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I'm a pretty conservative person, and this is the one view I break with hardliners completely with - I agree completely. The funny thing is, most people you ta

I'm a pretty conservative person, and this is the one view I break with hardliners completely with - I agree completely. The funny thing is, most people you talk to on either side of the aisle are for it. The healthcare lobby is so large as to buy politicians to make it seem like a wedge issue, but even a ton of conservatives agree with single payer in principle. I'd wager if you put it to a national vote, it'd break something like 80-20 for.

chefandy 2y ago
I think the core ideas of the ACA with the public option was originally Gingrich, in response to Hillary Clinton’s much more aggressive proposal for single payer, right? And then before the federal ACA, “Romneycare” was implemented in Massachusetts (without a public option, but with preexisting condition protection and not allowing separate high risk pools) by Republican Governor Mitt Romney. I think the discourse ended up polarized because Obama presented it that it seemed really partisan but the person that killed the public option in a Herculean commitment to insurance company profiteering was none other than liberal centrist Senator Joe Lieberman. This is not a partisan issue. There are obviously going to be ideological pockets in the extremes but outside of that, for the most part, the only people that are stepping up to defend the insurance companies are in their goddamned pockets.
- silisili 2y ago
  You're right, but there are people on both sides who toe the party line blindly(and stupidly, if I might add). I'll never forget Trump being cornered, and him saying he's not going to let people die in the streets, and his audience booing. He claimed they were all donors and lobbyists taking the audience seats, and despite his typical theatrics, I now believe that to be the truth. Either way, today it is a leftist idea I think, so there will exist some people who oppose it out of spite. I don't know a single person happy with the system today, which is damning. Just look at the reaction from recent events...
  - chefandy 2y ago
    Fair enough. It is rather telling and should be extremely concerning to the insurance industry that in our extremely polarized political culture of late, this has been a the largest patch of common-ground many of us have stood on in a long time. Obviously not a total common ground issue, but I can’t think of anything bigger recently.
nojvek 2y ago
I disagree with Medicare for all and single payer. The role of govt is a catch 22 - it is by design a monopoly, and monopolies are usually inefficient, so too much govt power gets monopoly capture but too little means govt can’t break the monopolies. The largest issue with US healthcare is lack of price-quality transparency and competition. This means tons of middle player monopolies e.g PBMs. I can’t go shop around for a procedure on a marketplace and pay out of pocket, the same rates an insurer would. I can’t deal directly with service provider or the labs. It has to be intermediaries. The # of medical licenses are capped, they’re not growing in proportion to population. Demand-supply dynamics, the basis of capitalism is wildly inefficient in US. Get rid of employer given insurers, make a law that insurers cannot negotiate a lower price than out of pocket price. Every procedure price should be openly put on an easily searchable marketplace. Make it easy to start new practices, more doctors and nurses and hospitals. The prices will come down. Single payer is a bandaid fix. It does nothing to fix the supply problem.
- hellotheretoday 2y ago
  this argument comes up every time and it always ignores a critical aspect of medicine: not all procedures can be “shopped for”. If I have cancer and I need to start treatment as soon as possible I’m not going to waste precious time comparing rates of infusion centers, especially given that one may be able to take me in for treatments 2 weeks sooner. That two weeks could make all the difference If I have a heart attack, stroke, car accident, etc, that incapacitates me, I am simply incapable of shopping around for the best price. I am going to be taken in for emergency care and treated to the point of stabilization (or better, depending on whether I have a guardian who can approve more. Said guardian could theoretically shop around at this point but it is difficult given the potential emotionality involved and danger in moving someone who is critically injured) Increasing provider supply is certainly a huge part of fixing things, if it’s done correctly. If you merely lower standards you just increase supply with substandard practitioners that overall worsen outcomes
  - nradov 2y ago
    The vast majority of healthcare can be shopped for. Emergency care is only a few percent of total spending.

chefandy 2y ago

I think the core ideas of the ACA with the public option was originally Gingrich, in response to Hillary Clinton’s much more aggressive proposal for single payer, right? And then before the federal ACA, “Romneycare” was implemented in Massachusetts (without a public option, but with preexisting condition protection and not allowing separate high risk pools) by Republican Governor Mitt Romney. I think the discourse ended up polarized because Obama presented it that it seemed really partisan but the person that killed the public option in a Herculean commitment to insurance company profiteering was none other than liberal centrist Senator Joe Lieberman. This is not a partisan issue. There are obviously going to be ideological pockets in the extremes but outside of that, for the most part, the only people that are stepping up to defend the insurance companies are in their goddamned pockets.

silisili 2y ago
You're right, but there are people on both sides who toe the party line blindly(and stupidly, if I might add). I'll never forget Trump being cornered, and him saying he's not going to let people die in the streets, and his audience booing. He claimed they were all donors and lobbyists taking the audience seats, and despite his typical theatrics, I now believe that to be the truth. Either way, today it is a leftist idea I think, so there will exist some people who oppose it out of spite. I don't know a single person happy with the system today, which is damning. Just look at the reaction from recent events...
- chefandy 2y ago
  Fair enough. It is rather telling and should be extremely concerning to the insurance industry that in our extremely polarized political culture of late, this has been a the largest patch of common-ground many of us have stood on in a long time. Obviously not a total common ground issue, but I can’t think of anything bigger recently.

nojvek 2y ago

I disagree with Medicare for all and single payer. The role of govt is a catch 22 - it is by design a monopoly, and monopolies are usually inefficient, so too much govt power gets monopoly capture but too little means govt can’t break the monopolies. The largest issue with US healthcare is lack of price-quality transparency and competition. This means tons of middle player monopolies e.g PBMs. I can’t go shop around for a procedure on a marketplace and pay out of pocket, the same rates an insurer would. I can’t deal directly with service provider or the labs. It has to be intermediaries. The # of medical licenses are capped, they’re not growing in proportion to population. Demand-supply dynamics, the basis of capitalism is wildly inefficient in US. Get rid of employer given insurers, make a law that insurers cannot negotiate a lower price than out of pocket price. Every procedure price should be openly put on an easily searchable marketplace. Make it easy to start new practices, more doctors and nurses and hospitals. The prices will come down. Single payer is a bandaid fix. It does nothing to fix the supply problem.

hellotheretoday 2y ago
this argument comes up every time and it always ignores a critical aspect of medicine: not all procedures can be “shopped for”. If I have cancer and I need to start treatment as soon as possible I’m not going to waste precious time comparing rates of infusion centers, especially given that one may be able to take me in for treatments 2 weeks sooner. That two weeks could make all the difference If I have a heart attack, stroke, car accident, etc, that incapacitates me, I am simply incapable of shopping around for the best price. I am going to be taken in for emergency care and treated to the point of stabilization (or better, depending on whether I have a guardian who can approve more. Said guardian could theoretically shop around at this point but it is difficult given the potential emotionality involved and danger in moving someone who is critically injured) Increasing provider supply is certainly a huge part of fixing things, if it’s done correctly. If you merely lower standards you just increase supply with substandard practitioners that overall worsen outcomes
- nradov 2y ago
  The vast majority of healthcare can be shopped for. Emergency care is only a few percent of total spending.