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Using dubious legalese to deny a life saving claim that happens to cost say $200,000 that you took premiums for is pretty close. If you pay out of pocket, it might save your life, but you're bankrupt, your children get no inheritance, and you probably lose your house. That's a pretty insidious act for profit IMO.
>Voters are widely split on healthcare reform and have no consensus beyond the fact that they want it. I want healthcare reform too, but probably dont agree with you on what that means. I don't that that justifies a consequentialist claim that the other is a killer, let alone reprisal.
I think the easiest step would be to drop the Medicaid age from 65 to 60. Drop it 5 years every 5 years or so. The lower it goes, the cheaper that bracket will be. I don't know why any politician hasn't suggested this, but I can guess.
Another fun fact: unexpected medical debt was the number one cause of bankruptcy in Australia prior to the introduction of Medicare in the 1980s.
EDIT: I should clarify that it is nuanced. Medical debt is unlikely to draw unwanted scrutiny from the US Trustee/BR Administrator and of course it doesn't leave the debtor with any assets arising from the debt. Regarding house loss that is far more dependent upon the state you're in than the debt you have. For ex., homestead exemptions will protect the home from most unsecured debt. Further nuance is beyond HN's scope.
Instead, I think medicaid should be offered, at cost, as a non-profit public option to all ages. This was discussed briefly during the Obama healthcare debates, but broadly rejected by left who wanted to eliminate private options. We got compulsory private healthcare instead, but I think it is still the best option. Give everyone a non-profit option with a national pool size.
As someone who voluteered in this field during that time, this is just a repetition of right wing propaganda. There was no serious movement to eliminate private options. Every country with a single-payer system that I'm aware of has private options as well, they just aren't popular because they aren't good or necessary. Right wing extremists want to present this as eliminating options, but in reality, it's just people not choosing private options when they have other options, because private options suck.
The real reason the left rejected a the "compromise" of non-profit options is that it still requires people who don't have money to pay for insurance. Simply slapping a non-profit label on an insurance company doesn't fix anything.
Note that non-profit health insurance companies exist already, and have solved exactly zero of America's health insurance problems.
If the entire "single payer" program was completely optional and offered at cost, they totally missed the messaging on that one, because I was paying attention and that wasnt my take away.
Correct, but that's a pretty big change from the propaganda you repeated in your previous comment. What you said was, "This was discussed briefly during the Obama healthcare debates, but broadly rejected by left who wanted to eliminate private options." In another now-deleted comment, you also said, "the left was too fixated On preventing people from buying better care".
Nothing about having single payer healthcare prevents people from also purchasing private healthcare. Single payer does not require the elimination of private options--when you said that was what the left wanted, you were repeating a lie. People can and do purchase private healthcare in countries with single-payer systems--it's just not common because generally the private healthcare options aren't worth it.
> If the entire "single payer" program was completely optional and offered at cost, they totally missed the messaging on that one, because I was paying attention and that wasnt my take away.
Single-payer is optional in the same sense that current subsidies to insurance companies are optional, it just costs less and results in less death and human suffering.
Your insistence that it has to be "offered at cost" is basically an insistence that people who can't afford that cost but need life saving care can just die. So no, it wasn't "offered at cost"--that's the entire point. I want Americans to be able to receive life-saving medical care when they need it, even if they are poor. That's just basic empathy for our fellow humans.
There is a big difference between supplemental insurance and alternative options, and I think you are conflating the two. the first big difference is being able to opt out of the cost of public insurance if you go with something else.
I think that any puclic healthcare should carry the true price tag, and any subsidies for the poor should be subsidized as a separate benefit. Essentially, I am strongly opposed to funding the public healthcare with an income/payroll tax because I dont thinnk there is much incentive to actually tackle prices.
I don't think that's a big difference. You can't opt out of paying tax for health insurance subsidies under the plan you're proposing--the difference here is that the amount of tax you can't opt out of under single-payer is less, because you're not forced to pay the corporate middle-men.
Yes, I'm saying the combined cost of paying your own healthcare AND poor people's healthcare under single payer is lower than the cost of paying just the poor people's healthcare under corporate health insurance, because it is. The government already pays more than half of health insurance costs[1]--the total cost would go down under single payer by every estimate I've found.
In short, it's literally cheaper to pay taxes for single payer AND a private health insurance premium, than to pay taxes for subsidies to private health insurance in addition to your private health insurance premium. The inefficiency introduced by ubiquitous private health insurance is that bad.
> I think that any puclic healthcare should carry the true price tag, and any subsidies for the poor should be subsidized as a separate benefit.
Ah yes, the "we should make poor people apply for healthcare, so that we can deny people coverage and so people who can't fill out paperwork can't receive coverage" solution to lowering costs.
I'm sure there's no way that right wingers will underfund these programs for the poor and then use their failure to function as an excuse to get rid of them.
> Essentially, I am strongly opposed to funding the public healthcare with an income/payroll tax because I dont thinnk there is much incentive to actually tackle prices.
I'm glad you brought up incentives! Here's how single-payer provides better incentives than what you're proposing:
1. Politicians are motivated to tackle the price of healthcare because this allows them to lower taxes for their constituents, which keeps them office. Money isn't the only incentive that exists. How do you justify ignoring this?
2. The perverse incentive to increase the price of healthcare to line the pockets of insurance is removed, because most of the healthcare isn't provided by private insurance companies that can lobby. How does your solution address this problem?
https://www.nytimes.com/2019/03/23/health/private-health-ins...
Warren and DeBlasio also signaled they would abolish private insurance.
As I've reiterated repeatedly, this isn't a loss of options. Health insurance companies can still operate and consumers can still pay for private health insurance, they'll simply be competing with a cheaper alternative that doesn't have a perverse incentive to deny care.
I suppose you could make the argument that there will be fewer options because some of these insurance companies will go bankrupt, but that's just capitalism--there's nothing about the current system which guarantees health insurance companies will remain solvent or guarantees a variety of insurance options. In practice there are many places in the U.S. where there's effectively only one health insurance option.
>There are few international analogues to the Medicare for all proposals, but Canada, which provides similar doctor and hospital benefits for its residents, probably comes closest. Even there, people buy private insurance for benefits that are not covered by the government program, like prescription drugs and dental care. Most other countries with single-payer systems allow a more expansive, competing role for private coverage. In Britain, for example, everyone is covered by a public system, but people can pay extra for insurance that gives them access to private doctors.
If you have something to say, say it--I'm not going to buy a NYT subscription so that I can speculate what you are referring when you can't be bothered to explain yourself.
Your claim at face value is absurd: if you want to waste your money on private insurance that is more expensive and will do everything they can to not pay out, have at it. Why would anyone on the left care? I assure you we don't. We're trying to give people healthcare, not take away options.
The only coherent complaint you have actually stated seems to be a poorly-communicated complaint that you don't get to pick and choose which taxes you pay. If that's your complaint, I find it a bit surprising that you want to start by opting out of paying for healthcare instead of, say, corporate subsidies to predatory lenders, farm subsidies to corn which is turned into HFCS, or NSA violating privacy of citizens. Or, for that matter, existing healthcare subsidies which are more expensive than single-payer healthcare would be?
If you support a public healthcare option where I can choose to opt of the cost and service, then you have my support too! It is really that simple.
No, I'm arguing with the reality of what you're saying. You want to block single-payer if it can't be opted out of--is that a straw man? Obviously not. I'm just telling you that the results of your ideology are not the results you're hoping for. The real results are:
1. Blocking single-payer if it can't be opted out of has resulted in private healthcare subsidies which are more expensive, and also can't be opted out of. What your ideology has achieved isn't the ability to opt out, it's simply to line the pockets of insurance companies.
2. If you want to start a larger conversation about being able to opt out of government services, why start with healthcare--a thing that people literally need to survive? Frankly, I don't believe that you're a principled believer in being able to opt out of tax: if you were, you'd start with one of the government programs which actively harms people. There are dozens, pick one of those taxes to fight for your right to opt out of instead of deciding that people in need of healthcare should die for your principled opt-out stance.
3. The most important reality of your ideology is that hundreds of thousands of Americans are financially harmed, don't receive healthcare, and ultimately, many of them die from lack of care because of right-wing extremists blocking Americans from receiving care. Your ideology literally kills people. Maybe if you got exactly what you wanted people wouldn't die, but the reality is that by opposing single-payer you're aligning yourself with murderers. No, I'm not holding you personally as responsible as a health insurance CEO, but you do bear some responsibility if you contribute to spreading this abhorrent, selfish ideology.
TL;DR: I'm all for a system where we get single-payer and can opt out of it, but that's not a realistic option that's on the table, and in pursuing that goal you're ignoring the real single-payer option and in doing so you're both failing to achieve the results you want and letting people die.
There's also a difference between letting people die for whom you have no responsibility, and actively taking on the responsibility to prevent deaths in exchange for profit, and then letting the people whose lives you're responsible for die.
If you don't want to be held responsible when you let people die, don't take on that responsibility by becoming a health insurer.
Health insurers actually did worse than that: when other people wanted to take on the responsibility (i.e. single-payer healthcare) they actively blocked them from saving lives so they could go on profiting.
If this isn't "murder" or "killing" in your eyes, then maybe we just need a new word for the callous abdication of responsibilities that you signed up to provide for profit, when doing so results in the deaths of thousands.
We already have a word for that, it's called "capitalism".