Iceland, Canada, UK, Japan, Norway, France all have single-payer healthcare and it works great. Why can’t we do it? Obamacare, IMO was a waste of time. If you’re going to call it the “Affordable care act” than prices need to go down, not up.
We also need to manage things much better. I used to work as a field computer technician for a company that managed nursing homes. A lot of the time, nobody would know what was going on and I often had to spend hours looking for missing computers, or computers that were sent to the wrong state instead of actually doing my job. Healthcare is the #1 cause of bankruptcy, and I highly doubt that paying overtime to an IT guy to sift through the warehouse, instead of keeping track of things to begin with, is going to cut costs.
If we can’t do single-payer for whatever reason, maybe we should cap the price of procedures. I have read articles saying that one hospital might charge $10k for an appendectomy, and another might charge over $100k.
I’m sure the Republican party will be very interested in hearing your suggestions.
IMHO it’s because a lot of powerful people (/corporations) have a lot invested in the current system.
Then there are the common people who think the current system works for them and fear change, especially if it involves government control.
History. Our healthcare system evolved over decades into what it is today. It wasn’t designed or built from the ground up but instead built on what came before, propped and patched together as new requirements were added or new regulations were put in (or removed). It’s a patchwork system that has worked well enough for the majority that no one really wanted to tear the entire thing down and build a coherent and cohesive system from scratch until fairly recently when the majority of people started to feel the pain, as opposed to just those who fall between the cracks. There is a lot of momentum behind the current creaky system from people who are afraid that change will be worse for them (will cost more or provide fewer services or just be change when what we had was good enough for grandpa). There are also a lot of vested interest in some businesses for the current system, and not only in the health care providers categories. As an example, a lot of companies and their HR departments are floundering in trying to figure out how to work with the new (bolted on patched) system with ACA because it’s not what they were used to or trained on, and change can be scary.
The fundamental reson, I think, is that the inefficiency in the US system represents profits for vested interests which have considerable power on the legislative level.
There are a lot of people who make a lot of money through healthcare in the USA.
That is why it is fucked up.
How does losing $2000 laptops on a regular basis make a profit unless it is an insurance scam?
Just charge $20 for an aspirin tab and you’re golden.
I would be happy at least knowing what a procedure will cost before I agree to it. As a practical matter you can’t comparison shop, prices aren’t advertised, and there’s no way to know with certainty what the billed price or the insurance-negotiated rate will be. It’s the only industry in the world that I can think of where the price of service is almost completely obscured until you’re stuck with the bill and it’s too late— and I strongly suspect they like it that way.
Predictable Republican American Doper Response, ninja’d before it happens:
“Cite! Cite that a hospital aspirin costs exactly, precisely $20!!”
It’s not like America is the only country with powerful private interests, yet our system seems uniquely terrible among comparable industrial nations. Hard to draw flattering views about our political or democratic processes.
You think the Republicans are really interested in hearing more about single payer?
Miller: Woosh.
Democrats wanted single payer AKA Medicare for all, a system akin to that practiced by most of the industrialized world. (There are other hybrid systems though.) Republicans provided a counter-plan: managed care. The Dems acceded to this, at which point the Republicans couldn’t take yes for an answer. Obamacare had a public option. That was voted down, courtesy of Joe Lieberman. What we got is Romneycare, in the teeth of record levels of Congressional obstruction by a minority party.
The ACA was considered a first step by its designers. It’s worked quite well, insuring millions and controlling costs better than expected. But there’s only so much you can do when one party is too cowardly to offer a serious proposal to address the nation’s problems.
The Affordable Care Act basically came out of the Heritage Foundation: Romneycare would be a reasonable term for it. And yet it did not receive one Republican vote in the Senate or House. Not one. The baffling modern conservative idea that we like democracy but hate compromise is at the center of today’s dysfunction in public policy: it can only be solved by keeping spoiled children away from the legislative process.
I agree it is unfortunate that responsible people only have one choice of party in national elections.
shrug Our system is a consensus system. You have to put forth stuff that both parties will agree too or it’s going to be like this. From the Republicans perspective ACA was shoved down their throats (at least, that’s how they recall things). This has little to do with my post, however, which is the system we have, which has been in place LONG before the current partisan bickering, evolved over literally decades and is what people in the US pretty much were brought up with. It worked (sort of) for the majority until fairly recently, and still sort of works for most, though the issues have become more and more prevalent as time goes on. It’s not an easy fix for the US to simply junk the entire system and go with something ‘akin to that practiced by most of the industrialized world’ in our political environment with the way our political system is set up. When you become god king of the country you can, of course, do what you like by fiat…in the mean time there are political realities that won’t let you do that without an overwhelming public mandate. One that doesn’t exist right now for massive healthcare reform. So, we got a bandaid that literally no one is happy with. Par for the course.
We’ll never know because, sadly, the Democrats didn’t have fiat control to do whatever they wanted to do exactly how they wanted to do them. I think that the tone of your post underscores the deep divide that has poisoned any sort of consensus that would be possible in our ACTUAL political system as it actually works in the real world. Along with your equally venomous counter parts on the Republican side, of course.
Possibly because Romney didn’t and doesn’t represent all Republicans and perhaps because, contrary to what is seemingly the opinion around here, many Republicans didn’t think it was a good idea when he did it either. You will note that Romney DIDN’T GET ELECTED AS PRESIDENT, which I think is telling. He got the nomination, but it was pretty tepid from the more conservative Republican folks who were basically supporting a not-Obama candidate, not who they really wanted.
The reality based party, right?
In any case, MY point was that our system is so fucked up because it evolved to be what it is, not because of evil Republicans or corporate interests. Those evolved along with the system, and at this point it would be a major change to get us to be like all the other much better and far superior nations around the world living the dream with single payer healthcare. I think part of the disconnect is that in the real world it’s more difficult to change something like this because there are so many moving parts and so many connections to the old system, and so much of a comfort level with what people know and are used to, even if something IS better on more rational analysis. Personally, I think the ACA was about as far as we could have gone in so short a time, and that REAL change will be a process that will happen over time…years, even decades instead of the instant fantasy that some folks seem to have had. There will be enough pain this way, but if it proves itself then we can make further changes down the road, and eventually, no matter what partisan roadblocks are put up we’ll get there if it really is better. Or, you know, you guys could just throw a coup, seize ultimate power (perhaps have a watery bint toss a sword at you), and rule by fiat as god kings and queens. Otherwise, you kind of have to work with what we have, instead of what you’d like.
But that’s horsepucky. Again, the ACA was basically Romneycare. And it didn’t get one Republican vote. Not one. When Romney ran for President in 2008, conservatives weren’t too upset about his health care plan. It was only when it became a Democratic proposal that they freaked. This is inane tribalism at the base level and careful strategizing at the Congressional level.
McConnell believed that bipartisanship disproportionately benefited the party in power. So he would have none of it, and fought hard to keep Republican fingerprints off the plan. Cite.
These are new developments. You can look at a chart of cloture votes to see that Republicans and their modern conservative base are undoing long held American civil traditions. Pushback on False Equivalence and the Filibuster - The Atlantic
Evil corporations are a challenge, but that can be surmounted. Indeed, it was. And you have a point: after all, health care reform was defeated multiple times before obstructionism became a way of life for the GOP. It’s ~1/6 of the economy now: it might have been easier to reform when it comprised a smaller share of GDP - interests -general interests not just special ones- might have been less entrenched. So, yeah.
But it would be wrong to dismiss GOP shenanigans over the past decade as same-old, same-old. It’s not. My fear is that essentially McConnell discovered an aspect/weakness of our political system which hadn’t been fully grasped earlier. It is well known that political systems with diffuse accountability tend to implode: the US experiment in that sense has been an exception, propped up more by institutional norms than by sound design.
I was going to say that it’s a Charlie Foxtrot because it’s for-profit instead of for-patients.
Money. It’s always money.
Hospital bill is high enough to raise anyone’s blood pressure
It’s like the traffic tickets over there.
Because democracy has failed.
It certainly doesnt work great. There are long waits and ever increasing costs. There are no good healthcare systems because people are living a lot longer and it costs the system a lot more money the older they get.