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Vox: Bernie Sanders outlines his single payer bill

Maxim726X

Member
I said it in another thread - there's no way insurance companies will just idly sit by and let themselves be literally outlawed out of a job. Any bill will have to either work out a way for them to continue existing, or get lobbied to death.

Not to mention the hundreds of thousands are people that are employed in the industry, as well as state run insurers.

Eradicating all of that just isn't feasible. It's going to have to be some kind of hybrid system if we want to pass it in this country.
 

Foffy

Banned
I'm reprising my hot take: funding is a myth because money is a fake idea and government money doubly so, so I'm glad that Bernie leaves that to a separate discussion.

People like their symbolic models, tho.

Sure, money isn't wealth, but good luck convincing the average person of this. ;)
 
I'm reprising my hot take: funding is a myth because money is a fake idea and government money doubly so, so I'm glad that Bernie leaves that to a separate discussion.

But muh household budget analogy!!!

I miss empty vessel in these cases. Hed come in and drop some knowledge bomb about this.
 

pigeon

Banned
People like their symbolic models, tho.

Sure, money isn't wealth, but good luck convincing the average person of this. ;)

That's why we should fund single-payer by minting a single platinum coin worth trillions of dollars. What could be more symbolic than that?
 

Zoe

Member
The outlawing private insurances part is just unnecessarily provocative. Bernard just blew it.

Also... Impossible?

At the very least, irresponsible.

I don't know literally anything about constitutional law, but I wonder if such a system could be challenged on constitutional grounds.

It's not outlawing private insurance. Private insurance can't "duplicate" the government plan:

It's not clear to me that this "outlaws" private insurance. See line 8 here:

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Mortemis

Banned
This is an argument for implementing all-payer rate setting in a multi-payer system. All-Payer rate setting means that Hospitals negotiate for a singular rate w/ all providers. Nothing is done individually, it's a collective negotiation.

Here in the states, Maryland has already implemented it, and its in many Euro countries as well.

I'm a little clueless in most healthcare discussions, has there been any talk of an all-payer rate for the whole US? It seems easier to do than a single payer system, but is it just not as good as a public option?

edit: The biggest point against I guess is the strong control over companies and the industry, but that's still not as big as wiping out the entire industry.
 
I'd love this discussion to be brought up but i feel it's not going to be fruitful to bring it up when we don't have control of the House nor the Senate.
 

kirblar

Member
I'm a little clueless in most healthcare discussions, has there been any talk of an all-payer rate for the whole US? It seems easier to do than a single payer system, but is it just not as good as a public option?
There's been some. Part of the reason this is so complicated is that states can/do have a lot of individual power and ability to regulate their own markets too. (see: Red States vetoing Medicaid expansion!)

All-Payer rate setting is not dependent on a public option. Ideally, you'd be using both. All-Payer is just how you're structuring negotiations between caregivers and insurance providers.
 

ApharmdX

Banned
Won't someone think of the poor, extremely wealthy, bloodsucking insurance investors?

Fuck those guys, you're right, but this makes the bill a harder sell in its current form. The American public likes options, even if they aren't going to take advantage of them. The ability to buy supplemental health coverage is important.

How is it even legal to put out a huge bill like this that will need lots of funding and then not include any ideas on how it will be paid within said bill. Just a; 'well that's someone else's problem after this is signed.'

This is not a little thing like building a park or creating a new federal holiday. It's a huge chunk of the economy. But hey, I guess that's someone else's problem. This is exactly what the pony analogy was talking about. Everyone wants a pony but nobody wants to discuss how to pay for the pony or it's upkeep. :|

But I guess Saint Bernard has personally done the calligraphy on the gold parchment so we better not question his holiness.

Till these bills can start answering these questions they are a waste of time and resources. Dems need to get it the fuck together and come out with a knock it out of the park Universal Healthcare bill. Not for now but if they ever in the unlikely event take control of the White House and Congress again, they can fast track a reasonable responsible bill through and not some vanity project of Bernie's.

You are consistently really salty about Bernie Sanders taking a leadership role in the Democratic Party.
 
some notes on that Chait article

First, most people who have employer-based coverage like it and don’t want to change

Do people "like" it in the sense of "I really like filing claims with Blue Cross Blue Shield, it's the best! I love getting bills in the mail two weeks after my last visit to cover a hospital fee I didn't know about", or do people "like" it because of actual specific coverage details that takes care of them when they're sick (which would be better for pretty much everyone under what I've seen of this plan, and also has the benefit of not being tied to your job, and also the likely benefit of being cheaper out of pocket). Those are two very different things. Obviously, there's the psychological aspect of people reacting negatively to something being "taken away", even if it's immediately replaced with something far better...but that's an argument for not framing the policy that way and instead emphasizing all the good shit that makes the negatives seem trivial in comparison, rather than an argument against the policy itself (since again, no one would lose actual coverage for their health issues, and they're still going to the same doctors)

And unlike when Republicans do shit like name their fossil fuel giveaway "The Clean Air and Freedom Act", the actual policy would improve the vast majority of people's lives in this case.

Second, higher taxes are unpopular. Yes, in an imaginary, rational world, people could be reassured that Medicare will be as good as what they have, and the taxes will merely replace the premiums they’re already paying. In reality, people are deeply loss-averse and distrustful of politicians.

Racism is super popular also, and tough to change people's mind, I guess we better not fight racism. And racism has a far greater psychological hold on people than their "love" of private insurance companies. Yes, people can be irrational. So you construct a bold policy message, organize, put in the work, get people on your side, grind it out and gain political power so that you can change that. That's what politics is, not just sitting around pretending like people can never respond to outside pressure, and only crafting policies based on a single unchanging snapshot of the political mood, and hoping people just magically fall in line because you're being "reasonable".

Asked by Vox about the difficulty of switching people out of employer-based insurance, he scoffs, “It’s not a question of switching plans,” and then segues into a generalized riff about the merits of universal insurance. (In real politics, you can’t answer people’s concerns by denying they’re concerns.) Asked by the Washington Post about the taxes needed to finance his plan, he insists that we have no idea how much it would cost because the only studies so far have been faked by big pharma and the insurance industry: “The truth is, embarrassingly, that on this enormously important issue, there has not been the kind of research and study that we need. You’ve got think tanks, in many cases funded by the drug companies and the insurance companies, telling us how terribly expensive it’s going to be.”

we do have an idea of what it would cost (we had a primary last year where those costs were debated! other countries have existed for years with examples of costs!). We also know for the vast majority of people, they would pay far less out of pocket. We also know that the US is an incredibly wealthy country overall. It's not like these are completely unanswered questions, the whole point of this initial salvo is to reframe the debate around values and material needs (since that's what actually motivates people to fight for a policy, as opposed to whether the tax rate is increased 1.2% vs. 2.5% ). And on a party politics level, it gives Democrats something far more specific to actually rally around, rather than just some even more vague concepts like "improve access", or "defend the ACA".

Evil corporations are the only impediment he acknowledges. At no point does he grant that the most important source of opposition will come from actual American voters concerned about losing their current plan or paying higher taxes.

But people's concerns are largely influenced by those same "evil corporations". That's the whole reason why they spend billions of dollars lobbying and advertising!

This is also why you don't make your message "Sorry Americans, you will all lose your plans and pay high taxes, ya got me. Please clap though." while ignoring the benefits. That's the whole point of emphasizing "you will have everything covered, and all the shit you hate like deductibles will be gone, and you will pay less than you do now". All of that is true, even if you technically "lose your current plan" and "pay higher taxes".

It's like going to Apple and complaining that they don't address the high cost of their phones. Of course not, since that's a flaw, so why would they make that a giant part of their messaging? They just emphasize all the good shit their phones actually do to the point that the flaws don't really matter as much anymore.

Sanders is not a details person, though. He prefers to act as though the important barrier is the abstract notion of government-run insurance, turning every question about specifics into a question about values

That's because specifics are handled in legislative meetings and debates and the less exciting parts of CSpan. Values are a major part of politics when trying to mobilize a mass base of support, which is how major changes actually get done. And it's not like it's some completely mystery about how it would be funded. In one breath, Chait's criticism is that this is funded by higher taxes that will scare people away, and in the other breath he says he absolutely needs to know how this will be funded, or else this will worry people. Which is it?

(sidenote: I agree with pigeon on something else as well, that although I understand this is a Senate bill, it would be nice to hear more acknowledgement in general of HR 676 from Conyers, which is even more radical than Sanders' proposal.)
 

Lowmelody

Member
That's still outlawing the vast majority of the health insurance marketplace.

Makes sense to me, if we establish that health care is a basic human right then we must set a base line for what is needed for your average person and disallow private companies from going below that baseline to chase profits at the expense of citizen's health. We will still have private insurance companies to offer premium plans that cover what government plans dont, that option is there. Everyone will be able to count on not having to pay out of pocket for normal health care but can choose to pay more to get more if they wish. This is what most of the world with some form of UHC has, no?
 

JustenP88

I earned 100 Gamerscore™ for collecting 300 widgets and thereby created Trump's America
The outlawing private insurances part is just unnecessarily provocative. Bernard just blew it.

So that can be a thing that is removed/reworded in future iterations of the bill. It's a built in concession. "Look at us doing bipartisanship and removing this thing you don't like from the initial draft of the bill." Reads like a diversion to me, but maybe I'm not understanding the political motivations.

There's no doing it without smothering private insurance anyways. I don't see why anyone should blink an eye at the death of that industry.

I also like the incremental change. Like half of my coworkers would be eligible for Medicare after the first year and, similarly to how they happily put their 20-something kids on their plans after bitching about Obamacare for months, they'll be in line for that sweet sweet Medicare day one and word of mouth will spread.

I think this is a good start so far.

I see him more as someone who is trying to split the party up because things aren't being done his way - which is the ONLY way to get things done according to him. We don't need that kind of leader. Man needs to retire already.

Lol no it's not that's just a dumb thing you guys keep saying over and over.
 

Koomaster

Member
It's also possible that a large number of people are enthusiastic about the policy, and it's not really about Bernie at all
Or maybe it is if you picked that one thing out of my post to complain about. Gotta stick up for Bernie right?
You are consistently really salty about Bernie Sanders taking a leadership role in the Democratic Party.
I see him more as someone who is trying to split the party up because things aren't being done his way - which is the ONLY way to get things done according to him. We don't need that kind of leader. Man needs to retire already.
 
How big a hunk of funding for a single-payer plan would come from money we already spend on Medicare, Medicaid, ACA subsidies, federal employee plans, etc.?

And how much might be saved by consolidating administration on all those programs?
 

Mortemis

Banned
There's been some. Part of the reason this is so complicated is that states can/do have a lot of individual power and ability to regulate their own markets too. (see: Red States vetoing Medicaid expansion!)

All-Payer rate setting is not dependent on a public option. Ideally, you'd be using both. All-Payer is just how you're structuring negotiations between caregivers and insurance providers.

Yeah, an all-payer rate plus public option would be great, but really I'm down for whatever we can do to actually fix this shit, public option, single payer, whatever.
 
Also... Impossible?

At the very least, irresponsible.
It's not impossible, property is a fake concept made real by the barrels of government guns, if those governments decide that health insurance companies are not legitimate property then they become fake.

I actually think that's a desirable and moral goal but probably unnecessarily provocative and unpragmatic in this current America.
 

Maxim726X

Member
No, it's not.

That's rather vague language.

I'm not sure how anyone can define exactly what that sentence means... And if you could, please share.

It's not impossible, property is a fake concept made real by the barrels of government guns, if those governments decide that health insurance companies are not legitimate property then they become fake.

I actually think that's a desirable and moral goal but probably unnecessarily provocative and unpragmatic in this current America.

Well, I know it's technically possible, but you're talking about cutting out one of the largest employers in the country, and dramatically re-shifting health care delivery. It may as well be impossible, regardless of difficult it may seem to pass right now.
 
Calling what the bill does "outlawing private insurance" is the most manipulative propaganda that I have ever seen in NeoGAF. Of course the current private insurances would need to change to reflect only what they offer over the public/universal one, that is not outlawing anything except fraud. Do you want to allow the private industry to make you pay for something you already have?
 

kirblar

Member
It's not impossible, property is a fake concept made real by the barrels of government guns, if those governments decide that health insurance companies are not legitimate property then they become fake.

I actually think that's a desirable and moral goal but probably unnecessarily provocative and unpragmatic in this current America.
Well, I guess you won't mind people taking your stuff, since it's not actually yours and it's a fake invented concept.
 

B-Dubs

No Scrubs
They can all get new jobs administering the new plan.

You're not going to need everyone to do that. The only reason there are so many jobs is that there's multiple companies covering the same ground, if it were all consolidated into one entity we wouldn't need as many people to administer it.
 

The Technomancer

card-carrying scientician
You're not going to need everyone to do that. The only reason there are so many jobs is that there's multiple companies covering the same ground, if it were all consolidated into one entity we wouldn't need as many people to administer it.

I actually don't....care that much about this from a pure "losing jobs is bad" perspective, industries evolve, this happens all the time, its not a great ideological reason to stand in the way of consoliation

But it should be a factor we consider about how this will be received
 
You're not going to need everyone to do that. The only reason there are so many jobs is that there's multiple companies covering the same ground, if it were all consolidated into one entity we wouldn't need as many people to administer it.

This reasoning is why we should save coal. The jobs man, the jobs. Let's ignore the vultures and forget about the environment. Jobs. Nothing from the status quo should change. Let's stop time. No SNES classic for any of us.
 
John Conyers: https://medium.com/@repjohnconyers/...-of-medicare-for-all-legislation-17d848c201a1

...“I’ve been introducing H.R. 676, The Expanded And Improved Medicare For All Act since 2003. Under my bill, instead of a complicated, expensive network of exchanges and employer-sponsored plans and networks administered by for-profit insurance companies that some people can afford and many others can’t, we would have one health insurance plan, one health insurer and one network available to every single American. In other words, we would finally have guaranteed, universal healthcare. I’m proud that we currently have 118 House Democrats who cosponsored the legislation — a majority of the Democratic Caucus.

“I applaud Senator Bernie Sanders’ introduction of the Senate companion to my Medicare for All bill and all of the momentum he has garnered in support of a universal single-payer healthcare system.

“Healthcare should be a right, not a privilege for those who can afford it. It deserves to be an essential service provided by the government, no different than fire departments, public schools, and military protection.
 

pigeon

Banned
Calling what the bill does "outlawing private insurance" is the most manipulative propaganda that I have ever seen in NeoGAF. Of course the current private insurances would need to change to reflect only what they offer over the public/universal one, that is not outlawing anything except fraud. Do you want to allow the private industry to make you pay for something you already have?

The bill literally says it's unlawful to offer insurance that covers the same benefits as Medicare. Calling that manipulative propaganda seems a little manipulative in itself!
 

kirblar

Member
This reasoning is why we should save coal. The jobs man, the jobs. Let's ignore the vultures and forget about the environment. Jobs. Nothing from the status quo should change. Let's stop time. No SNES classic for any of us.
Coal has slowly died out over a period of decades. We are arguing the same type of drawn out transition is far better than an immediate shock to the system.
this is the same restriction plans for over 65 year olds face that medicare instituted
Over 65s weren't being forced to give up employer base health care plans.
 
What do people mean when they say people like Hillary (as an example) can't find the cash for single player? Or that you would have to mint trillion $ coins? If an American lawmaker gets a law passed then the financial side of things will be taken care of electronically by public and private professionals same as any federal program these days.
 
That's still outlawing the vast majority of the health insurance marketplace.

Wouldn't private insurers rejoice only having to cover the most lucrative areas of coverage? Like persistent prescription medications?

Last I checked the worst maladies, cancer, and immunizations didn't make much money
 

sphagnum

Banned
Outlawing private plans is way more bold than I expected. Bernie's still got a red heart deep in there!

I don't really care about how this would get paid for or or since it's a symbolic bill. Once/if ever the Dems get power back then I'd need more specifics.
 
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