Obamacare Is Now on Life Support

[Onyx]

Honestly I don't see how a single payer healthcare system is better than what the affordable care act did. They are both bad, but the former is even more limiting and controlling than the latter. At least the ACA provided a degree of sustainability too; unlike the decade long fiction of single-payer healthcare, which is always bound to end in fiscal disaster

 

[dblack]

Honestly I don't see how a single payer healthcare system is better than what the affordable care act did. They are both bad, but the former is even more limiting and controlling than the latter. At least the ACA provided a degree of sustainability too; unlike the decade long fiction of single-payer healthcare, which is always bound to end in fiscal disaster

Single-payer could, in theory at least, be an honest government service, something like what we do with public education. And you're probably right. Single-payer would most likely not be sustainable. But we'd at least find that out.

ACA is an order of magnitude more corrupt, selling us out to corporate interests that have no public accountability, and no public motive other than generating profits for shareholders. It's the forerunner of corporatist government and will, in my view, pave the way for fascism in the US.

 

[Onyx]

Single-payer could, in theory at least, be an honest government service, something like we do with public education.

I do not find public education to be at all honest. It has just established itself into our society, therefore few people are left to argue against it. If you establish single payer healthcare for long enough, you will find it will become impossible to rid the nation of it. We have a "push forward" mentality, not one to promote taking a step back.

ACA is an order of magnitude more corrupt, selling us out to corporate interests that have no public accountability, and no public motive other than generating profits for shareholders. It's the forerunner of corporatist government and will, in my view, pave the way for fascism in the US.

I still don't exactly see how the ACA is MORE susceptible to corruption via corporatism. If anything, it is worst, because it takes the individual completely out of the equation in terms of making independent buying decision, leaving the only parties at the negotiating table being the government and corporations, and the corporations are influencing every policy decision in order to protect their interests.

 

[FA_Q2]

Single-payer could, in theory at least, be an honest government service, something like we do with public education.

I do not find public education to be at all honest. It has just established itself into our society, therefore few people are left to argue against it. If you establish single payer healthcare for long enough, you will find it will become impossible to rid the nation of it. We have a "push forward" mentality, not one to promote taking a step back.

ACA is an order of magnitude more corrupt, selling us out to corporate interests that have no public accountability, and no public motive other than generating profits for shareholders. It's the forerunner of corporatist government and will, in my view, pave the way for fascism in the US.

I still don't exactly see how the ACA is MORE susceptible to corruption via corporatism. If anything, it is worst, because it takes the individual completely out of the equation in terms of making independent buying decision, leaving the only parties at the negotiating table being the government and corporations, and the corporations are influencing every policy decision in order to protect their interests.

Because it give companies access to the powers of government. Government is bad on its own but the people have some modicum of control over it and it does not serve a profit motive. Companies, on the other hand, are only looking to increase the bottom line. Giving them access to governmental powers is enormously corrupt. This is no different than the religious governments of the past (or many of the ones that exist now). I can expect the government service to serve itself but that also entails servicing me. I can expect a company with the power to require me to pay it to only serve itself. It has no reason to give a shit about me and I have almost no power to influence it. All the company is going to really care about is how much they need to pay the politician to continue to keep the cash cow going.

 

[jon_berzerk]

yes except the numbers that 8 for 10 that use the market place get a subsidy a number the government brags about

(A) That has nothing to do with what dblack posted, and
(B) It's not 8 out of 10 who use the marketplace, but you are getting closer to understanding the actual figure.

When you're ready, kindly go over my math and show the errors, instead of simply repeating yourself.

If you can't, we'll assume my math is correct.

there are no errors jackass

 

[Arianrhod]

there are no errors

So we agree that the numbers you provided are correct; you simply misinterpreted them. Excellent.

 

[Onyx]

Because it give companies access to the powers of government.

That isn't different in single-payer.

:Government is bad on its own but the people have some modicum of control over it and it does not serve a profit motive.

First of all, the government does serve a profit motive when influenced by corporations, even on some level without corporations.

Anyways, the ACA IS having the government limit insurance companies. What, did you think it gave insurance companies more freedom to set premiums? It is the exact opposite.

Companies, on the other hand, are only looking to increase the bottom line. Giving them access to governmental powers is enormously corrupt.

That is exemplified in a single-payer system, since you are taking away all powers from the individual to make decisions regarding his or her healthcare, and shifting it solely to the government and insurance companies.

The ACA did help some corporations gain a business advantage since its primary function was controlling prices, which drove smaller insurance companies into ruins which could not compete. It didn't give them more economic freedom though.

I can expect the government service to serve itself but that also entails servicing me. I can expect a company with the power to require me to pay it to only serve itself. It has no reason to give a shit about me and I have almost no power to influence it. All the company is going to really care about is how much they need to pay the politician to continue to keep the cash cow going.

It is pretty naive to think that the government functions any different than a corporation simply out of principle. Even most corporations put forward quite noble goals "on paper."

 

[dblack]

Because it give companies access to the powers of government.

That isn't different in single-payer.

:Government is bad on its own but the people have some modicum of control over it and it does not serve a profit motive.

First of all, the government does serve a profit motive when influenced by corporations, even on some level without corporations.

Anyways, the ACA IS having the government limit insurance companies. What, did you think it gave insurance companies more freedom to set premiums? It is the exact opposite.

Companies, on the other hand, are only looking to increase the bottom line. Giving them access to governmental powers is enormously corrupt.

That is exemplified in a single-payer system, since you are taking away all powers from the individual to make decisions regarding his or her healthcare, and shifting it solely to the government and insurance companies.

It sounds like you have a different notion of what single-payer is referring to. In my understanding, insurance companies will have no role to play in single-payer, other than offering supplemental insurance for services the government plan doesn't cover.

The ACA did help some corporations gain a business advantage since its primary function was controlling prices, which drove smaller insurance companies into ruins which could not compete. It didn't give them more economic freedom though.

They major 'players' in industry generally don't have much trouble controlling regulatory regimes. Insurance executives and lobbyists wrote ACA. There's no reason to believe they won't be able to control it going forward.

I can expect the government service to serve itself but that also entails servicing me. I can expect a company with the power to require me to pay it to only serve itself. It has no reason to give a shit about me and I have almost no power to influence it. All the company is going to really care about is how much they need to pay the politician to continue to keep the cash cow going.

It is pretty naive to think that the government functions any different than a corporation simply out of principle. Even most corporations put forward quite noble goals "on paper."

Well, these days, there's some truth to that. But it's a major problem that we should never just concede. The merging of government and corporate power is very dangerous. That's really what we're talking about here.

 

[Onyx]

=
It sounds like you have a different notion of what single-payer is referring to. In my understanding, insurance companies will have no role to play in single-payer, other than offering supplemental insurance for services the government plan doesn't cover.

No, that's different. What you are thinking of is total government-run healthcare. Single-payer is where the government collects all dues from the populace, and negotiates and buys healthcare on behalf of everyone in the collective.

Insurance companies are not out of the picture. They are in direct negotiation with the government. There are some benefits to this system, but not really of the things you argued.

They major 'players' in industry generally don't have much trouble controlling regulatory regimes. Insurance executives and lobbyists wrote ACA. There's no reason to believe they won't be able to control it going forward.

The ACA was implemented because some insurance companies lobbied the government. I agree with you that the law was passed to protect certain corporate interests.

Well, these days, there's some truth to that. But it's a major problem that we should never just concede. The merging of government and corporate power is very dangerous. That's really what we're talking about here.

I don't think that can be prevented to be honest. Attempts to prevent it usually just lead to more controlling and oppressive regimes. When it comes down to giving governments power to limit corporations, or corporations power to limit governments, I would rather just tell both to fuck off. My personal opinion.[/QUOTE]

 

[Arianrhod]

Single-payer is where the government collects all dues from the populace, and negotiates and buys healthcare on behalf of everyone in the collective.

This is exactly what businesses do in terms of negotiating with insurers for a group plan to cover their employees, but try explaining that to the people screaming about the PPACA.

 

[Onyx]

Single-payer is where the government collects all dues from the populace, and negotiates and buys healthcare on behalf of everyone in the collective.

This is exactly what businesses do in terms of negotiating with insurers for a group plan to cover their employees, but try explaining that to the people screaming about the PPACA.

I have a problem with that though, because it takes away choice from the individual. There is a clause in the ACA that made businesses responsible for paying more into their employees health care plans, and this had really poor results.

 

[dblack]

=
It sounds like you have a different notion of what single-payer is referring to. In my understanding, insurance companies will have no role to play in single-payer, other than offering supplemental insurance for services the government plan doesn't cover.

No, that's different. What you are thinking of is total government-run healthcare. Single-payer is where the government collects all dues from the populace, and negotiates and buys healthcare on behalf of everyone in the collective.

Insurance companies are not out of the picture. They are in direct negotiation with the government.

Why would insurance companies be negotiating with government? If government is paying for our health care, where do insurance companies enter into it? (apart from, as I mentioned, supplemental insurance for services the government won't cover)

They major 'players' in industry generally don't have much trouble controlling regulatory regimes. Insurance executives and lobbyists wrote ACA. There's no reason to believe they won't be able to control it going forward.

The ACA was implemented because some insurance companies lobbied the government. I agree with you that the law was passed to protect certain corporate interests.

Well, these days, there's some truth to that. But it's a major problem that we should never just concede. The merging of government and corporate power is very dangerous. That's really what we're talking about here.

I don't think that can be prevented to be honest. Attempts to prevent it usually just lead to more controlling and oppressive regimes. When it comes down to giving governments power to limit corporations, or corporations power to limit governments, I would rather just tell both to fuck off. My personal opinion.

That's my opinion as well. The only way to reduce collusion between government and corporate interests is to revoke state power to interfere in our economic decisions.

 

[Onyx]

Why would insurance companies be negotiating with government? If government is paying for our health care, where do insurance companies enter into it? (apart from, as I mentioned, supplemental insurance for services the government won't cover)

That would involve the government keeping a constant stockpile of funds to pay for medical expenses, kind of like a safety net. Such a system isn't always viewed as being fiscally responsible, so many governments just pay immediate premiums to the insurance companies.

You could do it like you are saying, and just pay direct expenses, but there are risks associated with that as well.

That's my opinion as well. The only way to reduce collusion between government and corporate interests is to revoke state power to interfere in our economic decisions.

Absolutely agreed, and I think that goes back to my opinion of not giving the government ANY space in healthcare services. It just makes room for exploitation from the state, or corporations actively exploiting the state to protect their bottom line.

 

[dblack]

Why would insurance companies be negotiating with government? If government is paying for our health care, where do insurance companies enter into it? (apart from, as I mentioned, supplemental insurance for services the government won't cover)

That would involve the government keeping a constant stockpile of funds to pay for medical expenses, kind of like a safety net. Such a system isn't always viewed as being fiscally responsible, so many governments just pay immediate premiums to the insurance companies.

You could do it like you are saying, and just pay direct expenses, but there are risks associated with that as well.

The proposals I have read for single-payer don't include outsourcing it to private companies. I wouldn't certainly be opposed to doing it that way.

That's my opinion as well. The only way to reduce collusion between government and corporate interests is to revoke state power to interfere in our economic decisions.

Absolutely agreed, and I think that goes back to my opinion of not giving the government ANY space in healthcare services. It just makes room for exploitation from the state, or corporations actively exploiting the state to protect their bottom line.

Sure. But we were talking about why I saw hybrid programs like ACA as worse than direct government welfare programs like single-payer.

 

[FA_Q2]

Because it give companies access to the powers of government.

That isn't different in single-payer.

:Government is bad on its own but the people have some modicum of control over it and it does not serve a profit motive.

First of all, the government does serve a profit motive when influenced by corporations, even on some level without corporations.

Anyways, the ACA IS having the government limit insurance companies. What, did you think it gave insurance companies more freedom to set premiums? It is the exact opposite.

No, they don't/ The government is not motivated by profit motive as there is no share holders to gain. The government does not have a profit - they have a deficit and always will until the basics of our economy change.

Also, I have never stated that the ACA does not limit the insurance companies. I said that those companies are using the ACA to gain access to government power. The fact that the government limits the companies freedom is irrelevant (and actually something that the company itself seeks out in the end). By limiting those companies they are also limiting the possibility for competition and ensuring continued profits.

Companies, on the other hand, are only looking to increase the bottom line. Giving them access to governmental powers is enormously corrupt.

That is exemplified in a single-payer system, since you are taking away all powers from the individual to make decisions regarding his or her healthcare, and shifting it solely to the government and insurance companies.

The ACA did help some corporations gain a business advantage since its primary function was controlling prices, which drove smaller insurance companies into ruins which could not compete. It didn't give them more economic freedom though.

Large companies do not want more freedom. That means they actually have to compete and continue to innovate or refine processes. Large companies much prefer a static marketplace. A static marketplace ensures not only continued profits but also predictable ones. It limits the possibility of competition and allows the company to simply make money without risk.

I can expect the government service to serve itself but that also entails servicing me. I can expect a company with the power to require me to pay it to only serve itself. It has no reason to give a shit about me and I have almost no power to influence it. All the company is going to really care about is how much they need to pay the politician to continue to keep the cash cow going.

It is pretty naive to think that the government functions any different than a corporation simply out of principle. Even most corporations put forward quite noble goals "on paper."

No, its not. The government does not work like a corporation because it is nothing like a corporation at all. There is are similarities between company and the government. It really is naive to believe that the two entirely different entities operate in the same manner.

Boiled down to its most basic concept - the government has control and power over your RIGHTS as well as the sole entity in charge or protecting the same where a company is primarily driven by the profit motive of its members even at the expense of all that are not its members. Give the latter control over your rights and you will soon find that you have none.

 

[FA_Q2]

Why would insurance companies be negotiating with government? If government is paying for our health care, where do insurance companies enter into it? (apart from, as I mentioned, supplemental insurance for services the government won't cover)

That would involve the government keeping a constant stockpile of funds to pay for medical expenses, kind of like a safety net. Such a system isn't always viewed as being fiscally responsible, so many governments just pay immediate premiums to the insurance companies.

You could do it like you are saying, and just pay direct expenses, but there are risks associated with that as well.

The proposals I have read for single-payer don't include outsourcing it to private companies. I wouldn't certainly be opposed to doing it that way.

Why? That idea is rather silly IMHO.

You have to ask yourself what purpose the insurance companies serve? Why do they exist?

The simple answer is that they exist to establish risk. An insurance companies sole purpose is to establish what your overall risk is to determine what you need to pay into the whole in order to come out even at worst. That is it. They do not exist to pay your bills - that is the consequence of the system not its primary purpose. If the government is paying those premiums then what purpose does the insurance companies serve? Nothing at all. They would make money for essentially moving money around.

 

[dblack]

Why would insurance companies be negotiating with government? If government is paying for our health care, where do insurance companies enter into it? (apart from, as I mentioned, supplemental insurance for services the government won't cover)

That would involve the government keeping a constant stockpile of funds to pay for medical expenses, kind of like a safety net. Such a system isn't always viewed as being fiscally responsible, so many governments just pay immediate premiums to the insurance companies.

You could do it like you are saying, and just pay direct expenses, but there are risks associated with that as well.

The proposals I have read for single-payer don't include outsourcing it to private companies. I wouldn't certainly be opposed to doing it that way.

Why? That idea is rather silly IMHO.

You have to ask yourself what purpose the insurance companies serve? Why do they exist?

Well, yeah. That's what gets lost in all of this. Insurance is a hedge against risk. Not a viable means of financing the things we need.

 

[jon_berzerk]

there are no errors

So we agree that the numbers you provided are correct; you simply misinterpreted them. Excellent.

just like a libtard making up shit

i did not misinterpret anything

for all your twisting and dancing and jumping around

at the end of the day my original post is still correct

 

[Greenbeard]

Why? That idea is rather silly IMHO.

You have to ask yourself what purpose the insurance companies serve? Why do they exist?

The simple answer is that they exist to establish risk. An insurance companies sole purpose is to establish what your overall risk is to determine what you need to pay into the whole in order to come out even at worst. That is it. They do not exist to pay your bills - that is the consequence of the system not its primary purpose. If the government is paying those premiums then what purpose does the insurance companies serve? Nothing at all. They would make money for essentially moving money around.

You're conflating an insurance company with an actuary. Obviously insurers will employ actuaries for the function you're describing but more broadly insurers pool risk. They design and sell a financial product, the point being that they take on risk for your expenses if you have a health issue. (This is unavoidable--health spending is incredibly concentrated on a relative small segment of the population at any given time, which is why an insurance model--whether public or private--will always be needed to finance it.) And in doing so they have to do all of the administrative side of that: building and maintaining provider networks, negotiating prices, and yes actually paying the claims when you have a health issue.

If you imagine the basic template for single-payer health care being essentially Medicare-for-all, that program is still going to be administered by private insurers. That's how Medicare has always worked (today those insurers are called Medicare Administrative Contractors). They pay the claims, even as the government bears the actual financial risk and sets prices.

However, the trend of the past 20 years or so in public insurance has been away from that model. State Medicaid programs have gotten away from it and gone toward risk-bearing managed care organizations. In other words, they privatized. People in Medicaid tend to enroll in private insurance plans these days and their insurers are at risk for their expenses, not the state.

Same thing for the subset of Medicare that has been privatized (Medicare Advantage). Enrollees get to pick whether they want to enroll in traditional Medicare (which, again is still actually administered in practice by the MACs) or enroll in Medicare Advantage where they choose a private insurance plan. Enrollment in the latter has been growing pretty quickly.

So I would not expect that even if we ultimately migrate toward a "single-payer" model that it wouldn't follow the same trends that have re-shaped the single-payer programs we've had since the '60s. Namely partially privatized with less risk for the public sector and more risk for the private sector (in addition to the inevitable administrative role for the private sector).

 

[regent]

When Democrats wrote the Social Security Act, FDR insisted that it be written so that Republicans could not kill Social Security when they got into office. Of course, that did not stop Republicans from trying to change it as did Bush with his privatization plan, but now with Social Security gaining acceptance it will be even harder for Republicans to drop, or change Social Security.