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Extreme, but I have to admit I'm getting the popcorn ready for the next Presidential election. But if the American people literally don't want affordable health

Extreme, but I have to admit I'm getting the popcorn ready for the next Presidential election. But if the American people literally don't want affordable healthcare that is their choice.

bitwize 5y ago
The American people want it. Powerful business lobbies ensure it gets blocked. Things like that are why the USA is not a democracy but a corporate oligarchy.
- cryonics 5y ago
  How can the American people want single payer when a supermajority opposes abolishing private insurance?
  - jevoten 5y ago
    I don't know about single-payer specifically, but: Among the public overall, 63% of U.S. adults say the government has the responsibility to provide health care coverage for all https://www.pewresearch.org/fact-tank/2020/09/29/increasing-share-of-americans-favor-a-single-government-program-to-provide-health-care-coverage/ https://www.pewresearch.org/fact-tank/2020/09/29/increasing-...
    - nybble41 5y ago
      As zytron3 said, it's all about how the question is phrased. > > Do you want the government to give you free health care / health insurance? > Sure, why not? > > Do you want the government to be the only source of health care / health insurance, with everyone making more than $50k/year paying at least as much in additional taxes as they currently would pay for an unsubsidized ACA marketplace insurance plan to cover the expense? > Wait, what?! The question is meaningless if it only asks about what people want and not what they're willing to pay for it.
  - zytron3 5y ago
    It's a difference in how the question is phrased. Most people do essentially no research and make no effort to understand the details of things. In this case it's choice = good. No further thought is required as to the actual value added by private insurance.
    - csnover 5y ago
      Defending America’s status quo by saying “choice = good” is one of the crazier things that comes up in these discussions. A person on Original Medicare today has much more choice because there is no “in network”. All physicians[0] and hospitals and clinics are accessible, without restriction. Also, countries with national care systems like Canada and the UK still have supplemental insurance markets, if you really want that extra choice—but they are small because most people are satisfied with the state-funded care. The main “choice” you get with the private insurance system these days is which company you want to be locked into using for the rest of your life, as they seem to be increasingly dividing the market so that doctors from health care system A only accept insurance A, and doctors from health care system B only accept insurance B. Sure, you can “choose” another insurer, but then you can’t see any of the doctors you’ve built relationships with. Choice, indeed. [0] Technically physicians can opt out of accepting Medicare; in practice I’ve never found one who opted out of Medicare that didn’t simply refuse all insurance.
- colechristensen 5y ago
  I’m an American person, I don’t want it. Just look towards how the VA or operated and how many problems people have it and tell me you want to force that experience on everyone. People want healthcare to be magically free, that’s not how it’ll be. People who now pay almost no taxes and choose not to buy health insurance because they can’t afford it and their other life choices will suddenly be taxed quite a lot for “free” health insurance. A problem is a lot of American healthcare companies give away medicine and the results of their development to export at low cost, basically whatever they can get and then make up their profit in American markets. There is also a whole lot of waste and inefficiency and not enough pressure to fix it. Many changes need to be made to lower costs and can be made in many ways, but i simply don’t trust the government to do so by giving them all the money to spend, because they already demonstrate they’re bad at administering medical payments. Not to mention issues many countries have with their social medicine programs, if you’re not just a fan and look objectively, there is definitely a tradeoff.
  - KerrAvon 5y ago
    If single payer is funded through a payroll tax, it should be a net savings for those of us who do choose not to live dangerously. There’s a lot of pressure to fix the system, and there has been for decades. It’s blunted by politicians responsive to corporations and not to individuals (other than right-wing extremists, who they fear).
    - colechristensen 5y ago
      The pressure to fix is blunted by the issue's complexity and a public distaste for complexity. There isn't one issue, there are a million issues, and they have to be well understood to be fixed. "Single payer" is easy to rally behind but it is not a complex solution to a complex problem. There's no guarantee that the result wouldn't be similarly expensive helathcare which was now mandatory with taxes and no longer had economic competition as a pressure to fix.
  - SyzygistSix 5y ago
    The VA is not single payer; it is single provider. Those are two entirely different things.
cryonics 5y ago
You realize Vermont tried this and costs swelled so much that Democrats themselves reverted it back to non single payer?
- codyb 5y ago
  Don’t most national healthcare programs also add in collective bargaining? I can’t imagine it’d be possible to support on state coffers alone without that.
  - anamax 5y ago
    > Don’t most national healthcare programs also add in collective bargaining? Which of the major cost drivers in US healthcare does collective bargaining address? Yes, we could switch to paying marginal costs for drugs, but drugs don't happen unless the average costs are paid, so if someone is paying marginal, someone else has to pay above average. There are things that we could do to reduce said average costs, but we can do them without doing anything else.
CodeWriter23 5y ago
Having the state double income tax and then using those funds to pay for healthcare does not suddenly make it “affordable”. We need to address the underlying costs of healthcare in the US, we are paying much more than other Western Nations. Do that, maybe there is a chance of affordability.
deleted 5y ago
[deleted]
actually_a_dog 5y ago
Bizarrely, 90% of Americans only favor Medicare for All if it means not abolishing private insurance: https://thehill.com/hilltv/what-americas-thinking/428958-poll-voters-want-the-government-to-provide-healthcare-for https://thehill.com/hilltv/what-americas-thinking/428958-pol... Yet, 94% of Medicare recipients "report being very satisfied or satisfied with the quality of their medical care": https://www.kff.org/report-section/medicare-covered-older-adults-are-satisfied-with-their-coverage-have-similar-access-to-care-as-privately-insured-adults-ages-50-to-64-issue-brief/ https://www.kff.org/report-section/medicare-covered-older-ad... At the same time, 19 out of 22 studies in a systematic review concluded that M4A would produce immediate cost savings, and one additional study predicted savings over time. These studies were funded by "organizations across the political spectrum": https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961869/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961869/ I have no idea how to reconcile these findings, except to conclude that the average American has no clue how insurance works, while, at the same time, they want to keep what they have. I think it's propaganda that's getting in the way of people making an informed decision here.
- pessimizer 5y ago
  > they want to keep what they have And why wouldn't they? Significant changes in the US are only successful when they are backed by people who will profit massively from them. You can either continue to manage as you have, or waste effort on what is likely either an honest candidate who is going to get totally demolished or a corrupt candidate who is going to make your situation worse.
- s1artibartfast 5y ago
  >Yet, 94% of Medicare recipients "report being very satisfied or satisfied with the quality of their medical care I think the part you are missing is that 83% of Medicare recipients have supplemental insurance to cover their medical needs. The recipients know specifically the scope of Medicare and what they would loose. https://www.kff.org/medicare/issue-brief/a-snapshot-of-sources-of-coverage-among-medicare-beneficiaries-in-2018/ https://www.kff.org/medicare/issue-brief/a-snapshot-of-sourc...
  - 5y ago

Extreme, but I have to admit I'm getting the popcorn ready for the next Presidential election. But if the American people literally don't want affordable healthcare that is their choice.

bitwize 5y ago

The American people want it. Powerful business lobbies ensure it gets blocked. Things like that are why the USA is not a democracy but a corporate oligarchy.

cryonics 5y ago
How can the American people want single payer when a supermajority opposes abolishing private insurance?
- jevoten 5y ago
  I don't know about single-payer specifically, but: Among the public overall, 63% of U.S. adults say the government has the responsibility to provide health care coverage for all https://www.pewresearch.org/fact-tank/2020/09/29/increasing-share-of-americans-favor-a-single-government-program-to-provide-health-care-coverage/ https://www.pewresearch.org/fact-tank/2020/09/29/increasing-...
  - nybble41 5y ago
    As zytron3 said, it's all about how the question is phrased. > > Do you want the government to give you free health care / health insurance? > Sure, why not? > > Do you want the government to be the only source of health care / health insurance, with everyone making more than $50k/year paying at least as much in additional taxes as they currently would pay for an unsubsidized ACA marketplace insurance plan to cover the expense? > Wait, what?! The question is meaningless if it only asks about what people want and not what they're willing to pay for it.
- zytron3 5y ago
  It's a difference in how the question is phrased. Most people do essentially no research and make no effort to understand the details of things. In this case it's choice = good. No further thought is required as to the actual value added by private insurance.
  - csnover 5y ago
    Defending America’s status quo by saying “choice = good” is one of the crazier things that comes up in these discussions. A person on Original Medicare today has much more choice because there is no “in network”. All physicians[0] and hospitals and clinics are accessible, without restriction. Also, countries with national care systems like Canada and the UK still have supplemental insurance markets, if you really want that extra choice—but they are small because most people are satisfied with the state-funded care. The main “choice” you get with the private insurance system these days is which company you want to be locked into using for the rest of your life, as they seem to be increasingly dividing the market so that doctors from health care system A only accept insurance A, and doctors from health care system B only accept insurance B. Sure, you can “choose” another insurer, but then you can’t see any of the doctors you’ve built relationships with. Choice, indeed. [0] Technically physicians can opt out of accepting Medicare; in practice I’ve never found one who opted out of Medicare that didn’t simply refuse all insurance.
colechristensen 5y ago
I’m an American person, I don’t want it. Just look towards how the VA or operated and how many problems people have it and tell me you want to force that experience on everyone. People want healthcare to be magically free, that’s not how it’ll be. People who now pay almost no taxes and choose not to buy health insurance because they can’t afford it and their other life choices will suddenly be taxed quite a lot for “free” health insurance. A problem is a lot of American healthcare companies give away medicine and the results of their development to export at low cost, basically whatever they can get and then make up their profit in American markets. There is also a whole lot of waste and inefficiency and not enough pressure to fix it. Many changes need to be made to lower costs and can be made in many ways, but i simply don’t trust the government to do so by giving them all the money to spend, because they already demonstrate they’re bad at administering medical payments. Not to mention issues many countries have with their social medicine programs, if you’re not just a fan and look objectively, there is definitely a tradeoff.
- KerrAvon 5y ago
  If single payer is funded through a payroll tax, it should be a net savings for those of us who do choose not to live dangerously. There’s a lot of pressure to fix the system, and there has been for decades. It’s blunted by politicians responsive to corporations and not to individuals (other than right-wing extremists, who they fear).
  - colechristensen 5y ago
    The pressure to fix is blunted by the issue's complexity and a public distaste for complexity. There isn't one issue, there are a million issues, and they have to be well understood to be fixed. "Single payer" is easy to rally behind but it is not a complex solution to a complex problem. There's no guarantee that the result wouldn't be similarly expensive helathcare which was now mandatory with taxes and no longer had economic competition as a pressure to fix.
- SyzygistSix 5y ago
  The VA is not single payer; it is single provider. Those are two entirely different things.

cryonics 5y ago

You realize Vermont tried this and costs swelled so much that Democrats themselves reverted it back to non single payer?

codyb 5y ago
Don’t most national healthcare programs also add in collective bargaining? I can’t imagine it’d be possible to support on state coffers alone without that.
- anamax 5y ago
  > Don’t most national healthcare programs also add in collective bargaining? Which of the major cost drivers in US healthcare does collective bargaining address? Yes, we could switch to paying marginal costs for drugs, but drugs don't happen unless the average costs are paid, so if someone is paying marginal, someone else has to pay above average. There are things that we could do to reduce said average costs, but we can do them without doing anything else.

CodeWriter23 5y ago

Having the state double income tax and then using those funds to pay for healthcare does not suddenly make it “affordable”. We need to address the underlying costs of healthcare in the US, we are paying much more than other Western Nations. Do that, maybe there is a chance of affordability.

deleted 5y ago

[deleted]

actually_a_dog 5y ago

Bizarrely, 90% of Americans only favor Medicare for All if it means not abolishing private insurance: https://thehill.com/hilltv/what-americas-thinking/428958-poll-voters-want-the-government-to-provide-healthcare-for https://thehill.com/hilltv/what-americas-thinking/428958-pol... Yet, 94% of Medicare recipients "report being very satisfied or satisfied with the quality of their medical care": https://www.kff.org/report-section/medicare-covered-older-adults-are-satisfied-with-their-coverage-have-similar-access-to-care-as-privately-insured-adults-ages-50-to-64-issue-brief/ https://www.kff.org/report-section/medicare-covered-older-ad... At the same time, 19 out of 22 studies in a systematic review concluded that M4A would produce immediate cost savings, and one additional study predicted savings over time. These studies were funded by "organizations across the political spectrum": https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961869/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961869/ I have no idea how to reconcile these findings, except to conclude that the average American has no clue how insurance works, while, at the same time, they want to keep what they have. I think it's propaganda that's getting in the way of people making an informed decision here.

pessimizer 5y ago
> they want to keep what they have And why wouldn't they? Significant changes in the US are only successful when they are backed by people who will profit massively from them. You can either continue to manage as you have, or waste effort on what is likely either an honest candidate who is going to get totally demolished or a corrupt candidate who is going to make your situation worse.
s1artibartfast 5y ago
>Yet, 94% of Medicare recipients "report being very satisfied or satisfied with the quality of their medical care I think the part you are missing is that 83% of Medicare recipients have supplemental insurance to cover their medical needs. The recipients know specifically the scope of Medicare and what they would loose. https://www.kff.org/medicare/issue-brief/a-snapshot-of-sources-of-coverage-among-medicare-beneficiaries-in-2018/ https://www.kff.org/medicare/issue-brief/a-snapshot-of-sourc...
- 5y ago