Joe Biden promises to "provide health care for all"

[Gyuji]

El Salvador, Guatemala, and Honduras have libertarian-like economics, or in other words liberal economics, for much of their independent history and it's god-awful.

If you want to see the long-term effects of pure right-wing economics looks like, check over there. And I know the life over there myself.

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[Gyuji]

Alright dude/dudette,
Have fun in your Libertarian country with no government enforced standards as you car explodes, your house falls down, you drink even more poisoned water.

We’re done here

There's no point of arguing and debating against libertarians and liberal economic purists. That's what I've learn from my past experience.

They all think universal healthcare doesn't exist.

Still thinking 19th-century free-market economics solves everything.

Have no grasp on history and can't even explained the "golden age of capitalism" of 1945-1980 and what the economic ideology that helped it

Can't understand the political corruption game for some reason.

They're all badly influenced by the economic elites and corporations that hijacked our government that "reformed" our educational system by promoting liberal economics and omitting facts of economic reform history of the 1930's(FDR's New Deal platform) and political pressure from the working-class. As well, with the 1960's social movements and few attempts of healthcare reform.

Simply put, the ones here just don't like the transaction of paying medical service out-of-pocket becoming "obsolete."

 

[FutureInternist]

There's no point of arguing and debating against libertarians and liberal economic purists. That's what I've learn from my past experience.

They all think universal healthcare doesn't exist.

Still thinking 19th-century free-market economics solves everything.

Have no grasp on history and can't even explained the "golden age of capitalism" of 1945-1980 and what the economic ideology that helped it

Can't understand the political corruption game for some reason.

They're all badly influenced by the economic elites and corporations that hijacked our government that "reformed" our educational system by promoting liberal economics and omitting facts of economic reform history of the 1930's(FDR's New Deal platform) and political pressure from the working-class. As well, with the 1960's social movements and few attempts of healthcare reform.

Simply put, the ones here just don't like the transaction of paying medical service out-of-pocket becoming "obsolete."

I always ask Libertarians how they would like it if their pilot wasn’t certified, or if they would let just anyone drive an 18 wheeler on the same freeway as their family

As stupid as the Republican platform of “small government” (which is basically, let white, religious people trample on everybody else), Libertarians are that much stupider.

It’s an extremely non-funny version of Beevis and Butthead.

 

[Gyuji]

I always ask Libertarians how they would like it if their pilot wasn’t certified, or if they would let just anyone drive an 18 wheeler on the same freeway as their family

As stupid as the Republican platform of “small government” (which is basically, let white, religious people trample on everybody else), Libertarians are that much stupider.

It’s an extremely non-funny version of Beevis and Butthead.

That's the problem when you're arguing for and advocating libertarianism. They all say "no government involve" and with slight pushback from the opposition, they compromise with the government intervention/regulation argument.

Really, the vast majority of Americans don't understand the dangers of liberal economics though we already have neoliberalism as the current dominant economic ideology since the Carter years.

I just don't understand why libertarians and economic liberals don't accept neoliberalism which is the re-branded version of liberal economics of the 19th century. It promotes austerity, deregulation, marginalize labor unions, privatization, reduced government spending. Though I understand they are not in favor of corporate socialism and foreign intervention as both major political parties favors due to political corruption.

 

[zeloc]

The standard is set by AAMC.. Government enforces it.
You can argue that having to retake board after 10 years of practice has no bearing on your knowledge/expertise, and I won’t argue there, but there has to be some standard that distinguishes someone from knowing a pt’s head from their ass

Alright dude/dudette,
Have fun in your Libertarian country with no government enforced standards as you car explodes, your house falls down, you drink even more poisoned water.

We’re done here

This is silliness. Is Ford really going to start making cars that explode if the government stops enforcing standards? There are a gazillion examples of ppl's behavior changing as a response of mistakes made by companies. If a Ford explodes, I guarantee you that sales of Fords will plummet and they will go out of business.
Look at the quality control at places like Target, Walmart, etc. It goes way beyond government standards. They are not going to let harmful, unsafe products go on their shelves.
One can easily see the effect of social media on the behavior of companies, which is completely independent of government.

Anyone in medicine knows that the concept of people making the best choices for themselves is a lie.

There is extraordinary government regulation of medicine now and people don't make the best choices for themselves. Of course your point is that there needs to be a minimum standard, but looking at the individual is the wrong metric, one should look at population metrics.

El Salvador, Guatemala, and Honduras have libertarian-like economics, or in other words liberal economics, for much of their independent history and it's god-awful.

If you want to see the long-term effects of pure right-wing economics looks like, check over there. And I know the life over there myself.

I have spent time in the countries you have mentioned and to choose examples of places that have been ravaged by civil wars has no bearing on economic policy. Also look at the influence of the US government on the history of those countries. You can't only look at the positive effects of government action and ignore the negative effects.

 

[FutureSurgical]

What do y’all think of this article detailing how M4A saving the US billions of dollars by 2030? One thing I’m concerned about is still the potential reduction in pay for attending physicians. Not that I need to own 3 Tesla’s and 4 beach-front properties 10 years-post residency. But the debt I’d accumulate would only hurt me more if my pay went from, say, $300K to $115K. I won’t lie by saying “I’m only doing this because of the calling I had when I was 8 years old.” A (VERY small) part of me likes the lifestyle and pay once residency is finished and I can find a job that covers debt and affords me to not worry about money when it’s all said and done.

 

[FutureInternist]

What do y’all think of this article detailing how M4A saving the US billions of dollars by 2030? One thing I’m concerned about is still the potential reduction in pay for attending physicians. Not that I need to own 3 Tesla’s and 4 beach-front properties 10 years-post residency. But the debt I’d accumulate would only hurt me more if my pay went from, say, $300K to $115K. I won’t lie by saying “I’m only doing this because of the calling I had when I was 8 years old.” A (VERY small) part of me likes the lifestyle and pay once residency is finished and I can find a job that covers debt and affords me to not worry about money when it’s all said and done.

Part of the savings could be used by the gov to pay off private loans.
Gov loans should be forgiven

 

[dpmd]

This is silliness. Is Ford really going to start making cars that explode if the government stops enforcing standards? There are a gazillion examples of ppl's behavior changing as a response of mistakes made by companies. If a Ford explodes, I guarantee you that sales of Fords will plummet and they will go out of business.
Look at the quality control at places like Target, Walmart, etc. It goes way beyond government standards. They are not going to let harmful, unsafe products go on their shelves.
One can easily see the effect of social media on the behavior of companies, which is completely independent of government.

There is extraordinary government regulation of medicine now and people don't make the best choices for themselves. Of course your point is that there needs to be a minimum standard, but looking at the individual is the wrong metric, one should look at population metrics.

I have spent time in the countries you have mentioned and to choose examples of places that have been ravaged by civil wars has no bearing on economic policy. Also look at the influence of the US government on the history of those countries. You can't only look at the positive effects of government action and ignore the negative effects.

Uhhh, have you really never heard of the pinto?

 

[Gyuji]

I have spent time in the countries you have mentioned and to choose examples of places that have been ravaged by civil wars has no bearing on economic policy. Also look at the influence of the US government on the history of those countries. You can't only look at the positive effects of government action and ignore the negative effects.

This is silliness. Is Ford really going to start making cars that explode if the government stops enforcing standards? There are a gazillion examples of ppl's behavior changing as a response of mistakes made by companies. If a Ford explodes, I guarantee you that sales of Fords will plummet and they will go out of business.
Look at the quality control at places like Target, Walmart, etc. It goes way beyond government standards. They are not going to let harmful, unsafe products go on their shelves.
One can easily see the effect of social media on the behavior of companies, which is completely independent of government.

There is extraordinary government regulation of medicine now and people don't make the best choices for themselves. Of course your point is that there needs to be a minimum standard, but looking at the individual is the wrong metric, one should look at population metrics.

I have spent time in the countries you have mentioned and to choose examples of places that have been ravaged by civil wars has no bearing on economic policy. Also look at the influence of the US government on the history of those countries. You can't only look at the positive effects of government action and ignore the negative effects.

Like I said before "Have no grasp on history." Also, I'll add "no grasp on political terms and spectrum" to it as well.

Do you even know what cause those civil wars and tension throughout the 1960's to the mid-1990's?

It's the free-market liberal economic policies that benefitted the oligarchs and foreign corporations and investors that made government unresponsive to the need of the People while using its national militaries to control the population and protect the status quo and power of the wealthy and as well to eliminate any opponents, left-wing sentiment and ideology, and to combat rebel insurgence that was growing in numbers in the 1970's.

I know this stuff because I'm from that region and I know how bad right-wing economics are, time and time again. Europe has really shown you how embedded liberalism(regulated market, strong labor laws, public services) works so stop with this Chicago Boys nonsense. It failed miserably in Latin America, particularly in Chile under Pinochet in the 1980's.

 

[ChordaEpiphany]

What do y’all think of this article detailing how M4A saving the US billions of dollars by 2030? One thing I’m concerned about is still the potential reduction in pay for attending physicians. Not that I need to own 3 Tesla’s and 4 beach-front properties 10 years-post residency. But the debt I’d accumulate would only hurt me more if my pay went from, say, $300K to $115K. I won’t lie by saying “I’m only doing this because of the calling I had when I was 8 years old.” A (VERY small) part of me likes the lifestyle and pay once residency is finished and I can find a job that covers debt and affords me to not worry about money when it’s all said and done.

It's almost undeniable that M4A has the potential save hundreds of billions annually (or not, they said the same about Green Mountain Care...). That's also less than 10% of US healthcare expenditure. If you care about people, and not money/salary, M4A is still not a slam dunk, because it has the potential to severely reduce quality of care all over. I actually have no issue with M4A as a concept, but we're trying to do it in America, where half the government still believes in trickle down economics and the healthcare industry is infiltrated with profit-seekers who aren't just going away.

A brief synopsis of how healthcare got so bad

1) We established care on a mostly private basis nationally, which led to a large influx of profit-seekers.

2) Said profit-seekers created a bloated industry in which middle men and managers pay themselves at each step.

3) They get the general public to play along by giving the young/healthy great rates and giving the elderly medicare.

A brief synopsis on why simply reversing that by going completely public would be a disaster

1) Companies/executives would take the delta on savings instead of passing it along to their employees.

2) The young and/or healthy would pay more, while the older/sicker would pay less. The young and/or healthy is the majority, and they'll vote with their wallets for Republicans promising to cut taxes.

3) Republicans will gut the system, and there will be no private sector to pick up the slack. Hospital workers would get screwed because M4A actually does next to nothing to reduce the middle men/managerial garbage currently bloating the system. They'll still be here, hands out, looking for a fat paycheck, and they're closer to the money and therefore get the first slice.

4) Medicine will become a public service, much like public transport, public housing, public education, etc... Med school competitiveness will fall through the floor, and being a doctor will become, like one of my favorite SDN members loves to say of academic medicine, "a vanity job at a non-profit."

Also, I've never voted for a Republican in my life, but Jacobin is an absolute trash propaganda rag.

 

[whataschool_classof24]

It's almost undeniable that M4A has the potential save hundreds of billions annually (or not, they said the same about Green Mountain Care...). That's also less than 10% of US healthcare expenditure. If you care about people, and not money/salary, M4A is still not a slam dunk, because it has the potential to severely reduce quality of care all over. I actually have no issue with M4A as a concept, but we're trying to do it in America, where half the government still believes in trickle down economics and the healthcare industry is infiltrated with profit-seekers who aren't just going away.

A brief synopsis of how healthcare got so bad

1) We established care on a mostly private basis nationally, which led to a large influx of profit-seekers.

2) Said profit-seekers created a bloated industry in which middle men and managers pay themselves at each step.

3) They get the general public to play along by giving the young/healthy great rates and giving the elderly medicare.

A brief synopsis on why simply reversing that by going completely public would be a disaster

1) Companies/executives would take the delta on savings instead of passing it along to their employees.

2) The young and/or healthy would pay more, while the older/sicker would pay less. The young and/or healthy is the majority, and they'll vote with their wallets for Republicans promising to cut taxes.

3) Republicans will gut the system, and there will be no private sector to pick up the slack. Hospital workers would get screwed because M4A actually does next to nothing to reduce the middle men/managerial garbage currently bloating the system. They'll still be here, hands out, looking for a fat paycheck, and they're closer to the money and therefore get the first slice.

4) Medicine will become a public service, much like public transport, public housing, public education, etc... Med school competitiveness will fall through the floor, and being a doctor will become, like one of my favorite SDN members loves to say of academic medicine, "a vanity job at a non-profit."

Also, I've never voted for a Republican in my life, but Jacobin is an absolute trash propaganda rag.

Hence why m4a should be fought tooth and nail to be blocked. Nurses, PAs, pharms, etc all get a raw deal too

 

[FutureInternist]

It's almost undeniable that M4A has the potential save hundreds of billions annually (or not, they said the same about Green Mountain Care...). That's also less than 10% of US healthcare expenditure. If you care about people, and not money/salary, M4A is still not a slam dunk, because it has the potential to severely reduce quality of care all over. I actually have no issue with M4A as a concept, but we're trying to do it in America, where half the government still believes in trickle down economics and the healthcare industry is infiltrated with profit-seekers who aren't just going away.

A brief synopsis of how healthcare got so bad

1) We established care on a mostly private basis nationally, which led to a large influx of profit-seekers.

2) Said profit-seekers created a bloated industry in which middle men and managers pay themselves at each step.

3) They get the general public to play along by giving the young/healthy great rates and giving the elderly medicare.

A brief synopsis on why simply reversing that by going completely public would be a disaster

1) Companies/executives would take the delta on savings instead of passing it along to their employees.

2) The young and/or healthy would pay more, while the older/sicker would pay less. The young and/or healthy is the majority, and they'll vote with their wallets for Republicans promising to cut taxes.

3) Republicans will gut the system, and there will be no private sector to pick up the slack. Hospital workers would get screwed because M4A actually does next to nothing to reduce the middle men/managerial garbage currently bloating the system. They'll still be here, hands out, looking for a fat paycheck, and they're closer to the money and therefore get the first slice.

4) Medicine will become a public service, much like public transport, public housing, public education, etc... Med school competitiveness will fall through the floor, and being a doctor will become, like one of my favorite SDN members loves to say of academic medicine, "a vanity job at a non-profit."

Also, I've never voted for a Republican in my life, but Jacobin is an absolute trash propaganda rag.

Not sure why it becoming a public service is a bad thing.
Police, firefighters, army etc.. are all public services and help the most people (none of whom can do the job that they do).

I don’t see the point in having a chemo drug that treats X cancer and adds maybe 6 months to the end of someone’s life for $$$, when that could be used for healthcare for the poor

 

[PikminOC]

Joe Biden makes campaign stop in Lancaster, Pa., promising to provide health care for all

The former vice president is slated to talk about health care as he makes another visit to Pennsylvania, a key in the battle for the White House.

www.pennlive.com

Biden said he’d be unveiling more specifics on his health care plan in the next few weeks. But he said if elected, he would get to universal coverage quickly. He pointed to giving Americans a public option of a government-run health insurance program, similar to Medicare.

Biden said Americans need “a public option, now more than ever.” He noted it was especially important with 20 million Americans out of work.

“They need a president who will go in the White House and fight like hell to get Americans the health care coverage they need,” Biden said.

Biden said health care coverage was personal to him and his wife, Jill. He noted the loss of his son, Beau, who died of cancer at age 46."

Now Democrats have the senate, house , and presidency so hold on to your hats

 

[PikminOC]

Not sure why it becoming a public service is a bad thing.
Police, firefighters, army etc.. are all public services and help the most people (none of whom can do the job that they do).

I don’t see the point in having a chemo drug that treats X cancer and adds maybe 6 months to the end of someone’s life for $$$, when that could be used for healthcare for the poor

And their pensions are unsustainable

 

[FutureInternist]

And their pensions are unsustainable

So the way to fix not being able to pay pensions to ESSENTIAL LIFE SAVING workers is..... not to have them?

Or perhaps get the Republicans to get on board with actually forcing companies to pay their taxes in order to fund these ESSENTIAL
LIFE SAVING services 🤔

 

[PikminOC]

So the way to fix not being able to pay pensions to ESSENTIAL LIFE SAVING workers is..... not to have them?

Or perhaps get the Republicans to get on board with actually forcing companies to pay their taxes in order to fund these ESSENTIAL
LIFE SAVING services 🤔

Ask Nj and Illinois. When they are able to fix their systems, I will have more hope

 

[ChordaEpiphany]

Not sure why it becoming a public service is a bad thing.
Police, firefighters, army etc.. are all public services and help the most people (none of whom can do the job that they do).

Smart and compassionate people make better doctors and you can't bring smart and compassionate people into a profession unless you pay them well. No one is being turned down from social work positions because they don't have a strong history of serving the underserved. Being a good doctor is incredibly difficult, and the traits required are rare. It's in everyone's best interest to have a lot of people interested in the career.

Once you factor in opportunity cost and debt (doctors start earning in their mid-30s, missing out on a decade of compounded interest, and start their career with a second mortgage), doctors actually make less than comparative career paths (law, business, finance, tech, some paths of engineering, etc...). If you put doctors on par with European salaries without any of the other benefits (e.g. subsidized medical school, shortened path to medical school, decent work-life balance, etc...), the appeal for medicine would drop tremendously and you'd be left with a far less qualified group of applicants. They'd be less intelligent and less compassionate.

Further, he US has not managed a single public service correctly. As soon as something becomes a public service, the quality declines precipitously. Pretty much anyone can get one of these jobs if they set out to do it because they are just not in demand. The result is a really lackluster workforce and an overall lackluster service. We've just normalized this for some reason. Becoming a teacher should be a competitive, prestigious career. Instead, I spent most of my childhood watching VHS tapes. Look at how public services have fared in the US.

Education: Non-competitive

Social work: Non-competitive

Policing: Corrupt and non-competitive

Armed forces: Non-competitive

Public housing: Don't really need any explanation here

Public transport: Practically non-existent, chronically underfunded even where it's needed

There's a reason our best and brightest rarely enlist in the armed forces or become social workers or police officers. There's a reason public education in the US sucks and rich people prefer to send their kids to private school. The last thing we want is medicine as a public service here. Our right wing is evil and our left wing wants to charge through anyway and put the burden on the healthcare providers by slashing pay and bumping mid-levels up to full autonomy. It's just evil and stupid vs. reckless and stupid. What we need in the US is private insurance reform and a public option.

I don’t see the point in having a chemo drug that treats X cancer and adds maybe 6 months to the end of someone’s life for $$$, when that could be used for healthcare for the poor

I agree with you on that, but identifying deficiencies in a system is not the same as addressing them. If you see something wrong, the answer can't just be for the government to make it be a different way. That's just authoritarianism. Technically the government could solve every problem by stepping in and forcing people to work more or charge less, etc... but the reason we establish systems like we have is because that simply can't be the answer to everything. Governments are really, really bad at implementation and central planning, which is why capitalist systems, for all their faults, have fared as well as they have. The solution is to modify the system not to simply step in and force it to be so, which is what most on the far left are implying we do.

I'll also mention, for cancer specifically, it has been the cumulative effort of many treatments building on each other that has led to real progress in the field. If we abandoned drugs unless they produced a dramatic effect, we'd probably never make any progress. The extent to which they are monetized needs to be more heavily regulated, though.

 

[ChordaEpiphany]

Hence why m4a should be fought tooth and nail to be blocked. Nurses, PAs, pharms, etc all get a raw deal too

Workers do very poorly under M4A. It changes the payment system, but not the power dynamic, so workers will see a magnified reduction in pay (executives will attempt to keep their pay the same). We definitely need to uncouple healthcare from catastrophic costs, but that can be done with subsidies. At the end of the day, people are still making their living from working in healthcare, and that's a good thing.

I am all for universal healthcare. I'd even be for single-payer if they could set it up like they do elsewhere and clear out the corporate garbage that has filtered in over the years, but you can't just flip a switch and change to single-payer. Either ease into it with subsidies, private insurance reform, and a public option, or go whole hog and change the system. Don't build a good payment system on top of a terrible foundation and call it a day.

 

[whataschool_classof24]

Workers do very poorly under M4A. It changes the payment system, but not the power dynamic, so workers will see a magnified reduction in pay (executives will attempt to keep their pay the same). We definitely need to uncouple healthcare from catastrophic costs, but that can be done with subsidies. At the end of the day, people are still making their living from working in healthcare, and that's a good thing.

I am all for universal healthcare. I'd even be for single-payer if they could set it up like they do elsewhere and clear out the corporate garbage that has filtered in over the years, but you can't just flip a switch and change to single-payer. Either ease into it with subsidies, private insurance reform, and a public option, or go whole hog and change the system. Don't build a good payment system on top of a terrible foundation and call it a day.

Exactly. Under m4a you replace the insurance middlemen become government middlemen. We should be advocating for a system that gives power back to physicians, not one that transitions power to other middlemen while also harming the future of the profession. Now one thing that m4a could lead to would be US doctors unionizing because I do not think that in 7-8 years when I and my fellow peers are looking at 300-400k of debt and severely reduced salaries will be very happy about their financial burden for sacrificing their golden years to serve others. And for the public servant argument, physicians are highly skilled workers who go through extensive education, unlike other public servant sectors.

 

[ChordaEpiphany]

Exactly. Under m4a you replace the insurance middlemen become government middlemen. We should be advocating for a system that gives power back to physicians, not one that transitions power to other middlemen while also harming the future of the profession. Now one thing that m4a could lead to would be US doctors unionizing because I do not think that in 7-8 years when I and my fellow peers are looking at 300-400k of debt and severely reduced salaries will be very happy about their financial burden for sacrificing their golden years to serve others. And for the public servant argument, physicians are highly skilled workers who go through extensive education, unlike other public servant sectors.

You're not even replacing the middlemen, only a few of them, and you're replacing them with a system that will not play nice with the remaining middlemen. The middlemen are still there in M4A, because there is a middleman between CMS paying out for Medicare and you getting your paycheck, and that's corporate hospital groups. Groups that are doing stuff like this absolute nonsense are in charge of everyone's paycheck. Physicians and hospital workers will get caught in the crossfire between CMS and these corporate medical groups, and they will be the ones who pay the price. If we don't fix these issues alongside our broken insurance system, being a physician will be akin to being a low-level manager in the non-profit sector. I'm sure they pull in some intelligent people, but you're no longer going to be getting help from the valedictorian-types who devote their entire lives to their careers in your toughest moments.

I know we'd all love to imagine that if you paid doctors $200K while saddling them with debt and not letting them start saving for retirement until mid-late 30s, you'll be left with a highly competent workforce who cares only about the patient, but the reality is that you'd have to just start taking lower quality applicants. Our whole generation will be lamenting about how "medicine used to be a much more prestigious profession," or "medical students used to be so much more motivated."

If you do want single payer, at least advocate for the profession. Accept nothing less than full loan repayment, subsidized medical school for future generations, strict regulations on administrative take-home for hospitals accepting government payment, and generous increases to current Medicare reimbursement rates.

 

[Gyuji]

Now Democrats have the senate, house , and presidency so hold on to your hats

Nothing is going to happen. They're the majority and now can't use the excuse "We can not get it done because the Republicans" anymore, so they'll going to look back at their playbook of 2009-2011 during the first two years of Obama's presidency - Democrats had super-majority in both chambers of Congress when the public option was the big topic.

Americans wanted it, Democrats teased but donors don't want it.

Of course, being a popular policy, any Democrat Senator voting against it knows it would be a death sentence to their political career. So, someone had to volunteer to kill the policy that would be Ben Nelson then Joe Liebermann filibusted when public pressure arise. And of course, both resigned before the 2012 elections and got corporate jobs soon afterwards.

So, this time, it was quite obvious, it's going to be Joe Manchin to be the volunteer. And he already said recently he's going to block any public-friendly legislations.

Overall, Democrats are just like Republicans but hand-cuffed on what they can say and keep the charade going. So, I don't know where you guys get this weird sense of fear of Democrats are going revolutionize or something.

The Democratic Party's real job is to destablize revolutionary energy of their voter base and people by repeating the same motto "Right now isn't the time" and "we have to win back the house and/or Senate then we can talk policies" while "assisting" to help pass horrible policies with the Republicans.

 

[PikminOC]

Nothing is going to happen. They're the majority and now can't use the excuse "We can not get it done because the Republicans" anymore, so they'll going to look back at their playbook of 2009-2011 during the first two years of Obama's presidency - Democrats had super-majority in both chambers of Congress when the public option was the big topic.

Americans wanted it, Democrats teased but donors don't want it.

Of course, being a popular policy, any Democrat Senator voting against it knows it would be a death sentence to their political career. So, someone had to volunteer to kill the policy that would be Ben Nelson then Joe Liebermann filibusted when public pressure arise. And of course, both resigned before the 2012 elections and got corporate jobs soon afterwards.

So, this time, it was quite obvious, it's going to be Joe Manchin to be the volunteer. And he already said recently he's going to block any public-friendly legislations.

Overall, Democrats are just like Republicans but hand-cuffed on what they can say and keep the charade going. So, I don't know where you guys get this weird sense of fear of Democrats are going revolutionize or something.

The Democratic Party's real job is to destablize revolutionary energy of their voter base and people by repeating the same motto "Right now isn't the time" and "we have to win back the house and/or Senate then we can talk policies" while "assisting" to help pass horrible policies with the Republicans.

When they had it with Obama, they passed obamacare

 

[DrNotaDr]

When they had it with Obama, they passed obamacare

They had a super majority when they passed Obama care. Very different from today.

 

[ChordaEpiphany]

They had a super majority when they passed Obama care. Very different from today.

I think they'll be able to pass some healthcare reform. I hope the emphasis is on private insurance reform, because that is what is truly messed up in our system. If private insurance weren't so problematic, no one would think twice about our healthcare system. It's when the bill arrives in the mail that people get aggravated.

 

[Gyuji]

When they had it with Obama, they passed obamacare

Yeah, with the super-majority they had, why didn't they just spear-headed the liberal reform, universal healthcare, through Congress? Why didn't they re-install Glass-Steagall?

Like I said before, "no grasp on history" and "political spectrum."

Let me tell you something that Democrats and Republicans don't want you to know...

Obamacare is the right-wing conservative healthcare reform. Created to combat the ever-popular left-wing reform(universal healthcare). There were similar propositions in the past, similar to Obamacare, that were proposed and supported by Republicans and conservatives.

The prototype of Obamacare was Romneycare when former Governor of Massachusetts, Mitt Romney, "authored" and signed his healthcare legislation. You think I'm lying? Let's hear from CNN



Want to refute? Let's hear it from the CATO Institute



And this is the CATO Institute, the so-called libertarian think-tank, saying this.

Bob Dole proposed a similar policy during his 1996 presidential campaign. It was supported by ultra-conservatives Newt Gringrich and Chuck Grassley.

The Heritage Foundation, St. Reagan's favorite think-tank, wrote policy papers after policy papers to a policy similar to Obamacare in the late-1980's.

And of course, Richard Nixon, a staunch conservative, and jokingly our last liberal president, proposed a similar proposition in the early-1970's



Hell, Nixoncare was a better reform than Obamacare from what I read and hear from.

The reason why the Obamacare, the individual-mandate system, got passed by Democrats is because they were the super-majority and Obama campaign-promised on pushing a healthcare reform. Basically, they were pressured by the public to do something after the economy tanked. The public wanted the universal healthcare reform but the Democrats, who already taken campaign donations from private health insurance and pharmaceutical companies, squandered around for a year and offered the milquetoast Republican idea while teasing the public option, a buy-in to Medicare, to keep the public campaign down. Of course, Republicans had nowhere to go since their idea is already proposed by the Democrats.

Guess how any Republicans voted for their idea, the Obamacare? Zero.

Because they had no reform in their back pocket, the only thing they can do is vote against in order to keep the charade going for their both parties' donors.

And the over the years, as Democrats put healthcare on the backburner until Bernie Sanders came along, why do you think Republicans have a hard time re-appealing Obamacare? Here's why.



You see, the Republicans have nowhere to go, no ideas, no policies other than very unpopular proposals of RyanCare(Trumpcare) and RandPaulCare which are just a more of an individual-mandate. codeword for "tax more on the working poor," than Obamacare.

You see, both parties are the same and want to keep the endless tug-o-war going for their donors.

 

[DrNotaDr]

Yeah, with the super-majority they had, why didn't they just spear-headed the liberal reform, universal healthcare, through Congress? Why didn't they re-install Glass-Steagall?

Like I said before, "no grasp on history" and "political spectrum."

Let me tell you something that Democrats and Republicans don't want you to know...

Obamacare is the right-wing conservative healthcare reform. Created to combat the ever-popular left-wing reform(universal healthcare). There were similar propositions in the past, similar to Obamacare, that were proposed and supported by Republicans and conservatives.

The prototype of Obamacare was Romneycare when former Governor of Massachusetts, Mitt Romney, "authored" and signed his healthcare legislation. You think I'm lying? Let's hear from CNN



Want to refute? Let's hear it from the CATO Institute



And this is the CATO Institute, the so-called libertarian think-tank, saying this.

Bob Dole proposed a similar policy during his 1996 presidential campaign. It was supported by ultra-conservatives Newt Gringrich and Chuck Grassley.

The Heritage Foundation, St. Reagan's favorite think-tank, wrote policy papers after policy papers to a policy similar to Obamacare in the late-1980's.

And of course, Richard Nixon, a staunch conservative, and jokingly our last liberal president, proposed a similar proposition in the early-1970's



Hell, Nixoncare was a better reform than Obamacare from what I read and hear from.

The reason why the Obamacare, the individual-mandate system, got passed by Democrats is because they were the super-majority and Obama campaign-promised on pushing a healthcare reform. Basically, they were pressured by the public to do something after the economy tanked. The public wanted the universal healthcare reform but the Democrats, who already taken campaign donations from private health insurance and pharmaceutical companies, squandered around for a year and offered the milquetoast Republican idea while teasing the public option, a buy-in to Medicare, to keep the public campaign down. Of course, Republicans had nowhere to go since their idea is already proposed by the Democrats.

Guess how any Republicans voted for their idea, the Obamacare? Zero.

Because they had no reform in their back pocket, the only thing they can do is vote against in order to keep the charade going for their both parties' donors.

And the over the years, as Democrats put healthcare on the backburner until Bernie Sanders came along, why do you think Republicans have a hard time re-appealing Obamacare? Here's why.



You see, the Republicans have nowhere to go, no ideas, no policies other than very unpopular proposals of RyanCare(Trumpcare) and RandPaulCare which are just a more of an individual-mandate. codeword for "tax more on the working poor," than Obamacare.

You see, both parties are the same and want to keep the endless tug-o-war going for their donors.

The reason a public option didn’t get passed was because the dems didn’t feel the public supported it. That sentiment has now changed. The rest of what you said is true, Obamacare had its genesis in the GOP think tanks.

 

[deleted927028]

Nothing is going to happen. They're the majority and now can't use the excuse "We can not get it done because the Republicans" anymore, so they'll going to look back at their playbook of 2009-2011 during the first two years of Obama's presidency - Democrats had super-majority in both chambers of Congress when the public option was the big topic.

Americans wanted it, Democrats teased but donors don't want it.

Of course, being a popular policy, any Democrat Senator voting against it knows it would be a death sentence to their political career. So, someone had to volunteer to kill the policy that would be Ben Nelson then Joe Liebermann filibusted when public pressure arise. And of course, both resigned before the 2012 elections and got corporate jobs soon afterwards.

So, this time, it was quite obvious, it's going to be Joe Manchin to be the volunteer. And he already said recently he's going to block any public-friendly legislations.

Overall, Democrats are just like Republicans but hand-cuffed on what they can say and keep the charade going. So, I don't know where you guys get this weird sense of fear of Democrats are going revolutionize or something.

The Democratic Party's real job is to destablize revolutionary energy of their voter base and people by repeating the same motto "Right now isn't the time" and "we have to win back the house and/or Senate then we can talk policies" while "assisting" to help pass horrible policies with the Republicans.

You couldn’t have explained it better. You are one of the very few people who can read people’s real motives and intentions by looking at beyond their words. Yes, the Democrats are same as Republicans. The only difference is that they are adept at lying low until the right moment.

 

[deleted927028]

They had a super majority when they passed Obama care. Very different from today.

The Obamacare got passed because it was just another private insurance plan, the insurance companies loved it over a public option and the democratic donors did not object to it. Why do you think the private insurance companies are paying Obama millions in speaking fees? It is a legalized bribe for what Obama did (and did not do) to them.

 

[deleted927028]

The reason a public option didn’t get passed was because the dems didn’t feel the public supported it. That sentiment has now changed. The rest of what you said is true, Obamacare had its genesis in the GOP think tanks.

Single payer had 85% percent support in 2019. There is plenty of support now as well. Lack of public support had nothing to do with it. Our politicians (except very few) are in the pocketbooks of corporations and rich people. Nothing will get passed that hurt the interests of those people. Democrats or Republicans doesn’t matter.

The architects of the supposedly financial reform during Obama’s tenure (Barney frank and Chris Todd) were put on Wall Street boards to collect their payments FOR NOT DOING ANYTHING THAT THEY WERE SUPPOSED TO DO.

 

[whataschool_classof24]

Single payer had 85% percent support in 2019. There is plenty of support now as well. Lack of public support had nothing to do with it. Our politicians (except very few) are in the pocketbooks of corporations and rich people. Nothing will get passed that hurt the interests of those people. Democrats or Republicans doesn’t matter.

The architects of the supposedly financial reform during Obama’s tenure (Barney frank and Chris Todd) were put on Wall Street boards to collect their payments FOR NOT DOING ANYTHING THAT THEY WERE SUPPOSED TO DO.

Not true at all

 

[DrNotaDr]

Single payer had 85% percent support in 2019. There is plenty of support now as well. Lack of public support had nothing to do with it. Our politicians (except very few) are in the pocketbooks of corporations and rich people. Nothing will get passed that hurt the interests of those people. Democrats or Republicans doesn’t matter.

The architects of the supposedly financial reform during Obama’s tenure (Barney frank and Chris Todd) were put on Wall Street boards to collect their payments FOR NOT DOING ANYTHING THAT THEY WERE SUPPOSED TO DO.

Politicians almost every policy decision based on polling numbers on the respective issues. Lobbying plays a part, but it isn’t the only factor. In 2009 there wasn’t enough support for a single payer option, that’s why it didn’t get passed. That’s changed now.

 

[ChordaEpiphany]

Politicians almost every policy decision based on polling numbers on the respective issues. Lobbying plays a part, but it isn’t the only factor. In 2009 there wasn’t enough support for a single payer option, that’s why it didn’t get passed. That’s changed now.

Single payer option? Are you talking about a public option or single payer? The two are very different.

There wasn't support for a public option when the ACA passed because one democrat (Joe Lieberman) filibustered it. There has never been support for a single payer system, even now. Most house democrats support it, but not nearly enough. and the senate has less support. Republicans obviously virtually all oppose M4A.

 

[DrNotaDr]

Single payer option? Are you talking about a public option or single payer? The two are very different.

There wasn't support for a public option when the ACA passed because one democrat (Joe Lieberman) filibustered it. There has never been support for a single payer system, even now. Most house democrats support it, but not nearly enough. and the senate has less support. Republicans obviously virtually all oppose M4A.

Poll: 69 percent of voters support Medicare for All

Support for Medicare for All has remained consistently strong over the past two years, according to a new Hill-HarrisX poll.Sixty-nine percent of registered voters in the April 19-20 survey su…

thehill.com

 

[VA Hopeful Dr]

Poll: 69 percent of voters support Medicare for All

Support for Medicare for All has remained consistently strong over the past two years, according to a new Hill-HarrisX poll.Sixty-nine percent of registered voters in the April 19-20 survey su…

thehill.com

Public Opinion on Single-Payer, National Health Plans, and Expanding Access to Medicare Coverage | KFF

For many years, Kaiser Family Foundation has been tracking public opinion on the idea of a national health plan (including language referring to Medicare-for-all since 2017). Historically, our polls have shown support for the federal government doing more to help provide health insurance for...

www.kff.org

Figure 9

 

[jambro]

Single payer option? Are you talking about a public option or single payer? The two are very different.

There wasn't support for a public option when the ACA passed because one democrat (Joe Lieberman) filibustered it. There has never been support for a single payer system, even now. Most house democrats support it, but not nearly enough. and the senate has less support. Republicans obviously virtually all oppose M4A.

You guys may be talking past each other... there's "support" for a single-payer system in the fact that out of all the healthcare proposals its probably the most popular with the most amount of people. However, you're right that among politicians there is a lack of support for many of the reasons that Gyuji and LoveAll have mentioned. In fact, many of the cosponsors of M4A in the house don't even believe in it - for instance I believe Tim Ryan signed on officially and yet during his presidential run he was literally arguing against it as vociferously as anyone else

 

[DrNotaDr]

Public Opinion on Single-Payer, National Health Plans, and Expanding Access to Medicare Coverage | KFF

For many years, Kaiser Family Foundation has been tracking public opinion on the idea of a national health plan (including language referring to Medicare-for-all since 2017). Historically, our polls have shown support for the federal government doing more to help provide health insurance for...

www.kff.org

Figure 9

Figure 9 question wording is very poor. Leads to delays, what specifically? May threaten Medicare, how so? Leads to higher taxes, but doesn’t compare overall cost to current system. Very poorly worded, designed for bias.

 

[VA Hopeful Dr]

Figure 9 question wording is very poor. Leads to delays, what specifically? May threaten Medicare, how so? Leads to higher taxes, but doesn’t compare overall cost to current system. Very poorly worded, designed for bias.

Given how the KFF is very pro-single payer I don't think that's true.

They took the common complaints that people have about potential single payer and asked basically "if this happens will you still support single payer?".

 

[DrNotaDr]

Given how the KFF is very pro-single payer I don't think that's true.

They took the common complaints that people have about potential single payer and asked basically "if this happens will you still support single payer?".

Figure 10 shows a better representation of the question. It’s split evenly on cost. Majority believe healthcare is a right (which it is). This is like a personality test where they ask the same question worded 5 different ways. Believe the overall trend.

 

[jambro]

Imagine I ask the support of this question:

"Would you favor or support a health plan that is described as follows:

20% of your pay in premiums, after which you pay the first $5000 every single year

You cannot choose any doctor you want

medical bankruptcy will be the #1 cause of bankruptcy

insurance bureaucrats will decide if you can get a particular procedure

if you lose your job, you lose your healthcare (or you can pay out the nose with your new lack of income)

you can be denied coverage for any reason"

This is pretty close to our current health system - and I bet you it would be a pretty unpopular choice if we were starting today. It's not fair to compare questions decribing single payer boogeymen if you don't do the same with other systems.

 

[VA Hopeful Dr]

Figure 10 shows a better representation of the question. It’s split evenly on cost. Majority believe healthcare is a right (which it is). This is like a personality test where they ask the same question worded 5 different ways. Believe the overall trend.

Its not (lots of valid reasons to support universal healthcare, but that's not one of them), but let's not go down that rabbit hole.

The third question is the best since most everyone will pay more in taxes (even if the savings on insurance make it a net gain for people) and you still can't get a majority that still favor it and in fact more people oppose it despite that and even equally split if its only some people pay more in taxes.

 

[VA Hopeful Dr]

Imagine I ask the support of this question:

"Would you favor or support a health plan that is described as follows:

20% of your pay in premiums, after which you pay the first $5000 every single year

You cannot choose any doctor you want

medical bankruptcy will be the #1 cause of bankruptcy

insurance bureaucrats will decide if you can get a particular procedure

if you lose your job, you lose your healthcare (or you can pay out the nose with your new lack of income)

you can be denied coverage for any reason"

This is pretty close to our current health system - and I bet you it would be a pretty unpopular choice if we were starting today. It's not fair to compare questions decribing single payer boogeymen if you don't do the same with other systems.

Its the devil you know versus the one you don't.

 

[DrNotaDr]

Its the devil you know versus the one you don't.

That’s quite a devil to be content with. The number one cause of bankruptcy in this country more than all other causes combined is medical debt. It’s a grossly obscene system that the rest of the world figured out a long time ago.

 

[VA Hopeful Dr]

That’s quite a devil to be content with. The number one cause of bankruptcy in this country more than all other causes combined is medical debt. It’s a grossly obscene system that the rest of the world figured out a long time ago.

I'm going to need you to prove that.

 

[DrNotaDr]

I'm going to need you to prove that.

Medical Bankruptcy Is Killing The American Middle Class

Adobe stockA new study has found that a horrifying 530,000 families turn to bankruptcy each year due to medical bills they can’t pay. In the end,.

www.nasdaq.com

 

[VA Hopeful Dr]

Medical Bankruptcy Is Killing The American Middle Class

Adobe stockA new study has found that a horrifying 530,000 families turn to bankruptcy each year due to medical bills they can’t pay. In the end,.

www.nasdaq.com

That's what I thought. The WaPo did a fact check on that, wasn't pretty.

 

[ChordaEpiphany]

That's what I thought. The WaPo did a fact check on that, wasn't pretty.

It's true that that particular study grossly overestimated medical debt as a cause of bankruptcy. The problem was the methodology. Even if medical debt was a small part of your overall debt/reason for bankruptcy, it counted.

Another consideration is that medical debt is largely not planned for. If you're young and healthy, you're paying less even than in other countries with single payer. Our system is supported by catastrophic costs, and Americans simply don't prepare for it. Most live paycheck to paycheck, so any sudden expense will break the bank. Then they are hit with a $10K hospital bill. Meanwhile, the average person in America spends about 50% of their income on non-necessities. So you've been spending $20-30k/year on stuff like a new truck, a better iPhone, nights out on the town, etc... but you haven't left anything in the bank for an emergency. What bankrupted you, the sudden expense or the rampant overconsumption and failure to save any money?

Before I start sounding too Republican, let's revisit the goal of any healthcare system. The goal is to provide preventative care and treatment to the population with high efficacy and wide access. Clearly our system has failed to do that. However, listen to hardcore leftists talk about Medicare for All, it's about 90% about the catastrophic costs and 10% about things like access to care. 90% of the time the conversation will go the way of ambulance rides, expensive hospital stays, and mixed up billing fiascos (hospitals for some reason love to send people bills before they've been adjusted by insurance, and internet activists love to share these bills out of context).

To fix issues with access to quality care, you actually have to move away from single payer (or provide a version of single payer that greatly increases reimbursement to hospitals). You simply don't want healthcare to become another chronically underfunded public service, or you will start to see hospitals fail to meet demand for services, especially as we head into a time of major physician shortages and a growing elderly population. You'll also see stagnation in progress as more expensive (yet promising) therapies (e.g. biologics, CAR T cells, CRISPR gene editing, mRNA therapy, etc...) fail to find a meaningful market in a stingy government-run payment plan that is consistently cut for short-term political gain by those seeking to lower taxes.

What we need is greater subsidies for the middle class and a higher premium vs. OOP structure such that payment is more consistent year-to-year. We also need massive private health insurance reform.

You can't rely on the American people to vote for a well-funded healthcare system. We can't even get them to vote for well-funded public schools, even locally. If you can do it with (regulated) free market influence, you're better off doing so. Let the system stay competitive, but establish the social safety nets as necessary. Massachusetts is an example of balancing both for resounding success. They still need to control catastrophic costs better, but people there have fantastic access to care and receive some of the best care in the world.

 

[VA Hopeful Dr]

It's true that that particular study grossly overestimated medical debt as a cause of bankruptcy. The problem was the methodology. Even if medical debt was a small part of your overall debt/reason for bankruptcy, it counted.

Another consideration is that medical debt is largely not planned for. If you're young and healthy, you're paying less even than in other countries with single payer. Our system is supported by catastrophic costs, and Americans simply don't prepare for it. Most live paycheck to paycheck, so any sudden expense will break the bank. Then they are hit with a $10K hospital bill. Meanwhile, the average person in America spends about 50% of their income on non-necessities. So you've been spending $20-30k/year on stuff like a new truck, a better iPhone, nights out on the town, etc... but you haven't left anything in the bank for an emergency. What bankrupted you, the sudden expense or the rampant overconsumption and failure to save any money?

Before I start sounding too Republican, let's revisit the goal of any healthcare system. The goal is to provide preventative care and treatment to the population with high efficacy and wide access. Clearly our system has failed to do that. However, listen to hardcore leftists talk about Medicare for All, it's about 90% about the catastrophic costs and 10% about things like access to care. 90% of the time the conversation will go the way of ambulance rides, expensive hospital stays, and mixed up billing fiascos (hospitals for some reason love to send people bills before they've been adjusted by insurance, and internet activists love to share these bills out of context).

To fix issues with access to quality care, you actually have to move away from single payer (or provide a version of single payer that greatly increases reimbursement to hospitals). You simply don't want healthcare to become another chronically underfunded public service, or you will start to see hospitals fail to meet demand for services, especially as we head into a time of major physician shortages and a growing elderly population. You'll also see stagnation in progress as more expensive (yet promising) therapies (e.g. biologics, CAR T cells, CRISPR gene editing, mRNA therapy, etc...) fail to find a meaningful market in a stingy government-run payment plan that is consistently cut for short-term political gain by those seeking to lower taxes.

What we need is greater subsidies for the middle class and a higher premium vs. OOP structure such that payment is more consistent year-to-year. We also need massive private health insurance reform.

You can't rely on the American people to vote for a well-funded healthcare system. We can't even get them to vote for well-funded public schools, even locally. If you can do it with (regulated) free market influence, you're better off doing so. Let the system stay competitive, but establish the social safety nets as necessary. Massachusetts is an example of balancing both for resounding success. They still need to control catastrophic costs better, but people there have fantastic access to care and receive some of the best care in the world.

Excellent post that hits of some of the big issues that never seem to get discussed.

One part in particular I'd like to address is the idea of a regulated free market. We don't have anything close to that. I'll elaborate: Several years ago I owned a cash-only primary care office. When you remove insurance from the game, primary care is insanely inexpensive. For instance, labs. At my current job (hospital owned FM practice) you can't get any labs for under $40, most are over $60. At my cash office, the vast majority of the labs were under $10. A1c-7, lipid panel-7, CBC-5, TSH-8, CMP-6, PSA-14, Testosterone-22, Pap smear with HPV-50. The difference is absurd. I also dispensed medications (its allowed in 48 states last I checked). Most meds I could be a 90 day supply for under $10. Amlodipine cost me literally 1 cent per pill, same with lisinopril and meloxicam. Metformin was 3 cents/pill. A z pack was $4.

Radiology can be super cheap as well. I got an x-ray a few months back at my office. Total price after insurance adjustment for the films was $45, the read was $15. At the local independent imaging center, that same x-ray with read would be $30. Literally half the price. I had a patient last week who I ordered an MRI for. His portion of the cost was $1400. That same free standing place can do it for $600.

Here's the problem though: if you pay cash for something, it doesn't apply to your deductible. The MRI patient ended up going the $1400 route so if he needed surgery/injections he'd be that much closer to hitting his deductible. That's the part that always kills me. I have had similar issues at the pharmacy with Goodrx. Its routinely cheaper to do that than use my insurance but then it doesn't apply to the deductible.

That needs to be fixed.

 

[TwistedTea]

Great two posts above, unfortunately people are not good at accepting their own faults and never want to take financial blame for their mistakes. I would also be for aggressive expansion of HSA plans or maybe even a requirement to contribute to one. Much rather have that and the above than some M4A system..... unfortunately most of the general population seems to think M4A = "free" and "i do not have to be responsible" so thats going to get all the votes.


Idiocracy here we come

 

[dpmd]

Excellent post that hits of some of the big issues that never seem to get discussed.

One part in particular I'd like to address is the idea of a regulated free market. We don't have anything close to that. I'll elaborate: Several years ago I owned a cash-only primary care office. When you remove insurance from the game, primary care is insanely inexpensive. For instance, labs. At my current job (hospital owned FM practice) you can't get any labs for under $40, most are over $60. At my cash office, the vast majority of the labs were under $10. A1c-7, lipid panel-7, CBC-5, TSH-8, CMP-6, PSA-14, Testosterone-22, Pap smear with HPV-50. The difference is absurd. I also dispensed medications (its allowed in 48 states last I checked). Most meds I could be a 90 day supply for under $10. Amlodipine cost me literally 1 cent per pill, same with lisinopril and meloxicam. Metformin was 3 cents/pill. A z pack was $4.

Radiology can be super cheap as well. I got an x-ray a few months back at my office. Total price after insurance adjustment for the films was $45, the read was $15. At the local independent imaging center, that same x-ray with read would be $30. Literally half the price. I had a patient last week who I ordered an MRI for. His portion of the cost was $1400. That same free standing place can do it for $600.

Here's the problem though: if you pay cash for something, it doesn't apply to your deductible. The MRI patient ended up going the $1400 route so if he needed surgery/injections he'd be that much closer to hitting his deductible. That's the part that always kills me. I have had similar issues at the pharmacy with Goodrx. Its routinely cheaper to do that than use my insurance but then it doesn't apply to the deductible.

That needs to be fixed.

I don't understand why a person wouldn't be able to pay cash and then submit a claim form to their insurance

 

[VA Hopeful Dr]

I don't understand why a person wouldn't be able to pay cash and then submit a claim form to their insurance

Never made sense to me either, but I had a fair number of patients try it with no success.