Health Care

This is turning into the issue for 2020, only a war could change that now.

So let's discuss.


🕷Dante Atkins🕷
@DanteAtkins
·
6h
Replying to
@AOC
and
@neeratanden
A lot of people--NNU /CNA come to mind--believe that a public option is actually bad policy. What's your opinion on that?

Alexandria Ocasio-Cortez
@AOC
·
6h
I think it’s bad too, which is why I personally don’t think progressives should propose it.

Corporate insurance will push off their sickest patients on the public option

while keeping the healthy ones, forcing costs w/o benefits on the public.

That’s why we should push full M4A.

Alexandra Jaffe
@ajjaffe


AOC on likelihood of M4A getting passed:

“The worst-case scenario? We compromise deeply

and we end up getting a public option.

Is that a nightmare?

I don’t think so,” she said.
)

To those disingenuously wondering how it gets paid for it is really quite simple.

Have the political courage to:

Tax the donor class.
Be it individuals or corporations

Slash welfare designated to the weapons industry

Eliminate the health insurance industry.
/////

for 3 examples

And how exactly does that pass Congress when not even all Democrats would vote for it? You know Republicans will be screaming bloody murder the whole time. If Democrats had a super majority in both houses of Congress and the Presidency I still doubt it would pass.




I think Democrats should push for Medicare for all kids first. Let people get used to that for a few years then try for M4A.

that was what AOC addressed, the notion of settling for a public option as not the worst that could happen

Nice idea about M4A kids - hadn't thought of that before

Quote:

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Originally Posted by 57Brave

To those disingenuously wondering how it gets paid for it is really quite simple.

Have the political courage to:

Tax the donor class.
Be it individuals or corporations

Slash welfare designated to the weapons industry

Eliminate the health insurance industry.
/////

for 3 examples

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Payment for massive new social programs is ALWAYS a huge obstacle to their passing. It's not something that can simply be ignored. Some do latch onto this obstacle as a convenient excuse. Others, myself included, have fiscal responsibility as one of their most important political issues. Creating new benefits is fine if it is done in a responsible manner.

The next point is, as you say, "have the political courage to" institute various measures. This is easier said than done. So many politicians on both sides of the aisle are beholden to wealthy donors. With the rise of primarying, even those with safe districts are afraid of well funded challengers who are more amenable to the wishes of their patrons. Realistic attempts at funding a program like this will likely need to find revenue sources acceptable to wealthy donors.

Now to your ideas on how to raise the money. Weapons funding seems large because it's a large part of Congress' discretionary spending (about half). Compared to the cost of social programs, it's tiny. Total defense spending in 2018 was about $623 billion. Social security, Medicaid, and Medicare accounted for $1.953 trillion (more than 3 times all defense spending). Considering the stuff you're talking about cutting would be things like unnecessary weapons system, you're talking about only a fraction of total defense spending. This is the government equivalent of looking for change in the couch cushions.

Then there's taxing the donor class. While there's certainly some room here (e.g. rolling back the Trump tax changes), I caution against a dogmatic belief that the wealthy will just bear the increased tax burden if their taxes are increased. The problem is that wealth and power go hand in hand. The wealthy are the most able to bear tax burdens but they're also the ones with the greatest ability to evade taxes (e.g. find loopholes, move money around, etc) or else pass those burdens off to others.

For example, say you increase the corporate tax rate. Will corporations just slash dividends to account for this? Of course not. Those running the corporations are often judged on dividends and usually have a personal interest in them as well. So what do they do? They either cut costs or they increase revenue. This is usually done by either cutting jobs or raising their prices. Either way, the cost of this increase tax burden is usually passed off to the middle class.

I'm not saying don't do it, I'm just saying be aware of everything in play here. Know that these tax burdens wouldn't all stay with the rich.

Eliminating the health insurance industry is also tricky. You're talking about an industry that employs a couple million people and accounts for something like 2% of our economy. So just going to straight medicare for all would probably spin us into a massive recession. My guess is that you'd probably need to slowly transition to a single payer system if that's what we wanted to do as a country with the private health insurance industry becoming contractors for the federal government as the government would have a massive need for skilled manpower to handle the huge load of claims it would have to deal with.

Bottom line, it's an insanely complicated issue. It's not insurmountable but it's something I think should probably be tackled a bite at a time rather than a massive single stroke.

“We choose to go to the moon in this decade and do the other things,

not because they are easy, but because they are hard,

because that goal will serve to organize and measure the best of our

energies and skills, because that challenge is one that we are willing to accept,

one we are unwilling to postpone, and one which we intend to win.”

― John F. Kennedy

as the above is in the national record, why not set a goal to be

a) fossil fuel by 2030
b) the entire citizenry covered by a M4A by 2030
?

Put it into law attainable goals where by 2025 we accomplish x 2027 we accomplish y and 2029 we are at z.
From the time Kennedy made this speech we went through a few different phases of the space program that landed us at July 1969.
What is to say the same cant be done with HC ?
………….

Personally if I were King, I would nationalize both the health and energy industries and completely revamp them as we did with electricity and water.
Why isn't both ( HC and Energy) treated/ regulated as utilities ?

Quote:

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Originally Posted by 57Brave

“We choose to go to the moon in this decade and do the other things,

not because they are easy, but because they are hard,

because that goal will serve to organize and measure the best of our

energies and skills, because that challenge is one that we are willing to accept,

one we are unwilling to postpone, and one which we intend to win.”

― John F. Kennedy

---

I agree wholeheartedly that we need to expend an enormous amount of effort and resources fixing our healthcare system. It's incredibly difficult for the free market to work with healthcare as it does with, say, retail goods. Healthcare has inelastic demand much of the time. If you have a heart attack, you can't shop around for a cheaper hospital.

Then there's the fact that actually shopping around with healthcare is very, very difficult. There are no public lists of prices, having to transfer records and get set up at a new doctor is a pain (and that doctor will often want you to go in for an initial well visit), and you're often limited by your network.

There's also been a trend towards regional monopolies. Some areas (especially rural areas) are seeing their hospitals be bought up by companies like Wellstar who then close down some of them to prevent them from competing. This shifts leaves only one provider for an area making it difficult to control costs.

The only real market controls are the negotiations between health insurers and providers and even those can have problems.

So yes, we need a ton of reform. It just needs to be smart, well reasoned reform. When you're skydiving you don't jump out of a plane without having checked your equipment and hope all goes well. When you're doing something like this you don't pass a massive program without long and careful consideration of every issue and hope all goes well.

Quote:

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Originally Posted by cajunrevenge

And how exactly does that pass Congress when not even all Democrats would vote for it? You know Republicans will be screaming bloody murder the whole time. If Democrats had a super majority in both houses of Congress and the Presidency I still doubt it would pass.




I think Democrats should push for Medicare for all kids first. Let people get used to that for a few years then try for M4A.

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There is really no sense why all kids don't have all medical expenses completely covered.

Quote:

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Originally Posted by 57Brave

as the above is in the national record, why not set a goal to be
b) the entire citizenry covered by a M4A by 2030

---

https://content.gallup.com/origin/ga...rrhjpv99eg.png

How about we don't and instead set goals to widen access and lower costs without massively overhauling a system that a majority of Americans enjoy?

The conversation shouldn't start with the premise that M4A is incontrovertibly wonderful and what we should be shooting for...