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The other reason only 21% of people are against abolishing private insurance is that lots of people are insured through their employer, and thus the true cost o

The other reason only 21% of people are against abolishing private insurance is that lots of people are insured through their employer, and thus the true cost of their healthcare coverage is hidden from them. If they really knew how much it was costing them (because benefits are part of “total compensation”), they would sing a different tune.

kodablah 7y ago
And yet another is they don't have confidence in the public sector running it well.
- danaris 7y ago
  Because for at least the past 4 decades, one major political party has been running an enormous propaganda campaign to convince the country that "public sector" == "wasteful, inefficient, ineffective, and corrupt" and "private company" == "efficient market-driven utopia". They've been so successful, they've even convinced themselves—so much so that every time actual evidence to the contrary is presented, they pretend it doesn't exist and try to make everyone else do the same.
  - rayiner 7y ago
    That, along with peoples’ actual experiences with their government. The NYC MTA is better funded than London’s or Paris’s transit systems, yet has on the brink of system failure. Amtrak is similarly funded (adjusted for differences in passenger volume) to European rail systems. Yet it offers decrepit equipment and unreliable service. We spend more per student on education than all but a couple of other countries (like Switzerland), but our test scores are at the bottom of the pack. American cities like Baltimore and San Francisco are full of crime, homelessness, and drug use, even though they’ve been controlled by “the other major party” for decades. It should also be noted that, with the notable exception of healthcare, most of Western Europe has followed the trend of privatization, deregulation, and reliance on market mechanisms. Macron is talking about privatizing SNCF—not even Trump is talking about privatizing Amtrak.
    - enraged_camel 7y ago
      You are being disingenuous. Why don't you look at government-run programs in the actual sector we are discussing? Medicare and VA healthcare programs are both well-run and immensely popular among their recipients. They aren't without problems, but looking at them objectively should dispel any notion that "the government cannot run healthcare efficiently and effectively."
      - kodablah 7y ago
        > They aren't without problems, but looking at them objectively should dispel any notion that "the government cannot run healthcare efficiently and effectively." I think that wouldn't dispel the notion that "the government cannot regulate healthcare efficiently and effectively". Unless you expect all hospitals and doctors to be direct employees of the government, you need to look at how they regulate the sector, they won't be running it. I shouldn't have used "running" in my original comment as it implied more direct control than would be the case.
        sitkack 7y ago
        That is exactly how it works now. While VA hospitals do exist, there are no Medicare hospitals.
    - WorldMaker 7y ago
      Amtrak is already privatized (in the USPS model). If it were any more privatized it would be bankrupt and nobody would be providing the service. If someone were trying to compete with Amtrak, the country is ripe with old, falling apart cargo-only rails that haven't seen passengers in a century or longer. (It would also probably cost a fraction of what Musk, et al have thrown into silly pie-in-the-sky fantasies like the "hyper-loop" to old fashioned public transport planning with existing, proven modern technologies such as Japanese "bullet" train tech.) I think I agree with upthread. Probably more than anything what America needs in public transport is good propaganda again. There was a time that civic responsibility saw public transport as a public good to connect cities and Americans and make dreams happen. (Old 19th Century train ads were things of beauty.) The "American Dream" probably needs to shake its collective love affair with the automobile before anything real could be done for good, trustworthy public transport.
  - kodablah 7y ago
    That may be one minor reason of many, that may not. But this speculation that peoples' beliefs, such as my own, are propaganda driven needs to stop being presented as objective. Many people have statistical and empirical evidence to support their beliefs especially concerning issues such as health policy/regulation. When you disagree, those you disagree with are not automatically swayed by propaganda any more than your beliefs of the significant PR effects are propaganda-based themselves.
    - yourbandsucks 7y ago
      Medicare, Medicaid and the VA manage to be cheaper per capita despite specifically insuring the old, the poor, and veterans. What's your statistical and empirical reasoning and why should we ignore that elephant of a top line number?
      - gamblor956 7y ago
        There isn't any. Not a single private health plan manages to be more cost-effective than the 3 government health plans, despite private health plans having the ability to pick-and-choose the cream of the crop and to offload unprofitable customers to government health plans. BUT (when they actually provide health care) private health plans usually provide health care faster than government health plans. VA wait times, for example, still exceed 12 months in many parts of the country.
        FireBeyond 7y ago
        > BUT (when they actually provide health care) private health plans usually provide health care faster than government health plans. VA wait times, for example, still exceed 12 months in many parts of the country. I had a severe wrist injury from a car accident. I was told to start PT "ASAP", and given referrals within 24 hours of the injury. I was then told that I'd be waiting 10-12 weeks for a PT slot.
EpicEng 7y ago
Yet we're not going to see a big raise because we switch over to a single payer system. It's not unreasonable for people to be skeptical of such a massive change when their current situation works fine (for them.) A change like this would be far more beneficial to the under/uninsured than those of us with existing, comprehensive plans. I'm not making an argument either way. Personally I'm for single payer, but that's largely due to the issues my mother had when she became ill.
- wahern 7y ago
  > Yet we're not going to see a big raise because we switch over to a single payer system. Californian legislators released a study last year about the costs of moving to single-payer healthcare in the state. In total it would be $400 billion, requiring $200 billion in new tax revenues after accounting for the existing $200 billion in federal, state, and local expenditures. Diverting existing employer and individual premium payments would still leave anywhere from a $50 billion to $150 billion gap. California's existing budget is ~$200 billion, so covering that gap would require significant new taxes. Anybody telling you that you can get single-payer for free is lying to you. That would only be possible if we could significantly reduce costs, but we don't know how to reduce costs. Any suggestion you've heard is almost certainly part of the ACA/Obamacare in some form or fashion, and the strategies aren't working as well as originally believed. But this was predicted. The ACA was always intended to be a process of experimenting with cost reducing strategies, which is why there were supposed to be panels that could rewrite the rules as new information came in. But nobody is interested in the hard work of figuring out what those solutions are; all the electorate on both sides is interested in voting for are feel-good solutions. And they'll believe whatever they need to believe in order to support their political tribe.
  - sitkack 7y ago
    > we don't know how to reduce costs I am pretty sure administrators of health systems that are cheaper could tell us. Like just directly to our face.
    - 7y ago

kodablah 7y ago

And yet another is they don't have confidence in the public sector running it well.

danaris 7y ago
Because for at least the past 4 decades, one major political party has been running an enormous propaganda campaign to convince the country that "public sector" == "wasteful, inefficient, ineffective, and corrupt" and "private company" == "efficient market-driven utopia". They've been so successful, they've even convinced themselves—so much so that every time actual evidence to the contrary is presented, they pretend it doesn't exist and try to make everyone else do the same.
- rayiner 7y ago
  That, along with peoples’ actual experiences with their government. The NYC MTA is better funded than London’s or Paris’s transit systems, yet has on the brink of system failure. Amtrak is similarly funded (adjusted for differences in passenger volume) to European rail systems. Yet it offers decrepit equipment and unreliable service. We spend more per student on education than all but a couple of other countries (like Switzerland), but our test scores are at the bottom of the pack. American cities like Baltimore and San Francisco are full of crime, homelessness, and drug use, even though they’ve been controlled by “the other major party” for decades. It should also be noted that, with the notable exception of healthcare, most of Western Europe has followed the trend of privatization, deregulation, and reliance on market mechanisms. Macron is talking about privatizing SNCF—not even Trump is talking about privatizing Amtrak.
  - enraged_camel 7y ago
    You are being disingenuous. Why don't you look at government-run programs in the actual sector we are discussing? Medicare and VA healthcare programs are both well-run and immensely popular among their recipients. They aren't without problems, but looking at them objectively should dispel any notion that "the government cannot run healthcare efficiently and effectively."
    - kodablah 7y ago
      > They aren't without problems, but looking at them objectively should dispel any notion that "the government cannot run healthcare efficiently and effectively." I think that wouldn't dispel the notion that "the government cannot regulate healthcare efficiently and effectively". Unless you expect all hospitals and doctors to be direct employees of the government, you need to look at how they regulate the sector, they won't be running it. I shouldn't have used "running" in my original comment as it implied more direct control than would be the case.
      - sitkack 7y ago
        That is exactly how it works now. While VA hospitals do exist, there are no Medicare hospitals.
  - WorldMaker 7y ago
    Amtrak is already privatized (in the USPS model). If it were any more privatized it would be bankrupt and nobody would be providing the service. If someone were trying to compete with Amtrak, the country is ripe with old, falling apart cargo-only rails that haven't seen passengers in a century or longer. (It would also probably cost a fraction of what Musk, et al have thrown into silly pie-in-the-sky fantasies like the "hyper-loop" to old fashioned public transport planning with existing, proven modern technologies such as Japanese "bullet" train tech.) I think I agree with upthread. Probably more than anything what America needs in public transport is good propaganda again. There was a time that civic responsibility saw public transport as a public good to connect cities and Americans and make dreams happen. (Old 19th Century train ads were things of beauty.) The "American Dream" probably needs to shake its collective love affair with the automobile before anything real could be done for good, trustworthy public transport.
- kodablah 7y ago
  That may be one minor reason of many, that may not. But this speculation that peoples' beliefs, such as my own, are propaganda driven needs to stop being presented as objective. Many people have statistical and empirical evidence to support their beliefs especially concerning issues such as health policy/regulation. When you disagree, those you disagree with are not automatically swayed by propaganda any more than your beliefs of the significant PR effects are propaganda-based themselves.
  - yourbandsucks 7y ago
    Medicare, Medicaid and the VA manage to be cheaper per capita despite specifically insuring the old, the poor, and veterans. What's your statistical and empirical reasoning and why should we ignore that elephant of a top line number?
    - gamblor956 7y ago
      There isn't any. Not a single private health plan manages to be more cost-effective than the 3 government health plans, despite private health plans having the ability to pick-and-choose the cream of the crop and to offload unprofitable customers to government health plans. BUT (when they actually provide health care) private health plans usually provide health care faster than government health plans. VA wait times, for example, still exceed 12 months in many parts of the country.
      - FireBeyond 7y ago
        > BUT (when they actually provide health care) private health plans usually provide health care faster than government health plans. VA wait times, for example, still exceed 12 months in many parts of the country. I had a severe wrist injury from a car accident. I was told to start PT "ASAP", and given referrals within 24 hours of the injury. I was then told that I'd be waiting 10-12 weeks for a PT slot.

EpicEng 7y ago

Yet we're not going to see a big raise because we switch over to a single payer system. It's not unreasonable for people to be skeptical of such a massive change when their current situation works fine (for them.) A change like this would be far more beneficial to the under/uninsured than those of us with existing, comprehensive plans. I'm not making an argument either way. Personally I'm for single payer, but that's largely due to the issues my mother had when she became ill.

wahern 7y ago
> Yet we're not going to see a big raise because we switch over to a single payer system. Californian legislators released a study last year about the costs of moving to single-payer healthcare in the state. In total it would be $400 billion, requiring $200 billion in new tax revenues after accounting for the existing $200 billion in federal, state, and local expenditures. Diverting existing employer and individual premium payments would still leave anywhere from a $50 billion to $150 billion gap. California's existing budget is ~$200 billion, so covering that gap would require significant new taxes. Anybody telling you that you can get single-payer for free is lying to you. That would only be possible if we could significantly reduce costs, but we don't know how to reduce costs. Any suggestion you've heard is almost certainly part of the ACA/Obamacare in some form or fashion, and the strategies aren't working as well as originally believed. But this was predicted. The ACA was always intended to be a process of experimenting with cost reducing strategies, which is why there were supposed to be panels that could rewrite the rules as new information came in. But nobody is interested in the hard work of figuring out what those solutions are; all the electorate on both sides is interested in voting for are feel-good solutions. And they'll believe whatever they need to believe in order to support their political tribe.
- sitkack 7y ago
  > we don't know how to reduce costs I am pretty sure administrators of health systems that are cheaper could tell us. Like just directly to our face.
  - 7y ago