Republicans who want to get rid of Obamacare really don’t have to pass a bill, secret or not. All they have to do is to stop shoveling billions of dollars to insurance companies who expected that the taxpayer would bail out poorly designed and managed exchanges.
You could say pretty much the same thing about American K-12 education. But for some reason, the conventional wisdom is that the problem in health care is that we spend too much while the problem in education is that we don’t spend enough.
A straightforward solution to this problem would be to allow anyone who could not get affordable insurance due to a preexisting condition to enroll in Medicaid, irrespective of income level. This would have solved 95% of the problem without turning the whole medical insurance market inside out.
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We spend about as much as Chile as a proportion of our GDP, and what we really outspend on is letting states fuck around with education in their own with extremely mixed results. Our instructional spending is not that high, but we have massive security and administrative costs.
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That is a pretty surface reading of the conventional wisdom on both of those issues, and I’ll allow that a certain subpolloi of the larger hoi may be operating at this level. However, with anyone sufficiently well-meaning on the left, I think if you read past the headline on both of those conventions, you’ll actually see that they have an issue with the distribution of funding, rather than the total amount, in both cases.
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My post was describing the Canadian situation, in response to a comment on Canadian health care. Americans’ mileage may vary.
A hastily written secret bill that will effect the lives of millions of people - yup sounds about right.
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I’m relatively happy with my representatives in the house and state legislature, actually. Not so much with my senators, though they could be much worse, as the blue areas of the, which are growing in comparison to the rest of the state.
You do realize that we have a piecemeal privatized solution right now, yeah? And that I doubt your nephew’s medical costs would carry the same out of pocket costs elsewhere? That the costs are generally spread to the individual level, because we DON’T have a public option here. [quote=“Carbonman, post:37, topic:102941”]
I’m very worried that he’s going to die as a result of politicians on both sides of the aisle not giving a shit about the average citizen.
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And corporations do? The reason why many politicians don’t care is because their campaigns are funded by dark money (much of which is corporate money, we assume, but how can we know), their districts are generally gerrymandered to be safe as possible (often with people running literally unopposed!), and that they people they hear most from are lobbyists who can get into their offices to communicate with the politicians. This is not just because politicians are all evil, it’s because they are put into office primarily by corporate interests who pay a much larger portion of their campaigns then they used to.
I’m not sure what point you’re attempting to make here.
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You really expect that to happen?
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Public education worked for decades. The 1950s and even into the 1970s was a golden age of public education. We created a strong middle class that drove our consumer based economy. Even with all the problems still associated racism, pretty much all tides did rise during that period. Our public education system is in trouble precisely because people started pulling their kids out and putting them into private schools (first in response to integration - a wave of segregation academies popped up across the south, and the people who could afford to do so). Then over the course of the 1980s, the home schooling/religious schooling movement (for more conservative protestants pissed about a lack of prayer in school) gained traction at the same time that people also began attacking public institutions of higher learning as “too liberal” and anti-American. As such, resources have been increasingly pulled away from public schools. The places where plenty of money and resources and put into public schools, they are doing fine. In places where there has been consistent attacks, they are not.
Public options work if people want them to. Period. When the people running the show are hell bent on destroying the public options, surprise, they don’t work.
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while i don’t know much about the ramifications, it sounds good on the surface. it’d be awesome to see republicans come out with something like that which might actually work for people.
i rank the chances somewhere below zero.
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That’s a pretty gross mischaracterization of what’s going on with outcome-based payments and bundling. The ones who are “hurting” under the outcome-based carrot-and-stick approach are the ones with money-grubbing bean-counters running the show. If patient outcomes are actually more important than the bottom line, pay-for-performance has been successful. Pay-per-procedure has always been flawed; why stick with a system that disregards the value of the diagnostic/therapy to the real customer - the patient? I know the answer, it’s because some providers, hospitals, and health systems are optimized to reap the most rewards under the procedure-mill model. Answer: tough noogies. It’s more than time to move on to a performance-based payment system.
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None of that contradicts what I was saying. If you get paid more for quick, low cost surgeries with short recovery times and low readmission rates, the shortest path to success is to steer clear of the patients who are likely to fall off that pathway.
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President Obama had both houses of Congress and could have done it.
But the “Leaky roof? Let’s tear the house down and rebuild!” impulse proved irresistible.
If we were to compare the inflation-adjusted spend per pupil in public schools, 1965 to 2017, do you think it would show a decline???
It’s not about pure spending, which has risen, it’s about the distribution of resources and how that the increase in spending has been used. How much of that money is going to expanded administration, into the pockets of textbook manufacturers, to private corporations that profiting off schools (in all manner or ways), as opposed to things like teachers salaries and various resources that directly benefit students?
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It was the original “Obamacare” - the public offering was meant to set a bar of healthcare standard and force private insurance to compete. The GOP killed that along with “compromising” Dems despite the entire deal being a major compromise already.
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Compared to GDP it’s almost guaranteed.
Why fight it? It’s the surest path to a single payer system.
(note: not straightest, not cheapest, surest)
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In similar fashion, my local rail transit authority is saddled with highway debt payments, for some reason… meanwhile the trains are literally falling apart.
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