It's the deductibles, stupid!!

[Recursion]

52. Well hell I can think of dozens of ideas that are better than our current system

The question is as always getting there.

1. The health insurance industry employs about 750K people (it's roughly a quarter of all insurance employment). While they won't all lose their jobs, most of them will, and we need to find something for them to do.

1a. Simultaneously, Medicare Administration staffing will need to expand by (this is my rough guess) about 150%, along with a similar increase in contracting. This seems like an easy solution to 1, and in a perfect world it is, but the Government is so unbelievably slow at ramping up hiring that it would probably end up looking like healthcare.gov but ten times as big.

2. 10% only counts the cost of the treatments currently being delivered to people (this also bothers me about the bill's analysis). Usage will go up. That is the entire point of doing this in the first place. If the 12% of uninsured Americans use health care services at the same rate as insured Americans, it takes us back up to about 15%. But the big question is the currently underinsured: we don't know what their usage rate will be, and if it approaches the rate of people with better insurance, it's going to wind up costing a lot more than our system does now. We simply don't know enough about the rate of underutilization by underinsured people, which is why I think it's dishonest to say we know this will save money. It's not very difficult at all to imagine a scenario where it costs more, if you accept the premise that there is a large amount of underutilization currently.

3. Even if it's the best case and we cut the 17% of our GDP to 12% (IIRC it's that and not 10%, btw), that still represents an increase in government spending equal to 4% of GDP. That is a 20% across the board wage levy, or a 40% across the board corporate tax, or a 10% VAT. There's no getting around how huge of an increase in Federal spending (and so Federal power) that is -- and we need to remember that currently we're giving those reins to John Boehner. But beyond the policy skepticism (I'd much prefer the states do this because of the Boehner issue), the political problem here is a killer. We are advocating a tax (or deficit) increase equal to 4% of the GDP to a population that is less trusting of government than at any point in living memory. It would be a disaster to run on this nationally.

3a. Yes, I know that the tax increase is -- if things go well -- balanced by lower private insurance spending. But lots of people don't see their private insurance spending now (maybe their employer contributes most or all of their premiums) whereas they will see a payroll levy every two weeks. Furthermore, to understand the resistance to this, imagine that your sketchy uncle can get DVDs cheaper than you can at Best Buy. Does that mean you want to hand him your entire DVD budget and trust he'll do it?

4. Even here on the left we have people who are enraged that the government subpoenaed records of who called whom when one of the participants was a foreigner. Not recording what they said, mind you, just keeping the dots in case they want to connect them later. These are business records belonging to the phone company, but people still felt violated and outraged. And now we're talking about the Federal Government maintaining records of all medical procedures whatsoever? That's going to go over like a lead balloon. And I guarantee you a Republican President would abuse it.