Obamacare Architect: Time for Single Payer

Discussion in 'ObamaCare' started by Weatherman2020, Sep 9, 2017.

  1. Weatherman2020
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    Weatherman2020 Educating Libs Since 1978

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    Bet you never saw that one coming.

    It’s time for America to consider seriously a single-payer, government-run health system, says Max Baucus, Montana’s longest serving U.S. senator, former ambassador to China and one of the chief architects of Obamacare.

    “My personal view is we’ve got to start looking at single-payer,” Baucus said Thursday night at Montana State University. “I think we should have hearings…. We’re getting there. It’s going to happen.”

    It was a startling turnaround for Baucus, who eight years ago was chairman of the powerful Senate Finance Committee and a key Democratic leader in the political battles that ultimately passed the Affordable Care Act.

    Back then, Baucus said, he felt adamantly that Congress wouldn’t pass a government-run system like Canada’s. So it was the one alternative he refused to put “on the table” for consideration.

    But you can see the difference, Baucus said, when you visit hospitals on either side of the border. In Montana, half a rural hospital will be dedicated to processing medical insurance claims. In Canada, he said, just one small room is needed to verify that patients are residents.[…]

    Baucus decried several changes in Congress over the last 40 years. No longer do senators get together for bourbon, or lunch in a private dining hall. Instead every lunch is dedicated to party strategizing about how to defeat the terrible people down the hall, he said. No longer can you win an election with less than $1 million, he said. Now it can cost $24 million.

    Baucus also lamented the end of earmarks, which the press criticized as political “pork” for the folks back home and as “bridges to nowhere.” He spoke proudly of getting farm bills, rural hospital money, conserving open space and landing highway money for Montana that built Bozeman’s North 19th Avenue freeway interchange and interchanges in Belgrade and Billings. Ninety percent of earmarks were good, he said, and they were “the glue” that held politics together. “We got bamboozled by the press,” he said.

    Keep reading…
     
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  2. Fenton Lum
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    Fenton Lum BANNED

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    Obama-Romneycare was hatched at the Heritage Foundation hon, just sos' ya know.
    The Tortuous History of Conservatives and the Individual Mandate



    The individual mandate as an alternative to the employer mandate

    There are five obvious, and large, problems with an employer mandate. The first is that an employer mandate massively drives up the cost of hiring new employees, discouraging new hiring and increasing unemployment. The second is that forcing employers to pay for health costs increases the costs of running a business, and these increased costs are passed onto consumers in the form of higher prices for goods and services.

    The third problem is that an employer mandate does nothing to address the health needs of the unemployed. The fourth is that the employer-based system insulates consumers from the value of the health care they are paying for, giving them no incentive to economize, thereby driving up the cost of health insurance. The fifth is that the employer-based system leads to “job lock,” whereby people are afraid to leave their jobs if they fall ill on the job, because switching plans could mean higher premiums or denial of coverage.

    Hence, some conservatives, seeking a more market-oriented path to universal coverage, began endorsing an individual mandate over an employer mandate. An individual mandate would address the “free rider” problem caused by EMTALA, by requiring people to buy their own insurance. In addition, moving to a more individual-based system from the employer-based one would significantly increase the efficiency of the health-insurance market.

    With these considerations in mind, in 1989, Stuart Butler of the Heritage Foundation proposed a plan he called “Assuring Affordable Health Care for All Americans.” Stuart’s plan included a provision to “mandate all households to obtain adequate insurance,” which he framed explicitly as a way to address the “free rider” problem and employer mandates (emphasis added):

    Many states now require passengers in automobiles to wear seatbelts for their own protection. Many others require anybody driving a car to have liability insurance. But neither the federal government nor any state requires all households to protect themselves from the potentially catastrophic costs of a serious accident or illness. Under the Heritage plan, there would be such a requirement.

    This mandate is based on two important principles. First, that health care protection is a responsibility of individuals, not businesses.Thus to the extent that anybody should be required to provide coverage to a family, the household mandate assumes that it is the family that carries the first responsibility. Second, it assumes that there is an implicit contract between households and society, based on the notion that health insurance is not like other forms of insurance protection. If a young man wrecks his Porsche and has not had the foresight to obtain insurance, we may commiserate but society feels no obligation to repair his car. But health care is different. If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance. If we find that he has spent his money on other things rather than insurance, we may be angry but we will not deny him services—even if that means more prudent citizens end up paying the tab.

    A mandate on individuals recognizes this implicit contract. Society does feel a moral obligation to insure that its citizens do not suffer from the unavailability of health care. But on the other hand, each household has the obligation, to the extent it is able, to avoid placing demands on society by protecting itself…

    A mandate on households certainly would force those with adequate means to obtain insurance protection, which would end the problem of middle-class “free riders” on society’s sense of obligation.

    Republican support for the individual mandate

    As far as I have been able to find, Stuart’s 1989 brief is the first published proposal of an individual mandate in the context of private-sector-managed health systems. In 1991, Mark Pauly and others developed a proposal for George H.W. Bush that also included an individual mandate. While others credit Stanford economist Alain Enthoven with the idea, Enthoven’s earliest published reference to an individual mandate was an indirect one in the 1992 Jackson Hole paper.

    In 1992 and 1993, some Republicans in Congress, seeking an alternative to Hillarycare, used these ideas as a foundation for their own health-reform proposals. One such bill, the Health Equity and Access Reform Today Act of 1993, or HEART, was introduced in the Senate by John Chafee (R., R.I.) and co-sponsored by 19 other Senate Republicans, including Christopher Bond, Bob Dole, Chuck Grassley, Orrin Hatch, Richard Lugar, Alan Simpson, and Arlen Specter. Given that there were 43 Republicans in the Senate of the 103rd Congress, these 20 comprised nearly half of the Republican Senate Caucus at that time. The HEART Act proposed health insurance vouchers for low-income individuals, along with an individual mandate.

    Newt Gingrich, who was House Minority Leader in 1993, was also in favor of an individual mandate in those days. Gingrich continued to support a federal individual mandate as recently as May of last year.

    It would seem that 1990s conservatives weren’t concerned with the constitutional implications of allowing Congress to force people to buy a private product. “I don’t remember that being raised at all,” Mark Pauly told Ezra Klein last year. “The way it was viewed by the Congressional Budget Office in 1994 was, effectively, as a tax…So I’ve been surprised by that argument.”
     
  3. dblack
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    dblack Gold Member

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    Single Payer for Everyone for Everything!
     
  4. BlackFlag
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    BlackFlag I haz hoisted it!

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    Since both repeal and replace are now off the table, maybe it IS time for single payer
     
  5. dblack
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    dblack Gold Member

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    For everyone! For everything!
     
  6. basquebromance
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    basquebromance Gold Member

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    The "right to healthcare" is enshrined in the South African Constitution. The nation ranks 182/191 in health level.
     
  7. Kimura
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    Kimura VIP Member

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    It's the only way to bend the cost curve. As long as for-profit insurers are in the mix, and other rent extractors are in the feeding chain, the US will never lower costs and/or achieve universal coverage.
     
  8. Kimura
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    Kimura VIP Member

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    I currently live in Italy. We have a better health care system than the United States. In point of fact, most OECD countries outperform the US in overall health care outcomes.
     
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  9. Kimura
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    Kimura VIP Member

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    The ACA would work if health insures were not for profit. This is how they do it in France, Germany and Switerzland IIRC.
     
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  10. CrusaderFrank
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    CrusaderFrank Diamond Member

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    The best remedy for single payer? Helicopter rides
     

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