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Interesting, you have to wonder if this will help accelerate a push from rural voters for government-run health care where gov run hospitals have a mandate to s
by bwb 7y ago
Interesting, you have to wonder if this will help accelerate a push from rural voters for government-run health care where gov run hospitals have a mandate to stay open and the cost is spared across the system.
- brianpgordon 7y agoUnfortunately, I think it's more likely that no matter how bad private healthcare gets, people in the deep red states mentioned in the article will just assume that socialized healthcare would be even worse and dig in their heels all the more out of redoubled fear of losing what little they have left.
- vidanay 7y agoThey will demand that the government "do something" (aka, a bail-out) whilst simultaneously complaining about their taxes.
- Scoundreller 7y agoDon’t forget about subsidies and bailouts that are structured differently, but effectively that: - cheap loans to terrible creditors that nobody else in the world would loan to - not allowing governments to negotiate prices, even when they’re the buyer (drug prices) - extra taxes, errr, tariffs, on their competitors - exemptions from those same tariffs when its their input - access to cheaper labour pools that no small business could possibly do the paper work for (various visas)
- UncleEntity 7y agoOr... It could have been the plan all along to engineer a "market failure" so these people have no choice but to accept socialized healthcare even if they're vehemently opposed to it.
- slowmovintarget 7y agoThis shouldn't be downvoted, because this was was what the ACA was meant to do. Exacerbate the cost problem (which it has done), restrict doctor-run hospitals (which it does), and lead to a problem where the "solution" is a single-payer system so that 11% of the economy (back then), could be "captured". Many democrats thought (and said so) that there was a huge problem of all this money moving around without government control. The first attempt, which failed badly under Hillary Clinton's leadership during her time as First Lady, failed because it tried to do everything at once. It could therefore be seen as a massive power-grab. The ACA on the other hand, delivered an incremental approach that included lots of things people wanted: ignoring pre-existing conditions, broadening coverage. But it also did things like say there could be no new doctor-run hospitals, and existing ones could not add beds. Doctor-run hospitals, at the time, were actually a success of the free market in health care. Their outcomes in terms of patient recovery and survival rates were higher than state run hospitals. They were a direct threat to the idea that the government should run health care. The ACA also set the stage for the failure of private medical insurance. We're in limbo on that score, but the needle has moved toward that failure.
- guntars 7y agoAnd now you’re being downvoted because all of this is unsourced speculation and people here don’t really care for that.
- ryguytilidie 7y agoAlso because he is literally blaming Hillary Clinton for stuff that happened while she was first lady. I swear modern Republicanism is just agreeing with Donald Trump and blaming anything that goes wrong on Hillary or Obama.
- slowmovintarget 7y agoHillary Clinton led the effort to reform health care during her husband's first term in office [1]. I am literally claiming that Hillary did things that she actually did. I'm sorry you weren't aware of history. That Hillary led this effort was actually noteworthy less for its failure and more for the fact that this was the first time a First Lady took a publicly visible hand in core policy-making. I don't think Donald Trump is truly fit to be president, and I don't think the modern Republican party represents my views. Nor do I think Hillary Clinton was a suitable choice either. But disagreeing with the modern Democrat party is often met with derision, even if it is reasoned objection. I actually remember the political discourse during President Clinton's first term, having been part of it back then. I remember the speeches Hillary Clinton gave as chair of the task force, including the notion that it was tragedy to allow so much of the economy to flow outside the purview of government. The notion of regulatory capture is not new [2]. It is my opinion that the purpose of the ACA was to lead to single-payer. It was the kind of boiled-frog strategy that Democrat party leaders had been using successfully for decades at the point ACA came a along. The restrictions on doctor-owned hospitals are part of the law [3]. That the law would cause increased costs and dramatic deficits was predicted by the Congressional Budget Office (CBO) [4, 5]. The way I formed my opinion was taking all of this into account, including the model Hillary's task force put forth in the 90s as being what Democrats actually wanted. It is a reasonable opinion that if the ACA didn't deliver all of the things from the original plan, yet it opened up many unsolved problems, that the intent was to "continue reform" and make the "natural solution" a single-payer system. I do wish we could have discussion without every comment on politics becoming a college paper. [1] https://en.wikipedia.org/wiki/Clinton_health_care_plan_of_1993 https://en.wikipedia.org/wiki/Clinton_health_care_plan_of_19... [2] https://en.wikipedia.org/wiki/Regulatory_capture https://en.wikipedia.org/wiki/Regulatory_capture [3] https://www.cms.gov/medicare/fraud-and-abuse/physicianselfreferral/physician_owned_hospitals.html https://www.cms.gov/medicare/fraud-and-abuse/physicianselfre... [4] https://www.cbo.gov/topics/health-care/affordable-care-act https://www.cbo.gov/topics/health-care/affordable-care-act [5] https://www.factcheck.org/2017/03/cbos-obamacare-predictions-how-accurate/ https://www.factcheck.org/2017/03/cbos-obamacare-predictions...
- makomk 7y agoI'm not sure they'd be wrong. The politicians pushing to socalize US healthcare are doing so on a platform of cutting costs and are generally pretty hostile to the idea of subsidising rural folks. Both of those point in the direction of healthcare reforms that kill off rural hospitals.
- tjr225 7y ago> platform of cutting costs Costs should be cut, regardless of urban/rural, if we're being overcharged. Not sure what this has to do with killing off rural hospitals though. > generally pretty hostile to the idea of subsidising rural folks I have seen no evidence of this...do you care to elaborate or provide some links or something?
- deleted 7y ago[deleted]
- torpfactory 7y agoNah, rural politicians will most-likely find it more politically advantageous to claim that the hospitals are closing because of 'illegals', welfare-bound decadent city folks, or some hare-brained conspiracy theory. It will be too difficult to square their political convictions with economic realities. Providing healthcare in rural areas will always be economically difficult. There aren't enough consumers in rural areas to support modern hospital facilities. Admitting this isn't a problem markets will solve, and that government taxes and spending might be the answer, is something that will prove very difficult indeed.
- JPKab 7y agoThe hospital in the rural area I grew up in closed it's doors two years ago. The tribal politics in the comments here are obnoxious and myopic. Rural hospitals are receiving the majority of their money from Medicare and Medicaid. They don't pay enough. There was a great NPR show on this a few weeks ago. Hospitals in the US overcharge (cost shifting is the technical term) patients with private insurance to offset losses from offering services at below cost to Medicare/Medicaid patients. Too few private insurance patients means they close their doors.
- dd36 7y agoOr there’s just not enough volume in rural hospitals and reimbursement rates have to be higher than in denser areas to break even.
- 0xB31B1B 7y agoThat’s not the issue, the issue is that rural areas are also much older on average and have a much higher proportion of patients on Medicare.
- bwb 7y agoCould easily be both too, doesn't have to be just one. Not to mention many other things happening in rural issues that might be driving issues. Long live nuance.
- astronautjones 7y agoall of these points are irrelevant if the government is running the hospital. it shouldn't have to be profitable.
- dx87 7y agoI doubt it. My grandparents and inlaws both live in rural towns, and I think they'd rather have the hospital close down than have to pay more taxes. I know the news likes to show people from rural towns that want the government to provide urban ammenities in areas that can't financially support it, but in my experience, those people are in the minority. Most rural people I've met know the risks of living far from government services, and they think the benefits outweigh the risks.
- adamnemecek 7y agoIt might not increase taxes.
- Gusmann 7y agoStill even people living 'far from government services' should be able to get emergency help when they need to and the closure of the hospitals might just drop the general level of life in the area
- mymythisisthis 7y agoI've made a comment somewhere else in this thread, but I think it applies to your observation. We should have different laws for rural/urban about almost everything. Make flying cheaper in rural areas; less insurance, less safety standards. Rural people know what they are getting into and know the risk of living in rural areas. They are also more self-sufficient. The rural/urban divide is too great.
- sfkdjf9j3j 7y agoRural voters already have mostly government-run healthcare and broadly support medicare and medicaid. They just don't vote like they want to keep it.
- fucking_tragedy 7y agoThat depends on the state they're in. If they're in a state that didn't expand Medicaid with the ACA, like the states in orange on this map[1], then no, they do not have access to government-run healthcare unless they are retired or disabled. [1] https://www.kff.org/wp-content/uploads/2018/11/status-of-state-action-on-the-medicaid-expansionc2a0decision.png https://www.kff.org/wp-content/uploads/2018/11/status-of-sta...
- javagram 7y agoRural areas supported Trump who promised not to reform Medicare/Medicaid and was perceived by voters as a more moderate alternative to the rest of the GOP primary field (who did have plans to cut entitlements).
- asveikau 7y agoI have been told that once you go after increasing health care costs (one goal of government run health care) hospitals will have to accept lower payments, which will not be good for rural hospitals specifically. I am still in favor of doing that though. And ignoring that part, there are huge cost reductions to be had elsewhere, say, for example, an entire industry of medical billing and debt collection - though it'd sure be a shame to see all those nice folks out of work.
- a3n 7y agoNot in our lifetimes. For or against any form of publicly subsidized health service has become a bedrock part of people's identity.