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Glad they're taking off the gloves a little, but it's always been a non-option to just make our lives significantly and irrevocably better like M4A or the PRO act and although they're good at trying and failing, they never talk about the consequences as dire as they actually are with few exceptions.
Socialized healthcare is absolutely necessary in America. But we have to be honest and we have to be firm: a system that calls itself “socialized medicine” but is ultimately just Obamacare again (Harris’ proposal is basically one step further than the individual mandate, just removes more autonomy) is unacceptable and if anything is poisoning the well against the potential passage of actual socialized healthcare. Words matter and co-opting language to pass along what is basically the current system with an individual mandate that is inescapable will only serve to sour minds on the idea as none of the actual issues with American healthcare will be alleviated and if anything only exacerbated.
You cannot add an individual mandate to subsidize the care of the older population that is significantly more affluent without also reforming the system in such a way that material conditions increase for the younger populations. If healthcare costs went down because they actually addressed the gigantic amounts of waste spending with actual socialized medicine (e.g. removing the option for privatized insurance or highly regulating the system to one coherent standard) then they wouldn’t breed intense resentment that sends young single issue voters straight into the arms of the opposing party.
But they do that because they are either planned opposition at worst, or they are in a position to serve their donors above all else even if it will obviously lead to serving the interests of their opponents in 12-24 months. Malice or apathetic greed is up to you to decide but either way to act like voting for them will save you instead of simply slowing the process of destruction down is foolish
Americans spend 34 percent of medical spending on administrative overhead, in part because there is an excessive of amount of redundancy. Other developed countries spend less than half of this, 10-15%, or less. If we limit the definition to just insurance administration the waste is closer to 10-13% whereas in other countries it is closer to 2-5%.
Our system is overly complex with tens of thousands of billing codes and this complexity is made far worse by a fragmented network of thousands of redundant insurers, all providing the same service, but with different rules and standards. So as a provider I then have to navigate a significant amount of complexity to submit billing and dedicate 20-30% of my time (which could be spent seeing patients) to administrative bullshit because Aetna, Cigna, Oscar, United, Optum (which is United but different), the thousand BC/BS plans, geisinger, Highmark, etc all decided they each have their own verification portal, standards for eft/era, and billing submission practices. Or I can spend that time seeing clients and spend 5-10% of my gross practice income towards staff whose job is solely to deal with this stupid fucking system.
So beyond the inherent unfairness of proposing a two lane system that would once again penalize the poor with substandard care. Doing absolutely nothing to address the real systemic issues of American healthcare, meanwhile expanding privatized Medicare plans by a significant amount and funneling tax dollars into Aetna, Cigna, etc.
A non trivial amount of those tax dollars getting funneled get laundered right back to politicians via lobbying so that any proposal for healthcare reform will be neutered. This way rubes like you will buy it, hook, line, and sinker, keep voting for the party, the insurance industry keeps getting fat stacks, and then 5-10 years later when the insurance situation is still absolutely horrendous because no actual systemic issues were addressed you can then go “how is this the fault of tankies and republicans?? It certainly couldn’t have been my beloved democrats, who would never sell me out for money”.
typical neolib. Closet conservative that uses hateful, judgmental, and prejudiced language when you encounter debate that frustrates you because deep down you’re a judgmental person. If this were 2006 I bet money you would’ve called me a f*g.
The lack of introspection is why your party consistently loses unless people are truly sick of the republicans too. “Should we stop running the same failing strategies we’ve been playing since 2007? Nah, it’s the voters who are wrong”. Keep eating that shit up and blaming your socioeconomic peers instead of the party leadership that continually utterly fails you, living like modern kings while you slave away for a pittance
You're literally opposing progressive reform.
You are a conservative.
You are advocating for “progressive reform” that does not progress in any realistic way and only truly serves moneyed interests and eventually reinforcing the conservative movement because of resentment from such a slipshod implementation.
Again, typical neolib. You don’t respond to my many points at all, you resort to name calling when it appears you don’t get your way. It’s no wonder the party can’t capture more young voters with this arrogance and inability to listen. “I will tell you what progressivism is! It is giving lots of money to companies and special treatment to rich people without actually fixing anything of substance! Take it or leave it because the system has created a hostage crisis with your rights and instead of serving you I will exploit that to serve my own interests!”
Saving millions of people from pain suffering, and death isn't progress to you? I suddenly see where the disconect lies.
Specious reasoning with no rationale. How does her plan do such a thing? I outlined how it won’t: it will give access to Medicare but because of a compartmentalized two lane system people who are uninsured will struggle immensely to find any care providers in network without huge wait times (if they exist). This will mostly limit care to emergency treatment, which is basically how the uninsured handle their care already. There is also handwaving to how the massively increased costs of this will be handled, which will likely be increased tax burden on the middle and lower class because they won’t ever actually meaningfully tax the rich.
The plan is theater to make libs like you say such grandiose things while avoiding actual progress. That is why when actual progressive candidates with heat behind them pop up from the DSA the party can suddenly align like never before to condemn them and sabotage their campaign despite the “blue no matter who” mantra that is used to guilt rubes like you into voting for yet another corporate stooge with a 10 million+ stock portfolio who’s definitely out for your benefit, promise
Hospitals want to get payment for treatments. Hospitals want to treat people. The more people get covered through things like Medicare, the less insurance companies make, based on all data ever collected on the subject. The government offering to pay for treatment directly also gives the government more price setting power and REDUCES GOVERNMENT SPENDING on medical. This is not an assumption, this is proven fact.
Therefor, everyone except for insurance companies benefit. Waiting times are a non-issue for me if it means more people get treatment.
Way to sidestep the fact that her proposal still allows the following:
Privatized Medicare: those insurance companies still get money, in fact even more because now tax dollars are funneled directly to them.
No change for administrative complexity: because there will still be 10,000 private Medicare plans, all with their own rules, we would still spend 20-30 cents of every dollar (see Woolhandler, Campbell, & Himmelstein (2003), Health Affairs (2014) off the top of my recent tabs for the numbers from my first post here but numerous other studies have pegged the number between 25-35% from 2003-2021) where other countries spend 7-10.
Collective price setting power would shift, but only slightly: again, the vast majority of people would be under privatized Medicare plans the government would have little to no control over negotiating for. This would essentially increase the Medicaid population and roll them into medicare which would give Medicare more bargaining power to be fair, but likely not by as much as you think. Additionally this is only of concern to major providers, smaller specialist networks will simply opt out. If I can fill my practice with Aetna medicare patients that reimburse at $150 for a typical cpt code that medicare reimburses at $97, I will just do that.
You are oversimplifying the issue and further you are appealing to some magic made up bullshit. “Based on every study ever”, “based on all data ever collected” is obvious overgeneralization. “Proven fact” is meaningless. Weasel words from a lib without substance that insists they are right and demands that everyone yields.
To your point single payer systems can absolutely improve costs through collective bargaining. What Harris proposed was in no way a single payer system, nor was there a path to one. It was a system designed to shield the private insurance industry from a single payer system. This takes us back to what the system really is: a return of the individual mandate, eg forcing individuals who do not have insurance that are typically young and healthy to have it so you can have them fund the care of the disabled and elderly that have significantly higher utilization. This is a necessary evil of any insurance system but it is unjust to demand participation when the options given are classist in nature and once again are exploiting lower socioeconomic classes to give a higher quality of care to the higher classes at the lower classes expense.
Waiting times being a non issue for you implies you are privileged. This will not be the case if you are diagnosed with cancer in an emergency room, have a child with autism and want to begin early intervention, etc. A 6-12 month waiting period in these scenarios could mean the difference between your child being verbal or nonverbal, or you literally dying.
This also brings up another domain of the substandard care I only touched upon. Another big problem in controlling costs is shifting people away from emergency care to preventative care. A two lane system again does little to help here. Getting a cancer diagnosis in the ER generally (but not always) means you’ve been ignoring issues and routine primary care for some time. Just looking at medicare data around 23% of cancer diagnosesoccur in the ER, with a broader review showing 12-32%. This generally means these people don’t have a primary care relationship, that they only can seek care once it is debilitating (and unfortunately for them far more likely to be seriously complex or fatal) and tremendously more expensive. This is where you get into the barriers to primary care, which are plentiful, and once again nothing of substance is done on this front to alleviate the issue
The plan is all sizzle, no steak. Libs like you eat it up because you have a job and insurance. Your material conditions will not change, your Aetna plan will become Aetna medicare and you will still pay crazy amounts for healthcare and wonder “why didn’t this work?” Just like Obamacare didn’t work, and if anything hastened the problem as costs have dramatically risen in the decade since.
Finally, opposing your plan does not mean opposing socialized medicine. It means opposing a shitty plan that won’t help
Lmao, government run medicare isn't privatized by definition. The insurance companies don't get to set rates or commit price hikes, they can only take what the government gives them or if they choose not to participate then they end up competing with free: you cannot compete with free.
The system proposed is identical or even superior to European countries' approaches, some of which mandate citizens purchase government subsidized plans by private firms, all of which which statistically have better health outcomes and far more people receiving regular care instead of overburdening the ER.
You're not promoting any plan or system. You're only advocating we don't improve the current one. Because you're a conservative.
You clearly don’t even know what a medicare advantage plan is or that privatized medicare exists.
Medicare advantage: the member pays an additional amount, the insurance company gets a stipend from the government per member per month so they are heavily incentivized to get members off of government controlled insurance. This insurance, to be clear, is only government funded, it is not government controlled. Rates for Aetna medicare advantage are brokered by Aetna, not the CMS (do you even know what this is?). These rates are also completely opaque: as a provider I am contractually obligated to not tell you that Aetna pays $98 for 45 minute psychotherapy (yay anonymity) but the cms has a lookup tool for full transparency that shows you they pay $104 for the same (Aetna MA underpays in my area, in some areas they pay as much as 140 for this service and the “contractually obligated to not disclose rates” is basically “don’t talk about your salary” tied to an service contract)
Again I work in healthcare, I run a practice. Medicare advantage plans, which Harris’ plan enables because she (and/or her colleagues in the dnc) is in the pocket of the insurance industry and absolutely will not rock the boat. Her system ultimately serves to shovel them more tax money again without fixing any systemic issues.
When you speak of European countries that have similar systems you must be referring to countries like Norway, Germany, and Switzerland with Germany being the most similar. The key differences? They have extremely tight regulation that keeps waste down and insurers reigned in. This goes back to my initial point: she proposes nothing to reign in the absurd administrative waste that makes up almost 1/3rd of our spending. Secondly while these systems are demonstrably and objectively better than what the US that does not eliminate them from criticism as they are still classist and prioritize care to the more affluent regardless of need.
My role in this thread was to never promote an alternative though I believe solutions were implied by my pointing out specific issues. I mention this only because I think it is another weasel tactic to discredit valid criticism by trying to defuse it when it is not attached to a solution. Valid criticism is valid criticism, and while moving forward with an imperfect system is often necessary one should not embrace a deeply flawed system solely because it is attached to buzzwords that make you feel nice.
That said to be abundantly clear: If I did so it would be medicare expansion with the eradication of private insurers. This is the most realistic path forward. A single tier system that treats all people regardless of social class, though there will of course be private practitioners who work cash only with the extremely wealthy oligarchs.
This would not necessarily fix all administrative waste overnight but it would address a significant portion of it (over half), create billing consistency, and allow practitioners to focus more on patient care freeing time for patients. This would give a true negotiation mechanism for patients and the government/cms as now collective bargaining would include essentially every American.
This would push hospital networks to address the other administrative overhead because reimbursement rates and budgets would go down.
Therein lies the other issue: a true solution to the problem means putting many people out of work. This means hundreds of thousands, maybe millions, of middle managers, administrators, medical billers, etc all lose their job overnight. What do we do about this? America has an absolutely shit welfare state as well so unless we plan for this we will never see this progress occur. People within and adjacent to the industry will be very susceptible to propaganda and will actively vote and advocate against progress for self preservation, similar to those in the fossil fuel industry who vote to destroy the planet and themselves so they can continue working in a coal mine because it’s not like the failed US state will take care of them. So welfare reform must occur concurrently.
This is a secondary issue though to getting leadership away from slaving for corporate dollars in exchange for favorable treatment. You can’t even begin to address the issue of voters if the voters don’t have any proper options placed in front of them. If all they get is the illusion of choice yet again don’t be surprised when they become disillusioned, do better.