I hope everyone realizes Obamacare isn’t going anywhere. We have a majority and STILL can’t muster enough votes to get rid of it. It’s going to slowly deteriorate, fail, and be replaced with singer payer.
Yes, I’m a pessimist.
They want control of the MONEY..and thus the PEOPLE.
Hell that’s an optimistic view to me. I see the following “crisis “ being used for a lot more than single payer health care. Wouldn’t want to waste that one now, would they.
If you really think about it, single payer has probably been inevitable since the creation of Medicare.
Methinks that is the red line, if it was enacted, would trigger CW II ...
You are correct.
The actual fight is going to be over the private option, and you need to decide, now, what you want and will support along those lines.
The original Hillarycare bill banned private care, or, more exactly, had a $50 000 fine and five years in prison for any doctor who a) was enrolled to take payments from Hillarycare who then b) treated a patient for a fee not paid by the government using rules other than those approved by the government. Under this kind of single payer, obviously, independent practice would effectively cease.
But single payer does not need to be that way. President Trump's position, stated repeatedly during the campaign, was "we are going to take care of everybody". Making up the losses of private insurance companies who agree to "take care of everybody" under politically acceptable terms is very expensive, and ripe for corruption.
The Medicaid/uninsured population (which includes deadbeats, drug addicts, but also includes the working poor and the uninsurable) are going to get a National Health Card that gives them access to a large but limited menu of services. This is inevitable and it's foolish to fight it.
Anyone else who wants this card can get it also, if they are in legal status. If it's well-designed, the uptake may be rather high. Perhapswe will send one to everyone. The card will be free and will pay for care at the point of service with zero patient responsibility and zero bills.
The key is, private practice will have to be allowed (or, more accurately, allowed again), with certain enabling conditions:
1) Any patient, National Health Card or not, can see any doctor, any time, under mutually agreeable payment arrangements including cash, private insurance, or National Health, however, if a provider takes taxpayer dollars that will be payment in full.
2) Doctors can set their own fees and their own terms, however, access to hospital admission and operating facilities may have conditions such as taking service patients (as was always true).
3) For doctors who do not admit to hospitals and control outpatient surgery resources, and who therefore have no service obligations, they will have to sign up as National Health Care providers OR remain out of the system, but if they remain out, they must arrive at agreeable payment arrangements with National Health patients that do not include taxpayer dollars. This will constrain but not eliminate the "completely private" option, and will make it contingent on the willingness of a population to pay for care this way.
4) No more "free care". Most people will have National Health Cards to pay for hospitalization, surgery, etc. Others will have private insurance, or will be rich. But if you refuse National Health on principle and don't buy insurance because you "don't need it", then you will have to work it out if (when) you want a provider to treat you for free.
5) Medicare will be repealed and the Center for Medicare services will be abolished. All Medicare taxes paid will be refunded.
6) Providers may choose to use electronic or paper records, however, all incentive payments for EHR will cease and all rules about HOW EHR is to be used will also cease. The National Health payment system may sent minimum standards for documentation to receive taxpayer dollars, however.
And just repealing everything will make that happen faster.
The old system is gone. We can’t “Just go back”, the insurance structure was destroyed.
Most large companies WANT single payer. It will lower their overhead.
WE don't have a majority in either house. The Republicans do. And they are mostly uniparty swamp dwelling statist elites who look down their noses on us when they even bother to give us a thought...except for a month or two every two or six years.
Yeah...I'm a pessimist too.
I’d love for it to be replaced by a singer payer. They’d run out of money immediately. I just don’t want it to be replaced by single payer.