Imagine Single-Payer Healthcare and what the reaction would be.

[MineralMan]

Single-Payer healthcare is by far the best way to distribute healthcare among a population. No question about that at all, and most of the industrial world has already implemented it. So, why don't we have that?

Simple. It's tax-supported healthcare. Like Social Security and Medicare, we pay into it and everyone in the program benefits from it. And that's the issue that would bring screams from the Right. A lot of people would be covered who would be unable to contribute to their coverage. Poor people. Old people. Struggling people. And yet, a Single-payer universal healthcare system, like the ones in most of the western world, would cover healthcare costs for those people, just as much as it would cover healthcare for everyone else.

We're getting complaints from the libertarians, the Republicans, the young, in some cases, and others about the unfairness of mandatory health insurance in the ACA. Imagine what we'd be hearing if real tax-supported single-payer universal healthcare were being implemented this year. Everyone pays according to their income and everyone benefits according to their need. That's the idea. You pay now, while you're healthy, and get healthcare when you're not, and maybe even when you are no longer paying into the system.

But, we're impatient, selfish, and short-sighted. That's obvious from the complaints about ACA. Had this year been the first year of tax-supported single-payer universal healthcare, I can promise you that the screaming would be many decibels louder, and it would be coming from the same voices who are screaming now about ACA.

We must decide, as a nation, whether we want healthcare to be a right, not a privilege. We must decide and we must accept that we all have to pay the costs of it. Until we do, we will not have single-payer universal healthcare. Until we become a nation that accepts that we must think long-term instead of short-term and that those in need today may be us tomorrow. We must develop a better social consciousness than we have now. We must grow.

Bottom line: The complaints, whining, and screaming we're hearing now about ACA would be ten times louder if single-payer universal healthcare was being implemented this year. That is why we do not have it. To get it, we are going to have to make a shift in our way of looking at a lot of things.

[Hoyt]

1. I think you are exactly right. Everyone's thinking -providers, government, even consumer/patients

will need to change.

[NOVA_Dem]

14. Companies would drop health insurance coverage for almost EVERYONE if Single Payer passed.

I'm for single payer but if you think the political blowback now is bad wait until companies decide to shed the expense of employer contributions to health insurance and pocket it as profit.

[TheKentuckian]

31. Of course they would because no one would need insurance at all.

You levy a tax on employers to get their systemic contribution.

I don't grasp your point, the idea of single payer is to the rid of the cartel and have a pool of everyone.

[Bluenorthwest]

2. If we are going to have the complaints, whining and screaming anyway, it would have been nice

if it was over something excellent rather than this monument to mediocrity in service to moderation. The part you leave out is that if this had included even a public option, the right wing complaints would have to drown out the cheers of those who actually liked it. But people don't go cheering and banging the drum for just muddled mediocrity , so every peep out of the right wing resounds in an arena devoid of the masses who might be cheering for a less confusing, less profit driven system.

[MineralMan]

5. I'd rather have that, too. But the reason we don't have it is

because we, as a nation, aren't ready to accept it, and we don't have a government capable of putting into effect. All for the reasons I described, I think. As for its effects on individuals, we're beginning to hear about the people who are finding relief in the ACA. My wife is one of those. She's quite pleased. So are others.

I want single-payer, taxpayer-funded universal healthcare. We can't have that right now. There's not a chance anything of the sort will be enacted. Hell, we barely got this ACA. Change is slow, particularly in people's attitudes. That's where the change needs to happen. Government can't do that.

[woo me with science]

12. No, we got something far to the right of what the nation was asking for.

Polls at the time showed strong support for a public option.

That momentum could have been used to create a national conversation and demand for something better. Instead, the President quietly scrapped that option in backroom deals.

[MineralMan]

13. Yes, I know that's your opinion.

Polls also do not make laws. Congress makes laws. A public option, and much less a single payer system simply was not possible at the time. Congress would not have passed any such thing.

So, we have ACA. It's something. It benefits some a great deal. Others, not so much.

Single-payer is what is needed. It's a while off, though, I suspect strongly.

I don't make laws, either.

[woo me with science]

26. Nothing is possible when it is quietly and deliberately taken off the table.

It was a perfect opportunity to exert pressure and move the national conversation leftward.

Corporate Democrats do not hesitate to join complaints about how about Republicans use relentless repetition and Fox News brainwashing to perpetuate their lies and move the national consciousness rightward, but let a real Democrat suggest that our politicians make a sustained effort to COUNTER the lies and advocate publicly for policies that would actually help people, and the whining and scolding begin about "not possible."

Our President and corporate Democrats make soaring speeches about the need to eat austerity peas or spy on the entire US population. However, they cannot seem to muster the will to passionately advocate a policy that will actually help Americans...EVEN when they already control the Presidency and half of Congress, and EVEN when the country clearly supports the policy and could be rallied behind it.

We didn't hear about it BECAUSE the country supported it. That is the sad, ugly truth.

[TBF]

29. We didn't hear about it because the richest folks don't support it -

it has nothing to do with what the rest of us need or want.

[woo me with science]

36. I think you're right for the most part.

I suspect it would have been quietly removed even if the public hadn't been in support, for the reason you mention.

However, Corporate Dems do occasionally take the opportunity to pretend to advocate progressive policies, to sustain the illusion of working for the 99 percent.

IMO, that's *least* likely to happen when the public is primed to rally behind a policy and exert pressure that might change votes.

[sufrommich]

3. While I agree,he was going to be accused of

being a closet socialist anyway. He also won his first election promising single payer healthcare.

[MineralMan]

7. The President of The United States cannot make laws.

It is that simple.

[sufrommich]

9. Yes,I'm aware of that. Obamacare is called

that for a reason,it originated from the White House.

[woo me with science]

10. He chose not to fight for a public option

after he had promised to do so, when polls showed that the country was strongly behind it, and when public opinion could have been mobilized to demand it.

The truth is that he was working for the insurance companies' version all along.

[tridim]

19. 100% pure woo. nt

[arcane1]

25. Welcome to DU

[polichick]

4. Maybe the leaders/corps would be screaming but the people would be happy.

[MineralMan]

6. Not all of the people. I can promise that.

Both sides of the political spectrum are quick to refer to "The American People." There really is no such collective thing. That is what needs to change.

[woo me with science]

8. +1000000

Once people see comprehensive coverage for much, much less money and pain, the complaints would die down very quickly.

Support for Medicare is overwhelming across party lines. It is only the corporate propaganda that keeps the small fraction of protest alive.

[Hoyt]

22. I suspect if people knew how expensive Medicare for all would be, they'd still gripe.

Medicare has no annual cap on out-of-pocket-costs, and the government couldn't develop the systems necessary to administer it without insurance companies. In the best of worlds it would be 10, maybe 15% less than exchange policies right now. People would scream more than they are now. Longterm, we could probably do more to control costs, but not right now.

Personally, I think we are better off letting insurance companies take the risks, invest in the systems, take the heat, etc., in shortterm and then dump them for single payer if they can't keep up with what is needed to provide affordable care.

[sufrommich]

11. Other than the insurance industry,I doubt that most

corporations would have a problem with national healthcare,it certainly doesn't effect them in other countries.

[MineralMan]

15. I think you're right. I'd also add much of the healthcare provider industry and

the pharmaceutical industry to the list of those who have the most to lose. I have no answer for that. Change to a single-payer system is going to have to come from the grassroots, and we're still living in a country that is deeply divided on such issues. We have to change the minds of those who oppose single-payer somehow.

I still think a Medicare expansion is the answer. It could even be staged incrementally, I believe. Once people experience the Medicare system, they begin to understand. We could even use the current method of supplemental insurance with the expansion, which the insurance companies would like. They sure try hard to get people to pay that $100 to cover the 20% Medicare Part B doesn't pay. I've long been puzzled by that, but there it is. They spend enormous amounts of money to get those premiums and competition for that market is intense.

[sufrommich]

21. I'm not really disagreeing with you,I just

wish Obama would have at least forced congress to have a real debate about single payer,win or lose. It would be very easy to make the argument that most people would pay less in new taxes to cover their healthcare than they pay in monthly premiums because we pay insurance companies to act as a middle man.

[FarCenter]

32. Obamacare looks very much like means-tested Medicaid.

At least in this state, the state contracts with 4 insurance companies to administer Medicaid benefits. Medicaid is essentially a state-funded insurance policy.

With the expansion of Medicaid and the subsidy for low income people, there is sort of a smooth transition between Medicaid's policies which are 100% state/federal funded and people more than 400% of poverty level who thereafter pay the full premium.

[polichick]

18. That's who I meant - the insurance companies, the ones who helped write the ACA.

[JoePhilly]

16. That's why I think the path to single payer goes through a public option path.

We can't jump all the way to the end.

1) The ACA sets up state and federal exchanges. Not perfect, but much better than what we had.
2) Blue states add public options to their exchanges. This makes things even better in those states.
3) The Federal exchanges (after some screaming from the right) adds a public option, perhaps as a buy-in to Medicare.
4) Insurers struggle to compete in the blue states.
5) Insurers struggle to compete in the red states.
6) State plans and Federal plan compete with each other ... they improve as a result.
7) We reach a point where insurance companies give up.

I won't be surprised if we end up with a Federal plan and then an array of state plans.

But I don't see the US jumping directly to that final step. Its going to be a process.

[MineralMan]

17. I'm certain it will have to be a process.

I don't see a path to a radical system change at this point.

[sufrommich]

23. A voluntary public option may

be the answer.

[JoePhilly]

24. yup ... once you put it in the State exchanges, you have the competition you need.

Its a choice ... an option.

The insurance companies may survive, but they'll have to work harder at it.

[TheKentuckian]

45. That matters little. What we need is universal subsidized access to the exchanges

it hardly matters what options are there if virtually no one can choose.

Then if competition is the idea then we would have to make sure some exists and that can't reasonably be expected without ending the predatory cartel's antitrust exeption.

Seriously, who can delude themselves that an industry allowed by law to collude, set territories, and fix prices is going to be seriously regulated and I think it is foolish at the very best to be working under the assumption that market competition will bring down prices under such an arrangement. That is way beyond wishful thinking.

Then if you are going to have a public option then it can't be handcuffed to death to prevent phony "unfair competition" to the cartel and essentially be for nothing but a coverage ghetto for the cartel to dump "undesirable" into like ours was being turned into before they just killed it completely.

Of course even before any of that an environment has to be in play that doesn't result in the inmates running the asylum. Nothing good is going to come from the industry calling the shots and their lobbyists writing the laws and regulations.
Also, not even a market based approach is going to work when regulators are afraid and vastly out resourced nor can much of anything be accomplished with the first order of business being to not disturb the status quo.

[Lydia Leftcoast]

27. I know some American expats in Japan who hated the national health system when

they were single twentysomethings. Then they married and had kids, and they themselves grew older, and all of a sudden, they realized that there were advantages to having universal health coverage.

[MineralMan]

41. Yes. You pay for

the care you will need in advance.

[FarCenter]

28. "and everyone benefits according to their need"

How do you define 'need'?

Are the taxpayers expected to pay for the sum of the bills for all that care that doctors and hospitals can convince patients that they "need"? Or that patients can convince doctors and hospitals that they need?

Is a fiscal target set (e.g. 15% of GDP) and doctors, hospitals, etc. funded to that extent and they determine by scheduling who gets what? Who determines how many clinics and hospitals to put where and what staffing levels would be?

[MineralMan]

40. Need? If you are sick you get care.

Simple.

[PoliticAverse]

30. Most of the Industrial world does not in fact have 'single payer'. n/t

[Chisox08]

33. We have the network in place and it's very popular

All that we need to do is lower the medicare age to birth. Follow that up by making the sign up process simple and give multiple ways to sign up, either by phone, website or mail in card.

[MineralMan]

39. Exactly.

[Deep13]

34. I know what my reaction would be.

[Martin Eden]

35. "Everyone pays according to their income and everyone benefits according to their need."

Sound an awful lot like Karl Marx:
From each according to his ability and to each according to his need.

No doubt the screamers on the right would point that out in a heartbeat.

And you know what?
They'd be right, and they'd be dead wrong.
They'd be right in that the concept is Marxist, and dead wrong in their opposition to it.

We can have a capitalist economy with the profit motive and markets driven by supply & demand, and we can have universal single payer health care right alongside it. Because what makes sense for one doesn't necessarily make sense for the other, and corporate health insurance is a horrible failure in providing coverage. The corporate profit margin is DENIAL of coverage, there is a huge overhead with CEO's & major shareholders pocketing great wealth, and the people who most need medical care are least able to afford a policy based on actuarial tables.

It's going to be a rocky road to Single Payer, if we ever do get there. Critically important is how the ACA works out, both in providing health coverage and politically how it is perceived.

[TBF]

37. I think we need Marx in both places -

But for those who like the free market I would think they would want health care off their plates - most of the other industrialized countries of the world provide some sort of universal care and that frees up companies from having that responsibility.

[MineralMan]

38. Yes. Healthcare should be a socialist system.

No question.

[Laelth]

42. If our tax structure were more progressive, only the wealthy would complain.

I wouldn't feel very sorry for them.

-Laelth

[truebluegreen]

43. We don't have it because too many of our leaders

didn't want to disrupt the insurance biz and jeopardize contributions to their campaign chests.

[Romulox]

44. Nonsense. The ACA is a corporate first model first proposed by Mitt Romney.

To pretend that this is the "most liberal" plan we can get is massively disingenuous when Obamacare's private insurance mandate has its genesis in a plan first put forward by Mitt Romney and the Heritage Foundation.