We’re getting into the linguistic corruption of Frank Luntz with this argument.
When the only available options are between different forms of self-destruction, as they are for many seniors under the republican proposal, describing them in terms of offering the advantage of free choice is a perverse use of language. Presenting the free choice argument as being equivalent to proposals that actually provide adequate health care is utterly deceptive.
You’ve had enough experience on this board by now to understand that its readers will reliably see that kind of B.S. argument for what it is.
I live in CA. CA pays $X to the feds to cover medical issues. The feds currently return ($X-10%) to CA. The new plan would be to reduce $X another Y%. These numbers aren’t real, but the concept is real.
Say we send the feds $100 dedicated to medical, and they currently give us back $90 to spend on that. CA kicks in another $10 and provides a robust medical insurance program to its citizens. Now the feds want to take our $100 and give us back, say $75 so we’re in the hole for another $15 in addition to the previous $10. There is only so far a nickel can be squeezed. People will lose their coverage in droves for the simple fact that the well has run dry and the “friends of DJT” are doing better than ever.
I see the point, but at the same time the Feds are decreasing taxes (or at least say they will) on Ca residents and businesses by 25, leaving it open to Ca to raise that missing 25 on those self same residents. If Cali uses that cash to implement a public option, over time it should be able to increase efficiency and reduce healthcare costs to a more reasonable 8-10% of GDP.
Interesting you use that word, which also appears in the graham-Cassidy bill. I think you miss my point though, which isn’t to judge the republican position but to view the issue from their perspective. They’d perhaps query why seniors who never bothered to pay for health insurance before are now entitled to unlimited medical costs courtesy of the younger generation.
A universal healthcare system has to be regulated at every level or costs will spiral out of control. The ACA lacked the vision to truly reform the healthcare market, settling instead for a Frankenstein of government-mandated private provision which I don’t think is sustainable. I can see why repubs hate it. The solution i think is much closer to what sanders is advocating.
I’d also suspect that a lot of the “insurance” will be much weaker than today’s Obamacare exchange plans, due to the loss of Essential Health Benefits. The loss of the protection against discrimination based on preexisting conditions is also likely to lock some people out of plans that would actually help them.
In an economy where retirement systems have been routinely gutted and social security provides only minimal support, the republican notion that seniors never “bothered” to pay for health insurance is hardly an accurate description of the real world situation. Likewise the republican argument that it is implicitly unfair that the younger generation supports insurance costs is falls apart when it we recognize that in an established system those who are now elderly paid contributions themselves when they were younger. That is the basic proposition of all private health insurance, private life insurance, Medicare, and Social Security.
The 19 Republican-led states that refused to expand Medicaid under the ACA turned down a deal where the Federal government would pay 100 percent of the expansion for the first three years, then declining to 93, then 90 percent thereafter.
These people turned their back on the health and well-being of their own constituents – when the federal government offered to pick up the tab – in order to score points with their political base. What makes you think they would risk political capital to raise taxes, or to devise some “better” plan?
The problem here being it isn’t an established system. Also, even established systems are having massive issues because people are living far longer and far more (expensive) treatments are available for all manner of ailments. As I said, I agree with you. But the problem here is that with all those forced contributions a cream of profit is being skimmed from the top by insurance company shareholders. It’s a licence to print money, and it isn’t right. Further, there isn’t sufficient mechanism to control the costs that the insurance companies themselves have to pay out - to hospitals, suppliers, pharma companies etc. It’s a horrible, expensive, inefficient and profit-driven system. Granted it’s a bit better than what was there before, but it simply isn’t sustainable. And more than that, the electorate keeps voting for the people that couldn’t be clearer that they want nothing more than be rid of it.
That’s not railing. You opined that states could take up healthcare without federal support. That’s been tried; it’s failed.
Also, my example pointed out how misplaced and unrealistic your hope in these Republican-led states is.
They have done nothing since 2010 but sabotage the ACA – beginning with the day after President Obama signed it and they filed a lawsuit and took it all the way to the Supreme Court. They have been derelict in setting up their own state exchanges, in pushing back against proposed rate premium hikes, and in publicizing open-enrollment periods. They have spread scare stories about the “navigators” who work to help enrollees through the process.
And all this to blunt the impact of a bill – that got 60 votes in the Senate and was led by a President fresh off a landslide victory in the Electoral College and the popular vote – that came in response to a widely-reported healthcare crisis and which, in its short history, has already managed to slow medical inflation to historic levels, extend the actuarial life of Medicare, and reduce the uninsurance rate to nine percent.
The only reason why Red state voters were against it was because of their irrational, weaponized hatred of President Obama and the cynical claims of Republican legislators that they had a “better” bill just waiting in the wings.
So, no, it’s not democracy, but nullification – something you and your fellow confederates have a sordid history of.
You’re preaching to the converted here. I don’t have hope for these republican-led states as long as they remain republican led and republicans continue their vocal and forthright opposition to the ACA. However I do respect their democratic choice to have shitty healthcare systems. It’s worth considering that if the Dems had taken a more state-led approach in 2009 and enabled states to implement universal healthcare properly, with federal support should they choose, rather than forcing a solution upon them, we might not be in this sorry state of affairs. California might even have a functioning public healthcare system.
It’s interesting you bring up Obama’s sweeping 2008 victory. You may not recall, but he campaigned against an individual mandate and then proceeded to implement a law that had it as its lynchpin. He had no mandate for the mandate. Republicans do have a mandate to repeal it.
You can scoff at democracy all you want, thinking you know better than the ignorant masses, but this is the system we have. If you want to change the system, campaign for that, otherwise respect the rules.
As an aside, I’m completely in favour of an individual mandate, but in the context of a public health insurance system. Not a mandate that forces me to line the coffers of insurance company shareholders.
Actually, the Republicans’ rhetoric to the contrary, the ACA provides states with much latitude in achieving the federal goals of expanded coverage. It’s not a one-size-fits-all approach. And Vermont did take steps to expore adopting a single-payer system, but they couldn’t get the numbers to work.
I don’t recall Obama being against a mandate. I know he had to drop some of his priorities such as a public option because the votes were not there.
And as far as “knowing more than the ignorant masses,” those are your words, not mine.
I agree republicans horribly mischaracterised the ACA, but it’s cheap and condescending to assume nobody knows what it really is. I suspect people know full well how much they’re paying each year to keep insurance company executives and shareholders living in the lap of luxury, and that thanks to Obama it’s illegal not to. Many are of course thrilled they’re able to do so without worrying about pre-existing conditions. Many are pissed.
My “Democracy? Please.” referred to your comment that Red state citizens forgo health care because they don’t want it, and have decided that with their votes, and that it is all a part of the democratic process…
Also, the ACA includes the Medical Loss Ratio, which requires insurers to spend at least 85 percent of the proceeds of large-group premium payments on actual healthcare services, and at least 80 percent of the proceeds of large-group premium payments on actual healthcare services.
Your attempts to criticize the ACA from the left by focusing on the profits of insurers, while you attempt to justify Republican attempts at obstruction and sabotage, are blatantly transparent.
