Originally Posted By andyll >>>>Obamacare is ONLY useful as an intermediate step toward single payer.<<<< >Why? Cause you and Michael Moore say so? Because it doesn't address the cost of medical care. While it might stabilize the rate of increase we have to get our spending on medical care in line with other countries.
Originally Posted By ecdc >>Because it doesn't address the cost of medical care.<< 2/3rds of the bill does just that. Most of it is actually designed to lower healthcare costs. See what I mean about "not talking about those things?" Healthcare costs have increased at the slowest rate in years. Today it was announced that, for the first time in years, healthcare as a percentage of the GDP shrank. Granted, it's not yet directly clear Obamacare is responsible for all of this, but it's likely responsible for at least some of it.
Originally Posted By mawnck >>Obamacare could conceivably work well for twenty or thirty years<< Conceivably, but see post 11. We already have precedent for unpopular "necessary" provisions suddenly disappearing.
Originally Posted By andyll >>2/3rds of the bill does just that. Most of it is actually designed to lower healthcare costs. See what I mean about "not talking about those things?" Sorry but that is absolutely not true. Don't confuse lowered premiums... or slower growth rates of premiums... as lowering health care costs. Once the public option was pulled the CBO models showed that the ACA should slow the growth rate but would not decrease it. The growth rate has slowed over the last 4 years... which of course can't be attributed to the ACA since it started happening well before the ACA went into effect. On the medicare/medicaid side there was savings put in ( the doc fix ) and an attempt to reduce fraud. But the Doc fix was already weakened and it is up in the air whether their will be true cost decreases. On the private insurance side there is hope that the larger pools will lower premiums but that is just lowering the premiums... not lowering health care cost.
Originally Posted By ecdc >>Don't confuse lowered premiums... or slower growth rates of premiums... as lowering health care costs.<< I see what you're saying now, and you are correct. And I'm on board with the problem, truly. But tell me how we fix that problem in today's current political climate? Or in 2009? Again, it's easy to say "Well this isn't good enough, we need X." It's much harder to draw an actual line from A to X. Is Obamacare better than the previous status quo? Yes it is. By far. That's all I'd remind everyone of. You are either for Obamacare or you are for the status quo where people with pre-existing conditions were denied coverage and people without insurance routinely died. You don't get Secret Option #3 because that option isn't real yet. Hopefully someday it will be, but it isn't yet. And if your attitude toward Obamacare vs. the previous status quo is "puhtato potahto," then you aren't paying attention.
Originally Posted By andyll >>But tell me how we fix that problem in today's current political climate? Or in 2009? Beats me. But once it's accepted that ACA is not going to be repealed and becomes less of an election issue maybe small fixes could be made. Allowing the federal exchange to sell across states would be one thing. A public option would be another. On another political forum I used to be on many of the far right hated Obama and the ACA enough that they actually came around and said they'd support some type of single payer over the ACA. I actually think that most of the right hates Obama more then the policies. Perhaps even if we get a democratic president in 2016 the country can start moving forward again.
Originally Posted By Dabob2 <I actually think that most of the right hates Obama more then the policies.> No question. Most of the basic planks of the ACA were originally Republican proposals.
Originally Posted By mawnck >>But tell me how we fix that problem in today's current political climate? Or in 2009?<< By getting what you can get, problems and all, letting the problems become painfully obvious, and then winning an election or two so you can fix them. With single payer. I'll let the Dems use this idea free of charge if they want to. >>On another political forum I used to be on many of the far right hated Obama and the ACA enough that they actually came around and said they'd support some type of single payer over the ACA.<< Donny has said the same thing, repeatedly. Fascinating, ain't it.
Originally Posted By andyll >>Donny has said the same thing, repeatedly. Fascinating, ain't it. But they don't want to pay for it with taxes. My premiums are over 10K/ year. Other out of pocket for a year will range from 3-5K / year. I prefer to pay an extra 5-10% in payroll tax and have no or little additional health care costs. Over all for most people it would be cheaper. But the right hears 'taxes' and have a fit.
Originally Posted By ecdc >>By getting what you can get, problems and all<< They have a name for that...it's called Obamacare Maybe that's what you were getting at. Here's the thing. I know I'm such a vociferous defender of Obamacare it's a little silly. I know there are problems. I know it's not perfect. I'm a single payer guy, through and through. Come to that, so is Obama. But I admire effort. I admire the notion that government can be a force for good, in spite of its many shortcomings and imperfections. I have the utmost respect for Obama and the (often) unsung Nancy Pelosi for getting this legislation done. It took a solid year of blood, sweat, and tears, and all while playing against a dirty, cheating, insane team. The fact alone that we'll have millions fewer uninsured people impresses the hell out of me. The fact that they accomplished that while working within the limitations they had (private insurance isn't going anywhere, sorry) is a massive accomplishment, not a shortcoming. Yup, website debacle was embarrassing and ridiculous. Yup, there'll be tax hiccups. Yup, we're still fighting against states that are intransigent. But it's better than what we had before. That counts for something in this country, where getting anything major done is absurdly difficult.
Originally Posted By ecdc <a target="blank" rel="nofollow" href="http://www.bloomberg.com/news/2014-01-08/what-liberals-don-t-get-about-single-payer.html">http://www.bloomberg.com/news/...yer.html</a> A well-worth-your-time article on why single payer isn't he panacea you think it is, and the real cost problems with American healthcare.
Originally Posted By mawnck >>A well-worth-your-time article on why single payer isn't he panacea you think it is<< Well, the article's point is that the actual answer is "single price setter", which is what I think most people mean when they say "single payer". (A semantic imprecision to which I plead guilty.) The fundamental point is that when life and death is involved, the free market doesn't work in setting prices. It's time to stop trying to force it to.
Originally Posted By ecdc No disagreement at all here. I'm also guilty of the imprecision, both in referring to single payer and to "insurance companies," when I really mean the whole for-profit healthcare industry, including pharmaceuticals and medical equipment, which Klein touches on.
