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Government position as healthcare provider is exactly the opposite of private insurer. Government usually tries to limit its spending (because it already is in

by mamon 10y ago

Government position as healthcare provider is exactly the opposite of private insurer. Government usually tries to limit its spending (because it already is indebted beyond reason) thus using its effective monopoly to force lower and lower prices of all drugs and medical procedures. At the same time the voters pressure (every government wants to be re-elected) forces it to provide reasonable quality of service in healthcare. At least that's how it works in most of EU. Private insurers want to maximize profits, so they charge a lot of money for their policies, while lowering overall quality of healthcare (by denying insurance to low income, high risk clients - and healthcare quality for not insured is tragic). P.S. Social Security is a flawed analogy, inner workings of Social Security and Healthcare are totaly different.

wahern 10y ago
At least that's how it works in most of EU. But the US isn't the EU, and it sure as heck isn't as sane as a place like Germany. The US has _always_ been strongly deferential to corporate interests. It's the thing that stood out to me the most when I read the excellent book, "There is Power in a Union", a history of the American labor movement from the early 19th century to the mid 20th century. Even at the apex of the union movement--and thus the apex of a national collectivist mentality--the U.S. government and population both heavily favored corporate interests. That's not a value judgment or criticism, it's just the cold historic reality. I don't think Social Security is a flawed analogy at all. The core issue of viability isn't about the technical machinations of health care vs retirement income; it's about the politics of not only creating a national program, but _maintaining_ that program in earnest over the long-haul. And specifically the politics in the United States. Something like Social Security is the best we can hope for in terms of pervasiveness and stability. Social Security has survived precisely because it falls far short of the kind of a strong collectivist, redistributive commitment the country would need to make to enact and _sustain_ a single-payer program. In objective terms both Canada's and Japan's healthcare systems strike a decent balance between public and corporate interests, and Obamacare is tantalizingly close to them on the public/private spectrum. But I think American progressives don't appreciate how deep, strong, pervasive and _persistent_ are the conservative currents in American political culture. When progressives complain about the poor and working class voting against their own self-interest, they don't appreciate how consistent this behavior has been over the centuries. Without appreciating that, they are miscalculating the viability of their preferred options. If you examine American political history both over the long term (centuries) and short-term (decades), Obamacare was the best we could ever hope for, and even that was probably too much. And any progressive who thinks Obamacare is hopelessly flawed--because of unnecessary costs sustaining the superfluous private layers--should realize that the _only_ viable alternative is to refocus on state-based solutions. Let's imagine that Bernie Sanders won the presidency. No way in heck would he be able to champion a single-payer system. The nation didn't just elect President Trump, they gave conservatives a huge majority in _both_ Houses. So, again, the best progressives could have hoped for was tweaking Obamacare and keeping it fiscally viable. The rise of conservatism isn't going anyway any time soon; it's actually a regression to the mean for American politics. People need to keep that in mind, and stop with the wishful thinking.
- giardini 10y ago
  So you don't think that Trump could reframe a single-payer proposal and present it to America as a cost-saving and more efficient health insurance plan than the current system?

by mamon 10y ago

wahern 10y ago

At least that's how it works in most of EU. But the US isn't the EU, and it sure as heck isn't as sane as a place like Germany. The US has _always_ been strongly deferential to corporate interests. It's the thing that stood out to me the most when I read the excellent book, "There is Power in a Union", a history of the American labor movement from the early 19th century to the mid 20th century. Even at the apex of the union movement--and thus the apex of a national collectivist mentality--the U.S. government and population both heavily favored corporate interests. That's not a value judgment or criticism, it's just the cold historic reality. I don't think Social Security is a flawed analogy at all. The core issue of viability isn't about the technical machinations of health care vs retirement income; it's about the politics of not only creating a national program, but _maintaining_ that program in earnest over the long-haul. And specifically the politics in the United States. Something like Social Security is the best we can hope for in terms of pervasiveness and stability. Social Security has survived precisely because it falls far short of the kind of a strong collectivist, redistributive commitment the country would need to make to enact and _sustain_ a single-payer program. In objective terms both Canada's and Japan's healthcare systems strike a decent balance between public and corporate interests, and Obamacare is tantalizingly close to them on the public/private spectrum. But I think American progressives don't appreciate how deep, strong, pervasive and _persistent_ are the conservative currents in American political culture. When progressives complain about the poor and working class voting against their own self-interest, they don't appreciate how consistent this behavior has been over the centuries. Without appreciating that, they are miscalculating the viability of their preferred options. If you examine American political history both over the long term (centuries) and short-term (decades), Obamacare was the best we could ever hope for, and even that was probably too much. And any progressive who thinks Obamacare is hopelessly flawed--because of unnecessary costs sustaining the superfluous private layers--should realize that the _only_ viable alternative is to refocus on state-based solutions. Let's imagine that Bernie Sanders won the presidency. No way in heck would he be able to champion a single-payer system. The nation didn't just elect President Trump, they gave conservatives a huge majority in _both_ Houses. So, again, the best progressives could have hoped for was tweaking Obamacare and keeping it fiscally viable. The rise of conservatism isn't going anyway any time soon; it's actually a regression to the mean for American politics. People need to keep that in mind, and stop with the wishful thinking.

giardini 10y ago
So you don't think that Trump could reframe a single-payer proposal and present it to America as a cost-saving and more efficient health insurance plan than the current system?