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[David H Wong]

What I don't understand is how hard it is to get a single payer system in place. Obamacare was just a band aid on a gaping wound of the pathetic nature that is health care in America. As a Canadian, I find it fucking mind boggling that people don't have free access to health care. Like I mean that is fucking insane!

Yet, when I see American politicians talk about it on television, I get the feeling they think universal health care is some sort of theoretical concept, never before tried. It just seems like bizzaro world, where the things I've experienced growing up in my country must be some sort of falsehoods. Or that these people, just don't simply believe they work as they do.

I think its honestly pathetic. Both Democrats and Republicans have failed to provide the American public with any sort of path to single payer. The fact of the matter is that they have had decades to do something about it, and never have. What an embarrassment.

Because there's no clear way to transition the US to a single-payer system in a way that wouldn't cause mass rebellion once people see what it entails:

http://www.newsweek.com/quora-question-why-single-payer-healthcare-wont-work-611168

There WOULD be restrictions in terms of people's options and (in some cases) quality of care (ask anyone who is on Medicaid what it looks like). For example, Medicare forces prices lower by simply capping what it will pay for certain services, which turns Medicare into a money loser for many practices who have a choice to A) simply stop accepting patients who use it or B) make up the shortfall by charging other patients more. If you go to a system where everyone is paying Medicare rates, hospitals start closing.

It's not simple - anyone who tells you it's simple is lying. Medical costs in the USA are skyrocketing and it's not because evil billionaires are stealing all of the money; it's due to dozens of different factors that no one is quite sure how to solve. For example: we are already facing a potentially catastrophic doctor shortage. If we go to a government system that caps doctor salaries, do you think that problem gets better, or worse?

 

[SaviorX]

Because there's no clear way to transition the US to a single-payer system in a way that wouldn't cause mass rebellion once people see what it entails:

http://www.newsweek.com/quora-question-why-single-payer-healthcare-wont-work-611168

There WOULD be restrictions in terms of people's options and (in some cases) quality of care (ask anyone who is on Medicaid what it looks like). For example, Medicare forces prices lower by simply capping what it will pay for certain services, which turns Medicare into a money loser for many practices who have a choice to A) simply stop accepting patients who use it or B) make up the shortfall by charging other patients more. If you go to a system where everyone is paying Medicare rates, hospitals start closing.

It's not simple - anyone who tells you it's simple is lying. Medical costs in the USA are skyrocketing and it's not because evil billionaires are stealing all of the money; it's due to dozens of different factors that no one is quite sure how to solve. For example: we are already facing a potentially catastrophic doctor shortage. If we go to a government system that caps doctor salaries, do you think that problem gets better, or worse?

Minor side-note: the cost of medical school is astronomical

 

[Xe4]

Good. We'll be watching your actions in the senate, you fucking Turtle. Don't think this is some sort of ruse to make people drop their guard.

lol

 

[Raylan Targaryen]

it's due to dozens of different factors that no one is quite sure how to solve. For example: we are already facing a potentially catastrophic doctor shortage. If we go to a government system that caps doctor salaries, do you think that problem gets better, or worse?

There is no way to solve this in the foreseeable future

Anyone who wants to be a doctor either actually cares about helping people or are in it for the money.

Doctors already get paid a shit ton to do nothing other than give patients some prescriptions they don't even need. American culture is built around fuck you got mine so there's a severe shortage of people who care about others. Those that do are too broke to even go to med school or went to a shitty school and won't even be accepted

 

[KoopaTheCasual]

There is no way to solve this in the foreseeable future

Anyone who wants to be a doctor either actually cares about helping people or are in it for the money.

Doctors already get paid a shit ton to do nothing other than give patients some prescriptions they don't even need. American culture is built around fuck you got mine so there's a severe shortage of people who care about others. Those that do are too broke to even go to med school or went to a shitty school and won't even be accepted

Wow, you clearly have no idea what you're talking about. You're probably one of those people who thinks being a doctor means 4-6 years of additional school then it's on to the 'big bucks' huh?

 

[Ekai]

So after numerous years of pledging to get rid of it they don't even commit to dooming millions of people's lives. Least there's that......but god, you can't even commit to the one thing you actually pushed as your platform.

 

[matthewuk]

Because there's no clear way to transition the US to a single-payer system in a way that wouldn't cause mass rebellion once people see what it entails:

http://www.newsweek.com/quora-question-why-single-payer-healthcare-wont-work-611168

There WOULD be restrictions in terms of people's options and (in some cases) quality of care (ask anyone who is on Medicaid what it looks like). For example, Medicare forces prices lower by simply capping what it will pay for certain services, which turns Medicare into a money loser for many practices who have a choice to A) simply stop accepting patients who use it or B) make up the shortfall by charging other patients more. If you go to a system where everyone is paying Medicare rates, hospitals start closing.

It's not simple - anyone who tells you it's simple is lying. Medical costs in the USA are skyrocketing and it's not because evil billionaires are stealing all of the money; it's due to dozens of different factors that no one is quite sure how to solve. For example: we are already facing a potentially catastrophic doctor shortage. If we go to a government system that caps doctor salaries, do you think that problem gets better, or worse?

Your right, you cant make private practice Suddenly accept government money, the NHS was mainly built from the ground up, with private practices given the option to join. In the UK there are NHS hospitals and practices and private insurance hospitals and practices. Some are a mix of both. You can't take over the system, but it might be a good idea to start one independently. You'll soon find that as the majority of people switch over to the single payer, the private system will be only to happy to be competitive and to offer its services to the single payer system

 

[LiK]

The truth hurts.

 

[Steel]

Your right, you cant make private practice Suddenly accept government money, the NHS was mainly built from the ground up, with private practices given the option to join. In the UK there are NHS hospitals and practices and private insurance hospitals and practices. Some are a mix of both. You can't take over the system, but it might be a good idea to start one independently. You'll soon find that as the majority of people switch over to the single payer, the private system will be only to happy to be competitive and to offer its services to the single payer system

What you're saying is not a single-payer system, but a public option.

 

[Steeped in a Sea of Games]

What you're saying is not a single-payer system, but a public option.

He's saying that's a way to move towards single-payer.

 

[Ether_Snake]

Because there's no clear way to transition the US to a single-payer system in a way that wouldn't cause mass rebellion once people see what it entails:

http://www.newsweek.com/quora-question-why-single-payer-healthcare-wont-work-611168

There WOULD be restrictions in terms of people's options and (in some cases) quality of care (ask anyone who is on Medicaid what it looks like). For example, Medicare forces prices lower by simply capping what it will pay for certain services, which turns Medicare into a money loser for many practices who have a choice to A) simply stop accepting patients who use it or B) make up the shortfall by charging other patients more. If you go to a system where everyone is paying Medicare rates, hospitals start closing.

It's not simple - anyone who tells you it's simple is lying. Medical costs in the USA are skyrocketing and it's not because evil billionaires are stealing all of the money; it's due to dozens of different factors that no one is quite sure how to solve. For example: we are already facing a potentially catastrophic doctor shortage. If we go to a government system that caps doctor salaries, do you think that problem gets better, or worse?

Eh, the government would have all the means at its disposal to significantly increase the number of doctors. Free education, or any benefit imaginable really. And the more doctors there are the lower the salaries, so costs go down.

 

[fade_]

Always stay on guard.

Are you saying we should employ a turtle strategy?

 

[Codeblue]

Eh, the government would have all the means at its disposal to significantly increase the number of doctors. Free education, or any benefit imaginable really. And the more doctors there are the lower the salaries, so costs go down.

Cost of education isn't really an issue. Professional schools are getting way more applications than they can handle. Question is, do we open the flood gates and potentially destroy the quality of care? If we accept more students, do we really have the means to train them?

I strongly believe in single payer, as someone that accepts Medicaid knowing full well that I'm losing money every time I see a patient on it. It's a moral obligation for me. There are some tough issues to work around and it's going to be a rough transition.

 

[Not]

This guy is one of the worst people alive, I wouldn't be surprised if he's trying to get people to drop their guard

 

[mAcOdIn]

While I do think that the health care industries' total ails would be addressable by the government I honestly do think it would be a recession in the short term. Switching to single payer outright's something I think should be done during a massive economic downfall where there's already little to lose. It IS a large chunk of our economy, lets not pretend that massively hurting or taking over a large swath of industry would be good in the short term. God knows what it'd do to retirement plans, investments, and that shit. And one of the good things about single payer would be that it could be more efficient than what we have now in terms of staffing redundancy but that'd also be a lot of jobs eliminated for good that wouldn't be coming back.

But most importantly in regards to single payer is that, considering how short lived Obamacare may be and how undermined it has been thus far is that until we have both parties in general agreement that that's the way to go anything done by the Democrats will be watered down, neutered, underfunded or sabatoged until the day it's either repealed or enough of the population warms to the ideas that Republicans are brought to that position. Considering their stance on SS and Medicare and how old those programs are I wouldn't hold out hope for Republicans coming around any time soon.

Course, the flip side is that for a lot of those Americans to believe a government run plan could be good I guess you'd have to show them one first and force them to use it for a while. If the US ever decides to go single payer we better have one hell of a salesman for it, a fantastic, well thought out and good plan and the numbers to hold it long enough for people to get attached to it.

Frankly, with the numbers we have and the way our government's set up I think any single payer system implemented now or in the near future's doomed to mediocrity.

 

[Steel]

He's saying that's a way to move towards single-payer.

But why move further than that? What advantage would it bring?

 

[1.21Gigawatts]

Republicans are in the pockets of big pharma, thats why they opposed Obamacare, not because they think its bad for people.

They slowly realize that its their job to come up with an alternative now and they find themselves in a tough spot. If they cater to the will of their donors, millions upon millions of Americans will end up getting fucked.
Unlike with many other issues which mostly hit minorities, this will also hit the republican base hard.

The thing is that the status quo in the US is a godsend for big pharma. In no other country are their margins as high as in the US. But in order to have a functioning healthcare system thats good for everyone systemic changes would have to be made that would bring down profits for pharma corporations significantly(to a level thats comparable with their profit margins in other western countries).
But politicians have been receiving millions upon millions of dollars from these very corporations, because they want to keep politicians from implementing such a system.


Now we can only watch and see whether Republicans stay loyal to their donors or for a change think about whats best for the American people for once.

 

[Amibguous Cad]

This guy is one of the worst people alive, I wouldn't be surprised if he's trying to get people to drop their guard

He's not exactly doing that.

But he's not saying this because he he thinks is actually going to happen, either. He's saying that his caucus had better get in line or he'll have to reach across the aisle to get something that infuriates the conservative base, and the obstructionists will get blamed for it. He's basically threatening the Rand Pauls of the world with Tea Party primaries, or trying to.

 

[Saint Gregory]

He's not exactly doing that.

But he's not saying this because he he thinks is actually going to happen, either. He's saying that his caucus had better get in line or he'll have to reach across the aisle to get something that infuriates the conservative base, and the obstructionists will get blamed for it. He's basically threatening the Rand Pauls of the world with Tea Party primaries, or trying to.

Isn't that going to be difficult when every version of their bills are polling far worse than the existing ACA?

This feels like a situation where the Republicans have lost their base and are only posturing to each other now.

 

[Amibguous Cad]

Isn't that going to be difficult when every version of their bills are polling far worse than the existing ACA?

This feels like a situation where the Republicans have lost their base and are only posturing to each other now.

I'm not one hundred percent sure of it, but I do know the House bill polled just as bad, and they managed to get it passed.

My read on the situation is that the ~15% of diehard that support the bill are holding outsized influence. Many of these senators are in safe republican states. The only way they possibly lose their seats is if the tea party or base gets incensed enough to primary them. And in a primary, the enthusiasm of the ~15% can overwhelm everyone else.

Or more to the point, the failure is going to be able to be pinned on a certain number of people - maybe the freedom caucus sticks to their guns, maybe Susan Collins and the moderates get left holding the bag, whatever. The bottom line is that ~4 senators are going to kill the bill, if the bill gets killed, and no one wants to be in that group because movement conservatism is going to try to crush them.

(Why we didn't do that when Joe fucking Lieberman killed the public option, I have no idea.)

So basically a combination of the party system, the nationalization of politics, the great sort, and the nature of modern activism means that these Republican senators are primarily held accountable to their most fringe constituents, not their state or the country as a whole.

(Berniebros, take note)

 

[theWB27]

I'm not one hundred percent sure of it, but I do know the House bill polled just as bad, and they managed to get it passed.

My read on the situation is that the ~15% of diehard that support the bill are holding outsized influence. Many of these senators are in safe republican states. The only way they possibly lose their seats is if the tea party or base gets incensed enough to primary them. And in a primary, the enthusiasm of the ~15% can overwhelm everyone else.

Or more to the point, the failure is going to be able to be pinned on a certain number of people - maybe the freedom caucus sticks to their guns, maybe Susan Collins and the moderates get left holding the bag, whatever. The bottom line is that ~4 senators are going to kill the bill, if the bill gets killed, and no one wants to be in that group because movement conservatism is going to try to crush them.

(Why we didn't do that when Joe fucking Lieberman killed the public option, I have no idea.)

So basically a combination of the party system, the nationalization of politics, the great sort, and the nature of modern activism means that these Republican senators are primarily held accountable to their most fringe constituents, not their state or the country as a whole.

(Berniebros, take note)

That didn't pass on the strength of the bill...it passed because they wanted to stop losing and put the brunt of getting it done on the Senate.

 

[JCHandsom]

Alright, but can't get complacent. Need to stay focused and fight this!

 

[Ether_Snake]

Cost of education isn't really an issue. Professional schools are getting way more applications than they can handle. Question is, do we open the flood gates and potentially destroy the quality of care? If we accept more students, do we really have the means to train them?

Free education means no student debt, so you get no shortage of doctors because you get a lot of enrollment.

If demand outpaces supply, you open more schools.

This is really easy.

Key is to actually use technology to make major improvements. So much could be done with technology to do serious prevention and better monitoring.

Whatever, down the line it's inevitable that tech will shake up the industry.