently it hit a massive technical wall shortly after it launched, and contractor Xerox has since done a terrible job at addressing the problems.
Oregon and Massachusetts did the same thing. Both used CGI as their software contractor, like the feds, but obviously did not get the Tiger Team fix-it program the feds did.
This may be good in the long run, though - the more federalized this program is, the easier politically it may be to take the next step, the robust public option (i.e. expanded Medicare eligibility) on the way to single payer.
Or, on the way to the failure of a public option. Assuming Democrats would allow a public option to compete and fail.
Medicare is a failure? 
Medicare doesn’t compete with anything. The public option would compete side by side with private insurance options on the exchange.
Now it’s possible it could blow them out of the water and we have single payer. It’s also possible that it could fail to compete and go bankrupt. That’s the joys of competition, you don’t really know.
However, I think I can predict safely that the public option would do poorly. Democrats wanted to give their public option as many advantages as they could, because they knew it couldn’t compete on a level playing field.
A public option wouldn’t need to make a profit though. Can private insurance companies compete with another organization that doesn’t need to factor profits into their plans? How could they offer plans with the same coverage for the same, or lower price, and still make a profit? Are you sure you’ve thought this through?
You still feel safe predicting anything? Wow. If you are predicting this result, then I feel 100% confident that the opposite will be what actually happens.
If, as we keep getting told by the ideologues, the private sector can always operate more efficiently and effectively than government, well then, why doesn’t it?
Wrong, of course. But pointless to pursue.
That was my thought as well. Companies like Aetna have humongous buildings with shitloads of workers, many of which have as their performance measure how many claims they can deny. Plus armies of lawyers to defend the corporate treasury, plus make a profit for the stockholders. Go public and you eliminate the profit part of equation entirely and you deal with civil servants who aren’t trying to screw you over.
That is an advantage, but not an unfair one. Since the profit margins of insurance companies are only 3% or so, that spots the public option 3%. So all they’d have to do is run everything else as efficiently as the private companies and they’d outcompete them. So if they fail, they have no excuses.
What would be an unfair advantage would be backing the public option up with the promise of a bailout, or worse, subsidizing it so that it could offer what appear to be lower premiums. A public option must be 100% self-funding through premiums.
Then please let the Democrats championing the public option that it can compete, because they have zero confidence that it can without special government aid.
You’re also dealing with people who aren’t interested in efficiency or customer service and care not at all if you switch to a competitor. And who can’t be fired for poor performance.
So yeah, let’s find out. I favor the public option. Let’s do this.
Here’s a nice article on a recent single-payer advocacy gathering that took place in the capital. Nothing to report other than that the slog to single-payer nationally is going to be a LOOOOOOOONG process. Sen. Sanders is quoted in the article as saying essentially the same thing that I’ve been echoing for years: SP will not happen nationally anytime soon, but it WILL happen in individual states. His state (VT) will hopefully be the first, provided that the Gov. is able to get it off the ground.
A lot of people think that the ACA is the first step towards SP in the US; personally, I feel that it’s more of a detour from that than anything else. Until & unless a public option is introduced, the US healthcare system will remain a multi-payer, predominantly privately-run enterprise.
Well, yeah, maybe, but let me introduce you to Rosie, Rosie Scenario…
The favorite methods for Big Health to squeeze some extra money to build huge offices with retarded sculpture in the plaza…the grotesquely inhumane methods…those are going to be off the table. GreedCo will not be able to out-profit the Mammon Group by hiring more soulless cynics to find inventive ways to cancel someone’s health insurance because they didn’t report taking acne medication twenty-thirty years ago, stuff like that.
So, how do they compete? What’s left, but competing on price, on premiums? If GreedCo offers the same benefits as the Mammon Group for $200/yr less, and the Feds are looking over their shoulders to keep them honest, who you going to choose?
One of the inefficiencies of our, ah, “system” is profit. Profit does not benefit the consumer unless it can be used to force insurers into more efficiently run systems. Well, now it can. In theory, at any rate. Trouble is, of course, that the very same motivation that might move them to benefit the consumer by being an honest, transparent, and well meaning provider is the same motivation that moved them to behave like rotten sumbitches.
Won’t be easy. Can be done.
The incentives aren’t much different from the government. Profits and budget targets create the same incentives: a search for shortcuts.
Now, we all realize that the ACA is an unmitigated disaster because at its core…well, y’know, it just is. :smack: So take this following good news as the (in reality) terrible news that it really is:
New Jersey’s uninsurance rate plummets to its lowest level in nearly 25 years
That’s in spite of Gov. Lane-Closure not building a state-based marketplace or actively promoting ACA benefits. To his credit, he did expand Medicaid, which certainly has helped in the massive decline in the uninsured.
MSNBC has a good story today on Vermont’s Green Mountain Care:
The problem with any big change is that there are going to be winners and losers. And since Shumlin doesn’t seem interested in telling lies like the President did, he’s going to have a tougher time convincing the losers to take it on the chin for the greater good.
Surprised no one has commented on the LA times reporting that the administration is now using the risk corridors to try to entice insurers to not raise their rates too much.
But the change in regulations essentially provides insurers with another backup: If they keep rate increases modest over the next couple of years but lose money, the administration will tap federal funds as needed to cover shortfalls.
These guys are shameless. The risk corridors are only to cover losses due to insurers drawing a sicker pool than their competitors. It is not meant to bail out insurers who set their premiums too low.
This administration has made an art form out of using taxpayer dollars for campaigning purposes. It’s Chicago style!
You won’t find a lot of rational thinkers eager to argue that Obamacare details are perfect – we wanted a public option. But the taxpayer dollars you refer to would be spent not for campaigning, but for American healthcare. American health will certainly improve under ACA; that you look at healthier Americans and pretend to believe they are victims of Democrat campaign promises is amusing.
Actually, compensating Job-Creating™ insurance companies for Pernicious Mismanagement™ by the Death-Panel Commisars™ is precisely the sort of thing GOP might propose, in a less irrational moment. Since Obama thought of it first, you need to pretend it’s a bad idea.