Public option NYT article

[SSdoc33]

https://www.washingtonpost.com/opinions/a-public-option-for-health-insurance-is-a-terrible-idea/2019/07/24/fb651c1a-ae2e-11e9-8e77-03b30bc29f64_story.html?utm_term=.cf045b16278b

Verma conveniently glosses over WHY the ACA wasn't as successful as it could have been (GOP obstructionism) but she makes some good points.

I just cant see single payer or "medicare for all/public option" happening unless democrats take the senate AND the white house. pretty unlikely at this point.

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[drusso]

https://www.washingtonpost.com/opinions/a-public-option-for-health-insurance-is-a-terrible-idea/2019/07/24/fb651c1a-ae2e-11e9-8e77-03b30bc29f64_story.html?utm_term=.cf045b16278b

Verma conveniently glosses over WHY the ACA wasn't as successful as it could have been (GOP obstructionism) but she makes some good points.

I just cant see single payer or "medicare for all/public option" happening unless democrats take the senate AND the white house. pretty unlikely at this point.

D's and Obama sold out to Big Insurance to pass ACA. ACA was a boondoggle for hospitals and their lackeys who used SOS arbitrage to distort local markets and gain monopoly power. I will never forgive them. Want to see health systems that work? Visit Taiwan and Switzerland.

...Verma hits the nail on the head: "Instead of introducing even more government intrusion into the markets, we must strengthen and protect our existing safety-net programs and address the drivers of costs by fostering a competitive and dynamic private market in which plans and providers compete on the basis of cost and quality — not a system that makes promises that can’t be kept and leaves taxpayers to clean up the mess."

...which I've said all along...

"The bottom line is that when small providers are pushed out of the market by anti-competitive forces, patients are left with fewer choices, higher prices — and in some cases, lower-quality care. The ACA has driven hospitals to find new revenue streams, and they have found a prime source in physician services. The acquisition of independent practices increases costs and reduces patient choices leaving hospitals as the only winner. As a result, the concept of personalized care is being removed from the healthcare equation, leaving both patients and physicians holding the short end of the stick."

Healthcare Reform Creates Provider Monopolies | The Lund Report

www.thelundreport.org

 

[SSdoc33]

D's and Obama sold out to Big Insurance to pass ACA. ACA was a boondoggle for hospitals and their lackeys who used SOS arbitrage to distort local markets and gain monopoly power. I will never forgive them. Want to see health systems that work? Visit Taiwan and Switzerland.

...Verma hits the nail on the head: "Instead of introducing even more government intrusion into the markets, we must strengthen and protect our existing safety-net programs and address the drivers of costs by fostering a competitive and dynamic private market in which plans and providers compete on the basis of cost and quality — not a system that makes promises that can’t be kept and leaves taxpayers to clean up the mess."

...which I've said all along...

"The bottom line is that when small providers are pushed out of the market by anti-competitive forces, patients are left with fewer choices, higher prices — and in some cases, lower-quality care. The ACA has driven hospitals to find new revenue streams, and they have found a prime source in physician services. The acquisition of independent practices increases costs and reduces patient choices leaving hospitals as the only winner. As a result, the concept of personalized care is being removed from the healthcare equation, leaving both patients and physicians holding the short end of the stick."

Healthcare Reform Creates Provider Monopolies | The Lund Report

www.thelundreport.org

To be clear, Verma didn't go into PP vs. hospitals and SOS stuff. That is from your own Lund Report that you love to footnote.

I think the swiss have the right idea, but they have a mandate to buy insurance. Is that what you are looking for?

Healthcare in Switzerland - Wikipedia

en.wikipedia.org

Also, the demographics and economics in Switzerland aren't exactly the same as the US.

 

[drusso]

To be clear, Verma didn't go into PP vs. hospitals and SOS stuff. That is from your own Lund Report that you love to footnote.

I think the swiss have the right idea, but they have a mandate to buy insurance. Is that what you are looking for?

Healthcare in Switzerland - Wikipedia

en.wikipedia.org

Also, the demographics and economics in Switzerland aren't exactly the same as the US.

What else do you think she meant by the term "drivers of cost?" She's actually very tuned to SOS arbitrage.

Swiss regulate their health insurance industry like a public utility (but they are private entities). No, I don't favor compelling people to buy insurance, but I do favor giving them incentives (tax breaks or otherwise) to do so. Both Swiss and Taiwanese have invested in robust private markets.

 

[SSdoc33]

What else do you think she meant by the term "drivers of cost?" She's actually very tuned to SOS arbitrage.

Swiss regulate their health insurance industry like a public utility (but they are private entities). No, I don't favor compelling people to buy insurance, but I do favor giving them incentives (tax breaks or otherwise) to do so. Both Swiss and Taiwanese have invested in robust private markets.

so, if you read the actual details, the swiss plan is essentially the ACA. you are mandated to buy insurance, pre-existing conditions cant be held against you, and insurance companies CANNOT profit off the basic plan. this is key.

everyone is required to buy the basic plan, but there are gvt subsidies for the indigent.

ive said it before, and ill say it again: basic crappy plan for everyone -- you buy it if you have the means -- subsidies or free if you don't. call it a tax if you want -- that part is semantics. then, you have the option to buy better insurance if you have the $$$. this gets you name brand drugs, no waits for MRIs or surgery, and a nicer hospital bed. blue cross and Aetna are still in business, and the costs go way down. boom. done. call it the ssdoc33 plan

 

[drusso]

so, if you read the actual details, the swiss plan is essentially the ACA. you are mandated to buy insurance, pre-existing conditions cant be held against you, and insurance companies CANNOT profit off the basic plan. this is key.

everyone is required to buy the basic plan, but there are gvt subsidies for the indigent.

ive said it before, and ill say it again: basic crappy plan for everyone -- you buy it if you have the means -- subsidies or free if you don't. call it a tax if you want -- that part is semantics. then, you have the option to buy better insurance if you have the $$$. this gets you name brand drugs, no waits for MRIs or surgery, and a nicer hospital bed. blue cross and Aetna are still in business, and the costs go way down. boom. done. call it the ssdoc33 plan

It's not quite that simple. That Swiss have a degree of trust in their insurance companies because citizens have meaningful roles in the governance of those plans. That's why I don't think that the Swiss system would work here, but we have things to learn from them and borrow best practices--like meaningful participation in Governance of the plans.

Another sad mistake the D's and Obama made were cutting the private, non-profit, member-governed 501(c)(29) private health plans out of the risk corridor payments. I participated in the administration of these plans and they were truly patient-centered and member-governed with broad stakeholder input by private employers and individual members. Again, the private sector can usually accomplish more meaningful reform that "Big Government."

Health Republic Closing FAQs Archives – Health Republic Insurance of Oregon

healthrepublicinsurance.org

Congress passed the Affordable Care Act and called on new, smaller regional health plans like Health Republic Insurance to take on big risks by covering previously uninsured people. Congress knew there were risks. That’s why they set up a federal program to protect new health plans. They promised to pay these health plans for helping people get insurance. Now the Feds are backing out on their promise and owe billions to smaller competitive health plans across the country.

CO-OP health plans: patients’ interests first | healthinsurance.org

As of 2024, only three of the original 23 CO-OPs are still operational, with coverage available in Maine, Wisconsin, Idaho, Wyoming, and Montana. Most of the original CO-OPs failed for a variety of reasons, including premiums that were too low and the unexpected loss of federal funding that was...

www.healthinsurance.org

At the time, progressives who preferred a public option derided CO-OPs as a poor alternative because they can’t utilize the efficiencies of scale that would come with Medicare For All, nor do they have the market clout that a single payer system would have when negotiating reimbursement rates with providers. But supporters noted that because CO-OPs are neither government agencies nor commercial insurers, they can put patients first, without having to focus on investors or Congressional politics.

 

[hyperalgesia]

so, if you read the actual details, the swiss plan is essentially the ACA. you are mandated to buy insurance, pre-existing conditions cant be held against you, and insurance companies CANNOT profit off the basic plan. this is key.

everyone is required to buy the basic plan, but there are gvt subsidies for the indigent.

ive said it before, and ill say it again: basic crappy plan for everyone -- you buy it if you have the means -- subsidies or free if you don't. call it a tax if you want -- that part is semantics. then, you have the option to buy better insurance if you have the $$$. this gets you name brand drugs, no waits for MRIs or surgery, and a nicer hospital bed. blue cross and Aetna are still in business, and the costs go way down. boom. done. call it the ssdoc33 plan

You can't afford the kind of program you are talking about without using monopolistic leverage. This is poison to a free market economy.

Also, you will never be able to split the hairs into what poor people are entitled to vs rich people. Healthcare is either a "right" or it's not. Waiting for an MRI is either consistent with adequate healthcare or it's not.

That's why you and democrats always brush over the details and only speak in broad language.

You have to put the ssdoc33 plan into action in the real world at a state or local level for it to have any credibility. The federal govt should work with you to accommodate.

 

[drusso]

so, if you read the actual details, the swiss plan is essentially the ACA. you are mandated to buy insurance, pre-existing conditions cant be held against you, and insurance companies CANNOT profit off the basic plan. this is key.

everyone is required to buy the basic plan, but there are gvt subsidies for the indigent.

ive said it before, and ill say it again: basic crappy plan for everyone -- you buy it if you have the means -- subsidies or free if you don't. call it a tax if you want -- that part is semantics. then, you have the option to buy better insurance if you have the $$$. this gets you name brand drugs, no waits for MRIs or surgery, and a nicer hospital bed. blue cross and Aetna are still in business, and the costs go way down. boom. done. call it the ssdoc33 plan

Non-Profit Hospitals Are Making a Killing

The leading 82 non-profit hospitals in the US have combined net assets of $203 billion. Their average growth last year was 23.6 percent. These figures would make even the most loyal believers in the free market pause—except this isn’t capitalism.

fee.org

"Are these non-profits truly working for patients, or are they navigating and molding the system’s rules to ensure their greatest possible piece of the health care pie? In 2018, the American Hospital Association lobbying arm donated$23,937,842 in political contributions. I sincerely doubt that was to advance their healing mission."

#staywoke

 

[Apollyon]

Visit Taiwan and Switzerland.

Taiwan and Switzerland are also the size of Maryland. That's kind of dinky, and easier to regulate anything.