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> only the largest entities can have the best insurance Exactly. The bigger the better. I'm still baffled why local and state govts aren't easing into a publi

> only the largest entities can have the best insurance Exactly. The bigger the better. I'm still baffled why local and state govts aren't easing into a public option. Ditto the largest (self-insured) employers. It'd be so easy to extend benefits to their partners, local supporting businesses (eg daycares), and so forth.

WorldMaker 2y ago
> I'm still baffled why local and state govts aren't easing into a public option. That's easy enough to answer: lobbying efforts by major insurance companies (and insurance company adjacent companies) prevented it. In many states such lobbying efforts prevented it entirely in the legislature adding direct laws and some state constitutional amendments that states explicitly weren't allowed to build a public option as a part of their healthcare exchanges. It was a big part of the uproar when the ACA was passed at the federal level, a big part of why many states' healthcare exchanges were sabotaged and broken on Day One, and a large part of why the ACA itself made too many compromises in how it established the state-driven healthcare exchanges.
- specialist 2y ago
  Hmmm. If you happen to know any one or org working on this, I'd greatly appreciate it. TIA
  - WorldMaker 2y ago
    Most lobbying problems root cause analysis some way or another to the great need for Campaign Finance Reform [1]. (A problem the US has been overtly struggling with since 1828. Made so much worse and deeper in the 2010 Citizens United Supreme Court decision and the rise of the "Super-PACs".) [1] https://en.wikipedia.org/wiki/Campaign_finance_reform_in_the_United_States#Current_proposals_for_reform https://en.wikipedia.org/wiki/Campaign_finance_reform_in_the...
WalterBright 2y ago
> I'm still baffled why local and state govts aren't easing into a public option. Because socialism is well known for unsustainable costs and poor service.
- peutetre 2y ago
  Right, like how Walmart and McDonald's are subsidized by taxpayers. Businesses like Walmart and McDonald's should pay their own costs without relying on the crutch of the public purse. If these businesses are so inefficient that they can't survive without handouts then it is good and proper and correct that they die off and be replaced by more efficient businesses.
  - specialist 2y ago
    Further: All wealth is the result of governmental largess. Who benefits -- oligarches or the middle class -- is the neverending food fight. h/t economist Kevin Phillips.
- specialist 2y ago
  Larger health insurance pools are better. Regardless of societial structure.

WorldMaker 2y ago

> I'm still baffled why local and state govts aren't easing into a public option. That's easy enough to answer: lobbying efforts by major insurance companies (and insurance company adjacent companies) prevented it. In many states such lobbying efforts prevented it entirely in the legislature adding direct laws and some state constitutional amendments that states explicitly weren't allowed to build a public option as a part of their healthcare exchanges. It was a big part of the uproar when the ACA was passed at the federal level, a big part of why many states' healthcare exchanges were sabotaged and broken on Day One, and a large part of why the ACA itself made too many compromises in how it established the state-driven healthcare exchanges.

specialist 2y ago
Hmmm. If you happen to know any one or org working on this, I'd greatly appreciate it. TIA
- WorldMaker 2y ago
  Most lobbying problems root cause analysis some way or another to the great need for Campaign Finance Reform [1]. (A problem the US has been overtly struggling with since 1828. Made so much worse and deeper in the 2010 Citizens United Supreme Court decision and the rise of the "Super-PACs".) [1] https://en.wikipedia.org/wiki/Campaign_finance_reform_in_the_United_States#Current_proposals_for_reform https://en.wikipedia.org/wiki/Campaign_finance_reform_in_the...

WalterBright 2y ago

> I'm still baffled why local and state govts aren't easing into a public option. Because socialism is well known for unsustainable costs and poor service.

peutetre 2y ago
Right, like how Walmart and McDonald's are subsidized by taxpayers. Businesses like Walmart and McDonald's should pay their own costs without relying on the crutch of the public purse. If these businesses are so inefficient that they can't survive without handouts then it is good and proper and correct that they die off and be replaced by more efficient businesses.
- specialist 2y ago
  Further: All wealth is the result of governmental largess. Who benefits -- oligarches or the middle class -- is the neverending food fight. h/t economist Kevin Phillips.
specialist 2y ago
Larger health insurance pools are better. Regardless of societial structure.