dagblog - Comments for "What They've Wanted To Repeal For Seven Years"

Maiello... Good points... And

oldenGoldenDecoy — Thu, 03 Aug 2017 18:53:08 +0000

In reply to What They've Wanted To Repeal For Seven Years

Maiello... Good points... And about Single Payer?

Now here's what Single Payer/Improved Medicare for All would entail.

There is little debate that Representative John Conyers’s Medicare-for-All bill here would be a very heavily lift to properly introduce and implement.

Note the date. I posted this quite awhile back here at Dag.

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By oldenGoldenDecoy on Sat, 11/02/2013 - 9:32pm

Under a Single-Payer System Would People Be Buying Government Health Insurance Policies?

Howdy Daggers... How're you all doing . . .

It's been quite awhile since I dropped a post here at Dag, two months to be exact. I've been busy helping people (in 3D) navigate the real world of the ObamaCare sign up process here in California.

Now about buying government health insurance under single-payer. What caught my attention was a small point that I mildly disagree with that Michael posted earlier today at 12:22 pm in the thread of his well written "Dear angry American..." post. Here is the sentence.

"How is single-payer, which would require people to buy government health insurance, less excessive than ACA, which requires people to buy private health insurance."

Simply stated, the main point I'd like to make is this. Under a single-payer system people don't buy government health insurance, per se. The government pays the costs directly to a person's health services provider. There are no middle-man private health insurance companies.

Being that I'm in my 60s [I'm now 70] I may never see it in my lifetime, but eventually we won't be able to afford NOT to implement the following.

To help fully understand what the single-payer system is, the following info is quite helpful. Take the time and immerse yourselves in the nuts and bolts sections of... [The following is the original session of Congress when first introduced.]

H.R.676 - Expanded & Improved Medicare For All Act 113th Congress (2013-2014)

Make sure you at least take notice of:

TITLE I — ELIGIBILITY AND BENEFITS
Sec. 101. Eligibility and registration.
Sec. 102. Benefits and portability.
Sec. 103. Qualification of participating providers.
Sec. 104. Prohibition against duplicating coverage.

And the following is a quick overview from GovTrack:

Introduced in House (02/13/2013) [And it has been reintroduced every session since then.]

Expanded & Improved Medicare for All Act - Establishes the Medicare for All Program to provide all individuals residing in the United States and U.S. territories with free health care that includes all medically necessary care, such as primary care and prevention, dietary and nutritional therapies, prescription drugs, emergency care, long-term care, mental health services, dental services, and vision care.

Prohibits an institution from participating unless it is a public or nonprofit institution. Allows nonprofit health maintenance organizations (HMOs) that deliver care in their own facilities to participate.

Gives patients the freedom to choose from participating physicians and institutions.

Prohibits a private health insurer from selling health insurance coverage that duplicates the benefits provided under this Act. Allows such insurers to sell benefits that are not medically necessary, such as cosmetic surgery benefits.

Sets forth methods to pay institutional providers of care and health professionals for services. Prohibits financial incentives between HMOs and physicians based on utilization.

Establishes the Medicare for All Trust Fund to finance the Program with amounts deposited: (1) from existing sources of government revenues for health care, (2) by increasing personal income taxes on the top 5% income earners, (3) by instituting a modest and progressive excise tax on payroll and self-employment income, (4) by instituting a modest tax on unearned income, and (5) by instituting a small tax on stock and bond transactions. Transfers and appropriates to carry out this Act amounts that would have been appropriated for federal public health care programs, including Medicare, Medicaid, and the Children's Health Insurance Program (CHIP).

Requires the Medicare for All Program to give first priority in retraining and job placement and employment transition benefits to individuals whose jobs are eliminated due to reduced administration.

Requires creation of a confidential electronic patient record system.

Establishes a National Board of Universal Quality and Access to provide advice on quality, access, and affordability.

Requires the eventual integration of the Indian Health Service into the Program, and an evaluation of the continued independence of Department of Veterans Affairs (VA) health programs.

Like I said earlier, being that I'm in my 60s [I'm now 70] I may never see it in my lifetime, but eventually we won't be able to afford NOT to do it.

Everyone have a good weekend.

~OGD~

It's a tough call, of course,

Michael Wolraich — Tue, 01 Aug 2017 15:16:08 +0000

In reply to "It's jam tomorrow and jam

It's a tough call, of course, but I think Mike's right. A public option should have been a non-negotiable part of the plan. Instead it became a bargaining chip for negotiations with the insurance industry.

I found this very short

artappraiser — Mon, 31 Jul 2017 19:10:54 +0000

In reply to What They've Wanted To Repeal For Seven Years

I found this very short interview extremely helpful as regards everything going on with this. Especially on what Trump thinks. He met with Trump personally on it 3 times,and with Trump aides many times, and with many Dems.

The Future of Obamacare: Zeke Emanuel, an architect of the ACA, has some thoughts.

@ Salon.com, July 28

He's clearly not panicking, rather, he's " nothing if not optimistic" including about the Congressional GOP, that they will now come around to acting responsibly on the ACA.

"It's jam tomorrow and jam

Flavius — Mon, 31 Jul 2017 18:09:44 +0000

In reply to Flavius, political fortunes

"It's jam tomorrow and jam yesterday but never jam today".

In many cases, sure. Make a tough minded trade off for more jam tomorrow.

Health care is a very special case, Kenneth Arrow's basic 1963 argument . One way its special is that your wait for the full loaf may last forever. Because you die first. Unnecessarily

We've spent 9 years passing

PeraclesPlease — Mon, 31 Jul 2017 17:24:57 +0000

In reply to Perhaps so, but that's a

We've spent 9 years passing and defending Obamacare even though it was always a redhaired stepchild from what we thought we needed - not quite affordable, still not quite universal, even though 1000x better than anything the GOP offered.

How's minimum wage if you need minimum income? @that point someone's going to complain.

Perhaps so, but that's a

Michael Wolraich — Mon, 31 Jul 2017 15:01:50 +0000

In reply to My problem is aside from

Perhaps so, but that's a different question--a better one. If we stop pushing aside ideas that today's Congress won't pass, we can have a productive debate about what the right solution should be. That said, I don't think minimum wage and minimum income are mutually exclusive. In fact, they complement each other.

My problem is aside from

PeraclesPlease — Mon, 31 Jul 2017 06:48:00 +0000

In reply to Flavius, political fortunes

My problem is aside from "easy affordable healthcare", I find many of these "full loaf" ideas a bit wanting. The "minimum income" is more compelling to me than the $15 minimum wage argument (what if you're unemployed and unemployable? or simply not worth $15 an hour however hard you try?). And I don't get how most people are preparing philosophically/economically for our future.

Flavius, political fortunes

Michael Wolraich — Sun, 30 Jul 2017 20:45:00 +0000

In reply to We can't get there from here.

Flavius, political fortunes can turn faster than you think. At the dawn of the Progressive Era in 1909, Republicans dominated the Senate (59-32), House (219-171), White House (Taft), and the courts--as they had for decades. Corporations controlled the political machines that elected the politicians, and the progressive ideas seemed like pipe dreams.

But by 1913, the situation was reversed. Democrats controlled the Senate (49-42), House (291-134), and the White House (Wilson). The next eights years saw one of the biggest bursts of progressive legislation in U.S. history, not just laws but also 4 constitutional amendments. (OK, one was prohibition, but the others were huge: one to create an income tax, one to elect senators by popular vote, and one to let women vote.)

How did this happen? Not through strategic action. The early attempts under Theodore Roosevelt to pass mealy compromise measures with conservative obstructionists achieved little of significance. What turned the tide were hard, seemingly hopeless campaigns for big ideas. I give you this quote from Fighting Bob La Follette, one of the pioneers of the progressive movement:

“In legislation no bread is often better than half a loaf...Half a loaf, as a rule, dulls the appetite, and destroys the keenness of interest in attaining the full loaf.”

La Follette harnessed the growing frustration of voters to get rid of the obstructionists, allowing progressive legislators to pass historic "full loaf" bills that we still depend on today.

Perhaps I'm senile, but didn

PeraclesPlease — Sun, 30 Jul 2017 05:05:45 +0000

In reply to Schumer has been floating the

Perhaps I'm senile, but didn't we pitch this Medicare buyin 10, 20 years ago? Everything looks like a re-run. Even Trump, think I saw the Borgias series on PBS or maybe it was Caligula with orange-haired Malcolm McDowell...

We can't get there from here.

Flavius — Sun, 30 Jul 2017 02:33:38 +0000

In reply to What They've Wanted To Repeal For Seven Years

We can't get there from here. Given Citizens United at best it will be decades before we have any prospect of 60 seats.

So ,sadly, we're stuck with the need to act strategically.

Obama got us in the ball park. The son of Obamacare of course has to be better for our voters , but only to the extent consistent with recruiting at least some Republican support. Ideally enough to get us to 60 but in any rate more. .

Operate at that level while proving ourselves to this larger audience. Then go for it.

"God sees the truth. But waits".

A. Chekhov