I don't think anyone quite gets it. Doctor offices are usually first point of contact. The doctor is the collection agent. The doctor doesn't know what the final will be at the date of service. They have to balance bill.

What happens is that patient doesn't pay the bill, the doctor gets stiffed and doctor can't pay their bills. But this all sounds fine to society because patient was insured and received medical treatment. Bad doctor who puts a sick patient into collections because doctore all are so rich.

At the end of the day the entire health care debate is simple. You are either in favor of everyone getting coverage or you aren't.

If you're in favor of universal coverage, then the next question is how to provide that, which leads to things like an NHS, single payer, or maybe Obamacare.

If you're not, then the next question is who doesn't get health care? Then you have to find a way to tell them.

The problem in the US right now is that the GOP is in favor of the second option, but basically doesn't want to admit it.

"The problem in the US right now is that the GOP is in favor of the second option, but basically doesn't want to admit it."

And the Dems want everyone to have care but won't come out with any sort of concrete statement as to how they're going to pay for it. The NHS has had a good run, but seems to be staggering now - docs on strike and patients not being seen can't be a good sign. I'd like to see them get it together, because if a program that is pretty much loved by the population falls apart, it looks grim for any such program in the future. (And yeah, I know the Scandi's have it working pretty well, but they're a lot more homogeneous than the UK/US, and I'm not optimistic that their programs would translate well)

In passing, I voted Dem the last 3 elections nationally, GOP locally (LOL Sharon Angle) . Neither party is covering themselves in glory at present, although the GOP on the executive/senatorial level have a monopoly on smarmy douchbags who deserve to be repeatedly KITN.

MM MD

Makes sense. If he goes after the nutjob Rs he would lose others. If he placates the "moderate" Rs it might work to get it back to the House.



https://twitter.com/davidaxelrod/sta...96369629794304

Wat? I think all three of single payer, NHS, and Obamacare have their funding methods well established. What part are you struggling to understand?

I mean I'm sure we could pay for it, but taxes would have to be raised in some way, and that is insanely difficult in the U.S. You can pretty much forget it about with R's in control of the House. It's a non-starter.

The problem is it's cheaper in the long run but you would have to raise taxes in the short run, and a bunch of insurance companies would, well I guess they would go out of business. Good riddance I say but it's a big shuffle in the market. Dem voters support single payer much more than Dem politicians do. Lobbyists and corporate influence is a problem here. Same for Republican voters actually as well. Republican voters, about 25% by recent polls I've seen support single-payer. But 0% of Republican politicians. There's definitely a pattern on both sides of the aisle here and the people are gonna have to push hard for the right solution here.

The Dems can credibly claim they are honest with being willing to pay for improved health care because they raised taxes to fund Obamacare instead of tacking it onto the deficit.

I think support for single payer would go away rapidly once oeople found out that means their employer plans would be cancelled.

They are not putting Cigna, Humana, United Healthcare, Blue Cross and Blue Shield out of business.

The insurance companies can become administrators of single payer. What would have to come down is the multi-million dollar salaries of all the top executives. And those are the people that will do the hardest lobbying agains this ball.

Single-payer can work here. And for those comparing it to England, we spend far more per capita on healthcare, so money isn't an issue.

It is the entrenched interests that we can't overcome. There will be no popular vote on this and no way will congress go against such a strong lobbying power.

Stuck. Until this utterly breaks down perhaps. 20 years? Not happening soon.

And their taxes would go up significantly.

And their benefits would go down. Technically their taxes would go up but the tax they were paying through their employer would go down. It'd be a transfer instead of a tax. But good luck explaining that.

yup.

Also in theory their salary should go up by whatever their employer was putting towards healthcare premiums. But good luck with that.

Who is buying this bs about free-market health insurance or pay only what for what you use.

Fine, one of these people supporting this gets Alzehimers, they can pay for it themselves. I don't have Alzheimers nor do I want to pay for it.

I guess they want to get rid of Medicare too. Why should the government enter their lives at age 65. The government should stay out of healthcare period.

We only get what we each individually pay for. Just like car insurance. If you car insurance goes up too much, you can't afford to drive. If your health insurance goes up too much, you can't afford to live.

This sounds like a dystopian dream since someone was drinking a beer out of keg.

Rather have a dysfunctional single-payer than what we have now. You are still allowed to pay for extra care. But it would be nice if everyone got a basic level of care. What is sad is that it easily doable if someone could just start from scratch. We would have more money that we knew how to spend if that were the case. Instead, we are going from bad to worse. We have more money than ever before but we are kicking people off of health insurance to support an ideal. Giving rich people additional tax breaks who don't need it. They are fine. I promise you that.

We are so powerless individually it is frightening. The vast majority know it and want it, yet all we can really do is go on a message board.

LOL

***Speaker Ryan will be asking members to vote on a piece of legislation that impacts a fifth of the economy before members are able to understand its budget impact, its effects on their constituents, or any of the other outcomes typically assessed by a CBO report.***

How is there not public hearings on this bill? 20% of economy that affects 100% of society. There is not one person in America that has a health related issue for themselves, family or friends.

There is something wrong with our system. This is the type of stuff that leads to revolutions. At least pretend everyone has a voice.

This is the same CEO the GOP keeps quoting as saying that Obamacare is in a death spiral

Ryan's constant lying about Trumpcare is pretty disgusting.

Of course it fits with the guy dreaming about cutting poor people's healthcare over a keg.

looooollll

The House "tweak" is telling the senate to set up a reserve fund for low income semi-olds.

Trump is saying he's going to put in something to lower drug prices. Sounds good, but without a buy-in from the industry he's going to get even more heat. Also he said if he can't get it in this bill he'll do it later, which will never happen.

It is sad that Ryan has said that he wants to run in Medicaid because he doesn't want people becoming dependent on it.

Dependent on healthcare ah the horror. I know none of them have any awareness but this is why we just need to provide EVERYBODY healthcare. Then we don't have to worry about anyone becoming dependent on it or cheating any systems. It would literally be one less thing to worry about.

The solution has been obvious forever yet we continue these charades. The government pays for healthcare for everyone. Once that is in place we can actually attack the areas with the most bloated costs and reduce our overall healthcare costs by a significant amount. However there is no way to reach the later without the former. ANY non single payer universal care is going to remain too expensive by a huge amount and total costs the American people pay for total healthcare will remain ridiculously high.

While the actual work would indeed be involved getting there is not even a little big difficult. Until we change our healthcare costs are going to be too high by double and continue to increase at an enormous rate.

We actually have a win-win-so long health insurance industry solution but we keep jerking around. It is as fiscally irresponsible as we could be under the circumstances and it's amusing that self proclaimed fiscal hawk conservatives want to continue overpaying for healthcare. If we magically wiped out all government healthcare programs tomorrow (Medicare, Medicaid etc) the amount the federal government would end up spending as it relates to healthcare would go up. That is how silly all this is.

Yes, everything you wrote is right. So what can any of do about besides write message about how messed up this and that given the astronomical amounts of money we spend on healthcare, should be fixable. But it is impossible to fix inside the current system. Perhaps it just needs to be completely broken. But what does that really mean? When is it truly broker vs. the reality of us paying higher premiums and getting mediocre care? Perhaps Bernie Sanders could have done this. Who knows.

https://twitter.com/Taniel/status/844014843254444036

https://twitter.com/charlesornstein/...96512327958528

At this point, they only really have to do enough to be confident it passes on Thursday.

I'm patient and hopeful but it is going to take time. It's going to require the republicans crash and burn directly or indirectly than more time on top of that. I said years ago in this thread that I thought even as flawed as it was the passage of the ACA was substantial because it would be pretty much impossible to unwind. Even if Ryan's wet dream of killing millions of Americans comes true it will absolutely destroy the republican position in congress.

The reality is even if Clinton or Sanders won there would not have been single payer under either of them. Healthcare has turned into one of the biggest political hot potatos in the history of the US. The surprise Trump victory, though, turned it into a grenade, pulled the pin and dropped it into congresses hand.

I don't really have any good ideas on how we expedite things myself. It's going to take time and it's likely worst case short term outcomes are the only way to exchange time for long term changes. The current issue is what does Ryan secretly change and can the house pass it? Ultimately they won't get any kind of actual bill turned into law but failure can improve the optics to help unseat republicans. The question is how many Americans will experience worse outcomes before 2018 elections? That will likely only be a small stepping stone but I think healthcare kills the GOP in congress in 2020. Hard to really see out beyond that. But I still believe there is no really backwards with all this so we will ultimately get there. It just might not be pretty.

There are some well versed activists here who can probably provide stronger guidance in terms of how we can best influence real change in congress in the next four plus years. That is going to be the key to how long it takes.

A final thought is the republicans are likely going to be scorched by being stuck with the potato. Healthcare was not and is not some huge idealogy conundrum for republicans. (Except for budget burners). It was simple a means to an end. So once it actually backfires on them it's not like there are going to be a lot of future republican congress people opposing a single payer healthcare, at least not in any way that can not be overcome.

If everything broke absolutely right you might see a serious single payer system on the table and with a chance of passing in 4-5 years. But that is pretty much the best case scenario. Which is pretty depressing.