My ex-husband's medical debt is why we had to file for bankruptcy. Iirc, his prescriptions alone ran about $3500/month - and all the multiple, multiple specialist appts trying to figure out wtf was actually wrong with him? I don't even want to know (and/or have mercifully forgotten). I do recall one single bill in the low six figures. This, incidentally, is also how I lost my house & wound up functionally homeless for half a year.
This is a 20th century argument, seriously. Ask the folks in Youngstown what its like to have an entire sector of the economy eliminated. We are rapidly heading into a future where SO MANY of our jobs are going to be automated out of existence, and no one other than maybe Andrew Yang or microdosing tech philosophers seem to have begun to consider that world. Do you think your great-grandchildren will consider it a fair trade-off that we propped up coal plants to save ~job$~ at the expense of breathable air? Should we keep ICE going because ~job$~?
I do understand your concern, and even 25 years ago that would be a valid question. But things are changing *fast*, jobs are going away all the time (I see you, retail sector), and people need affordable healthcare full stop, unemployed or not.
This makes my head explode. "But if we have a single-payer system where everything is covered, for everyone, what is it that will be left for private insurance companies to cover? What is it that they will be doing?" I love you Robin, but this statement shows a massive lack of understanding of the heatlhcare system. I'm a health policy wonk and support universal healthcare. I am no fan of insurance companies. But to say they do nothing really misses the boat.
Remember that a lot of countries with universal coverage use insurance companies to pay for and organize care: Germany, Switzerland, Israel, the Netherlands... And even those without insurance companies use other mechanisms for organizing and coordinating services. England has gone through any number of different efforts to deliver care more efficiently.
Remember that over a third of people in Medicare are now opting to be covered through private insurance plans. There's a reason for that. In the best possible cases, the insurance plans are helping them manage their care more effectively. Those are not common, I give you that -- these plans tend to be nonprofit. The issue is with FOR PROFIT insurers and the massive inefficiencies created by the profit motive and duplicative systems.
I'll get off my hobby horse now, but PLEASE do not say something this dumb again.
I think that the death of private insurance can't come soon enough, after a public option is put in place. But since I am a human with occasional feels, what will happen to those literal tens of thousands of employees, and their families? I'm not talking about the higher ups, I'm talking about an admin. assistant, or manager guy, you know, the people who might be your next door neighbor.
What is the solution? I don't want to hear about these mythical re-training programs that never materialise, either. Nobody's going to hire a 55 year old middle manager who's been with a big insurance company for 35 years, no matter how much "re-training" he gets.
While I'm generally in favor of single payer, I worry about that also too.
And it's not only the people who work for the insurance companies. What about the legion of medical billers and coders and admin staff that every medical practice employs?
I used to be one of them... in a busy pediatricians' office, with four partners, two additional doctors, and three nurse practitioners, in addition to the roster of front desk people who did the scheduling and the forms and the record-keeping, we had a billing office that employed ten to handle coding each visit, billing the requisite company, and following up on claims.
Every one of those women - and they were all women - needed those jobs, and every one of them would be out of work under M4A.
"They're not in love with their insurance companies, they like their providers." So true. But watch, when you point that out, the pseudoconservatives will say, "Then why do they switch insurance plans during open enrollment?" The answer for that is, "To get lower copays and deductibles, they'll sacrifice keeping their provider." This issue also goes away with single-payer universal insurance, since copays and deductibles - if any - are the same for all.
Once that argument is toast, the next one will be, "Then the doctors will leave." Sure, to where? Canada, Great Britain, New Zealand, Australia, the US Virgin Islands? 'Cause learning a new language to practice medicine with is a bridge to far for most monolingual Americans. And those other places (except maybe USVI - don't know about them) have universal health insurance.
I think the point is that doctors and hospitals are going to be making less. However, their costs will be reduced as well. The net will be similar. They will still be able to afford the second home and adjust their portfolios as before.
I quote from the article: ""As Pete Buttigieg pointed out last night, Republicans are allowed to be as ambitious as they like with their shit, which actually terrifying and which actually hurt people, but Democrats are supposed to walk on eggshells with things that will actually help people. Democratic candidates are supposed to act as if they know that liberal policies are a thing no one actually wants, like they are vegetables that have to be disguised as vegetti in order to get anyone to swallow them. This is a marketing strategy. Part of the reason why I love Elizabeth Warren is because she does not play that game."
John Delaney made me gag. aas Elizabeth Warren said: "What's the point of taking the trouble of running for president if only to enumerate all the things that re impossible?"
Fuck the naysayers. I don't want a Democratic presidency that is "Republican Lite".
Virtually all doctors will remain in the US and learn the new system. Some time ago at my doctor's office, I had to put up with some arbitrary decision by my insurance company regarding a drug reimbursement policy (to the consumer's disadvantage, of course). I said to the doctor: "They're being assholes". He agreed. Doctors are sick and tired of commercial insurance companies; and that's not just by my doctor's comment. It's a well-known fact nationwide.
If you think for a moment that commercial insurance companies give a second thought about laying off 1000s when their profits go down 1 or 2%, I have news for you.
Thank you for that info. I came across a great article today too:
"I have to confess to having missed how private equity is a central bad actor in the “surprise billing” scam that is being targeted by Federal and state legislation. This abuse takes place when hospital patients, even when using a hospital that is in their insurer’s network, are hit with charges for “out of network” services that are billed at inflated rack rates. Even patients who have done everything they can to avoid being snared, like insisting their hospital use only in-network doctors for a surgery and even getting their identities in advance to assure compliance, get caught. The hospital is in charge of scheduling and can and will swap in out-of-network practitioners at the last minute.
Private equity maven and co-director of the Center for Economic and Policy Research Eileen Appelbaum explained in an editorial in The Hill in May how private equity firms have bought specialist physicians’ practices to exploit the opportunity to hit vulnerable patients with egregious charges:"
Obviously, running a status quo candidate in the last US Presidential election didn't move the window one iota. What did that candidate offer other than "more of the same" when people were hungry for change? Alas, the change was the wrong direction. Where you shift the narrativew is at the local level... electing leftists to county and municipal offices, maybe the House, is essential. That's how the "Christian Coalition" took over the Republican Party and moved the window so far to the right. A strong left-wing Presidential candidate might not win nationally, but his or her "coattails" will bring substantial change to US politics. Think of Theodore Roosevelt's Progressives here... No Roosevelt didn't win in 1912, but it forced the Democrats to change from the part of the status quo to the party of change. For good or bad, that's how it works.
So if you want to change anything you don’t sit home on your ass in a major election and ignore local and state elections and midterms. You vote for the best available candidate in every election including primaries and try and move them to where you want to go by getting candidates you believe in into as many offices as possible. Also there is the fact that Hillary got 3 million more votes in the primaries and general election then the people she was running against.
But hey just wait until the perfect candidate shows up before you bother to vote to “move the window to the left” because that works so well.
The perfect is always the enemy of the good, which is true, but laying the groundwork doesn't hurt (why I think the left should study the Christian Coalition and how they took over Republican organizations in the 1980s and 90s... running for down-ballot offices no one paid attention to).
Because I live abroad, in a country where there have always been foreign powers interfering in our elections (Mexico, where the foreign "influencer" is... well... you guys), I tend to discount those that just want to blame Trump on alleged Russian influence. I'd be more likely to "credit" Trump's victory with paying attention to the Electoral College (more votes doesn't mean shit in US elections, and the Ds know better than to keep harping on who got the popular vote nationwide). And, blame the Ds for running just another status quo candidate. Maybe it's the deep conservatism in US culture that keeps an 18th century electoral system, and 19th century liberal parties as the only choices, but if you're gonna change, you gotta break out of the same old-same old candidates and platforms.
One thing I notice is that the US has very low voter turnout compared to just about anywhere else on the planet. I wonder if the lack of real ideological choices doesn't have something to do with it. Two capitalist parties, just don't represent most people's interests and I can see why people, looking for a change of some sort, might have been tempted to vote for a Fascist like Trump.
My ex-husband's medical debt is why we had to file for bankruptcy. Iirc, his prescriptions alone ran about $3500/month - and all the multiple, multiple specialist appts trying to figure out wtf was actually wrong with him? I don't even want to know (and/or have mercifully forgotten). I do recall one single bill in the low six figures. This, incidentally, is also how I lost my house & wound up functionally homeless for half a year.
This is a 20th century argument, seriously. Ask the folks in Youngstown what its like to have an entire sector of the economy eliminated. We are rapidly heading into a future where SO MANY of our jobs are going to be automated out of existence, and no one other than maybe Andrew Yang or microdosing tech philosophers seem to have begun to consider that world. Do you think your great-grandchildren will consider it a fair trade-off that we propped up coal plants to save ~job$~ at the expense of breathable air? Should we keep ICE going because ~job$~?
I do understand your concern, and even 25 years ago that would be a valid question. But things are changing *fast*, jobs are going away all the time (I see you, retail sector), and people need affordable healthcare full stop, unemployed or not.
This makes my head explode. "But if we have a single-payer system where everything is covered, for everyone, what is it that will be left for private insurance companies to cover? What is it that they will be doing?" I love you Robin, but this statement shows a massive lack of understanding of the heatlhcare system. I'm a health policy wonk and support universal healthcare. I am no fan of insurance companies. But to say they do nothing really misses the boat.
Remember that a lot of countries with universal coverage use insurance companies to pay for and organize care: Germany, Switzerland, Israel, the Netherlands... And even those without insurance companies use other mechanisms for organizing and coordinating services. England has gone through any number of different efforts to deliver care more efficiently.
Remember that over a third of people in Medicare are now opting to be covered through private insurance plans. There's a reason for that. In the best possible cases, the insurance plans are helping them manage their care more effectively. Those are not common, I give you that -- these plans tend to be nonprofit. The issue is with FOR PROFIT insurers and the massive inefficiencies created by the profit motive and duplicative systems.
I'll get off my hobby horse now, but PLEASE do not say something this dumb again.
I think that the death of private insurance can't come soon enough, after a public option is put in place. But since I am a human with occasional feels, what will happen to those literal tens of thousands of employees, and their families? I'm not talking about the higher ups, I'm talking about an admin. assistant, or manager guy, you know, the people who might be your next door neighbor.
What is the solution? I don't want to hear about these mythical re-training programs that never materialise, either. Nobody's going to hire a 55 year old middle manager who's been with a big insurance company for 35 years, no matter how much "re-training" he gets.
While I'm generally in favor of single payer, I worry about that also too.
And it's not only the people who work for the insurance companies. What about the legion of medical billers and coders and admin staff that every medical practice employs?
I used to be one of them... in a busy pediatricians' office, with four partners, two additional doctors, and three nurse practitioners, in addition to the roster of front desk people who did the scheduling and the forms and the record-keeping, we had a billing office that employed ten to handle coding each visit, billing the requisite company, and following up on claims.
Every one of those women - and they were all women - needed those jobs, and every one of them would be out of work under M4A.
"They're not in love with their insurance companies, they like their providers." So true. But watch, when you point that out, the pseudoconservatives will say, "Then why do they switch insurance plans during open enrollment?" The answer for that is, "To get lower copays and deductibles, they'll sacrifice keeping their provider." This issue also goes away with single-payer universal insurance, since copays and deductibles - if any - are the same for all.
Once that argument is toast, the next one will be, "Then the doctors will leave." Sure, to where? Canada, Great Britain, New Zealand, Australia, the US Virgin Islands? 'Cause learning a new language to practice medicine with is a bridge to far for most monolingual Americans. And those other places (except maybe USVI - don't know about them) have universal health insurance.
I think the point is that doctors and hospitals are going to be making less. However, their costs will be reduced as well. The net will be similar. They will still be able to afford the second home and adjust their portfolios as before.
I quote from the article: ""As Pete Buttigieg pointed out last night, Republicans are allowed to be as ambitious as they like with their shit, which actually terrifying and which actually hurt people, but Democrats are supposed to walk on eggshells with things that will actually help people. Democratic candidates are supposed to act as if they know that liberal policies are a thing no one actually wants, like they are vegetables that have to be disguised as vegetti in order to get anyone to swallow them. This is a marketing strategy. Part of the reason why I love Elizabeth Warren is because she does not play that game."
John Delaney made me gag. aas Elizabeth Warren said: "What's the point of taking the trouble of running for president if only to enumerate all the things that re impossible?"
Fuck the naysayers. I don't want a Democratic presidency that is "Republican Lite".
Virtually all doctors will remain in the US and learn the new system. Some time ago at my doctor's office, I had to put up with some arbitrary decision by my insurance company regarding a drug reimbursement policy (to the consumer's disadvantage, of course). I said to the doctor: "They're being assholes". He agreed. Doctors are sick and tired of commercial insurance companies; and that's not just by my doctor's comment. It's a well-known fact nationwide.
If you think for a moment that commercial insurance companies give a second thought about laying off 1000s when their profits go down 1 or 2%, I have news for you.
Thank you for that info. I came across a great article today too:
"I have to confess to having missed how private equity is a central bad actor in the “surprise billing” scam that is being targeted by Federal and state legislation. This abuse takes place when hospital patients, even when using a hospital that is in their insurer’s network, are hit with charges for “out of network” services that are billed at inflated rack rates. Even patients who have done everything they can to avoid being snared, like insisting their hospital use only in-network doctors for a surgery and even getting their identities in advance to assure compliance, get caught. The hospital is in charge of scheduling and can and will swap in out-of-network practitioners at the last minute.
Private equity maven and co-director of the Center for Economic and Policy Research Eileen Appelbaum explained in an editorial in The Hill in May how private equity firms have bought specialist physicians’ practices to exploit the opportunity to hit vulnerable patients with egregious charges:"
https://www.nakedcapitalism...
I have the crappy "Bronze Plan" 60/40 from Kaiser. It really sucks. I feel for your son, but he's better off than I am. lol.
GOP won't admit it, but socialism is only for rich corporations, not us "little people."
Obviously, running a status quo candidate in the last US Presidential election didn't move the window one iota. What did that candidate offer other than "more of the same" when people were hungry for change? Alas, the change was the wrong direction. Where you shift the narrativew is at the local level... electing leftists to county and municipal offices, maybe the House, is essential. That's how the "Christian Coalition" took over the Republican Party and moved the window so far to the right. A strong left-wing Presidential candidate might not win nationally, but his or her "coattails" will bring substantial change to US politics. Think of Theodore Roosevelt's Progressives here... No Roosevelt didn't win in 1912, but it forced the Democrats to change from the part of the status quo to the party of change. For good or bad, that's how it works.
So if you want to change anything you don’t sit home on your ass in a major election and ignore local and state elections and midterms. You vote for the best available candidate in every election including primaries and try and move them to where you want to go by getting candidates you believe in into as many offices as possible. Also there is the fact that Hillary got 3 million more votes in the primaries and general election then the people she was running against.
But hey just wait until the perfect candidate shows up before you bother to vote to “move the window to the left” because that works so well.
The perfect is always the enemy of the good, which is true, but laying the groundwork doesn't hurt (why I think the left should study the Christian Coalition and how they took over Republican organizations in the 1980s and 90s... running for down-ballot offices no one paid attention to).
Because I live abroad, in a country where there have always been foreign powers interfering in our elections (Mexico, where the foreign "influencer" is... well... you guys), I tend to discount those that just want to blame Trump on alleged Russian influence. I'd be more likely to "credit" Trump's victory with paying attention to the Electoral College (more votes doesn't mean shit in US elections, and the Ds know better than to keep harping on who got the popular vote nationwide). And, blame the Ds for running just another status quo candidate. Maybe it's the deep conservatism in US culture that keeps an 18th century electoral system, and 19th century liberal parties as the only choices, but if you're gonna change, you gotta break out of the same old-same old candidates and platforms.
One thing I notice is that the US has very low voter turnout compared to just about anywhere else on the planet. I wonder if the lack of real ideological choices doesn't have something to do with it. Two capitalist parties, just don't represent most people's interests and I can see why people, looking for a change of some sort, might have been tempted to vote for a Fascist like Trump.