4 ms·

Your prior plan was part of what made care more expensive for sick people.

EvanAnderson 7y ago
Absolutely. And we should have just gone to a single-payer system. Instead we have this useless compromise that further transfers wealth from the middle class to the rich. I don't want what I had back, but I don't want what we have now either.
- wahern 7y ago
  A single-payer system will require significantly more taxes, and those taxes will come out of your pocket. Which is exactly why we'll never get a single-payer system. Everybody wants better this or that, but nobody wants to pay for it. Which, in a nutshell, is precisely what your rant amounts to. Here's the a rundown of what single-payer would cost in California: * $400 billion total (2x the entire existing California budget) * $200 billion in additional expenditures (the first $200 billion being covered by what people, employers, and state and federal programs already pay) * "Under one scenario, the average statewide sales tax rate would have to jump from 8.5 percent to nearly 37 percent to generate the amount of revenue needed. Under another, California would have to create a new 15 percent payroll tax, withholding $150 from a $1,000-a-week paycheck." Source: https://www.sacbee.com/news/politics-government/capitol-alert/article201541734.html https://www.sacbee.com/news/politics-government/capitol-aler... So, yeah, good luck with that, considering that we can barely keep the ACA alive. Of course you paid less before the ACA. It's a fairly safe assumption you were a healthy, young or middle-aged person without any pre-existing health conditions. But one day that will change; hopefully your fellow Americans won't be as indignant about having to fork over more money to benefit someone else. Perhaps you were paying more than what other people in other states had to pay (for example, in California premiums never really went up much), but whatever the amount you were paying more to subsidize healthcare for others who previously didn't have it or had too little of it. If you think this country is going to get single-payer without you paying significantly more.... And even if you were okay with that, 40-50% of Americans aren't okay with any tax increase. The amount of Americans willing to vote for a 10-20% across the board tax increase is probably in the single-digits. So no matter how many people want a better system, even more more people have a stronger aversion to more taxes. (The overlap is, of course, enormous.) It's irresponsible to advocate for a system that isn't politically viable. Just like the previous broken system, and just like with the ACA today, it will fail unless and until people are willing to accept more taxes or, at a minimum, commit to the existing system and make the best of it by refining it. (BTW, single-payer is the exception across Western Europe and Japan, the very same places Americans love to point at as better models.) As a practical matter, the ACA went as far as it could in terms of costs that could be covered without a significant raise in taxes, and in retrospect it was overly optimistic in our ability to cut costs. Of course, many people--particularly healthy people--were taxed in hidden ways, such as you were. And, FWIW, the huge increase of premiums in certain states could be fixed by those states. For one thing, they could make the exchanges easier, as well as offer better state-funded healthcare. These are two reasons why premiums never really went up much in California with ACA. But if you're not willing to make it work in your state, why should I assume you, as a fellow citizen, wouldn't be equally lazy and cynical when we have to make even more difficult decisions on a national scale? Everybody has answers. And every politician is making promises. I'm sure the proposals from candidates like Bernie Sanders are theoretically fiscally possible, but only if you vanished 80% of Americans, replaced them with French and Canadian citizens, and then did the same for our healthcare infrastructure. Politics is the art of the possible. Ideas and promises aren't worth squat. That's the problem today--every grand idea and promise is an excuse to turn our backs from resolving the hard problems; problems that would also need to be resolved for those grand ideas to have a snowflake's chance in hell of delivering; problems that once resolved would make the existing system infinitely more tolerable without having to go through a revolution.
  - EvanAnderson 7y ago
    I am willing (desiring, even) for my money to go toward building a social safety net. Right now my inflated premiums aren't doing that. I would much rather pay taxes as a hedge against the fear of lack or loss of coverage that I have now. (Especially since my ability to hedge with savings has been completely obliterated by the continued spiral of cost increases for medical goods and services.) I also think single-payer is our best shot at getting spiraling costs under control.
  - ceejayoz 7y ago
    > A single-payer system will require significantly more taxes... We know this isn't true. The rest of the developed world spends about half what we do per-capita on healthcare, including their taxes. We pay almost as much in taxes as they do already. We just do it tremendously inefficiently. (Or efficiently, if you consider the goal to be shuffling money off to rent-seeking middlemen.) https://www.kff.org/health-costs/issue-brief/snapshots-health-care-spending-in-the-united-states-selected-oecd-countries/attachment/health-care-spending-in-the-united-states-selected-oecd-countries_chart10/ https://www.kff.org/health-costs/issue-brief/snapshots-healt...

Absolutely. And we should have just gone to a single-payer system. Instead we have this useless compromise that further transfers wealth from the middle class to the rich. I don't want what I had back, but I don't want what we have now either.

wahern 7y ago
A single-payer system will require significantly more taxes, and those taxes will come out of your pocket. Which is exactly why we'll never get a single-payer system. Everybody wants better this or that, but nobody wants to pay for it. Which, in a nutshell, is precisely what your rant amounts to. Here's the a rundown of what single-payer would cost in California: * $400 billion total (2x the entire existing California budget) * $200 billion in additional expenditures (the first $200 billion being covered by what people, employers, and state and federal programs already pay) * "Under one scenario, the average statewide sales tax rate would have to jump from 8.5 percent to nearly 37 percent to generate the amount of revenue needed. Under another, California would have to create a new 15 percent payroll tax, withholding $150 from a $1,000-a-week paycheck." Source: https://www.sacbee.com/news/politics-government/capitol-alert/article201541734.html https://www.sacbee.com/news/politics-government/capitol-aler... So, yeah, good luck with that, considering that we can barely keep the ACA alive. Of course you paid less before the ACA. It's a fairly safe assumption you were a healthy, young or middle-aged person without any pre-existing health conditions. But one day that will change; hopefully your fellow Americans won't be as indignant about having to fork over more money to benefit someone else. Perhaps you were paying more than what other people in other states had to pay (for example, in California premiums never really went up much), but whatever the amount you were paying more to subsidize healthcare for others who previously didn't have it or had too little of it. If you think this country is going to get single-payer without you paying significantly more.... And even if you were okay with that, 40-50% of Americans aren't okay with any tax increase. The amount of Americans willing to vote for a 10-20% across the board tax increase is probably in the single-digits. So no matter how many people want a better system, even more more people have a stronger aversion to more taxes. (The overlap is, of course, enormous.) It's irresponsible to advocate for a system that isn't politically viable. Just like the previous broken system, and just like with the ACA today, it will fail unless and until people are willing to accept more taxes or, at a minimum, commit to the existing system and make the best of it by refining it. (BTW, single-payer is the exception across Western Europe and Japan, the very same places Americans love to point at as better models.) As a practical matter, the ACA went as far as it could in terms of costs that could be covered without a significant raise in taxes, and in retrospect it was overly optimistic in our ability to cut costs. Of course, many people--particularly healthy people--were taxed in hidden ways, such as you were. And, FWIW, the huge increase of premiums in certain states could be fixed by those states. For one thing, they could make the exchanges easier, as well as offer better state-funded healthcare. These are two reasons why premiums never really went up much in California with ACA. But if you're not willing to make it work in your state, why should I assume you, as a fellow citizen, wouldn't be equally lazy and cynical when we have to make even more difficult decisions on a national scale? Everybody has answers. And every politician is making promises. I'm sure the proposals from candidates like Bernie Sanders are theoretically fiscally possible, but only if you vanished 80% of Americans, replaced them with French and Canadian citizens, and then did the same for our healthcare infrastructure. Politics is the art of the possible. Ideas and promises aren't worth squat. That's the problem today--every grand idea and promise is an excuse to turn our backs from resolving the hard problems; problems that would also need to be resolved for those grand ideas to have a snowflake's chance in hell of delivering; problems that once resolved would make the existing system infinitely more tolerable without having to go through a revolution.
- EvanAnderson 7y ago
  I am willing (desiring, even) for my money to go toward building a social safety net. Right now my inflated premiums aren't doing that. I would much rather pay taxes as a hedge against the fear of lack or loss of coverage that I have now. (Especially since my ability to hedge with savings has been completely obliterated by the continued spiral of cost increases for medical goods and services.) I also think single-payer is our best shot at getting spiraling costs under control.
- ceejayoz 7y ago
  > A single-payer system will require significantly more taxes... We know this isn't true. The rest of the developed world spends about half what we do per-capita on healthcare, including their taxes. We pay almost as much in taxes as they do already. We just do it tremendously inefficiently. (Or efficiently, if you consider the goal to be shuffling money off to rent-seeking middlemen.) https://www.kff.org/health-costs/issue-brief/snapshots-health-care-spending-in-the-united-states-selected-oecd-countries/attachment/health-care-spending-in-the-united-states-selected-oecd-countries_chart10/ https://www.kff.org/health-costs/issue-brief/snapshots-healt...