Posted by dahsdebater on 5/4/2017 11:05:00 PM (view original):
You can make the argument sound as pretty as you like. There aren't fewer people dying since the ACA passed. This is a fact. I don't know what your conditions are. I can't tell you you're wrong. I hope you're wrong because I don't want to see anybody dying needlessly. And I'm sure as hell not defending the House bill.
But you aren't making a logical argument. You're making an emotional argument. The root of your actual point is "Health care is a right. Everybody should have healthcare. Therefore, single payer is the best way to handle our healthcare system." Those are 2 almost entirely unrelated things you're presenting as a logical progression. It's not. There are other ways of handling healthcare. Single-payer hasn't worked all that well in Canada, and while it has worked well in Taiwan it has been prohibitively expensive. You translate what Taiwan spends on Healthcare to the US GDP/population and propose that spending you get laughed out of town. Even left-leaning Democrats don't think we can spend hundreds of billions more per year on healthcare. So neither of the existing single-payer systems provides a roadmap to a feasible solution in the near future in this country. Hybrid public/private systems are much more cost-effective. The ACA is just a bad example.
As far as pre-existing conditions go, my solution would be to remove price protections but preserve coverage protections. Then provide a federal subsidy for individual payers with pre-existing conditions to make their effective price equivalent to a "healthy" person. The insuree doesn't see a price hike associated with their condition(s), and the government can negotiate directly with the insurance companies for what added premiums they should be paying to subsidize the coverage. This shifts the burden for pre-existing conditions from the general population of insured people to the tax-paying public. Right now, people paying for personal coverage are bearing an undue portion of the burden, and they tend to be on the lower end of the income spectrum. If you shift the burden to the taxpayers, it shifts more of the burden to wealthier people. I can see why many Republicans wouldn't like it, and I'm not a fan of increased Federal spending, but from my perspective this solves a lot of problems and provides a more equitable distribution of the cost of healthcare for people with pre-existing conditions without resorting to a single-payer system.
At least you're discussing actual solutions.
I'm willing to discuss actual solutions. Single-payer is a starting point. I'm not saying it necessarily has to go there.
But if you want to pull the ACA, yes, you'd better HAVE a real solution. I'm not going to sit here and tell you it's the best thing ever, or even the best alternative to single-payer. It definitely has flaws -- though a great many of those flaws can be attributed to states refusing to expand Medicaid to score political points. But yeah, it's not a great option. Ironic point here, of course, is that this is the Republican plan itself. Look it up, ACA is basically the Heritage Foundation plan from the 90s. A more liberal plan would've been single-payer...
You raise reasonable points. I find the complaints about Canadian healthcare to be overblown when I actually look at the data. Wait times is often complained about -- I wrote a paper on this for a college class a few years ago, their times are not significantly worse than the US except in a very few specialist cases.
...where did Taiwan come from? Literally no progressive I've ever talked to has ever suggested Taiwan as a model. And you explain very well why. There's a reason we tend to look at Europe. (EDIT: and the data in the above post supports the European model as well. Single-payer forms do not necessitate going to Canada either.)
So, looking through your suggestions... what exactly is the difference between your proposal, and single-payer, other than that your proposal still allows private companies to clean profits off the top on healthcare? 'cause that pretty much sounds like a Medicare for All expansion. I'm down with that... though I'm not sure this does much to deal with all the problems healthcare has, I can see the pattern you have in mind and how it could be applied to solve most everything. But as I said, that comes pretty close to being Medicare for All... which would definitely be a good step as well.
As a general comment, I have *always, always* had better experiences working with government agencies than I have with companies. I would never, ever put something in the hands of the private sector if I thought it critical and it were up to me. I've seen far too much crap otherwise. At least with the government, if you're getting screwed over, you can vote them out. Not much you can do about big money corporations doing it -- unless, as I noted, nonparticipation is a viable option. Free markets are great when you have easy entrance and exit. But that's a completely necessary component to the health of the market.