ChrisWeigant.com

Democrats Should Bring Back The Public Option

[ Posted Wednesday, June 28th, 2017 – 17:17 UTC ]

Up until now, congressional Democrats have been smart to merely stand on the sidelines and watch Republicans flail on their "repeal and replace Obamacare" efforts. This follows the sound political theory of: "When your opponent is digging his own grave, don't interrupt him." But at some point in the near future, Democrats are going to have to offer up their own better ideas for what to do next on healthcare. There are already many pushing for single-payer or (as Bernie Sanders likes to call it) "Medicare for all." This, however, is quite likely a bridge too far -- even within the Democratic Party. Instead of such a radical change, Democrats would do much better to rally around a more transitional idea that was jettisoned during the drafting of the Obamacare law: the public option.

The biggest political selling point about this is that a public option would be just that -- optional. Call it "Medicare for all, if that's what you want," perhaps. Or rebrand it entirely as something like "Medichoice," to take its place alongside Medicare and Medicaid. By doing so, Democrats could avoid a tsunami of Republican negative ads which screamed: "Washington bureaucrats are going to force you into their plan!" But unlike universal single-payer, Medichoice might actually have a prayer of garnering Republican votes and passing this Congress.

If the Senate Republican bill fails (which is by no means assured, even at this point), then Mitch McConnell has already expressed an interest in working with Democrats to fix some of the worst problems with Obamacare, because McConnell knows that if the system collapses at this point, Republicans will be held accountable for letting it happen. Fixing Obamacare mostly means addressing the problems with the individual market exchanges (a relatively small part of Obamacare, but also the most publicly visible). This could probably be quickly accomplished with a good-faith effort by both parties, and it may indeed be all that happens to Obamacare for the next two years. But Democrats should at least make the attempt at something more ambitious in these negotiations. Even if they fail, they will at least have created a campaign platform for the 2018 midterm elections -- a positive message of change instead of just "we're not as bad as those evil Republicans."

Many Democrats -- including, now, Elizabeth Warren -- are convinced that this next step should be a push for single-payer. But while they're right that this should be the ultimate goal, to push too hard for it now only sets Democrats up for another round of massive disappointment. In the first place, to get anything passed now would require not just a unified Democratic Party, but also peeling off a significant amount of Republican votes in both the House and Senate. Does anyone expect any single-payer plan to clear this very high bar in the next year and a half? I don't.

Regular readers of mine know that I am not generally a big fan of incrementalism. I regularly take Democrats to task for being too timid and for not thinking big enough (including, most prominently, Hillary Clinton). But with the congressional math Democrats currently face, at this point it seems like the best that could even be reasonably hoped for. So while I would support an eventual move to single-payer, I just don't now see it as a realistic possibility, unless Democrats have a spectacular midterm election and regain control of both houses of Congress. Until that comes to pass, though, I think the public option is what Democrats should focus on.

The recent history of single-payer efforts at the state level bears this out. At least two states have attempted to move to this liberal Utopia of healthcare for all. They both failed, when confronted with the cost. Politically, single-payer couldn't even get enough support in deep-blue Vermont and California, so it's hard to see the entire country getting behind the idea at this point.

The political problem isn't so much the cost as it is the disruption to the system. This disruption wouldn't just impact the insurance companies and healthcare providers, it would also radically change everyone's paychecks. Even if your take-home pay turned out to be exactly the same as before, how it got to that figure would be very different. Change scares people, to state the obvious, and it's clear that not everyone's take-home pay would be exactly the same. There would be winners and losers, most likely. It would be incredibly disruptive to everyone's paycheck, even if you turned out to be one of the winners.

Another political problem is the sheer size of the numbers involved. Take the case of California. This year, the state senate passed a single-payer bill. The only problem? It didn't address the funding for the program at all. They were trying to punt that thorny problem to the state assembly (which, in response, just refused to deal with the bill). Single-payer care in California would cover everyone, at a projected total cost of $400 billion per year. Of that, something like $200 billion would be from federal funds, and the rest would have to be made up with a new income tax. This tax would replace all the money now paid by both employers and employees for health insurance. An academic study found that doing so -- even while insuring all the currently-uninsured people in the state -- would successfully save California something like $37 billion each year. Even so, that $400 billion number is huge. By comparison, California's entire state budget (including federal aid) is currently only $250 billion a year.

What true single-payer systems lack is choice. Absent that choice, everyone is forced into the new system. But American voters aren't crazy about being forced into much of anything. The liberal dreamers insist that since the new system will be so much better, everyone just needs to bite the bullet, adapt to the change, and happiness will then ensue for all. But such technocratic "we know what's best for you, trust us" thinking is not exactly a proven winner at the ballot box. This reason alone is why the better route for Democrats to take would be a public option, or Medichoice -- in other words, "we think it's better, but the choice is totally up to you." This is a much easier political message to sell, for obvious reasons.

Which is why more attention should have been paid to what recently happened in Nevada, rather than to California and the other states attempting true single-payer. Because Nevada attempted to create a "Medicaid-for-all" system, which is just another way of saying "a public option." It passed the statehouse, but the governor vetoed it, mostly due to lack of specifics (the entire bill was reportedly only four pages long). But what was proposed is exactly what Democrats should consider proposing nationwide.

The Republicans have been complaining about Obamacare since before it was even written. Most of their criticisms were wildly inaccurate, designed merely as scary stories to frighten the public (see: death panels, Sarah Palin). But since Obamacare has become law, they have had to refocus their complaints on the reality of Obamacare. In the healthcare debate this year, their complaints have focused on three flaws with the exchanges: rising premiums, lack of choice in certain counties and states, and large deductibles.

Introducing a public option would seem to address all of these problems. It would provide a choice for everyone in every county. It would stabilize the premiums and deductibles by giving the private insurance companies a baseline to shoot for. It would guarantee that Republicans couldn't complain that there were "zero" choices on the exchanges in certain parts of the country.

Of course, the insurance companies would howl, but they had their chance -- and in the places that currently only have one or zero choices, the private marketplace has obviously failed to deliver. Perhaps the system could be phased in, initially only covering markets with fewer than three insurers on the exchanges. But eventually, everyone in the country should get the same choice -- buy private health insurance in some fashion (through employer-provided insurance or through the exchanges), or sign up for the public option instead.

The Nevada legislators obviously weren't completely serious about their new idea. Four pages? That's not much detail. Studies would have to be done to figure out how many people would choose a public option if offered, what such a public option would actually cover, and what all the expected costs would be (premiums, deductibles, and other out-of-pocket costs for consumers; as well as the government's costs to run the system). But at least Nevada moved the debate forward in a significant way. They have shown there may be a possible compromise to be struck between those demanding single-payer health systems and those who just want to fix the worst problems of the Obamacare system already in place.

Over time, if enough people migrated to the public option, either through choice on the exchanges or through employers deciding to sign their workers up for the idea, then the American insurance market would have to change to adapt. It would move towards a system already in use in several European countries (France or Ireland, for instance), where basic health insurance is provided on a single-payer basis, but private insurance also exists for a whole range of extras -- lower out-of-pocket costs, better hospital rooms (private instead of shared), and other enticements. American insurance companies would turn to concentrating on selling such extras, and the public option could begin to morph into a basic guarantee of health insurance for all (a real universal single-payer system instead of an optional one).

Because health insurance is such a contentious issue, this would seem to be the better path forward. Defining it as Medichoice rather than single-payer would be a lot more appealing to a lot more people, perhaps on both sides of the political divide. It would only be an incremental step forward, not the giant leap towards single-payer some now wish to see, but it would be a lot more possible politically. A few Blue Dog Democrats killed the possibility of the public option in Obamacare (Max Baucus and Joe Lieberman, to name the two most prominent), but it now seems like an idea whose time has come. The national Democratic Party should closely examine what Nevada just tried to do, and then dive deep into the details to see how plausible such a system could be, nationwide. Then when the time is ripe (when either the Republican plan dies in the Senate or passes and begins throwing people off their insurance by the tens of millions), Democrats would have a solid plan ready on a better way to move forward. For now, it's fine that they're content to sit back and watch Republicans shoot themselves in the foot, but at some point in the very near future, Democrats are going to need to be ready and willing to offer a way forward that actually solves problems with the healthcare system by making it better for more people, rather than (as with the GOP plan) making all the problems much worse.

-- Chris Weigant

 

Cross-posted at The Huffington Post

Follow Chris on Twitter: @ChrisWeigant

 

93 Comments on “Democrats Should Bring Back The Public Option”

  1. [1] 
    John M from Ct. wrote:

    I like your concluding point that the Democrats have a responsibility to have a plan ready for when they (if ever) have the political power in D.C. again.

    The weirdest and most frightening thing about the entire healthcare debacle this year is that the Republicans, over six years, obviously had never prepared an actual proposal to 'repeal and replace' Obamacare.

    Leaving aside the snarky comments about why that was, it should be a lesson to the Dems at the very least. Can they avoid the same trap of simply harping at the opposition (it's all Trump's fault; it's all the GOP's fault, etc.), and recover their claim to be a party that actually knows how to make and execute public policy on a national scale?

  2. [2] 
    neilm wrote:

    The Democrats should put together a bill then get an independent organization to replicate the CBO's scoring and show the two side-by-side

    It doesn't matter then whether 45care passes or not, the graphic will be dynamite in the 2018 elections (provided Democratic voters can be bothered to go to the polls).

  3. [3] 
    neilm wrote:

    I think 4-5 high profile "gavel ready" bills that are scored in a similar fashion to the CBO's scoring with simple infographics should be easy enough to gin up:

    1. Medichoice vs. 45care
    2. Cheap Clean Energy vs. Dirty Energy
    3. Addiction Relief vs. Build the Wall
    4. An Infrastructure Bill vs. Infrastructure Privatization
    5. Student Loan Forgiveness vs. Billionaire's Tax Relief

    The title of the campaign should be "What is Better for Americans Like You?"

  4. [4] 
    Don Harris wrote:

    Good point that Americans want choice. That was my problem with Obamacare that I didn't have the choice of the public option. I am just as opposed to being forced to buy insurance from an insurance company as many citizens are opposed to to being forced into buying it from the government.
    But what happens to all citizens that get employer based insurance? Do they get to choose for themselves or does their employer choose for them?

  5. [5] 
    Don Harris wrote:

    Neilm (3)-
    A pointless campaign that we have seen before and has lead us to where we are.
    But a great question.
    If you want to make the campaign more than just the same old political rhetoric then it must start with the one issue that effects all other issues, the issue that must be solved before any meaningful progress on other issues can be achieved-
    1. Small contribution candidates vs. BIG MONEY candidates.

  6. [6] 
    Don Harris wrote:

    CW-
    It will not be allowed to happen.
    see comment 5.
    If you want it to happen then you will have to finally inform citizens about One Demand. It is ready for citizens to sign up for 2018.
    When will you be ready and why aren't you ready if you're not ready yet?

  7. [7] 
    Elizabeth Miller wrote:

    John M from Ct.,

    I like your concluding point that the Democrats have a responsibility to have a plan ready for when they (if ever) have the political power in D.C. again.

    But, this is precisely the problem!

    I mean, WHY WAIT for something that may never happen on its own!? Ahem.

    I'm with former speaker Boehner on this one. Republicans are never going to pass healthcare legislation. The reasons are simple. In particular, they are split ideologically on what the government's role should be in delivering adequate healthcare to all Americans. So, do too much in one direction or too much in the other and you lose support from one group or another.

    Of course, this provides the Democrats - and especially Barack Obama- with an excellent opportunity to do something they have been loath to do since Obamacare went into effect. And, that is champion what's good about it, lead the way to fixing what's bad about it, and make it crystal clear to everyone that it is just one step on the pathway toward a single-payer government-run and taxpayer funded healthcare system ... the only effective way to lower costs and provide excellence in healthcare for all Americans.

    In other words, if Democrats want to have power in Washington again, then this is their ticket to ride. But, they had better start acting now - and, by now I mean YESTERDAY! - if they hope to retain any credibility on this issue or any other.

    America has an opportunity to devise and implement the greatest single-payer/government-run, taxpayer-funded healthcare system that the industrialized world has ever known!

    Next up, Chris's piece - I'm intrigued by "the public option" ... and whether this represents one more step on the road to single-payer ... ??

  8. [8] 
    Elizabeth Miller wrote:

    By the way,

    Don keeps making great points about where US politics needs to go but, they don't seem to get much traction here, of all places!!??

    I'd like to understand why that is ...

  9. [9] 
    Elizabeth Miller wrote:

    The US healthcare system is in desperate need of radical change.

    Are Democrats up to the grand task of advocating for that change through a persistent information campaign aimed at persuading voters of all stripes that single payer is the best option for all concerned? Can they get states on board as test cases? Can they do anything!!??

  10. [10] 
    Bclancy wrote:

    Chris
    I think you make a very good point about a public option vs single payer. Good article. Hopefully the Democratic leadership will agree it's time to make some kind of positive case on this issue. I worry that they are complacent enough to believe that all they need to do is criticize Trump to win.

  11. [11] 
    ListenWhenYouHear wrote:

    CW,

    Great article! When you have a large segment of the public who do not know that the ACA and ObamaCare are the same piece of legislation, it becomes clear just how good the GOP has gotten at misleading their supporters.

    Sadly, the other issue that will keep us from having universal coverage is that conservative ideology has conditioned the masses to only be concerned with preventing people who refuse to work and choose to mooch off of the government (Read: non-whites) from getting even a single of their tax dollars; ignoring what costs they, themselves, will have to pay in order to make sure these mythical free loaders do not "win".

    They will oppose any legislation that they believe would allow even a single "welfare queen/king" to take advantage of the system, even if by preventing that single person they also cause 200,000 people who DO have jobs to lose their healthcare coverage... They will feel the cost is justified. It is so ingrained into their political mindset that I am not sure they could ever support any healthcare system that is supposed to help ALL Americans.

    "If you can convince the lowest white man he's better than the best colored man, he won't notice you're picking his pocket. Hell, give him somebody to look down on, and he'll empty his pockets for you." -- LBJ

  12. [12] 
    michale wrote:

    Democrats are going to have to offer up their own better ideas for what to do next on healthcare.

    They already gave us their "better" idea....

    And TrainWreckCare sucks.

    Do you HONESTLY think the American people are going to be fooled TWICE by Democrats??

    The recent history of single-payer efforts at the state level bears this out. At least two states have attempted to move to this liberal Utopia of healthcare for all. They both failed, when confronted with the cost. Politically, single-payer couldn't even get enough support in deep-blue Vermont and California, so it's hard to see the entire country getting behind the idea at this point.

    Yep, yep.. Just as I predicted.. :D

    It would stabilize the premiums and deductibles by giving the private insurance companies a baseline to shoot for.

    It would stabilize at what level??

    THAT's the question ya'all ignore...

    The problem with "fixing" Obamacare is the problem that Liz alluded to in the previous commentary...

    To "FIX" Obamacare, Democrats first have to admit that it's broken..

    But they can't do that because Party loyalty won't let them..

  13. [13] 
    michale wrote:

    Liz,

    Don keeps making great points about where US politics needs to go but, they don't seem to get much traction here, of all places!!??

    I'd like to understand why that is ...

    It's simple.. At one point in time, Don rose to my defense over some such point or issue and was mercilessly and ruthlessly attacked by several Weigantians..

    Every since that time, he has had a hard time gaining traction here..

    Which is a shame because he definitely has some good ideas...

  14. [14] 
    michale wrote:

    JMCT,

    I like your concluding point that the Democrats have a responsibility to have a plan ready for when they (if ever) have the political power in D.C. again.

    I like the way you think.. :D

    The weirdest and most frightening thing about the entire healthcare debacle this year is that the Republicans, over six years, obviously had never prepared an actual proposal to 'repeal and replace' Obamacare.

    That's not factually accurate..

  15. [15] 
    michale wrote:

    Neil,

    It doesn't matter then whether 45care passes or not, the graphic will be dynamite in the 2018 elections (provided Democratic voters can be bothered to go to the polls).

    Wow.. First JMCT and now you..

    Looks like reality is finally sinking in here in Weigantia.. :D

  16. [16] 
    michale wrote:

    Liz,

    In other words, if Democrats want to have power in Washington again, then this is their ticket to ride. But, they had better start acting now - and, by now I mean YESTERDAY! - if they hope to retain any credibility on this issue or any other.

    The problem with Democrats is that they think that all they need is a HATE TRUMP campaign to win..

    No matter HOW MANY TIMES it's proven to be a losing campaign, THAT is all that the Democrat Party has..

  17. [17] 
    ListenWhenYouHear wrote:

    Liz [7]

    I had not read you post when I posted the above, but you are correct that Republicans cannot offer any legislation that benefits those that don't deserve to be helped in the minds of their supporters. They will work to prevent a single moocher from taking advantage of "the system", even if it costs them more to do so!

    Granted, they may not personally know anyone who refuses to get a job in favor of letting welfare pay all of their bills, but they have heard stories of such evil creatures and know in their hearts that they must exist. They also tend to believe that welfare checks are generous enough to allow people to live the "good life" without the need for any other source of income. These mythical free-loading parasites are possibly the most powerful tool in the GOP's propaganda arsenal.

  18. [18] 
    michale wrote:

    Neil,

    I think 4-5 high profile "gavel ready" bills that are scored in a similar fashion to the CBO's scoring with simple infographics should be easy enough to gin up:

    Would you include all the cock-ups that the CBO has committed??? :D

    https://www.forbes.com/sites/theapothecary/2017/06/27/cbo-predictions-about-the-senate-health-care-bill-are-deeply-flawed/#3ffc3eda79d4

    Let's face reality.. Ya are only touting the CBO because it fits in with your anti-Trump agenda..

  19. [19] 
    Elizabeth Miller wrote:

    Russ,

    Just to be clear, post #7 was not about welfare but, great societies are not made greater by taking away safety nets.

    What Republicans don't understand about healthcare insurance, though, is quite a lot, apparently ...

  20. [20] 
    michale wrote:

    What Republicans don't understand about healthcare insurance, though, is quite a lot, apparently ...

    From the facts no more than the Democrats don't understand..

    Apparently.. :D

  21. [21] 
    michale wrote:

    B,

    I worry that they are complacent enough to believe that all they need to do is criticize Trump to win.

    Given the facts and reality, that worry is well-founded...

  22. [22] 
    michale wrote:

    Just to be clear, post #7 was not about welfare but, great societies are not made greater by taking away safety nets.

    I would, conditionally, disagree with that conclusion...

  23. [23] 
    michale wrote:

    "Nobody likes a helicopter parent."
    -Chuck AKA god, SUPERNATURAL

    :D

  24. [24] 
    Elizabeth Miller wrote:

    On what condition, Michale, would you disagree with me?

  25. [25] 
    Don Harris wrote:

    Liz (8)- Michale (13)-
    Thank you. (Hope you're mot just saying that because it's my birthday.)
    But I do think it goes deeper than just that I agreed with Michale (icing on the cake for many here).
    After all, it doesn't seem to gain much traction anywhere.
    I have noticed with many people that they don't want a solution that forces them to change what they are doing that leads to bad results. They want a solution that lets them keep doing what they are doing and get different results.
    And both CMPs are willing to exploit this contradiction.

  26. [26] 
    michale wrote:

    On what condition, Michale, would you disagree with me?

    When the safety net becomes an end instead of a means to an end..

  27. [27] 
    michale wrote:

    Welfare is supposed to be an emergency stop-gap measure, not a way of life...

    I read an article in Georgia (I think) where food stamps membership fell 98% when the state re-imposed work requirements...

    The training wheels have to come off sometime..

  28. [28] 
    michale wrote:

    Don,

    Thank you. (Hope you're mot just saying that because it's my birthday.)

    Of course i was!! Hehehehe J/K Happy B-Day... The big nine oh, eh? heh

    But I do think it goes deeper than just that I agreed with Michale (icing on the cake for many here).

    Perhaps.. But one of your detractors came right out and said it..

    "Around here, you're not helping your case by coming to the defense of Michale"

    ... or words to that effect... :D

    Your ideas upset the status quo... And THAT's why it's hard to find traction..

  29. [29] 
    nypoet22 wrote:

    The real trouble with the public option is that in most cases it is significantly better and cheaper than any private option, which would inevitably lead to it being the only option. Insurance companies can do math, and they know that a public choice will mean the end of their oligopoly. Thus they will fight it tooth and nail.

  30. [30] 
    Bclancy wrote:

    Michale
    "They already gave us their "better" idea....

    And TrainWreckCare sucks."

    One factor in a person's determination of whether a system, policy, or law "sucks" is that person's values. What does that person think the end goal of the US's policy on healthcare should be? Should it be as many people insured as possible? Should it be the greatest possible number of people having access to healthcare(which could be the same thing, but isn't necessarily)? The lowest burden on taxpayers? The lowest amount of regulation? Should the ideal be that only people whose work the market values enough (in terms of what they get paid) that they can afford medical costs on their own dime should have access to healthcare?

    I think most people have a combination of values with some taking priority over others. I am curious what your values are. If our values(or how we prioritize) are different, then it is only natural that our assessment of the ACA(or Republican healthcare bill) will be different. And I think that, because nobody to my knowledge has solved Hume's is/ought problem(logically deriving values from facts), what we value is to some extent, subjective. Meaning any differences we have in values may not be completely resolvable(empirically and logically, I mean). But I am curious what you think a good healthcare policy should do. Not the means by which it tries to accomplish those ends I'm just asking about the ends themselves.
    -B

  31. [31] 
    michale wrote:

    JL,

    The real trouble with the public option is that in most cases it is significantly better and cheaper than any private option,

    Assumes facts not in evidence...

  32. [32] 
    michale wrote:

    B,

    I am curious what your values are.

    I am a simple knuckle dragging ground-pounder...

    I believe if a law is called the *AFFORDABLE* Care Act, it should be... yunno... AFFORDABLE... :D

  33. [33] 
    michale wrote:

    I also believe that health care laws should be governed by common sense and in keeping with American freedoms..

    That means don't force men to purchase maternity or gynecological insurance...

    That means don't force people to buy something they don't want or need...

    "Being an asshole and treating other people like dirt is every New Yorker's god given right!!"
    Mayor Lenny, GHOSTBUSTERS 2

    :D

  34. [34] 
    michale wrote:

    Further, if you have to blatantly LIE to the American people to pass a healthcare bill....

    Then the healthcare bill is likely NOT in the bests interests of those same American people...

  35. [35] 
    nypoet22 wrote:

    Assumes facts not in evidence...

    There's plenty of evidence. Many countries have public coverage. every single one has lower costs and less waste than ours, and most allow anyone who is not satisfied to supplement public coverage with private.

  36. [36] 
    Bclancy wrote:

    Then I think our values aren't so different. Like most people, I have a combination of values, but the primary one is a system where the most people have access to healthcare.

  37. [37] 
    nypoet22 wrote:

    That means don't force men to purchase maternity or gynecological insurance...
    This is a dumb argument.
    Men have other risks and costs that women don't. Should women have to pay for plans that cover prostate exams? Should they pay to cover men's higher risk of heart disease?

  38. [38] 
    michale wrote:

    This is a dumb argument.

    Is it??? Forcing men to pay for pregnancy coverage???

    THAT is dumb...

    Many countries have public coverage. every single one has lower costs and less waste than ours, and most allow anyone who is not satisfied to supplement public coverage with private.

    But is it BETTER care???

    I can cite factual report after factual report after factual report that shows it's not BETTER care...

    Your claim was that, not only is it significantly LOWER, it's also significantly BETTER...

    There are no facts to support that...

  39. [39] 
    michale wrote:

    Then I think our values aren't so different. Like most people, I have a combination of values, but the primary one is a system where the most people have access to healthcare.

    What good is access to healthcare if you can't afford it??

    I know of MANY people who have such high deductibles that they can't afford to go to the doctor.. They say they might as well not even HAVE healthcare..

    EVERYONE has "access" to healthcare... It's called the emergency room... :D

    The key is to making the healthcare affordable... Once it is, access takes care of itself..

  40. [40] 
    nypoet22 wrote:

    If insurance becomes gender segregated, men would likely end up paying substantially more than women. Especially after age 40.

  41. [41] 
    michale wrote:

    Men have other risks and costs that women don't. Should women have to pay for plans that cover prostate exams?

    I dunno... Do women have prostates?? The only female anatomy classes I ever had were.....

    well, let's just skip that for now... :D

    If women don't have prostates, then it's ridiculous to have women pay for that...

    Don't you agree???

  42. [42] 
    michale wrote:

    If insurance becomes gender segregated, men would likely end up paying substantially more than women. Especially after age 40.

    Then so be it...

    "That's the way the cookie crumbles"
    -Jim Carrey, BRUCE ALMIGHTY

  43. [43] 
    nypoet22 wrote:

    Your claim was that, not only is it significantly LOWER, it's also significantly BETTER...

    Cheaper is a fact, better is an opinion. Better for whom, is part of that equation. Perhaps not better for those who are wealthy enough to afford top level care.

  44. [44] 
    nypoet22 wrote:

    Certainly better for those who get sick and can't afford high premiums.

  45. [45] 
    michale wrote:

    Cheaper is a fact, better is an opinion.

    So, to be clear.. You are talking a better PRICE, not better care..

  46. [46] 
    nypoet22 wrote:

    i'm talking about better price, better coverage, better value of care for the cost. i will concede that our high prices tend to attract the most talented physicians and the newest technology, so those who can afford it are able to buy the best. however, anyone for whom cost is an issue loses out in our system. that's factually well supported by data from various health NGO's.

    JL

  47. [47] 
    michale wrote:

    however, anyone for whom cost is an issue loses out in our system. that's factually well supported by data from various health NGO's.

    Exactly..

    So, if our politicians REALLY want to help the American people, then make healthcare affordable..

  48. [48] 
    nypoet22 wrote:

    So, if our politicians REALLY want to help the American people, then make healthcare affordable..

    which brings us back to my original point: health coverage gets you the most for your money when it is managed by government instead of the free market. companies will do anything to prevent a public option because they know they couldn't hope to compete.

    JL

  49. [49] 
    michale wrote:

    which brings us back to my original point: health coverage gets you the most for your money when it is managed by government instead of the free market.

    Yea??? Let's ask those who regularly use the VA???

    Then there was the Forbes report that showed that Medicaid is WORSE than having no insurance...

    Like I said.. Democrats have GREAT theories...

    But, as we saw in California, when reality rears it's ugly head???

  50. [50] 
    michale wrote:

    You will simply NEVER convince me that the Government can run a successful health care program...

    Because there are just too many facts against it...

  51. [51] 
    nypoet22 wrote:

    obamacare actually did make health coverage somewhat better for many people by limiting the ability of insurers to engage in various sharp business practices. the exchanges are having trouble because the law didn't address the underlying issue of price gouging by providers of medical goods and services.

    neither of the republican bills goes anywhere near that root problem either. read the bills, not a peep about cost controls at the point of service. they just undo the patient protections, impose additional austerity measures on the most vulnerable, and hand a huge windfall to the wealthy. is it any wonder that obamacare is suddenly popular?

    JL

  52. [52] 
    michale wrote:

    It's just like when ya'all claimed that Seattle raising the min wage to $15 would be GREAT for low-paid workers...

    We now come to find out that those workers are making over one hundred dollars LESS per months...

    Democrats... Great in theory... Lousy in reality....

  53. [53] 
    nypoet22 wrote:

    You will simply NEVER convince me that the Government can run a successful health care program...

    MANY governments already do.

    Because there are just too many facts against it...

    i'm not aware of ANY facts that prove our government incapable of administering healthcare. medicare and medicaid have both been fairly successful by most measures. yet again, the problems they encounter are mainly due to the fee for service model, which encourages doctors and pharmacies to gouge patients (and their insurers) for unnecessary procedures.

    JL

  54. [54] 
    michale wrote:

    MANY governments already do.

    "Many" governments are not the US government..

    i'm not aware of ANY facts that prove our government incapable of administering healthcare.

    That's because you ignore the facts.. I brought up the VA...

    I brought up the fact that not having insurance is better than having medicaid...

  55. [55] 
    michale wrote:

    MANY governments already do

    The old Soviet Union was able to do a GREAT government health care plan...

    Not so sure it would be good for the US though... :^/

  56. [56] 
    michale wrote:

    “Take, for example, the state of Kentucky. Almost one-third of those people in that state are covered by Medicaid, and so they’re talking about eliminating 700 billion in, uh, Trumpcare bill.”
    -Maxine Waters

    Yea.. Glad the Democrats aren't resorting to hysterical fear mongering.. :^/

  57. [57] 
    LeaningBlue wrote:

    [68]
    The ... four corners of the EO.
    ...
    AND Constitutionality...

    I think, in this context, those are synonymous. The lawyers are more flowery.

    [69]
    adjective which both press and president so dearly love [... which]
    the Left would have dearly loved

    I think, in this context, those are synonymous. The alliteration is more flowery my way.

  58. [58] 
    michale wrote:

    LB,

    Just wanted to confirm we're on the same page.. :D

  59. [59] 
    LeaningBlue wrote:

    Oh, good lord.
    I did it again. Comment [57] pertains to the Mishmash thread.

  60. [60] 
    michale wrote:

    I think, in this context, those are synonymous. The lawyers are more flowery.

    I would have a different term for lawyers, but I bow to your superior compassion.. :D

  61. [61] 
    michale wrote:

    Oh, good lord.
    I did it again. Comment [57] pertains to the Mishmash thread.

    Yea... Been there...

    "I woke up this morning with a hangover and a swore wrist."
    "Heh. Been there."

    -SPIN CITY

    :D

  62. [62] 
    nypoet22 wrote:

    Not so sure it would be good for the US though... :^/

    it's good for most of the 36 countries ranked above us by the world health organization for overall efficiency of care. and even for those like singapore who do not have socialized care, there's still a safety net with public options for people who can't afford top level care. here's the list of countries who have more efficient healthcare systems than us:

    France
    Italy
    San Marino
    Andorra
    Malta
    Singapore
    Spain
    Oman
    Austria
    Japan
    Norway
    Portugal
    Monaco
    Greece
    Iceland
    Luxembourg
    Netherlands
    United Kingdom
    Ireland
    Switzerland
    Belgium
    Colombia
    Sweden
    Cyprus
    Germany
    Saudi Arabia
    United Arab Emirates
    Israel
    Morocco
    Canada
    Finland
    Australia
    Chile
    Denmark
    Dominica
    Costa Rica

    good news though, with obamacare we've leapfrogged cuba and slovenia into 37th place! go USA!

    JL

  63. [63] 
    michale wrote:

    VA...

    Medicaid is WORSE for health care than no insurance..

    Until you can address those facts, you ain't got nuttin' :D

  64. [64] 
    Elizabeth Miller wrote:

    How is Medicaid worse than no insurance?

  65. [65] 
    nypoet22 wrote:

    Medicaid is WORSE for health care than no insurance..

    Until you can address those facts, you ain't got nuttin' :D

    those are not facts, they are conclusions drawn from one study. the confounding variable that wasn't accounted for in that conclusion is poverty. on the whole, poor people have been found to get sicker more frequently than people who are not poor, and that variable is a stronger predictor of health problems than whether or not one is insured. none of which has any bearing on the effectiveness of medicaid.

    JL

  66. [66] 
    nypoet22 wrote:

    @liz,

    it isn't. that's a right-wing talking point based on a misinterpretation of a study. medicaid patients overall have worse outcomes than the uninsured - most of whom aren't poor enough to qualify for medicaid. the poverty variable outweighs the healthcare variable.

    JL

  67. [67] 
    Balthasar wrote:

    VA...Medicaid is WORSE for health care than no insurance..Until you can address those facts, you ain't got nuttin'

    Okay, let's start with the VA: my father used the VA. Got surgeries, treatments, glasses, medicine, loved it. Looked forward to his visits, which made it more popular with him than most things my mother made him go to.

    Re: "Medicaid is worse than no insurance." Wow, is that ever bullshit. Here's a story: while in NY once, I felt serious stabby pains in my chest, and went to the local emergency room. Several hours later I learned that my heart was fine, but that my stomach was truly giving me bad reviews, and needed to be more regularly tended with antacids. That piece of advice cost me several thousand dollars.

    Right now in America, lots of folks are stuck with no insurance for one reason or another, and have to rely on emergency rooms for basic healthcare needs, like a painful elbow, or sore throat, that might be better, and more economically served in a clinic.

    Needless to say, for the very poor, many of those bills go unpaid. For those that do play by the rules and pay, they're charged at higher rates than richer insured patients for similar services.

    If you think that it isn't cheaper to insure clinical visits rather than have the cost of millions of emergency room visits comped, you're not just lacking common sense, you're un-conservative!

  68. [68] 
    nypoet22 wrote:

    based on a review of 108 studies, those who used to be ineligible for medicaid (not poor enough) but qualified under the obamacare expansion generally did tend to have improved health outcomes.

    "Most research demonstrates that Medicaid expansion positively impacts access to care and utilization of health care services among the low-income population, but some studies have not identified significant effects in these areas."

    http://www.kff.org/medicaid/issue-brief/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review/

    JL

  69. [69] 
    michale wrote:

    Balthy,

    Re: "Medicaid is worse than no insurance." Wow, is that ever bullshit.

    No, it's not bullshit, it's misquoted..

    Medicaid offers no benefits over having no insurance...

    If you agree then fine..

  70. [70] 
    michale wrote:

    JL,

    those are not facts, they are conclusions drawn from one study.

    Just like ya'all's accusations about Trump are drawn from SINGLE anonymous sources...

    Funny how SINGLE sources are fine if they suit ya'all's agenda... :D

  71. [71] 
    michale wrote:

    Okay, let's start with the VA: my father used the VA. Got surgeries, treatments, glasses, medicine, loved it. Looked forward to his visits, which made it more popular with him than most things my mother made him go to.

    Again, you got ONE VA story..

    And you somehow think that applies to the entire VA!??

    *ONLY* because it suits your partisan agenda...

  72. [72] 
    Kick wrote:

    Michale
    13

    It's simple.. At one point in time, Don rose to my defense over some such point or issue and was mercilessly and ruthlessly attacked by several Weigantians..

    Every since that time, he has had a hard time gaining traction here..

    OMG... Spew alert!

    Elizabeth makes a very good point about Don, and guess who explains that "it's simple" and all about him?

  73. [73] 
    Balthasar wrote:

    Medicaid offers no benefits over having no insurance...

    Still false, for the reasons I stated above, and because your statement translates into english as:

    "Insurance offers no benefits over having no insurance.."

    Because that's all Medicaid is: insurance. For a lot of folks, the doctors are the same, the hospital is exactly the same, the ailments are similarly treated.

  74. [74] 
    Kick wrote:

    EM and LWYH

    Yes, yes, and totally right. Y'all are making too much sense.

    Republicans and health care? It reminds me of that joke: I went to a fight, and a hockey game broke out.

    Republicans formulated a health care plan and a tax cut for the rich showed up. :)

    Does it surprise anyone at all that the Republicans' idea of a "health care plan" cuts a trillion dollars out of Medicare and block grants it back to the states on a per capita basis? Anyone?

    And a great many of the GOP faithful are happy as a pig in mud because they're finally going to do away with that darned Obamacare that insures "poor people," thanking their lucky stars that they themselves are covered by the ACA. I'm not kidding; they actually believe this.

  75. [75] 
    Kick wrote:

    Correction to [74]

    Obviously, I meant Medicaid being block granted to the states on a per capita basis.

  76. [76] 
    Kick wrote:
  77. [77] 
    Chris Weigant wrote:

    Kick [74] -

    Shouldn't that be:

    Republicans got together to write a tax-cut bill, and the destruction of healthcare broke out...

    ?

    Heh. I've always liked that hockey game quote, myself.

    :-)

    -CW

  78. [78] 
    Kick wrote:

    Michale
    70

    Just like ya'all's accusations about Trump are drawn from SINGLE anonymous sources...

    Funny how SINGLE sources are fine if they suit ya'all's agenda... :D

    Claims to know everyone's sources and expects to be taken seriously. *LOL* :)

  79. [79] 
    ListenWhenYouHear wrote:

    Happy Birthday, Don!!!

    Liz [19],

    Oh, I was just using Republican's views on welfare as one example of how conservative ideology makes it highly unlikely that we will ever get the majority of Republicans to support for any program designed to benefit ALL Americans.

    Look no further than Michale ranting on here for an example of this:

    That means don't force men to purchase maternity or gynecological insurance...

    That means don't force people to buy something they don't want or need...

    Insurance keeps costs down by pooling large numbers of plans together so everyone pays a little of the costs. You don't get to have a la carte coverage. The closest thing to that would be to not have any insurance and just paying with cash whenever you need a doctor.

  80. [80] 
    Kick wrote:

    CW
    77

    Shouldn't that be:

    Republicans got together to write a tax-cut bill, and the destruction of healthcare broke out...

    Yes, thank you, CW!

    EXACTLY what I was trying to say. :)

  81. [81] 
    ListenWhenYouHear wrote:

    Kick [73],

    Republicans will ignore that a program may help thousands of people with disabilities and focus on the fear of some "undeserving moocher" benefitting from their hard earned tax dollars.

    Heck, in just about any discussion on immigration you will eventually hear someone bring up how illegals take advantage of free medical care that their tax dollars pay for.

    They really have an over-inflated view of just how far the money they pay in taxes actually covers. Devon likes to hand people a penny -- as a refund -- when they complain that their taxes pays for his paycheck and they aren't happy.

  82. [82] 
    Kick wrote:

    LWYH
    81

    They really have an over-inflated view of just how far the money they pay in taxes actually covers. Devon likes to hand people a penny -- as a refund -- when they complain that their taxes pays for his paycheck and they aren't happy.

    A penny! *LOL* THAT is hilarious. :)

  83. [83] 
    Bclancy wrote:

    "What good is access to healthcare if you can't afford it??

    I know of MANY people who have such high deductibles that they can't afford to go to the doctor.. They say they might as well not even HAVE healthcare..

    EVERYONE has 'access' to healthcare... It's called the emergency room... :D

    The key is to making the healthcare affordable... Once it is, access takes care of itself.."

    Ah I see "access" was not the best choice of words. I quite agree with you.

  84. [84] 
    michale wrote:

    Balthy,

    Still false, for the reasons I stated above, and because your statement translates into english as:

    The facts say otherwise..

    Oregon Study: Medicaid 'Had No Significant Effect' On Health Outcomes vs. Being Uninsured
    https://www.forbes.com/sites/theapothecary/2013/05/02/oregon-study-medicaid-had-no-significant-effect-on-health-outcomes-vs-being-uninsured/#1440d4d60430

  85. [85] 
    michale wrote:

    B,

    Ah I see "access" was not the best choice of words. I quite agree with you.

    Someone on the Left who thinks rationally and logically!

    Who would have thunked it!! :D

    heh

  86. [86] 
    nypoet22 wrote:

    Oregon Study: Medicaid 'Had No Significant Effect' On Health Outcomes vs. Being Uninsured

    that's science-speak for 'inconclusive' - the reason it was inconclusive is because they didn't control for poverty.

    however, as the kff review of research shows, controlled studies have found that previously uninsured newcomers to medicaid report improved outcomes both in their health and their finances.

    JL

  87. [87] 
    michale wrote:

    however, as the kff review of research shows, controlled studies have found that previously uninsured newcomers to medicaid report improved outcomes both in their health and their finances.

    You have your studies and the other side has their studies..

    YOUR studies are right and THEIR studies are wrong. :D

  88. [88] 
    michale wrote:

    You can spin it all you want, but the fact is a scientific study refutes the effectiveness of government run insurance...

    And I *KNOW* ya'all are ALL about scientific studies.. :D

    Couple that with the disaster that is the VA and the case against government run health insurance is clear...

    "Crystal....
    -Tom Cruise, A FEW GOOD MEN

    :D

  89. [89] 
    nypoet22 wrote:

    Accusations against the va are generally rooted in anecdotal fallacy. Yes there have been a few instances of va facilities being poorly run or underfunded, but the department overall does good work. If you don't believe me I'll track down some of the success stories for you.

  90. [90] 
    michale wrote:

    Accusations against the va are generally rooted in anecdotal fallacy. Yes there have been a few instances of va facilities being poorly run or underfunded, but the department overall does good work.

    Of COURSE it does good work.. No one is disputing that..

    The problem is, it doesn't OFTEN work..

    If you don't believe me I'll track down some of the success stories for you.

    And for every success story, I can point to 5 horror stories.

    No one is claiming that the VA never does ANY good..

    The claim is that it's not run very well and is indicative of how bad government run health care is crap..

    One only has to look at TrainWreckCare to know this is true..

  91. [91] 
    nypoet22 wrote:

    @m,
    Some studies confirm that Medicaid is effective, some are inconclusive. Conclusion: it improves outcomes under some conditions but not others. Exactly zero studies "refute" the effectiveness of Medicaid, no matter how politicians try to spin Oregon's results.
    JL

  92. [92] 
    nypoet22 wrote:

    And for every success story, I can point to 5 horror stories.

    Do you have data to support a 5:1 ratio of negative to positive, or are you just blowing smoke? I have looked for studies on success rates but haven't found anything conclusive.

  93. [93] 
    nypoet22 wrote:
Comments for this article are closed.