As soon as I read this, I thought of TurboTax and its mission to preserve the crappy system of filing US taxes so that its software can continue to profit.
The insurers have somehow created which ensures their survival at a real cost. Attempts to rationalize the system have failed because of the focus on getting everyone health insurance rather than health care (admittedly among other reasons).
This a common theme in politics: Actually solving the problem might remove enthusiasm for your candidate or party, so instead they propose things with no realistic chance of passing. Their business is being front and center in public discourse, not quietly fixing things.
EDIT: I’m getting downvoted because a comment below is denying this part of the bill, so I’m adding the exact text here:
> SEC. 107. PROHIBITION AGAINST DUPLICATING COVERAGE. (a) IN GENERAL.—Beginning on the effective date described in section 106(a), it shall be unlawful for— (1) a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act; or (2) an employer to provide benefits for an employee, former employee, or the dependents of an employee or former employee that duplicate the benefits provided under this Act.
The comment below is incorrect. The bill would have made people’s existing insurance plans illegal to offer.
Although we all might agree that this is necessary, people usually tend to vote for people who promise "real" solutions. As in, short term solutions to problems we've been carrying for decades (which obviously requires policies that also take decades to cement).
> SEC. 107. PROHIBITION AGAINST DUPLICATING COVERAGE. (a) IN GENERAL.—Beginning on the effective date described in section 106(a), it shall be unlawful for— (1) a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act; or (2) an employer to provide benefits for an employee, former employee, or the dependents of an employee or former employee that duplicate the benefits provided under this Act.
You could technically also buy extra insurance for… something extra, but your existing insurance plan would have become illegal.
This was a huge sticking point, despite how many people try to deny it or downplay it.
This is an example of a situation where people dislike the system but when you ask them about it they like their part of the system.
For example, people generally have an extremely low opinion of Congress, but on average they like their own Congress person.
You get similar results when you poll people about healthcare and health insurance: People generally hate the health insurance system, but if you start talking about taking away their health insurance or their doctor and replacing it with an unknown system, they get upset.
> Why would you want duplicating coverage anyway? Is it not strictly better for any consumer to only be paying for the extra coverage you want on top of the public coverage?
Duplicating coverage is superfluous if you assume the new plan would be better in every way and you give up nothing in the process, obviously.
However, the fear is that upending the entire system would require people to give things up and replace it with unknowns. There's a good chance that some people would be forced to be reassigned to different doctors under a centrally-planned system, or that access to things would be reset and need to be re-determined under new guidelines.
If this doesn't make sense, consider a situation where someone got special approval for off-label coverage of a drug (happens all the time) but the new government insurance had stricter guidelines about which conditions could be treated with which drugs (to keep cost down). Those people could lose access to medications or treatments that were covered privately.
We tend to think of "Medicare for All" type plans as being without downsides, but when you get into the details of changing the entire health care system out and banning the old ways, it's inevitable that some people would start losing things they liked. And that's where people get upset.
It would be extremely difficult to get an accurate idea of what the general public thinks about a measure before certain interests get involved with publicizing FUD.
But that’s literally what the bill said.
Why is it “fear mongering” to state the effects of a bill? People truly didn’t like this idea.
They understood that it was being replaced. Nobody ever pretended like health care was going away and being banned. People weren't assuming that. That would be nonsensical.
People thought the bill was going to be about a Medicare option for all, but then it came out as forced Medicare for all. People didn't like that.
It wasn't fear mongering, people just didn't like that. It's demonstrably unpopular, and this isn't news to anyone who has been paying attention.
This is simply not the case and it's naive to think otherwise.
What I have works. It doesn’t for everyone. But it does for me.
If I’m too busy to read a thousand-page bill, it’s rational to default to the status quo. (Also, Americans like competition. Banning duplicate coverage sounds like ruling out the competition.)
They had to prohibit overlapping coverage in order to make sure that all private practice physicians accepted the medicare system, which has lower reimbursement rates than private insurance. You can pay for more coverage, because that doesn't compete with the public system, but you cannot pay for private insurance that may lead to lower access for publicly insured persons.
Unfortunately, not so simple:
1) Health insurance is already required to pay out at least 90% of your contributions, so even a hypothetically perfectly efficient replacement could only eliminate 10% of costs, all things equal.
2) The government run system would realistically be expensive to run, like any program covering all Americans. Many of those private insurance costs would just be transferred to a government-run operation. In theory it should be more efficient to have single payer, but it would also be extremely expensive in the short term to build and overhaul the system.
3) The actual cost savings wouldn’t come from operational efficiency (not the government’s strongest ability) but from forcing prices down because nobody would have any choice but to accept the government insurance. They were going to drive costs down by forcing doctors and hospitals to take lower payments and, as unpopular as it is to say, by limiting the types and amounts of treatments available to people.
Single-payer could be cheaper and more efficient simply by returning the massive profits of health insurers directly to taxpayers. Part of high cost for healthcare in the USA is the huge number of middlemen.
https://content.naic.org/sites/default/files/inline-files/he...
Contrast that with the average of all industry profit margins at ~10% and with SaaS type firms of ~80%.
If you want to improve US healthcare costs by getting rid of the profit margin of insurers, it's probably a bad idea. You wouldn't notice the impact.
The government is already the largest health insurer in the country, and providers can't turn them down. There's no system to overhaul.
The idea of "Medicare for all" is actually very simple - if you do not have private market health insurance, you can opt in to the health insurance the government already provides for about 65 million people.
This is completely false. Many providers don’t accept Medicare or Medicare.
I don't know where you’re getting the idea that Medicare/Medicaid can’t be turned down by private practices.
> The idea of "Medicare for all" is actually very simple - if you do not have private market health insurance, you can opt in to the health insurance the government already provides for about 65 million people.
Again, that’s not what the “Medicare for All” bill actually said.
People just assumed it was an optional thing, but the bill said something else entirely.
Your post is a great example of how people had their own ideas about how things work or would work under new bills, but when you actually read the details it’s a different situation altogether.
I’m also amazed at the confidence with which people will deny the basic facts of “Medicare for All”, as evidenced by many comments in this thread. I posted an actual excerpt from the bill above, yet people are still trying to argue that it said something else.
While sure, providers could choose to not accept Medicare, practically all do because the people that need the most healthcare are all on it. That would be akin to not treating anyone over the age of 65.
I don't think I am. You haven't provided any specifics and your claims above were easily disproven, so I'm not sure what you think I'm doing wrong.
> As well as equating the notion of Medicare For All as a policy with one attempt to pass it that failed.
See above: My parent comment was specifically talking about the Medicare for All bill. You are the one trying to substitute a different concept into the discussion.
> While sure, providers could choose to not accept Medicare
This is the exact opposite of what you claimed two comments up.
This discussion is a perfect example of what I'm talking about: When it comes to these discussions, people like to substitute their own facts and pretend like we can just ignore the reality of of what goes into bills. Once you start looking at actual legislation these things aren't as popular as people think because it doesn't match their imaginary ideal.
Hence my original point: Politicians have an incentive to keep these concepts as far from reality as possible, because it allows people to cling to their own idealized versions of what it would look like. The closer you get to reality, the more people realize that tradeoffs and compromise are necessary in the real world.
All things remaining same, yes. But all things won't remain same because the incentives would be completely different. The 10% rule has incentivized the entire industry to raise their prices so that 10% will be worth more each quarter. Private insurance would rather have insulin at $1000/mo instead of $10/mo so that they can take $100 instead of $1 and they would rather collect $2000/mo in premiums than $200/mo. Medicare, on the other hand, can and should negotiate prices down: https://www.cms.gov/inflation-reduction-act-and-medicare/med...
Yea… things were going to get better when more people were being ripped off.
Likewise, I imagine they pass anti-fossil fuel laws because there aren't really any major fossil fuel producing countries in Europe besides Russia which is both a pariah and the continent's gas station.
https://en.m.wikipedia.org/wiki/List_of_largest_oil_and_gas_...
So yes obviously Europe is a paradise of direct democracy where every citizen bloom thanks to a social structure made to help each of them thrive and reach the best version of themselves acting everyday for an harmonious society free of any anxiety about future that promise only bright shiny days for the masses and their children.
> This is quite independent of the US.
Happens less in electoral systems where the 2nd party can become 3rd overnight. Politics become less rigid.
I also wouldn’t describe US politics as “rigid” just because we have the same two parties, because each party has different factions and some of the most powerful factions were either marginal or completely nonexistent a couple decades ago.
France effectively has that by way of the infamous 49.3. the majority party coalition can effectively force all others to accept a law, without ever presenting it for a vote.
The caveat is that the other parties can start a vote of no confidence and dissolve the government with a simple majority, but in reality this never happens because dissolving the government over [pension reform, the budget, insert issue here] is disproportionate.
The current government's lack of caring about their voter base because of the Overton windows shifting to the right has obviously aggravated this.
any sentence that starts this way is just walking straight into its own falsity.
No human system as complex as "the state" ever functions "purely" to do anything. Instead, it's a venue in which different interests and power levels sometimes compete and sometimes cooperate, sometimes achieving goals and often not.
Form your own opinions, but I had to mention real action that happened.
Right now I'm not doing billions of things, and don't see a cent is coming in!
In the tech sector, we see many examples of the disruptor opening a temporary wedge to either get acquired by the dominant player or becoming the new hegemonist.
I get your point: These are not for profit enterprises and they still get important work done.
I'm making a different point: People don't work for the benefit of others without being rewarded.
Open Source Software is not a bad counter example. I think there are rewards in the joy of programming, making a name for yourself, and a few other things, but I'll concede that there is some nuance there.