Posted on 07/20/2013 7:43:48 AM PDT by Kaslin
There is stirring on the left.
Now that the odds that ObamaCare will crash and burn have ticked up a notch or two, the words "single payer" are being heard more frequently.
[For those who have been living under a rock, "single payer" is what we used to call "national health insurance," and before that "socialized medicine" and before that "government-provided health care," by people who today call themselves "progressives" but used to call themselves "liberals" and before that "socialists" in some cases — all in the hope that continual re-labeling will make the ideas actually seem sensible.]
Take Dennis Kucinich. The other night on Fox News he announced that the Affordable Care Act was a bad idea from the get-go. "Everybody should be in Medicare," he said, and "We should get for profit companies out of health care." My problem with people on the left is that they are so obsessed with "public" rather than "private" and "non-profit" rather than "for-profit" that they become oblivious to basic facts, including these:
• Most government health care programs are mainly managed by private companies — for-profit companies more often than not.
• One in four Medicare enrollees is actually in a private insurance plan and almost all the rest of Medicare is being managed by private companies (Blue Cross, Cigna, etc.)
• 70 percent of Medicaid enrollees are in private plans — a number that is expected to grow — and I believe all the rest are mainly being managed by private companies.
More importantly, THERE IS NOT A SINGLE MAJOR PROBLEM IN OBAMACARE THAT WOULD BE SOLVED BY MOVING EVERYONE INTO MEDICARE. And any minor problems that might be improved by universal Medicare could have been easily solved by tweaks to ObamaCare as well.
Paying for the expansion. Sometime back,the NCPA calculated that we could pay for national health insurance with a 15% VAT tax. But if it were easy to impose such a tax the Democrats would have financed ObamaCare that way. Bottom line: the easiest way to fund universal Medicare is the same way we are funding ObamaCare. That means:
Individual mandate. For the very same reasons that ObamaCare made insurance mandatory, universal Medicare would also have to be compulsory. Otherwise, people would only join when they are sick. To make the budget balance, people would have to pay a premium that, on the average, equals the expected cost of their care. Just like ObamaCare, there would have to be subsidies for lower-income families. Since no one on the left believes in charging buyers a fair price for almost anything, the healthy would be over-charged and the sick would be under-charged. Incentives to game the system would be monumentally destructive without a mandate. Note: none of the problems with the individual mandate have gone away.
Employer mandate. For people at work, there would be enormous pressure to pretend that employers pay for fringe benefits rather than workers themselves. So employers would have to buy their employees into Medicare. That would raise the issue of exempting small business, exempting part-time workers, etc. Note: none of the problems of the employer mandate have gone away.
Cuts in Medicare Spending on the elderly and the disabled. Almost half the funding for ObamaCare comes from reduced spending on current Medicare beneficiaries. Since the money will still be needed, these cuts will not go away.
New taxes on everything from tanning salons to pacemakers to wheelchairs and crutches. Obviously, these are not going to go away.
Managed care. Doctors on the left hate managed care every bit as much as doctors on the right. The problem is that current third-party payment practices give everyone perverse incentives; and when they act on those incentives they make costs higher, quality lower and access to care more difficult than otherwise would have been the case. The Obama administration is experimenting with Accountable Care Organizations and other reforms to deal with this problem. Of course, nothing the administration is doing is working, but that doesn't change anything. Under universal Medicare, we can't change the rate of growth of health care spending unless we change the way providers are paid.
Actually there is one place where the Obama ideas for reform are working — though not in the way Washington bureaucrats have planned — in the Medicare Advantage plans. These plans are not going to go away under universal Medicare for the same reason they are not going away under ObamaCare.
The exchanges. If the truth be known, what the left hates the most about ObamaCare is the idea of competition. That's because of their fundamental dislike of the economic model of medical care delivery. I have been critical of the exchanges because they are managed competition rather than real competition and they create perverse incentives for everyone who participates. The left dislikes the exchanges because they dislike the idea of competition as such.
But for reasons given above, we have no alternative to the economic model if we want to control costs.
Medicare already has an exchange: it's how enrollees get into Medicare Advantage plans. And if employers get involved, it's almost certain people will want to enroll in their employer plans as an alternative to traditional Medicare.
Here's the upshot: In moving everyone into Medicare, we will not have solved a single problem of any importance that we started with in ObamaCare.
Single Payer has been the plan all along.
Managed competition rather than real competition.
Looks like Obama’s look nothing up my sleeve line has failed like everything else he tries.
Fixed!
If the proponents had told us the truth, it would have met with a lot more resistance and may have not passed.
Not only has that been the plan all along, they have in effect implemented the most importnat part of the plan, requiring insurance companies to cover evrything under the sun. A recent headline in ca:
Without changes, health costs expected to soar in state
The average California family could spend a third of its income for health insurance by 2022 if costs continue to spiral
http://www.pressdemocrat.com/article/20130719/ARTICLES/130719439?title=Without-changes,-health-costs-expected-to-soar-in-state
Had the healthcare plan been fully in place it would have been blamed, but now it is just those nasty insurance companies who people cannot understand are supposed to be in the insurance business, not the health care business.
Perhaps so, but I think it'll be a harder sell than it would have been without Obamacare.
People will be less likely to accept single payer, when they know that those pushing it are the same ones who gave us Obamacare under the promise that it would do wondrous things for health care -- something that turned out to be a crap sandwich instead. Particularly when the vast majority of people remember and liked the health care they were getting before.
An unexpected benefit: most (but not all) people will be healthier and live longer.
Monopolies are bad, except government monopolies.
Government monopolies are good because government is good.
Obamacare was always going to crash and burn when they started taking money out of people's pockets to pay for it.
Single-payer will crash and burn when they start taking money out of peoples' pockets to pay for it.
But none of this has ever been about health care. It's been about overwhelming the system, and that part is working just fine.
Once the system is overwhelmed they can get down to the business they always intended with all those armored personnel carriers and MP5s and billions of rounds of ammo.
uh huh
A huge problem is that, no matter whether it is administered by government or by private companies, the administrative costs of insurance are huge. Coupled with the inefficiencies of government, they’ll be that much larger.
A real way of cutting the cost of medical care would be to get people to stop thinking that insurance should cover everything. It should not. If it takes, for example, one insurance adjuster one day to process 25 claims, and 20 of those claims are for routine office visits that the patients could pay for—then simply shifting insurance to cover the unusual visits would allow for the number of insurance adjusters to be decreased by 80%. Medical clinics could decrease the number of administrative personnel. Plus, there would be financial incentive for patients to shop around for better deals on the routine health care, since they would be paying directly, instead of paying through the insurance intermediary that has to take its cut.
I noticed a long time ago that annual insurance costs are far higher than medical costs for most people.
I’d like to see more physicians move to cash only practices. That would be a huge cost-cutter.
Isn't that the principle of insurance? To guard against catastrophic loss?
You do recognize sarcasm? Tell me I didn’t need a sarcasm tag. Please.
A religious tenet of the left. After all, the government is “fair”.
This was known when it was passed. We have Olympia Snowe to thank. She could have killed Obamacare in committee—but she gave Max Baucus the political cover he needed to vote it to the floor. (BIPARTISAN, ya know)
SINGLE PAYER HEALTH CARE IS THE CORNERSTONE OF SOCIALISM: —paraphrasing Vladimir Lenin.
That will never happen. A vast segment of US society has been taught to believe that if you pay for health care insurance and they don't, it's unfair that you get insurance coverage when they don't.
The only hope we have at this point of returning to any kind of health care market sanity is to outlaw all medical insurance.
If you notice, under the guise of "changing" things of the better, he is actually destroying things. Look at NASA, the BSA, the housing industry...
Yep - if ObamaCare does its intended job, it will not be considered a failure by the Left when it crashes and burns.
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