Yeah the West Coast could probably all agree to work together on a single payer system, but it'd be three identical systems, not one collective system.
I don't see why they couldn't create an interstate body to administer it. That'd actually be fucking fantastic because if it worked you just add more states to it and build off of it.
Giggles_Funsworth on
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Giggles_FunsworthBlight on DiscourseBay Area SprawlRegistered Userregular
I'd think right now would be a great time for dems to build up the case for single payer. Since they're out of power, there's no risk associated with having to produce legislation, but they can still work on crafting the basics so that when they retake power, they can roll with it if it looks like the people are receptive. And if the people aren't receptive, no big. Work on smaller scale tweaks to the existing law.
Meanwhile, they can still work the message of "the pubs have terrible ideas that will literally kill you."
Basically, they should mimic the pubs during the last decade, except actually come up with viable alternatives.
Two things terrify me.
One is the Republicans in power now, who seem like they're more or less on track to make massive cuts to Medicaid. They want to wage a massive assault on the poor. It is a humanitarian disaster in the making. And it's not just a moral failing -- it's dangerous. Nations that neglect the poor tend to end up in very bad situations, historically speaking.
However.
@ElJeffe's suggestion, a single-payer healthcare system, scares me too. We ought to be extremely reluctant to go that far. For the United States, it's the nuclear option. It carries massive risk.
You all are correct that a single payer system would reduce costs. A single payer system would do so by fixing prices -- the government would have the ability to say how much it'll pay for a particular device or treatment, and that would be that. Sander said his Medicare-for-all plan would cut healthcare costs by $8 trillion over ten years, and that sounds great, right?
But what effect would that have on innovation? $8 trillion is a massive amount of money. It seems almost self-evident that of course we would see less innovation. You can't cut $8 trillion dollars from an industry and expect to see no effect. The magnitude of the effect seems to be a matter of considerable disagreement, however. But it could be massive. The development of life-saving (or simply life-enhancing, which ought to be considered too) treatments might be delayed by years or decades if we collectively decide to fix prices. And typically speaking, a stifling of innovation is precisely what happens when a monopoly takes over a market.
And then there are the political consequences. A single payer system is a massive, MASSIVE political risk. Look at Obamacare. Look at the massive backlash it caused. The worst midterm election for the Democrats in modern history, and the party still hasn't recovered from it. And that was just philosophical opposition! No one was actually, personally injured by Obamacare in 2010, and yet the reaction was huge and terrible.
When a real single-payer plan kicks people off the insurance plans they've been used to, they'll be mad. When things go wrong -- and they will go wrong -- they'll be mad. The backlash will almost certainly be worse. The legislation might be able to survive until the benefits fully kick in and people get used to the new system, but that to me seems highly unlikely. What will likely happen is another Republican president will get himself elected with another Republican congress, and we'll see the pendulum swing towards the same kind of irresponsible leadership we're watching right now.
There's a number of other criticism to be made, but I'll stop there. It's a scary move, and an ill-advised one. Every time it came up in the Democratic primary, I cringed. And besides, there are smaller, incremental steps you can take that are much better -- like expanding Medicaid. Give the poor the help they need, but leave the rest of us free to participate in the market as we see fit.
I don't think you're arguing from a position of knowledge considering your first fear is literally equivalent to the health insurance industry:
I wasn't aware of this until just now when I looked it up out of curiosity, and having criticized Sanders for bogus math before I figured that was a best case scenario. Now it seems conservative.
I mean, look at pretty much every other developed western nation. They all have variations on single payer or government-guaranteed health care for everyone, and they almost invariably perform better than the U.S. by any metric that is not just "what can rich people get?"
So pick one out of a hat, and it's going to be better than what we have here. The question is less the destination and more how to get there. And "how to get there" is 90% "how do we get it past a GOP who has "the ability to die in a gutter of easily treated ailments" as a fundamental right?
We're a big country, and we're a rich country, and we could find a way to absorb the shock of transition if we wanted to. The hard part is getting it past the portion of the country who will literally try to sabotage it out of spite. It's like going grocery shopping with someone who keeps setting fire to your cart.
I submitted an entry to Lego Ideas, and if 10,000 people support me, it'll be turned into an actual Lego set!If you'd like to see and support my submission, follow this link.
Honestly I think the best way to do it would be to just have universal preventative/wellness programs.
Like, routine doctors visits, generic drugs, eye exams, dental visits? All covered. Just fucking go, mang, go get your shit checked.
Which, frankly, shouldn't be insurance based. Insurance kicks in when a routine wellness check finds something. The wellness stuff itself should just be comp'd.
Honestly I think the best way to do it would be to just have universal preventative/wellness programs.
Like, routine doctors visits, generic drugs, eye exams, dental visits? All covered. Just fucking go, mang, go get your shit checked.
Which, frankly, shouldn't be insurance based. Insurance kicks in when a routine wellness check finds something. The wellness stuff itself should just be comp'd.
Why require insurance for the other things though, once you've socialized routine care? Insurance is a useless drain on the system that routinely drives up costs for everyone because they can.
Then just pump that 8 trillion into Government funded research. You'll get way more bang for your buck, and have far better outcomes in terms of helping poorer countries with epidemics, and wont have to fuck around with patents and generics and stuff.
Also, more control over research regulations instead of having to constantly negotiate with lobbying groups. As a layman, it seems as though that would allow you to ensure testing protocols and drug releases are safer?
Big Pharma and government typically operate within two different spheres of medical research. To be really succinct about it, in the realm of pharmaceuticals, it's academic researchers that typically hunt for the potential active pharmaceutical agent, and Big Pharma then takes over to find a way to actually deliver that prospective drug effectively. Big Pharma's largely withdrawn from the discovery part of the pipeline in the past few decades - it's too financially risky - so most new medical advances nowadays* are initially from academic researchers, who then license the agent to a pharmaceutical company for the last mile.
That being said, Big Pharma has actually started getting back into the discovery part of the pipeline nowadays, because they've come to realise that there isn't anything for them to carry on the last mile if academic researchers don't keep discovering shit. So, ironically, they've started getting into funding public researchers themselves, selectively supporting their work as public research funding is cut by governments looking to trim deficits. They've also started releasing more of their data publicly - to researchers anyways - because they realised that they were sitting on all this data about possible pharmacologically active chemicals and keeping it private just in case it could one day be capitalized on, but meanwhile the public researchers their business models are dependent on were being starved of data and funding.
On the flip-side, public researchers don't really have the apparatuses that would be required to do the final leg themselves. It's a massive logistical task, starting with developing various chemical permutations of the potential pharmaceutical agent to find a derivation that remains active and is deliverable, to the incredible process of running clinical trials (and bearing the legal risks of said trials). Just shunting the money over isn't going to allow for the replication of the infrastructure, administrative and otherwise, required to perform all that.
* The thing is, actually, most new medical advances these days are non-pharmaceutical. If you look at, for example, CNN's top 10 medical breakthroughs of the past 10 years, c. 2013, only four are medications: HIV cocktails, birth control pills that suppress the female period, targeted cancer therapies, and the HPV vaccine. And two of those (HIV cocktails, HPV vaccine) were primarily government-driven discoveries, with cancer and AIDS research long being the domain of government researchers and doctors. The other six include the Human Genome Project, stem-cell research, laproscopic surgery, anti-smoking laws, and bionic limbs, which is fairly indicative of the fact that many major gains in health outcomes aren't driven by pharmaceutical research.
hippofant on
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ButtersA glass of some milksRegistered Userregular
Other countries had for profit healthcare just like we did before they went UHC. It'll suck for some insurance companies and employees of those companies, but oh well, at least they'll have health care while they look for a job.
We don't have to get rid of private insurance entirely, those can still theoretically coexist with single payer.
I don't disagree with you and I think ultimately it should be done but you can't trivialize the transition the United States would require. "Other countries" don't have state lines within them, all but two don't have 320 million citizens (17 million of which work in healthcare), and the developed nations with more socialized systems started their transition long before they had this level of size and complexity to their networks. Four of the top 10 largest pharmaceutical companies are US-based and I'm pretty sure all of them generate the bulk of their profits in the US.
I think it's a necessary undertaking but after seeing how disruptive ACA was it's clear universal care would be many times more so and that's a fact that shouldn't be underestimated
Other countries had for profit healthcare just like we did before they went UHC. It'll suck for some insurance companies and employees of those companies, but oh well, at least they'll have health care while they look for a job.
We don't have to get rid of private insurance entirely, those can still theoretically coexist with single payer.
I don't disagree with you and I think ultimately it should be done but you can't trivialize the transition the United States would require. "Other countries" don't have state lines within them, all but two don't have 320 million citizens (17 million of which work in healthcare), and the developed nations with more socialized systems started their transition long before they had this level of size and complexity to their networks. Four of the top 10 largest pharmaceutical companies are US-based and I'm pretty sure all of them generate the bulk of their profits in the US.
I think it's a necessary undertaking but after seeing how disruptive ACA was it's clear universal care would be many times more so and that's a fact that shouldn't be underestimated
I think we're one of the wealthiest countries in the world. We can stop dumping trillions into our defense fund for a few weeks.
not a doctor, not a lawyer, examples I use may not be fully researched so don't take out of context plz, don't @ me
Yeah the West Coast could probably all agree to work together on a single payer system, but it'd be three identical systems, not one collective system.
I don't see why they couldn't create an interstate body to administer it. That'd actually be fucking fantastic because if it worked you just add more states to it and build off of it.
I'd think right now would be a great time for dems to build up the case for single payer. Since they're out of power, there's no risk associated with having to produce legislation, but they can still work on crafting the basics so that when they retake power, they can roll with it if it looks like the people are receptive. And if the people aren't receptive, no big. Work on smaller scale tweaks to the existing law.
Meanwhile, they can still work the message of "the pubs have terrible ideas that will literally kill you."
Basically, they should mimic the pubs during the last decade, except actually come up with viable alternatives.
Two things terrify me.
One is the Republicans in power now, who seem like they're more or less on track to make massive cuts to Medicaid. They want to wage a massive assault on the poor. It is a humanitarian disaster in the making. And it's not just a moral failing -- it's dangerous. Nations that neglect the poor tend to end up in very bad situations, historically speaking.
However.
@ElJeffe's suggestion, a single-payer healthcare system, scares me too. We ought to be extremely reluctant to go that far. For the United States, it's the nuclear option. It carries massive risk.
You all are correct that a single payer system would reduce costs. A single payer system would do so by fixing prices -- the government would have the ability to say how much it'll pay for a particular device or treatment, and that would be that. Sander said his Medicare-for-all plan would cut healthcare costs by $8 trillion over ten years, and that sounds great, right?
But what effect would that have on innovation? $8 trillion is a massive amount of money. It seems almost self-evident that of course we would see less innovation. You can't cut $8 trillion dollars from an industry and expect to see no effect. The magnitude of the effect seems to be a matter of considerable disagreement, however. But it could be massive. The development of life-saving (or simply life-enhancing, which ought to be considered too) treatments might be delayed by years or decades if we collectively decide to fix prices. And typically speaking, a stifling of innovation is precisely what happens when a monopoly takes over a market.
And then there are the political consequences. A single payer system is a massive, MASSIVE political risk. Look at Obamacare. Look at the massive backlash it caused. The worst midterm election for the Democrats in modern history, and the party still hasn't recovered from it. And that was just philosophical opposition! No one was actually, personally injured by Obamacare in 2010, and yet the reaction was huge and terrible.
When a real single-payer plan kicks people off the insurance plans they've been used to, they'll be mad. When things go wrong -- and they will go wrong -- they'll be mad. The backlash will almost certainly be worse. The legislation might be able to survive until the benefits fully kick in and people get used to the new system, but that to me seems highly unlikely. What will likely happen is another Republican president will get himself elected with another Republican congress, and we'll see the pendulum swing towards the same kind of irresponsible leadership we're watching right now.
There's a number of other criticism to be made, but I'll stop there. It's a scary move, and an ill-advised one. Every time it came up in the Democratic primary, I cringed. And besides, there are smaller, incremental steps you can take that are much better -- like expanding Medicaid. Give the poor the help they need, but leave the rest of us free to participate in the market as we see fit.
I don't think you're arguing from a position of knowledge considering your first fear is literally equivalent to the health insurance industry:
I wasn't aware of this until just now when I looked it up out of curiosity, and having criticized Sanders for bogus math before I figured that was a best case scenario. Now it seems conservative.
I don't think I understand what you're trying to say here, what was it that I said that was parasitic? What part of Sander's math was bogus?
I think we're one of the wealthiest countries in the world. We can stop dumping trillions into our defense fund for a few weeks.
We can actually do both and still not approach other OECD countries' spending as a percentage of GDP.
The U.S. is incredibly rich, especially its incredibly rich. The U.S. Government Presented by Grover Norquist has done a wonderful job convincing its citizens otherwise.
Other countries had for profit healthcare just like we did before they went UHC. It'll suck for some insurance companies and employees of those companies, but oh well, at least they'll have health care while they look for a job.
We don't have to get rid of private insurance entirely, those can still theoretically coexist with single payer.
I don't disagree with you and I think ultimately it should be done but you can't trivialize the transition the United States would require. "Other countries" don't have state lines within them, all but two don't have 320 million citizens (17 million of which work in healthcare), and the developed nations with more socialized systems started their transition long before they had this level of size and complexity to their networks. Four of the top 10 largest pharmaceutical companies are US-based and I'm pretty sure all of them generate the bulk of their profits in the US.
I think it's a necessary undertaking but after seeing how disruptive ACA was it's clear universal care would be many times more so and that's a fact that shouldn't be underestimated
I think we're one of the wealthiest countries in the world. We can stop dumping trillions into our defense fund for a few weeks.
We don't pour trillions into our defense fund in the span of weeks, btw. Not sure if you were just exaggerating for effect there. We spend about ~$600 billion per year on defense.
Cutting defense funding isn't enough to pay for any kind of single payer system.
It might be enough to pay for a nice Medicaid expansion, though.
Other countries had for profit healthcare just like we did before they went UHC. It'll suck for some insurance companies and employees of those companies, but oh well, at least they'll have health care while they look for a job.
We don't have to get rid of private insurance entirely, those can still theoretically coexist with single payer.
I don't disagree with you and I think ultimately it should be done but you can't trivialize the transition the United States would require. "Other countries" don't have state lines within them, all but two don't have 320 million citizens (17 million of which work in healthcare), and the developed nations with more socialized systems started their transition long before they had this level of size and complexity to their networks. Four of the top 10 largest pharmaceutical companies are US-based and I'm pretty sure all of them generate the bulk of their profits in the US.
I think it's a necessary undertaking but after seeing how disruptive ACA was it's clear universal care would be many times more so and that's a fact that shouldn't be underestimated
I think we're one of the wealthiest countries in the world. We can stop dumping trillions into our defense fund for a few weeks.
GOP: *gasps, pops monocles and/or clutches pearls in unison*
I mean, look at pretty much every other developed western nation. They all have variations on single payer or government-guaranteed health care for everyone, and they almost invariably perform better than the U.S. by any metric that is not just "what can rich people get?"
So pick one out of a hat, and it's going to be better than what we have here. The question is less the destination and more how to get there. And "how to get there" is 90% "how do we get it past a GOP who has "the ability to die in a gutter of easily treated ailments" as a fundamental right?
We're a big country, and we're a rich country, and we could find a way to absorb the shock of transition if we wanted to. The hard part is getting it past the portion of the country who will literally try to sabotage it out of spite. It's like going grocery shopping with someone who keeps setting fire to your cart.
They set fire to the cart because the left hasn't convinced them that the government ought to be trusted to take over the health insurance that they like.
This is what I don't get. I don't get why the left isn't content with going for something like "We should pay for the healthcare of those who cannot afford it."
Instead they have to keep saying things like "We should blow up the entire healthcare system. We should take away the health insurance that you like and replace it with one that the government runs. You know, the same government that takes 4 hours to get your driver's license renewed. That government."
And then you're surprised that more than half the country isn't on board with that plan.
I'm not on board with that plan.
I'm with you on the "helping poor people who can't afford it" part. I'm with you on reforming parts of our system. I'm with you on expanding government-funded research. I support medicaid expansion. I support the public exchanges. I support health insurance subsidies. I am not with you taking away my health insurance plan and replacing it with one the government runs.
I mean, look at pretty much every other developed western nation. They all have variations on single payer or government-guaranteed health care for everyone, and they almost invariably perform better than the U.S. by any metric that is not just "what can rich people get?"
So pick one out of a hat, and it's going to be better than what we have here. The question is less the destination and more how to get there. And "how to get there" is 90% "how do we get it past a GOP who has "the ability to die in a gutter of easily treated ailments" as a fundamental right?
We're a big country, and we're a rich country, and we could find a way to absorb the shock of transition if we wanted to. The hard part is getting it past the portion of the country who will literally try to sabotage it out of spite. It's like going grocery shopping with someone who keeps setting fire to your cart.
They set fire to the cart because the left hasn't convinced them that the government ought to be trusted to take over the health insurance that they like.
This is what I don't get. I don't get why the left isn't content with going for something like "We should pay for the healthcare of those who cannot afford it."
Instead they have to keep saying things like "We should blow up the entire healthcare system. We should take away the health insurance that you like and replace it with one that the government runs. You know, the same government that takes 4 hours to get your driver's license renewed. That government."
And then you're surprised that more than half the country isn't on board with that plan.
I'm not on board with that plan.
I'm with you on the "helping poor people who can't afford it" part. I'm with you on reforming parts of our system. I'm with you on expanding government-funded research. I support medicaid expansion. I support the public exchanges. I support health insurance subsidies. I am not with you taking away my health insurance plan and replacing it with one the government runs.
Because it's unclear whether anybody in the US will be able to afford healthcare in the near future:
Some of this has to do with the aging of the population - note healthcare expenditure increases in all OECD nations - but 17% of GDP IS A LOT, and there was no sign of that growth abating. If it was at least steady at ~17%, that'd still be one thing, but it hasn't been!
hippofant on
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TL DRNot at all confident in his reflexive opinions of thingsRegistered Userregular
I'd think right now would be a great time for dems to build up the case for single payer. Since they're out of power, there's no risk associated with having to produce legislation, but they can still work on crafting the basics so that when they retake power, they can roll with it if it looks like the people are receptive. And if the people aren't receptive, no big. Work on smaller scale tweaks to the existing law.
I'd very much like them to--desperately, even, as I'm personally the somewhat person who statistically makes the least use of healthcare on an individual-basis, and also have experienced both the Republican-local-interference bullshit failings of the ACA and the distinct and separate bad-plannings-in-design failings of the ACA (in fact, I complained about them at the Healthcare.gov thread in D&D), which has not left me terribly cheery on the program, but I understand how desperate many less fortunate people (from a health aspect) are, and don't want them dying.
What I wonder is if they can overcome their own institutional opposition (among some portion of the party staff and leadership) to what is, by American standards, a radical idea. Nevermind that some Democrats do oppose it--you'll find other Democrats who'll oppose it because of how important it is to present a united front as the minority party across multiple branches of government. It's the whole, "Well of course I want (insert non-stupid healthplan here), but not everyone feels that way--and if we let them realize it, the Republicans will eat us alive." It's not like the Republicans aren't embarrassing themselves with their own discord.
It's not a radical idea, it's an idea that generally doesn't work - that's why politics is mainly compromise.
The Dems have to 1) get it past the conservative Dems first (which can be a huge task all in itself, God help us if we get another Liebermann) then 2) the GOP - who are even more difficult, and this is where the whole thing tends to fall apart usually. Obama was lucky to get the ACA passed as it was, and repeating that today would be greater challenge.
What's what makes it a "radical" notion, I would argue--I don't think it's radical, but I can certainly think of quite a few significant Democratic legislators who are sickened by the idea for a few different reasons. Across the general, non-member-of-congress population, it seems to poll well, but I'm always pessimistic on that.
There's a big difference between what is popular with the public and what will pass congress. That's why what your proposing isn't risky per se politically it's suicidal. there's a way things are done in politics and they can't be avoided if they want to pass a bill.
Having a few Dems on your side is good, what you need all of them plus some Republicans and they have to maker sure it's strong enough to not get vetoed by the Republican president. We barely got a watered down ACA with a Dem president.
How the public polls helps, but ultimately it's up to congress to vote - if they don't want that bill to be voted for or have enough votes to pass or if the pres voters the bill it dies. Then we're back to square one with absolutely nothing to show for it.
I'm still uncertain why you're assuming the Dems are in a better position to pass a more left leaning bill (on anything) compared to the situation with the ACA. If anything it's a million times harder in this political environment.
Other countries had for profit healthcare just like we did before they went UHC. It'll suck for some insurance companies and employees of those companies, but oh well, at least they'll have health care while they look for a job.
We don't have to get rid of private insurance entirely, those can still theoretically coexist with single payer.
England, at least, established theirs after WW2. I am gonna guess at least some of Europe did the same. It was probably a lot easier to establish sweeping changes at that point.
Canada's was established much later, in the late 60s/early 70s. In a similar parallel to the state-first method Pelosi suggested, it was proven in Saskatchewan first, fighting against doctor and insurance groups, then once proven to be A Very Good Thing, spread to the rest of the provinces shortly after. Insurance is mostly a provincial deal, even now.
So not all single payer systems in use now were established right after a nation went through a system shock, basically.
And it was done by one charismatic guy on a mission.
"it's too hard right now " is only true because you keep making it true.
Insert quote about thinking you'll win or thinking you'll lose blah blah here.
Nope. If it was that simple the Dems would have passed single payer etc into law when Obama was president.
This isn't a sports game where believing in yourself is going to make you score a touch down and win the game.
The GOP aren't suddenly going to come to their senses next week and allow anything the left wants to pass congress.
Our system is such a god damn spiderweb I don't see any way you get single payer without a massive and immediate shock to the market.
To be fair, I'm increasingly viewing the consequence of insurance executives becoming destitute as a feature, not a bug.
The consequences we care about start at middle management and go down from there. Also any impacts on the actual medical professionals providing care (and that's it's own mess we need to figure out - the cost of medical school is absurd in the US)
I'd think right now would be a great time for dems to build up the case for single payer. Since they're out of power, there's no risk associated with having to produce legislation, but they can still work on crafting the basics so that when they retake power, they can roll with it if it looks like the people are receptive. And if the people aren't receptive, no big. Work on smaller scale tweaks to the existing law.
Meanwhile, they can still work the message of "the pubs have terrible ideas that will literally kill you."
Basically, they should mimic the pubs during the last decade, except actually come up with viable alternatives.
Two things terrify me.
One is the Republicans in power now, who seem like they're more or less on track to make massive cuts to Medicaid. They want to wage a massive assault on the poor. It is a humanitarian disaster in the making. And it's not just a moral failing -- it's dangerous. Nations that neglect the poor tend to end up in very bad situations, historically speaking.
However.
@ElJeffe's suggestion, a single-payer healthcare system, scares me too. We ought to be extremely reluctant to go that far. For the United States, it's the nuclear option. It carries massive risk.
You all are correct that a single payer system would reduce costs. A single payer system would do so by fixing prices -- the government would have the ability to say how much it'll pay for a particular device or treatment, and that would be that. Sander said his Medicare-for-all plan would cut healthcare costs by $8 trillion over ten years, and that sounds great, right?
But what effect would that have on innovation? $8 trillion is a massive amount of money. It seems almost self-evident that of course we would see less innovation. You can't cut $8 trillion dollars from an industry and expect to see no effect. The magnitude of the effect seems to be a matter of considerable disagreement, however. But it could be massive. The development of life-saving (or simply life-enhancing, which ought to be considered too) treatments might be delayed by years or decades if we collectively decide to fix prices. And typically speaking, a stifling of innovation is precisely what happens when a monopoly takes over a market.
And then there are the political consequences. A single payer system is a massive, MASSIVE political risk. Look at Obamacare. Look at the massive backlash it caused. The worst midterm election for the Democrats in modern history, and the party still hasn't recovered from it. And that was just philosophical opposition! No one was actually, personally injured by Obamacare in 2010, and yet the reaction was huge and terrible.
When a real single-payer plan kicks people off the insurance plans they've been used to, they'll be mad. When things go wrong -- and they will go wrong -- they'll be mad. The backlash will almost certainly be worse. The legislation might be able to survive until the benefits fully kick in and people get used to the new system, but that to me seems highly unlikely. What will likely happen is another Republican president will get himself elected with another Republican congress, and we'll see the pendulum swing towards the same kind of irresponsible leadership we're watching right now.
There's a number of other criticism to be made, but I'll stop there. It's a scary move, and an ill-advised one. Every time it came up in the Democratic primary, I cringed. And besides, there are smaller, incremental steps you can take that are much better -- like expanding Medicaid. Give the poor the help they need, but leave the rest of us free to participate in the market as we see fit.
I don't think you're arguing from a position of knowledge considering your first fear is literally equivalent to the health insurance industry:
I wasn't aware of this until just now when I looked it up out of curiosity, and having criticized Sanders for bogus math before I figured that was a best case scenario. Now it seems conservative.
I don't think I understand what you're trying to say here, what was it that I said that was parasitic? What part of Sander's math was bogus?
Sorry if I wasn't coming across clearly, addled pretty fiercely on cold meds atm.
The health insurance industry itself is parasitic. They're middlemen that provide no added value to healthcare and make it more expensive by their profit driven nature. They only make sense if your starting assumption is that government can't provide healthcare, or for premium optional services.
Bernie's math was wrong, IIRC about prescription drug costs, at one point he was saying his policy would save us more money than we actually spend on them.
It's not really relevant here but what is is I just decided Bernie was an ideas man with a suboptimal grounding in actual math for his policy, so I never bothered to look into the claim that Medicare for all would save us $8 trillion before tonight.
If you follow that link, you'll see that the projected health insurance industry revenues from the last available year are about dead on for $8 trillion over 10 years, probably way more if you assume inflation will continue happening and premiums will consider rising.
So just by cutting the health insurance industry out of the equation you'd already be getting pretty close to hitting that $8 trillion in savings. You factor in savings from economies of scale, no more ridiculous executive salaries, and centralized points of service and I'd be willing to bet we'd save a lot more than $8 trillon over 10 years.
We wouldn't have to try and carve out savings because of how much waste there is currently. It's fucking ridiculous.
I mean, look at pretty much every other developed western nation. They all have variations on single payer or government-guaranteed health care for everyone, and they almost invariably perform better than the U.S. by any metric that is not just "what can rich people get?"
So pick one out of a hat, and it's going to be better than what we have here. The question is less the destination and more how to get there. And "how to get there" is 90% "how do we get it past a GOP who has "the ability to die in a gutter of easily treated ailments" as a fundamental right?
We're a big country, and we're a rich country, and we could find a way to absorb the shock of transition if we wanted to. The hard part is getting it past the portion of the country who will literally try to sabotage it out of spite. It's like going grocery shopping with someone who keeps setting fire to your cart.
They set fire to the cart because the left hasn't convinced them that the government ought to be trusted to take over the health insurance that they like.
This is what I don't get. I don't get why the left isn't content with going for something like "We should pay for the healthcare of those who cannot afford it."
Instead they have to keep saying things like "We should blow up the entire healthcare system. We should take away the health insurance that you like and replace it with one that the government runs. You know, the same government that takes 4 hours to get your driver's license renewed. That government."
And then you're surprised that more than half the country isn't on board with that plan.
I'm not on board with that plan.
It's the only plan that gets this done in congress.
Convincing the GOP of the error of their ways is a hell of a task under any circumstances, they outdo Dems in basically every format that counts.
Your last paragraph is why the Dems have to do this incrementally in the first place. It's not easy convincing millions of people and their representives that our ideas are worth voting for.
I'm with you on the "helping poor people who can't afford it" part.I'm with you on reforming parts of our system. I'm with you on expanding government-funded research. I support medicaid expansion. I support the public exchanges. I support health insurance subsidies. I am not with you taking away my health insurance plan and replacing it with one the government runs.
So is everyone else, the argument is how to get there. Unfortunately America hasn't got the luxury to do this on your terms or we'd be half way there by now.
Part of the reason that many people distrust the government (and the reason it takes 4 hours to get a drivers license) is that the Republicans have been actively working to cripple government, and people's perception of government, for literally decades. For probably longer than I have been alive they have been doing this. It was Ronald Reagan who said, "The nine most terrifying words in the English language are: 'I'm from the government and I'm here to help.'" That was (I think?) when he was running for President the first time in 1980, but it could have been something from when he ran for Governor of California.
There's a small program called Medicare that people seem to trust just fine. It even runs pretty efficiently.
It's entirely a fiction that people are unable or unwilling to trust goverment and it's stood up as some magic roadblock instead of saying "it's too hard and too scary so we'll take whatever scraps we can"
There's a small program called Medicare that people seem to trust just fine. It even runs pretty efficiently.
It's entirely a fiction that people are unable or unwilling to trust goverment and it's stood up as some magic roadblock instead of saying "it's too hard and too scary so we'll take whatever scraps we can"
Counterpoint: every time somebody yells for the government to stay out of their Medicare. Or when people complain about government involvement in healthcare while being treated at a VA hospital where they have had nothing but good experiences.
There's a small program called Medicare that people seem to trust just fine. It even runs pretty efficiently.
It's entirely a fiction that people are unable or unwilling to trust goverment and it's stood up as some magic roadblock instead of saying "it's too hard and too scary so we'll take whatever scraps we can"
"Keep your government hands off my Medicare."
Don't assume logic or consistency from voters.
The US has a very real perception problem about it's own government. It's not the same across demographics and such but it's skewed towards people who vote a lot traditionally.
There's a small program called Medicare that people seem to trust just fine. It even runs pretty efficiently.
It's entirely a fiction that people are unable or unwilling to trust goverment and it's stood up as some magic roadblock instead of saying "it's too hard and too scary so we'll take whatever scraps we can"
People love government programs because they experience the benefits from them directly and see how they work and generally the people who work for them want to help.
People hate quote unquote government because they have been told it is evil and wasteful by 40 years of politicians.
Shake it all up, put it in a blender, and you get this:
That is what we have to contend with.
edit: damnit i went for the visual aide and got m-m-m-mega ghosted.
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lonelyahavaCall me Ahava ~~She/Her~~Move to New ZealandRegistered Userregular
Honestly I think the best way to do it would be to just have universal preventative/wellness programs.
Like, routine doctors visits, generic drugs, eye exams, dental visits? All covered. Just fucking go, mang, go get your shit checked.
Which, frankly, shouldn't be insurance based. Insurance kicks in when a routine wellness check finds something. The wellness stuff itself should just be comp'd.
Why require insurance for the other things though, once you've socialized routine care? Insurance is a useless drain on the system that routinely drives up costs for everyone because they can.
because you have to start somewhere.
NZ recently changed our laws so that any preventative/routine care for children (under 13 i think) is free. Baby has a few days pf fever and vomiting? Go see the dr, it's free. she gets worse? go to the ER, it's free. needs some full on antibiotics? they're free. need to do a follow up appointment? that's free.
How much better would quality of life be for families in the states if they could take their kids to the dr and not worry about money? how many preventable illnesses could get caught and tended to before the worst happens?
it's possible to do these things, and more, in the us. just, nobody seems to care enough to do them.
I realize all that and that's what I am saying.
The ideas aren't the problem because they benefit people directly.
The problem is no one on either side is, nor wants to be, Tommy Douglas except maybe Sanders.
It's hard to solve a problem when the people who are designated to solve it don't have the courage to do it or even talk about it.
You can lament the underinformed voter forever but shit only changes when someone says they can change it.
Edit: all I am saying is that democrats shouldn't be waiting for Healthcare Moses to bring the single payer/universal healthcare tablets down to them. It's not going to be handed to them from the voters, someone's gotta lead.
I realize all that and that's what I am saying.
The ideas aren't the problem because they benefit people directly.
The problem is no one on either side is, nor wants to be, Tommy Douglas except maybe Sanders.
It's hard to solve a problem when the people who are designated to solve it don't have the courage to do it or even talk about it.
You can lament the underinformed voter forever but shit only changes when someone says they can change it.
No, it's the opposite of what you were saying. People can directly benefit from the government and still not trust it or have that benefit shape their views on government.
The ACA barely passed. That's where those quotes above come from. That's what you have to deal with.
I realize all that and that's what I am saying.
The ideas aren't the problem because they benefit people directly.
The problem is no one on either side is, nor wants to be, Tommy Douglas except maybe Sanders.
It's hard to solve a problem when the people who are designated to solve it don't have the courage to do it or even talk about it.
You can lament the underinformed voter forever but shit only changes when someone says they can change it.
This isn't going to solved by ignoring one of the biggest reasons the opposition retains power.
Dems gave trying what you've suggested for literally years, this won't be solved over night. It'll take lots of money, manpower, strategy, neutering the GOP inferstructure - like Fox News and right wing radio - and depend on many very old conservative dying off to have an effect and thus will take generations.
A big reason why things are hard to change is down to those voters, too. This is what they honestly want.
Other countries had for profit healthcare just like we did before they went UHC. It'll suck for some insurance companies and employees of those companies, but oh well, at least they'll have health care while they look for a job.
We don't have to get rid of private insurance entirely, those can still theoretically coexist with single payer.
England, at least, established theirs after WW2. I am gonna guess at least some of Europe did the same. It was probably a lot easier to establish sweeping changes at that point.
Canada's was established much later, in the late 60s/early 70s. In a similar parallel to the state-first method Pelosi suggested, it was proven in Saskatchewan first, fighting against doctor and insurance groups, then once proven to be A Very Good Thing, spread to the rest of the provinces shortly after. Insurance is mostly a provincial deal, even now.
So not all single payer systems in use now were established right after a nation went through a system shock, basically.
And it was done by one charismatic guy on a mission.
"it's too hard right now " is only true because you keep making it true.
Insert quote about thinking you'll win or thinking you'll lose blah blah here.
Nope. If it was that simple the Dems would have passed single payer etc into law when Obama was president.
This isn't a sports game where believing in yourself is going to make you score a touch down and win the game.
The GOP aren't suddenly going to come to their senses next week and allow anything the left wants to pass congress.
It was on the table when Obama was president. It was because of the Al Fraken-Ted Kennedy timeline and Lieberman's intransigence that we didn't get it.
Other countries had for profit healthcare just like we did before they went UHC. It'll suck for some insurance companies and employees of those companies, but oh well, at least they'll have health care while they look for a job.
We don't have to get rid of private insurance entirely, those can still theoretically coexist with single payer.
England, at least, established theirs after WW2. I am gonna guess at least some of Europe did the same. It was probably a lot easier to establish sweeping changes at that point.
Canada's was established much later, in the late 60s/early 70s. In a similar parallel to the state-first method Pelosi suggested, it was proven in Saskatchewan first, fighting against doctor and insurance groups, then once proven to be A Very Good Thing, spread to the rest of the provinces shortly after. Insurance is mostly a provincial deal, even now.
So not all single payer systems in use now were established right after a nation went through a system shock, basically.
And it was done by one charismatic guy on a mission.
"it's too hard right now " is only true because you keep making it true.
Insert quote about thinking you'll win or thinking you'll lose blah blah here.
Nope. If it was that simple the Dems would have passed single payer etc into law when Obama was president.
This isn't a sports game where believing in yourself is going to make you score a touch down and win the game.
The GOP aren't suddenly going to come to their senses next week and allow anything the left wants to pass congress.
It was on the table when Obama was president. It was because of the Al Fraken-Ted Kennedy timeline and Lieberman's intransigence that we didn't get it.
I can't recall Obama's position ever starting with the single payer in negotiating with the GOP. That's why they got disrupted by Code Pink protesters.
Dems gave trying what you've suggested for literally years, this won't be solved over night.
The Dems pushed Medicare for all for years? The whole point of that is you can use the populist appeal of cutting out the insurance companies to push down costs. When was this argument made to Americans?
I mean, look at pretty much every other developed western nation. They all have variations on single payer or government-guaranteed health care for everyone, and they almost invariably perform better than the U.S. by any metric that is not just "what can rich people get?"
So pick one out of a hat, and it's going to be better than what we have here. The question is less the destination and more how to get there. And "how to get there" is 90% "how do we get it past a GOP who has "the ability to die in a gutter of easily treated ailments" as a fundamental right?
We're a big country, and we're a rich country, and we could find a way to absorb the shock of transition if we wanted to. The hard part is getting it past the portion of the country who will literally try to sabotage it out of spite. It's like going grocery shopping with someone who keeps setting fire to your cart.
They set fire to the cart because the left hasn't convinced them that the government ought to be trusted to take over the health insurance that they like.
This is what I don't get. I don't get why the left isn't content with going for something like "We should pay for the healthcare of those who cannot afford it."
Instead they have to keep saying things like "We should blow up the entire healthcare system. We should take away the health insurance that you like and replace it with one that the government runs. You know, the same government that takes 4 hours to get your driver's license renewed. That government."
And then you're surprised that more than half the country isn't on board with that plan.
I'm not on board with that plan.
I'm with you on the "helping poor people who can't afford it" part. I'm with you on reforming parts of our system. I'm with you on expanding government-funded research. I support medicaid expansion. I support the public exchanges. I support health insurance subsidies. I am not with you taking away my health insurance plan and replacing it with one the government runs.
Because it's unclear whether anybody in the US will be able to afford healthcare in the near future:
Some of this has to do with the aging of the population - note healthcare expenditure increases in all OECD nations - but 17% of GDP IS A LOT, and there was no sign of that growth abating. If it was at least steady at ~17%, that'd still be one thing, but it hasn't been!
Some of it likely has to do with aging population, but the amount spent doesn't mean that people were necessarily using their health insurance more. With the steady rise in premiums since the late 90s, many people have been spending more on healthcare to use it the same amount or less than they used it before.
Honestly I think the best way to do it would be to just have universal preventative/wellness programs.
Like, routine doctors visits, generic drugs, eye exams, dental visits? All covered. Just fucking go, mang, go get your shit checked.
Which, frankly, shouldn't be insurance based. Insurance kicks in when a routine wellness check finds something. The wellness stuff itself should just be comp'd.
Why require insurance for the other things though, once you've socialized routine care? Insurance is a useless drain on the system that routinely drives up costs for everyone because they can.
because you have to start somewhere.
NZ recently changed our laws so that any preventative/routine care for children (under 13 i think) is free. Baby has a few days pf fever and vomiting? Go see the dr, it's free. she gets worse? go to the ER, it's free. needs some full on antibiotics? they're free. need to do a follow up appointment? that's free.
How much better would quality of life be for families in the states if they could take their kids to the dr and not worry about money? how many preventable illnesses could get caught and tended to before the worst happens?
it's possible to do these things, and more, in the us. just, nobody seems to care enough to do them.
Firstly, that's awesome, go New Zealand. Secondly, I've always thought that'd be a great place to start.
It's easy for Pubs to build a narrative around Joe Welfare being a leech on society for not getting a "proper" job and not deserving health care.
It's a little harder to justify that little Billy Welfare, and Suzie McOrphan also deserve to not have health care, simply because their parents are poor or nonexistent. Stuff they had no power to choose or change. (Note, I said harder, not impossible. There's some fucking monsters in Congress. However, "Voted against children" is a really easy ad campaign to sell.)
Offer free health care to kids under 13. If you get it through Congress, then changing the age at a later date will be a lot easier.
But what effect would that have on innovation? $8 trillion is a massive amount of money. It seems almost self-evident that of course we would see less innovation. You can't cut $8 trillion dollars from an industry and expect to see no effect.
Whilst this is true, it's worth considering which industries would be affected. For instance, at current levels of spending and current rates of growth of that spending (yes I know that's not a very safe extrapolation), the pharma industry will spend about $150b on advertising over the next 10 years. And that's direct advertising spend, not including "marketing" budgets to cover things such as all expenses paid "medical conferences" that happen to be in premium holiday resorts.
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I don't see why they couldn't create an interstate body to administer it. That'd actually be fucking fantastic because if it worked you just add more states to it and build off of it.
I don't think you're arguing from a position of knowledge considering your first fear is literally equivalent to the health insurance industry:
https://www.statista.com/statistics/214544/total-revenue-of-us-life-and-health-insurance-industry/
It's parasitic.
I wasn't aware of this until just now when I looked it up out of curiosity, and having criticized Sanders for bogus math before I figured that was a best case scenario. Now it seems conservative.
So pick one out of a hat, and it's going to be better than what we have here. The question is less the destination and more how to get there. And "how to get there" is 90% "how do we get it past a GOP who has "the ability to die in a gutter of easily treated ailments" as a fundamental right?
We're a big country, and we're a rich country, and we could find a way to absorb the shock of transition if we wanted to. The hard part is getting it past the portion of the country who will literally try to sabotage it out of spite. It's like going grocery shopping with someone who keeps setting fire to your cart.
Like, routine doctors visits, generic drugs, eye exams, dental visits? All covered. Just fucking go, mang, go get your shit checked.
Which, frankly, shouldn't be insurance based. Insurance kicks in when a routine wellness check finds something. The wellness stuff itself should just be comp'd.
(By being rich.)
Why require insurance for the other things though, once you've socialized routine care? Insurance is a useless drain on the system that routinely drives up costs for everyone because they can.
Big Pharma and government typically operate within two different spheres of medical research. To be really succinct about it, in the realm of pharmaceuticals, it's academic researchers that typically hunt for the potential active pharmaceutical agent, and Big Pharma then takes over to find a way to actually deliver that prospective drug effectively. Big Pharma's largely withdrawn from the discovery part of the pipeline in the past few decades - it's too financially risky - so most new medical advances nowadays* are initially from academic researchers, who then license the agent to a pharmaceutical company for the last mile.
That being said, Big Pharma has actually started getting back into the discovery part of the pipeline nowadays, because they've come to realise that there isn't anything for them to carry on the last mile if academic researchers don't keep discovering shit. So, ironically, they've started getting into funding public researchers themselves, selectively supporting their work as public research funding is cut by governments looking to trim deficits. They've also started releasing more of their data publicly - to researchers anyways - because they realised that they were sitting on all this data about possible pharmacologically active chemicals and keeping it private just in case it could one day be capitalized on, but meanwhile the public researchers their business models are dependent on were being starved of data and funding.
On the flip-side, public researchers don't really have the apparatuses that would be required to do the final leg themselves. It's a massive logistical task, starting with developing various chemical permutations of the potential pharmaceutical agent to find a derivation that remains active and is deliverable, to the incredible process of running clinical trials (and bearing the legal risks of said trials). Just shunting the money over isn't going to allow for the replication of the infrastructure, administrative and otherwise, required to perform all that.
* The thing is, actually, most new medical advances these days are non-pharmaceutical. If you look at, for example, CNN's top 10 medical breakthroughs of the past 10 years, c. 2013, only four are medications: HIV cocktails, birth control pills that suppress the female period, targeted cancer therapies, and the HPV vaccine. And two of those (HIV cocktails, HPV vaccine) were primarily government-driven discoveries, with cancer and AIDS research long being the domain of government researchers and doctors. The other six include the Human Genome Project, stem-cell research, laproscopic surgery, anti-smoking laws, and bionic limbs, which is fairly indicative of the fact that many major gains in health outcomes aren't driven by pharmaceutical research.
I don't disagree with you and I think ultimately it should be done but you can't trivialize the transition the United States would require. "Other countries" don't have state lines within them, all but two don't have 320 million citizens (17 million of which work in healthcare), and the developed nations with more socialized systems started their transition long before they had this level of size and complexity to their networks. Four of the top 10 largest pharmaceutical companies are US-based and I'm pretty sure all of them generate the bulk of their profits in the US.
I think it's a necessary undertaking but after seeing how disruptive ACA was it's clear universal care would be many times more so and that's a fact that shouldn't be underestimated
I think we're one of the wealthiest countries in the world. We can stop dumping trillions into our defense fund for a few weeks.
works for water usage in some areas.
I don't think I understand what you're trying to say here, what was it that I said that was parasitic? What part of Sander's math was bogus?
We can actually do both and still not approach other OECD countries' spending as a percentage of GDP.
The U.S. is incredibly rich, especially its incredibly rich. The U.S. Government Presented by Grover Norquist has done a wonderful job convincing its citizens otherwise.
We don't pour trillions into our defense fund in the span of weeks, btw. Not sure if you were just exaggerating for effect there. We spend about ~$600 billion per year on defense.
Cutting defense funding isn't enough to pay for any kind of single payer system.
It might be enough to pay for a nice Medicaid expansion, though.
GOP: *gasps, pops monocles and/or clutches pearls in unison*
They set fire to the cart because the left hasn't convinced them that the government ought to be trusted to take over the health insurance that they like.
This is what I don't get. I don't get why the left isn't content with going for something like "We should pay for the healthcare of those who cannot afford it."
Instead they have to keep saying things like "We should blow up the entire healthcare system. We should take away the health insurance that you like and replace it with one that the government runs. You know, the same government that takes 4 hours to get your driver's license renewed. That government."
And then you're surprised that more than half the country isn't on board with that plan.
I'm not on board with that plan.
I'm with you on the "helping poor people who can't afford it" part. I'm with you on reforming parts of our system. I'm with you on expanding government-funded research. I support medicaid expansion. I support the public exchanges. I support health insurance subsidies. I am not with you taking away my health insurance plan and replacing it with one the government runs.
Because it's unclear whether anybody in the US will be able to afford healthcare in the near future:
Some of this has to do with the aging of the population - note healthcare expenditure increases in all OECD nations - but 17% of GDP IS A LOT, and there was no sign of that growth abating. If it was at least steady at ~17%, that'd still be one thing, but it hasn't been!
To be fair, I'm increasingly viewing the consequence of insurance executives becoming destitute as a feature, not a bug.
There's a big difference between what is popular with the public and what will pass congress. That's why what your proposing isn't risky per se politically it's suicidal. there's a way things are done in politics and they can't be avoided if they want to pass a bill.
Having a few Dems on your side is good, what you need all of them plus some Republicans and they have to maker sure it's strong enough to not get vetoed by the Republican president. We barely got a watered down ACA with a Dem president.
How the public polls helps, but ultimately it's up to congress to vote - if they don't want that bill to be voted for or have enough votes to pass or if the pres voters the bill it dies. Then we're back to square one with absolutely nothing to show for it.
I'm still uncertain why you're assuming the Dems are in a better position to pass a more left leaning bill (on anything) compared to the situation with the ACA. If anything it's a million times harder in this political environment.
Nope. If it was that simple the Dems would have passed single payer etc into law when Obama was president.
This isn't a sports game where believing in yourself is going to make you score a touch down and win the game.
The GOP aren't suddenly going to come to their senses next week and allow anything the left wants to pass congress.
"The government is inefficient and terrible abloo bloo" shtick is old and Bullshit.
I DO trust the govt to do a better job at healthcare than private companies who have a vested interest in Fucking their customers.
Seriously your posts all carry some unfounded undercurrent of "goverment is bad!" which makes discussion impossible.
The consequences we care about start at middle management and go down from there. Also any impacts on the actual medical professionals providing care (and that's it's own mess we need to figure out - the cost of medical school is absurd in the US)
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Sorry if I wasn't coming across clearly, addled pretty fiercely on cold meds atm.
The health insurance industry itself is parasitic. They're middlemen that provide no added value to healthcare and make it more expensive by their profit driven nature. They only make sense if your starting assumption is that government can't provide healthcare, or for premium optional services.
Bernie's math was wrong, IIRC about prescription drug costs, at one point he was saying his policy would save us more money than we actually spend on them.
It's not really relevant here but what is is I just decided Bernie was an ideas man with a suboptimal grounding in actual math for his policy, so I never bothered to look into the claim that Medicare for all would save us $8 trillion before tonight.
If you follow that link, you'll see that the projected health insurance industry revenues from the last available year are about dead on for $8 trillion over 10 years, probably way more if you assume inflation will continue happening and premiums will consider rising.
So just by cutting the health insurance industry out of the equation you'd already be getting pretty close to hitting that $8 trillion in savings. You factor in savings from economies of scale, no more ridiculous executive salaries, and centralized points of service and I'd be willing to bet we'd save a lot more than $8 trillon over 10 years.
We wouldn't have to try and carve out savings because of how much waste there is currently. It's fucking ridiculous.
It's the only plan that gets this done in congress.
Convincing the GOP of the error of their ways is a hell of a task under any circumstances, they outdo Dems in basically every format that counts.
Your last paragraph is why the Dems have to do this incrementally in the first place. It's not easy convincing millions of people and their representives that our ideas are worth voting for.
So is everyone else, the argument is how to get there. Unfortunately America hasn't got the luxury to do this on your terms or we'd be half way there by now.
There's a small program called Medicare that people seem to trust just fine. It even runs pretty efficiently.
It's entirely a fiction that people are unable or unwilling to trust goverment and it's stood up as some magic roadblock instead of saying "it's too hard and too scary so we'll take whatever scraps we can"
Counterpoint: every time somebody yells for the government to stay out of their Medicare. Or when people complain about government involvement in healthcare while being treated at a VA hospital where they have had nothing but good experiences.
"Keep your government hands off my Medicare."
Don't assume logic or consistency from voters.
The US has a very real perception problem about it's own government. It's not the same across demographics and such but it's skewed towards people who vote a lot traditionally.
People love government programs because they experience the benefits from them directly and see how they work and generally the people who work for them want to help.
People hate quote unquote government because they have been told it is evil and wasteful by 40 years of politicians.
Shake it all up, put it in a blender, and you get this:
That is what we have to contend with.
edit: damnit i went for the visual aide and got m-m-m-mega ghosted.
because you have to start somewhere.
NZ recently changed our laws so that any preventative/routine care for children (under 13 i think) is free. Baby has a few days pf fever and vomiting? Go see the dr, it's free. she gets worse? go to the ER, it's free. needs some full on antibiotics? they're free. need to do a follow up appointment? that's free.
How much better would quality of life be for families in the states if they could take their kids to the dr and not worry about money? how many preventable illnesses could get caught and tended to before the worst happens?
it's possible to do these things, and more, in the us. just, nobody seems to care enough to do them.
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The ideas aren't the problem because they benefit people directly.
The problem is no one on either side is, nor wants to be, Tommy Douglas except maybe Sanders.
It's hard to solve a problem when the people who are designated to solve it don't have the courage to do it or even talk about it.
You can lament the underinformed voter forever but shit only changes when someone says they can change it.
Edit: all I am saying is that democrats shouldn't be waiting for Healthcare Moses to bring the single payer/universal healthcare tablets down to them. It's not going to be handed to them from the voters, someone's gotta lead.
No, it's the opposite of what you were saying. People can directly benefit from the government and still not trust it or have that benefit shape their views on government.
The ACA barely passed. That's where those quotes above come from. That's what you have to deal with.
This isn't going to solved by ignoring one of the biggest reasons the opposition retains power.
Dems gave trying what you've suggested for literally years, this won't be solved over night. It'll take lots of money, manpower, strategy, neutering the GOP inferstructure - like Fox News and right wing radio - and depend on many very old conservative dying off to have an effect and thus will take generations.
A big reason why things are hard to change is down to those voters, too. This is what they honestly want.
It was on the table when Obama was president. It was because of the Al Fraken-Ted Kennedy timeline and Lieberman's intransigence that we didn't get it.
I can't recall Obama's position ever starting with the single payer in negotiating with the GOP. That's why they got disrupted by Code Pink protesters.
The Dems pushed Medicare for all for years? The whole point of that is you can use the populist appeal of cutting out the insurance companies to push down costs. When was this argument made to Americans?
I might be confusing the terms between single payer and medicare for all?
Some of it likely has to do with aging population, but the amount spent doesn't mean that people were necessarily using their health insurance more. With the steady rise in premiums since the late 90s, many people have been spending more on healthcare to use it the same amount or less than they used it before.
Firstly, that's awesome, go New Zealand. Secondly, I've always thought that'd be a great place to start.
It's easy for Pubs to build a narrative around Joe Welfare being a leech on society for not getting a "proper" job and not deserving health care.
It's a little harder to justify that little Billy Welfare, and Suzie McOrphan also deserve to not have health care, simply because their parents are poor or nonexistent. Stuff they had no power to choose or change. (Note, I said harder, not impossible. There's some fucking monsters in Congress. However, "Voted against children" is a really easy ad campaign to sell.)
Offer free health care to kids under 13. If you get it through Congress, then changing the age at a later date will be a lot easier.
Whilst this is true, it's worth considering which industries would be affected. For instance, at current levels of spending and current rates of growth of that spending (yes I know that's not a very safe extrapolation), the pharma industry will spend about $150b on advertising over the next 10 years. And that's direct advertising spend, not including "marketing" budgets to cover things such as all expenses paid "medical conferences" that happen to be in premium holiday resorts.