This seems useful.
Also, big thunderstorm here and I will probably lose my internet. Again.
Reader Interactions
63Comments
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Come for the politics, stay for the snark.
Republicans in disarray!
The republican caucus is already covering themselves with something, and it’s not glory.
You cannot shame the shameless.
No offense, but this thread hasn’t been about you for quite a while.
Sitting here in limbo waiting for the dice to roll
I did not have this on my fuck 2022 bingo card.
Take hopelessness and turn it into resilience.
Presidents are not kings, and Plaintiff is not President.
Bark louder, little dog.
You don’t get rid of your umbrella while it’s still raining.
I’m pretty sure there’s only one Jack Smith.
Whoever he was, that guy was nuts.
They traffic in fear. it is their only currency. if we are fearful, they are winning.
Why did Dr. Oz lose? well, according to the exit polls, it’s because Fetterman won.
Too often we hand the biggest microphones to the cynics and the critics who delight in declaring failure.
Jesus, Mary, & Joseph how is that election even close?
Shallow, uninformed, and lacking identity
Peak wingnut was a lie.
Being the leader of the world means to be the leader of peace.
We are builders in a constant struggle with destroyers. let’s win this.
Wow, you are pre-disappointed. How surprising.
Optimism opens the door to great things.
Damn right I heard that as a threat.
If you tweet it in all caps, that makes it true!
MikeJ
Facts?
TLDR
Axe Diesel Palin
One thing I always think about in the Obamacare debate is flood insurance. Many people cannot buy flood insurance because of where they live. I like to think that their neighborhood has a preexisting condition. So, the federal government guarantees access to flood insurance – http://www.fema.gov/library/viewRecord.do?id=3002. Isn’t this socialism too?
Warren Terra
the correct, single-page link is here
(sorry, the Times’s policy of splitting some pages across multiple pages is a pet peeve of mine).
Warren Terra
er, corrected link for the single-page version – must have dropped a quotation mark.
Sorry – and when’s that site update, with the Preview and Edit functions?
Snark Based Reality
How about someone post a link that isn’t behind the NY Times account wall, eh? ;)
Sentient Puddle
Not bad, though I think it’s mostly fluff for those who have been following health care. It calls out some lies (such as Obama wants to kill the elderly to cut costs), but clearly that means this primer is part of th’ librul media and cannot be trusted.
Warren Terra
@ Axe Diesel Palin, #2
Flood insurance isn’t necessarily a great example – the government makes it possible to insure properties that aren’t merely uninsurable by private companies but that probably shouldn’t exist, or be insured.
Now, it’s possible that the rest of the government’s land management, including building levees and permitting parking lots and deforestation and all, has made the flooding more common and more serious, and so they’re really liable. And maybe subsidizing insurance is the correct response to that liability. But there are certainly people getting subsidized insurance and being allowed to claim for damages and to rebuild the same vulnerable structures in the same endangered spots – some of those houses on barrier islands being a great example. This is not great public policy.
MikeJ
This wouldn’t happen if we had Sarah Palin’s death boards.
Warren Terra
I thought it was all free with (free) registration?
I mean, I’m not wild about generating user accounts all over the place that I’ll inevitably forget and all that, but the Times site is very good at not forgetting my details and making me log in again and again, and their content is top-notch.
Keith G
Neat primer. Too late? A problem is that there is no consensus about what our society wants or needs out of a healthcare system. I’m not sure that there is a consensus that we are a single society.
It was/is up to leadership to identify, sell, and try like hell to achieve a consensus. On this issue, I am feeling a bit let down by my Prez. I understand the what and why about his choices, but I was hoping for a different mythology. I think we are going to fall short of what might have been.
/20-20 hindsight
JGabriel
NYT:
That works out to something like $1500/per recipient/per year.
I gotta confess, that sounds like a significant cut – especially when Medicare reimbursal rates are already too low, for the most part. I know that’s supposed to come from consolidating redundant tests, but I don’t see how you wring $1500/recipient/year out of that.
Of course, the article says it cuts from “private health plans”. If that’s just a shift of funds to a public option or direct reimbursement, that’s fine. But the wording makes it sound like they’re just cutting it.
.
Andrei
Barely a primer, imho.
The biggest question that is not being asked on either side in this whole fiasco is:
Should every American be required to buy health insurance, and if so, should the government force the industry to control costs?
That’s pretty much it. If you answer yes to the first half (which I think pretty much everyone would say yes to, myself included), then you get easily past basic issues like insurance companies cannot be allowed to deny coverage to anyone, and pre-existing conditions fall by the wayside.
The second half is the tougher piece. A case can be made for many different answers. If the government went the “free market” route, that would presume the health insurance industry would be given a huge boost in revenue since they have a guaranteed market of customers. Who knows if they truly compete with each other or simply milk the country dry, but one would hop that a unregulated market as such would still breed some competition to keep prices in check. If the government opts to go “free market” but finance a public option, then they artificially attempt to regulate profit by offering a lowest common denominator choice. Who knows if a such a move would kill private insurance companies as we know it? Maybe there would be a few left offering premium coverage at a decent cost to still make a lot of profit in that model. A third option is the government can regulate the industry and set prices and such, and then the whole thing might reflect how a Kaiser-Permanente works. Would such a model beat down innovation?
I’m not sure on any of it, and have been reading up and keeping myself open to various answers as much as humanly possible, but I won’t lie and say I tend to tilt towards a regulated industry, even at the expense of some potential innovation that may take longer. (I tend to believe the global market will keep innovation moving forward at a reasonable clip.)
But what is clear is that the debates and discussions aren’t focusing on *ASKING* the American public what they believe they want as a country if they all claim that everyone should be covered. If we all want that, we then have to choose very specifically what model we want.
The people screaming and yelling at the town halls are doing this country a massive disservice by not owning up to what they want to see. And those on the other side need to start forcing that part of the conversation to make any headway.
IMHO.
Andrei
Meh.. I wrote that middle part a bit confusing. I’m currently leaning towards a regulated industry option given everything I understand at the moment.
JenJen
O/T, but Dan Froomkin’s first piece for HuffPo is a winner:
http://www.huffingtonpost.com/2009/08/10/our-fuzzy-president-is-ab_n_255524.html
And John? Also O/T, but my mom emailed me today to tell me she’s falling more and more in love with her little dog Sailor every day… the dog she partly adopted because your Lily posts inspired her to. Thought you’d like to hear that as much as I did. :-)
Dude in Jersey
“Conservative critics say the legislation could limit end-of-life care and even encourage euthanasia. Moreover, some assert, it would require people to draw up plans saying how they want to die.
These concerns appear to be unfounded. AARP, the lobby for older Americans, says, “The rumors out there are flat-out lies.”
The House bill would provide Medicare coverage for optional consultations with doctors who advise patients on life-sustaining treatment and “end-of-life services,” including hospice care.”
I’m sorry, these guys are classic msm assclowns. Why say that these concerns “appear” to be unfounded, and in the next paragraph affirm that they are unfounded?
Warren Terra
@ JGabriel, #11
With the Gingrich Revoution in 1994 there arrived a bunch of Republicans in power for the first time in a half-century convinced that Private Industry was always better than Government.
Consistent with this belief, they pushed for, and got, a partial privatization of Medicare – the so-called “Medicare Advantage” plans – in which companies would take a per-patient premium from Medicare and provide those patients with private insurance, usually through an HMO.
Thing is, it didn’t work out. It really, really didn’t work out, and as time went on it got worse. First of all, as could be predicted, although in theory some safeguards existed the private companies went out of their way to cherrypick the cheapest, healthiest of the elderly patients – and to drop them back into the publicly-insured population after a few years as they became worse bets, even if (as in some cases) this meant closing down the entire plan and everyone who’d signed up to get insurance through it (a mechanism they resorted to because patient protections meant they couldn’t readily drop individual patients).
From the start, the privately-provided insurance for the elderly, even with its cherrypicking, was having trouble competing with ordinary Medicare. This even though at the beginning they were getting the same money per patient that Medicare spends, although of course the older and sicker patients were the least likely to switch plans and sign up with them. So, because of the power of lobbyists, they managed to obtain a subsidy – the privately-provided Medicare plans receive 15% more per patient than the whole Medicare program costs per patient. Keep in mind, this plan was introduced with the claim that it would save money on providing care, and took further advantage from its efforts to sign up healthier patients. This is money basically taken away from Medicare and stuffed into the pockets of the private insurance industry. The proposal is simply to eliminate this 15% subsidy.
Punchy
John — does your Lil(l)y hide in the closet during thunderstorms? Ours hits the closet at full-speed at the mere sight of lightning. Just wondering if that’s a dog thing, or a “our dogs” thing.
PeakVT
Tip: if you clear the cookies for the NYT site you can generally get the article without logging on. There’s a Firefox extension that allows you to do this with a single right-click. The same trick works at the FT. Also.
geg6
@Warren Terra:
I’m with you about the NYTimes site. It never forgets me even if it’s a year since I went in. Can’t say the same for many other sites I don’t visit often. And I get no spam due to my account. I actually think it’s one of the most user friendly sites that requires an account and it’s FREE. No problemo, IMHO.
Face
Does ObamaCare abort all babies, or just most of them? Just the ones from Republican car dealerships?
MikeJ
@PeakVT: IIRC, they had a way to rewrite the urls so they were linkable from blogs and didn’t require login. In fact, there was a FF extension to automatically do it. I don’t think I’ve ever seen a login screen at the Times.
MikeJ
@MikeJ: To reply to myself, the trick was to add a partner=rss param
Napoleon
@JGabriel:
Keep in mind that the various governments in this country already pays on a pro rata basis as much per person for healthcare as countries that have universal coverage like France. To put it another way if we were France everything private employers and private citizens pay into the system would instantly go away and they system would operate on what funds the governments were already paying into it.
I listened to this podcast of Talk of the Nation with the CEO of Kaiser Permanente (which I really didn’t realize is basically a combination of both a hospital system and insurer) and during the qestion and answer he comes out and says that he thinks the whole system could provide universal coverage on the money that is going into now. Keep in mind, this is from someone who has every reason to highball that number, which means there is a pretty good chance you could get universal coverage at a lower cost then today.
Most Americans have no idea of how much money appears to be all but burned in open pits in our system compared to other systems.
http://www.npr.org/templates/story/story.php?storyId=106853465
farmette
The most important aspect of health care reform is this: affordable care must be available to those who need it the day after a reform bill is signed. This can be done. All those who present to a hospital/facility/doctor who are uninsured are billed as follows:
over 55 – billed to Medicare
under 55 -billed to the federally subsidized state health care program (Medicaid)
While care is provided, the individual, at the point of contact with the health care system, completes an application for federally subsidized health insurance that is submitted by the provider with the first bill. In addition, those who have outstanding medical care debt will be able to relieve that debt through an amended Medical Bankruptcy bill. The government pays 30 cents on the dollar to providers, debt collectors, credit card companies – whomever is holding the balance due. The remaining balance becomes a tax write off for the debt holder – the cost of doing business.
Immediate health care coverage and medical debt relief. First things first.
Then, the real reform gets underway. True changes to our health care delivery system require an approach beyond immediate and long term physical care. It entails a change in how we see ourselves as mortal beings, how we define personal responsibility, what we collectively determine as necessary and fair, and how we, as a society, make life and death decisions. Real reform requires imagination, altruism, commitment, willingness to accept that the status quo is not working and the acceptance that change, though at times personally challenging, must ensue.
There is much to reform including medical education for all beginning grade 1, expanding primary health care services and use of care providers other than MDs, revamping medical school to control costs and promote an increase in general medical practitioners, tort reform and much more ( including global collective bargaining for lower cost pharmaceutical and medical products). But job one – cover everyone now. Free people up to explore a variety of money producing job/life options. This can be done.
jwb
@Warren Terra:
See, this is great; but how can you ever hope to make this point amidst the din of the crazy? And even if you can be heard, crazy just shouts back that you haven’t read the bill and are just making shit up?
geg6
@JGabriel:
“That works out to something like $1500/per recipient/per year.
I gotta confess, that sounds like a significant cut – especially when Medicare reimbursal rates are already too low, for the most part. I know that’s supposed to come from consolidating redundant tests, but I don’t see how you wring $1500/recipient/year out of that.”
Seriously? I can see that happening with about 2 or 3 unneccessary test cut out. My mother was on Medicare for several years before she died and there were lots of ways they could have cut the cost of her care enough that she would never have gotten to the point where they wouldn’t pay for her chemo (this was long before the prescription benefit), mainly through cutting the dozens of tests she took every.single.month.whether.she.needed.the.test.or.not. It was literally tens of thousands of dollars of tests (most her oncologist admitted were not needed but had to be done to keep proving that, yes, she had bone cancer and so that the hospital wouldn’t get sued) over the course of six months, let alone a year. $1500/year is nothing when discussing the treatments and costs of medical care for the elderly and severely ill, even taking Medicare reimsbursements into account.
Linkmeister
Politifact has a good fact-check page on health care, too.
John S.
It depends on the dog.
My in-laws have had two 100+ lb. German Shepherds that literally freak out when a thunderstorm hits. They hide in the bathtub, the closest, between your legs…anywhere that they feel safe.
My 16 lb. Dachshund could give a shit. A cannon being fired on my doorstep wouldn’t bother her. She is absolutely fearless because in her mind I think she believes that she is an 800 lb. gorilla.
But I guess that’s to be expected of a breed engineered to go after badgers in their own holes.
kay
@Warren Terra:
This is a great, great point, and I don’t know why no one is discussing it. Well, I DO know. Because it’s a crazy transfer of taxpayer funds to private insurers, that’s why.
I wonder how much of GOP opposition to the House plan is based on killing this cash cow.
“Last year, CBO estimated that setting payments to private plans at the same level it would cost traditional Medicare to serve the same beneficiaries would save $54 billion over five years (2008-2012) and $149 billion over ten years (2008-2017). These are the amounts by which the private plans are overpaid.[7]
The Chief Actuary at the Centers for Medicare and Medicaid Services (CMS) has testified that the overpayments advance the date when the Medicare Hospital Insurance Trust Fund will become insolvent by 18 months.[8] Because of the overpayments, restoring solvency will require substantially larger benefit cuts and/or tax increases than would otherwise be needed. In testimony before the Health Subcommittee of the House Ways and Means Committee earlier this year, Glenn Hackbarth, MedPAC’s chairman, warned that “these added expenditures contribute to the worsening long-range financial sustainability of the Medicare program.”[9] Hackbarth similarly warned last year that the Medicare program faces “a very clear and imminent risk from this overpayment that will put this country in an untenable position.”[10]
Martin
Remember that the deal with Pharma is that they’ll cut drug costs by $80B over the next 10 years. Since a big chunk of the Medicare dollars going to private insurers is Part D money, I’d say half the savings are right there in front of us.
kay
@JGabriel:
They’re taking it from Medicare Advantage, which is the private plan. Low income Medicare premiums for people who opt for the government plan are actually HIGHER to help cover the cost of the over-payments to the private plans.
It was a horrible idea, and it failed miserably, and now that they’re entrenched, Congress has not had the spine to insist they be cut off.
Zifnab
NYT:
Sorry, but this and other claims in the article are ringing my bullshit detector. The piece has a definitive slant against health care, mostly focusing on how one can take the blanket statements by the party and parse them into lies.
The Democrats aren’t arguing it right. The Democrats aren’t being truthful about “keeping your own health care plan”. They leave the public option – the biggest contention in the debate – virtually unexplained. Lots of he-said-she-said. Very thin on specifics.
I wouldn’t recommend this article to anyone trying to bone up on the health care bills. If one of the biggest complaints stems from the House Bill 1200 page length, this doesn’t do much more than parse through the first few pages.
kay
@Warren Terra:
I fear you are going to have to post this repeatedly. Do that, because it’s important.
jcricket
Here’s my health care primer:
GOP and Libertarians are full of shit. They do not understand the current systems (pros and cons). They are lying about the impacts of the proposed reforms. Their “solutions” would in no way address any of the failings of the current system, and would likely make things worse. Everything out of their mouth is a lie or a result of their stupidity – and sometimes deliberately so.
Democrats are weak-kneed losers overly driven by concern-trolling Villagers and fear of Republicans. The proposed reforms don’t go nearly far enough, but none of them will make anything worse. The 8 or 9 regulations are absolutely needed. The public option, even if watered down, will make things more bearable for 10s of millions of Americans.
So your choices are between lying, mendacious, rapacious-profit-mongering idiots who don’t give a shit about you or your family, or weak-kneed losers who at least get that something needs to be done and are proposing stuff that might work (and are occasionally amenable to logic in improving the “might” portion of that).
Napoleon
@kay:
Kay said: “I wonder how much of GOP opposition to the House plan is based on killing this cash cow.”
No doubt it is part of it. Didn’t killing the subsidy come up as a separate a year or 2 ago and the Republicans went berserk to kill it? (amazing how private companies need a thumb on the scale to compete). On a related matter an extremely similar program in the student loan arena came up a few months ago as a stand alone proposal (private companies get a premium over the public program) and it faced the same type of opposition (remember that is when Ben Nelson showed his true face that he would try to kill off any public type option).
General Winfield Stuck
Sarah says democrats want to establish “Death Panels” to deny health care.
I give Sarah the “Denial Engines” currently being used by private insurers to deny claims when people get sick.
“Denial Engines” exist and are killing people, Government “Death Panels” do not, nor will they ever. Herein lies a lie versus the truth. There are many more.
Technology of death.
Martin
No, in fact it’d probably improve it.
I’ve had Kaiser for a decade and a half, and to be honest, I love it. As a customer, I show up, flash my card, do whatever needs to happen, and that’s it. No bill, no paperwork. I’ve never had to call them for anything other than test results. I consistently get appointments for illnesses same day, and they run urgent care facilities so that if I run a nail through my thumb on a sunday afternoon, I can cruise right in and get it sorted out. Never waited more than 20 minutes.
Kaiser is as paperless as you’ll find in this country. They innovated that. Because doctors don’t need to deal with insurers, there’s no incentive to overbill or over/under treat patients. My wifes Ob/Gyn is amazingly good. We asked him years ago why he works at Kaiser and he said that he never spends less than 50% of his time seeing patients – and he runs the Ob/Gyn unit here. There’s almost no paperwork, very little administrative work to do, he does his job and gets paid and never needs to worry about 90% of the things that other doctors in private practice need to deal with. He earns less, but considering the reduced aggravation, it’s worth it to him. I’d consider that innovation as well because they’re getting great doctors working for less money, just by cutting all the bullshit out.
When we had concerns with our first pregnancy, Kaiser sent us a few towns over to use the holy-shit-that’s-cool 3D color ultrasound. They were one of the first to have one in SoCal, but they don’t feel compelled to have one in every facility. It was no big deal to drive the extra 20 minutes.
In every way they are extremely efficient and it’s precisely how medical care should be, IMO. They’ve have an automated online call center for appointments for ages. It takes care of reminders (it calls you, you press ‘1’ or something, and you’ve confirmed your appt) takes care of test results automatically as well. It frees up the staff to deal with real problems. We have no problem calling (or email and ask for a callback) our doctors for clarifications on things, which is pretty impressive given their size. They offer a lot of classes for preventative care, but also for pre/post issues. Lots of classes around having a baby (normal) but also around various common surgeries.
But because they are a closed network (both insurer and care provider) they have a huge incentive to innovate because they know the innovations will provide a return. If Kaiser was the norm, nobody would ever talk about health care reform ever again, IMO.
Cyrus
@Dude in Jersey:
Heh, I can’t complain about the way it was written. That’s some classic, and very skillful, passive-aggressive journalism there. Genre conventions require using as neutral, mealy-mouthed phrasing as possible for criticism of a group of people, such as saying that their claims “appear to be unfounded.” But following up with a quote from the leading public organization when it says “flat-out lies” is about as harsh as you can get in “serious” journalism.
Mike P
I’m sure someone else said this already, but the linked Times piece has yet another example of the kind of weak in the knees reporting that’s letting idiocy like “death panels” stick around in the discourse even though it has no grounding in fact.
eric U.
the situation we are in right now is that the insurance companies have interjected themselves into our healthcare, and are extorting money from us. It really feels like a hostage situation to me. I worry about sending my kids to get care because it may make them uninsurable in the future. That’s a ridiculous situation to allow ourselves to be in. Not to mention that you have to be crazy to start a business because getting health insurance is outrageously expensive.
b-psycho
@Andrei:
Suppose my answer to the 1st question is no? Then what?
b-psycho
Stupid quote glitch…
arguingwithsignposts
Could I use this as an open thread? doing better than I was two weeks ago, still not up as much as I’d wish. today has been dark. cheers all.
eric U.
@Punchy: we had a dog that was deathly afraid of fireworks. I don’t remember, but I don’t think that lightning was that big of a deal with her. On July 4th, someone that knew us saw her leaving town — this was miles from our house.
Demo Woman
@Martin: I’ve heard the same thing about Kaiser and if memory serves me, Obama has spoken highly about them. Unfortunately most folks like me are stuck with paying 7000 a year for a 1000 deductible. Hey I feel fortunate because I know the insurance company can not drop me if I get sick. Of course, if I get sick I’m not going to a doctor.
Demo Woman
@arguingwithsignposts: Did you take the opportunity to speak with a professional. I can’t tell you how much that helped me.
Andrei
@b-psycho: If your answer is that not everyone should be required to own health insurance (and therefore not be covered) then you tell me what it means.
Because it’s what we have today, and it’s not working. I’d love to hear someone talk about how to reform health care and the insurance industry without mandating that everyone be covered. Because it’s what we have these days, and it’s decidedly broken and no one has been able to fix it.
Andrei
@Martin: I’m about to switch jobs, and in doing so, I’m taking the Kaiser option and leaving the other options. From everything I know and hear about it, I figure it’s time for me to put up or shut up about moving to a system that seems to aim to be the kind of model I think works in the long run.
kay
@Napoleon:
I followed the student loan battle because I am genuinely worried about all the debt they’re taking on, in the context of the broader economy, in the same way I wondered why all of my neighbors could suddenly afford huge new houses, in 2004. My daughter was teasing me at the height of the bubble: “why are we so POOR?”. I told her they were all up to their ears in debt.
jeffreyw
Thunderstorm here, too. It has Jack wanting up on his daddy’s lap.
b-psycho
@Andrei: So you’re all for forcing people who can’t afford it anyway to pay for it? Or maybe simultaneously force them and subsidize it so the same insurance companies that we’re generally in agreement on about them screwing people can get even more money?
If someone can afford it and won’t get it, then yeah, they’re stupid and begging for trouble. But how many are in that group, as opposed to the “well I’d like to have insurance, but I’d also like to not starve to death” group?
Perry Como
Popped on a horror movie last night and right after the opening scene the room lit up from lightning. Wait for it…BOOM. The dog looked up, got up, and went to the window to see what was going on. After seeing nothing of interest he laid back down.
b-psycho
The way I see it, forcing people to buy insurance = power grab + functional equivalent of insurance industry bailout. Am I being too cynical?
Ideally, I would prefer if we simply removed the factors* that made health care so expensive in the first place. If that is absolutely unattainable politically, then I say cut the crap and just go single-payer already, because it’s going to come to that regardless.
(* – Before anyone barks: I personally disagree with his 3rd point, thinking malpractice is nowhere near as relevant as popularly portrayed, and wondering how someone by definition so far out of the mainstream came to accept that bit of conventional non-wisdom)
Gus
@jeffreyw:
Awww, he’s cute. My dog does the same thing.
RedKitten
@arguingwithsignposts: Glad to hear things are getting better. And yes, there are still going to be dark times, but make sure you reach out to people when the darkness seems like it’s too much.
On another completely OT (although it IS healthcare related), I had my second obstetrician appointment in 5 days, and after some rather…invasive…examinations, have been left feeling like I’ve been brutally raped by a coat tree. Follow this by an hour-long drive home, 15 minutes of which is rutted dirt road.
Fuck, do I need a drink right now.
General Winfield Stuck
@RedKitten:
I think it was Oprah who once said, if menfolk had to do the stirrups thing, the world would be a different place. Likely true.
Demo Woman
@RedKitten: On the previous post I wrote this…
Somehow I think after your day, you would really come up with something good.
RedKitten
@Demo Woman: Doubtful. I’m utterly drained, and have been either sleeping, crying or on the verge of tears since about 4:30 or so. In that state, the headline would probably amount to something as pithy and well-thought-out as, “Fuck you, you fucking fuckers!”
Demo Woman
@RedKitten: LOL This feeling will pass. BUT in the mean time an occasional fuck fuckity fuck is just fine.
Andrei
@b-psycho: That post is certainly idealist in nature, and entirely untenable in the next decade. And not quite an anarchist viewpoint to be honest.
If you are for a single-payer system as the alternative, how do you imagine that working without requiring everyone pay into it? Unless you plan to deny those who don’t pay into a single-payer system access to doctors or health services. And since it would be a single-payer system, are those people who don’t pay into it to be left to die on their own, without any access to doctors and such?
A single payer system is like roads and services, built and maintained by cities, states and the federal government. You pay taxes to fund roads and such. That’s basically a mandated fee you are charged for being a citizen and using services around infrastructure. However, the point of trying to avoid a single-payer system is to avoid going the government funded and managed route, which is where the underlying screams of “socialized medicine” come from. The whole of point of trying to find a solution that allows both a public option and private option for health coverage is to create something that can work for everyone. In that model, the only way I can see it working is if the feds regulate the industry *after* mandating that everyone must pay into health coverage in some form or fashion.
The reason to require that everyone buy insurance is to *fund* the system. You can do so via taxes or a requirement to pay insurance, but either way, you are paying for it, even if its a single-payer system.
Uloborus
I worked for Kaiser, actually. I was proud to work for Kaiser, and everyone I knew there was. Basically, because Kaiser was a nonprofit run by doctors, and had the least incentive to screw customers.
Unfortunately, that does not make Kaiser perfect. For one thing, even without shareholders to please, Kaiser is feeling the financial pinch of the insurance system’s craziness. The doctors weren’t pleased when Kaiser started offering a low-premium, high-deductible option for young people. It’s basically a scam, kind of like a predatory loan. You end up paying way more than you think. Unfortunately, it’s an incredibly popular scam that other insurance companies are using to siphon off the most profilable (young and healthy) customers, and Kaiser basically has to try and win them back with the same thing.
Also, bear in mind, you get what you pay for. As the physician-in-charge at my clinic put it, everyone in his area had Kaiser – who could afford it. Kaiser is the high end, expensive option.
b-psycho
@Andrei: Obviously single-payer would be funded with taxes, I didn’t say it could be funded any other way. That proposal I linked to is an example of what someone who rejected the existence of government would suggest about US health care policy. Because of its focus on that one issue it ends up something that’s possible to do without dissolving government elsewhere, I’m assuming that’s what you mean by “not particularly anarchist” right?
As for “socialized medicine”: they were already going to scream it regardless, why bother? Those people aren’t my peers, never were, never will be. The closest thing to a coherent view I can discern from their mess is an assumption that anything not done for profit is evil, and I disagree. In fact, I’d rather that medicine be non-profit to whatever extent is feasible.
YellowJournalism
@RedKitten: Do you find yourself crying for no reason whatsoever? Something little will set me off, then someone asks me why I’m crying and I say, “I don’t know.” Then I just start crying harder because I realize what a complete lunatic I must look like. Fucking horomones.