https://www.vox.com/2019/9/10/20857668/life-expectancy-wealt...
While his policies and voting record may tell a different story, that comment left a lasting impression on a lot of people. I have yet to see him speak directly to poor white people as Yang did, and I suspect he (Bernie) is afraid of alienating his younger, left-learning base. To see who I mean, check out those replies to Yang's tweet.
[0] https://www.politico.com/story/2016/03/bernie-sanders-povert...
Working class people understand completely that Bernie and what he advocates for, things like Medicare for All, are what are in their interests. And likewise that Yang’s plans to dismantle the welfare state and replace it with a check that will get eaten up by all the landlords and insurance companies that have always preyed them will accomplish nothing. It’s why Bernie has the largest donor base of any candidate and especially among donations from working class people.
In a U.S. presidential election, I think perception is at least as important as policy. Most Americans aren't policy wonks, and they don't scrutinize all aspect of a candidate's platform. They simply choose the candidate who they feel will best represent their interests. When one candidate addresses them and their suffering by name but the other one doesn't (or even minimizes it, a la Bernie 2016), that second candidate's a tougher sell.
https://www.opensecrets.org/news/2019/09/sanders-vs-warren-w...
I’ll just restate that all of this pointing at Yang’s Twitter account is nonsense.
For the other candidates with weaker policies, or less name recognition, I think my point is even more important. Intersectional politics have put race at the top of everyone's mind. When a candidate mentions every race by name but yours, and when yours is facing the steepest decline in life expectancy of nearly all of them (I haven't checked, but I assume life's worse as always for American Indians), folks tend to notice.
There will be another four years of mutual accusations between "the idiots in the Senate" and "the idiot in the White House" with a bunch of policies implemented as executive orders adding to the mess.
There are a lot of small changes which can improve US healthcare: untie health insurance from employers. Make hospitals responsible for the billing, do that people don't get separate bills from anesthesiologists and surgeons. Make catastrophic plans accessible for everyone. Give free health insurance to children under 5.
All these are small things, but they are doable. Once done, let's pause and reconsider.
Thousands upon thousands are being denied care, bankrupted, and killed each year by the American healthcare system. This is the status quo you’re defending. People going broke because they have a disabled child, rationing care and medicines they can’t afford at great harm to themselves.
These people, the people being ground up by this system, aren’t interested in pausing things so you can get more comfortable than you already are with this state of affairs.
Which means most people agree that ACA does more good than bad.
It may feel very good to fight for a noble goal without a compromise and half measures, but while you are fighting, the people you are fighting for are no better.
But that's not your fault, right?
I could care less about some contest of nobility, but I can tell you for certain that this kind of cowardly rhetoric, where you think you can deflect the blame of those who profit off the poor, the ill, and the disabled onto those who dare to fight for them, convinces absolutely no one.
The actual rate of denied claims varies wildly from state to state and from insurer to insurer inside those states; some states have rejection rates in the single digits. Meanwhile, the report authors don't have the reason for rejection, and the reason matters a lot: providers have varying competence submitting claims, and a large chunk of denials are probably miskeyed services. Very, very few denials are appealed, suggesting either clerical errors or low-dollar claims (the financial value of those denials would be a number you'd really want to see but does not exist either). Much of this is covered in the Discussion section of the report.
Right now, this 1-in-5 thing really just seems like a cudgel for people to swing randomly around in message board arguments.
Here’s my perspective: for profit healthcare is a form of eugenics against the poor and disabled. Insurance companies are parasitic middlemen who are directly responsible for the deaths and bankruptcy of many. Denial of claims under the ACA is done to preserve the existence and profits of these middleman. Thinking you can suss out whether the 20% of claims they deny are moral or necessary entirely misses the point.
Here's just one example of what's flawed about your argument: average claim denials in Oregon are just 8%, a fraction of what they are in Illinois. Are health insurers in Oregon more moral than they are in Illinois? Will your rationale for that argument hold up when I note other states with low denial rates that aren't at all similar to Oregon?
You don't need data to know that health insurers deny claims to to preserve their existence and protect profits. It's how every form of insurance works. The only thing that data will tell you is to what degree they deny claims in this pursuit relative to their other tactics, from jacking up premiums, imposing high deductibles, etc.
>Average claim denials in Oregon are just 8%, a fraction of what they are in Illinois. Are health insurers in Oregon more moral than they are in Illinois? Will your rationale for that argument hold up when I note other states with low denial rates that aren't at all similar to Oregon?
They're not variably immoral, because that's not the premise. The premise is that they're entire existence is unnecessary and immoral and has caused the bankruptcy and deaths of many. This isn't even internally consistent with your other arguments, as you've claimed that the variability of denials makes aggregate figures not a particularly useful measure.
Since we're also demanding responses now, please, again, feel free to describe what threshold of bankruptcy, injury to the sick and disabled, and deaths you feel is appropriate for the status quo. How much of this is necessary?
https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2018....
For example, please describe how denial of claims by ACA plans is unrelated to the continued medical bankruptcies I cited? Or, if it is related, what level of medical bankruptcies is permissible in your perspective?
I mean, this is absurd on its face, but you can read the study I linked about medical bankruptcies. It explicitly states that insurance coverage (which inherently includes denial of claims) is a leading driver of medical bankruptcies. Here’s what it’s co-author said about the issue if you can’t get access to it:
“The culprit for the lack of improvement [in medical bankruptcy rates] was inadequate health-care insurance, according to a co-author of the research, Dr. David U. Himmelstein, a distinguished professor at Hunter College and founder of advocacy group Physicians for a National Health Program. ‘Unless you’re Jeff Bezos, people don’t have very good alternatives, because the insurance that is available and affordable to people, or that most people’s employers provide them, is not adequate protection if you’re sick,’ Himmelstein said.”
https://www.cnbc.com/2019/02/11/this-is-the-real-reason-most...
Claims denial and the struggle to pay medical bills has also been examined by Kaiser:
“About a quarter (26 percent) of the insured who had medical bill problems say they had a claim denied by their insurance company. Common reported reasons for denial include a particular treatment not being covered (25 percent of those with denied claims) and receiving care from an out-of-network provider (14 percent); 21 percent of those who say they had a claim denied did not know or could not provide a reason for the denial.”
https://www.kff.org/report-section/the-burden-of-medical-deb...
Still waiting on what level of bankruptcy and suffering justifies the status quo too.
Ask too much and you will get nothing.
One thing that always kept me wondering: all politicians readily talk about their priorities. I want to know what is not their priorities. What are they willing to offer in their negotiations?
We know the mechanisms that cause these things to happen. Landlords lobby the government for restrictive zoning to constrain supply and cause rents to rise and absorb more of the tenants' income. Insurance companies lobby for laws against catastrophic-only plans so that people have to buy more expensive plans with higher premiums. These are their own battles and we should try to win them. But they're the same in kind as things like certificate of need laws that make medical services more scarce and therefore more expensive.
What I don't think you've explained is how that will happen less if the government is cutting checks directly to drug companies and the other government contractors/unions than if people are given cash to spend on whatever they choose and then at least have the possibility that there exists a substitute good which competes and thereby limits how much of the money can be captured by drug companies/landlords, which would leave the rest the money as surplus to actually improve their lives.