mead cohen berger shevtsova garfinkle michta grygiel blankenhorn
Single Payer Pivot
The Gray Lady Is Singing. Does That Mean It’s Over?
Features Icon
Features
show comments
  • QET

    Apparently TAI doesn’t know the facts. The facts as reported by the paper of record in our nation’s capital. WaPo sez (9/30): “Republicans predicted an Obamacare apocalypse. It hasn’t happened.”

    Case closed. Science settled. Victory declared.

  • ljgude

    A little distance can put things in perspective. I am an American living in Australia which is one of those average OECD countries in which healthcare costs about half of what it costs in the US for the same or slightly better health outcomes. From that perspective, the ACA was obviously going to fail because when enacted US healthcare cost 16% of GDP and the law itself capped expenditure to 17.5% by 2017. I guess the sky’s the limit after that. Reform of US healthcare always involved bringing the costs down to the known real cost of healthcare or about 10% of GDP. There is no way any law is going to pry the healthcare industry’s cold dead hands off the 6-8% of US GDP. That is why the Blue Model is dying fast. It is beyond reversal or reform. The Democrats haven’t recognized it is broken and the GOPe haven’t either. Trump says he wants healthcare but I doubt if he has any coherent plan and even if he decided to go after that 6-8% he would be up against an industry protected by having both parties in Congress bought and paid for. Bitter Pill, Steven Brill’s 2013 Article in Time, pointed out that the healthcare industry spends more on lobbying that the defence industry. Ike was wrong. It is is medical industrial complex that has the US by the short and curlies.

  • Anthony

    Not just the politics, WRM, which themselves are formidable but the “interests”, which are embedded and intense (not to mention profit inclined) help to insure the dysfunction you lament.

    Health care (Delivery, Provision, et al), as most recently revealed by ACA, provides a “bundle of money” to a vast infrastructure. The Post bemoans a system that at minimum comprises 18% of our GDP – there is no incentive to give it up (beyond editorial boards and upscale policy web-sites perhaps).

    Though I’m in agreement with thrust of Post, expecting our current (including ACA aspect appended to since its passage) massive, very well financed, high revenue, high margin, high growth, and high costs health care infrastructure to change stasis (aiding paralysis/double downing perhaps) via offerings of information revolution may be misreading the landscape. Though ACA is definitely part of the problem (it has added to the problem), our problem is bigger and avoided like so much more in Present Day America.

    And yes, it is a terrible shame but more importantly health care restructuring of which you infer (in a democracy) requires both extensive public support and public intensity to get something done in a country of approximately 320 million people; that consensus, public intensity, and organizational dynamic, WRM, must push back the thicket of political paralysis, embedded interests, and stasis which sustains a very remunerative sector. The Grey Lady may be singing but its far from over.

  • Arkeygeezer

    Hopefully we wil go back to the system that we had before Obamacare. Expanding Medicaid benefits to more and more families through state supported systems such as TennCare. This seemed to be efficient and a public supported way to expand healthcare benefits.

    • Andrew Allison

      The problem with your proposal is that Medicaid is not insurance but taxpayer-funded welfare. What’s needed, in simplistic terms, is Medicare for all who can afford the premium, and Medicaid for the rest.

    • bff426

      Good luck finding doctors worth going to that will take new Medicaid patients.

  • DiogenesDespairs

    The architects of Obamacare designed it to fail – so there would be a health-care crisis and the government could step in and “rescue” us from the crisis it caused with government- control of health-care spending. Now we’re getting to crush time. Not to be too simplistic or anything, but it seems way past time to throw the buggers out.

    • Stephen

      It is an easy sop to think it was designed to fail, but it is far more likely that the architects and the supporting politicians sincerely believed that it would succeed: They drank their own Kool Aid.

      The text of the PPACA is really an outline, but more importantly an enabling act for the Obama administration, and hoped for Democrat run administrations into the future, to enact a redistributive and centrally controlled system that would address the problem of access. Cost was a selling point but less of a priority. When Nancy Pelosi quipped that you would have to pass the law to see what was in it, she spoke the truth.

      • LarryD

        It was always intended as a stepping stone to “single payer”. Shall we dig up the reports of Obama’s advisors crowing about how they put one over on the American public.

        Anyone who votes for a bill whose contents they don’t know, or understand, shouldn’t be trusted with any public office. Including dog catcher. Excuse me, “animal control officer”.

        • Andrew Allison

          I don’t think that this widely held belief is correct. I think it’s pretty clear that the legislation was written by the insurance-provider complex and (as Pelosi so eloquently demonstrated) the legislators who voted for it (all Democrats) didn’t have a clue what the results would be.

          • LarryD

            Do you consider Snopes in any way reliable?
            http://www.snopes.com/politics/medical/gruber.asp
            ‘TRUE: Jonathan Gruber said Obamacare only passed due to the “stupidity” of the American voter and a lack of “transparency.’

            They have the video. Feel free to watch.

            “This bill was written in a tortured way to make sure [the Congressional Budget Office] did not score the mandate as taxes. If CBO scored the mandate as taxes, the bill dies. OK? So it’s written to do that. In terms of risk-rated subsidies, if you had a law which said healthy people are going to pay in — you made explicit that healthy people pay in and sick people get money — it would not have passed. OK? Lack of transparency is a huge political
            advantage. And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical to get the thing to pass. Look, I wish … we could make it all transparent, but I’d rather have this law than not.”

          • Andrew Allison

            What, pray tell does Gruber’s comment have to do with the intent of the legislation? It was clearly written to benefit private insurance companies and hospitals, both of which would suffer terribly if single-payer insurance were to come about.

          • Proud Skeptic

            Another good point but I must differ with you on the idea that it was written specifically to benefit the insurance companies. The insurance companies are a powerful lobby. If I recall correctly, they were the ones who killed HillaryCare. The politicians needed to make sure that didn’t happen again so they were careful to appease them.

            If the Democrats had had their druthers, the bill would have killed off the insurance companies. But legislation doesn’t work that way…especially big legislation like ACA.

            No…the Democrats did what they had to do to get it passed. In doing so, it added things like risk corridors that sounded good but didn’t work as planned.

            The underlying flaw in ObamaCare is the same underlying flaw in most legislation that tries to manipulate a market…unpredictability of top down regulations. Markets are powerful forces that are constantly underestimated by politicians.

          • Andrew Allison

            Yes, the insurance companies are a powerful lobby, and the key tenet of the ACA is that everybody must purchase insurance or pay a penalty. I rest my case.

      • Andrew Allison

        As you point out, the supporting politicians were told that they’d have to pass it to see what was in it.I, for one, would like nothing better than to see them forced to drink their own Kool Aid, but of course, they exempted themselves from doing so.

      • Proud Skeptic

        I suspect you are right…though I’m not sure Pelosi’s comment was a quip. She was dead serious and accidentally exposed the inner workings of her mind.

  • LeePefley

    The New York Times! An anti-white racist syndicate that devotes ten issues to the killing of a black person by a white policeman while saying next to nothing about the killing in one city alone of 500-600 black persons at the hands of other black persons. I’ve long suspected that if you scratch the surface of an Ashkenazim you’ll see all sorts of anti-white loathing, disguises to the contrary not alway sufficing.
    tito perdue
    Alt Right author

  • LeePefley

    I’ve never understood the notion that all Americans deserve healthcare at collective expense. I don’t care a fig for 85% of the American demographic, and would never wish to interfere with their declining health.

    • Andrew Allison

      All the OECD countries except the USA have decided that all their legal residents deserve a minimal level of health care, and pay for it via mandatory single-payer insurance (this may, just possibly, be a result of recognition that that overall cost of not doing so outweighs the cost). They also, let it quickly be said, provide for private insurance for those who want something better, and don’t necessarily offer socialized medicine. The USA has decided otherwise. The existential question is whether we should. If the answer is yes, Medicare for all is the only viable solution: if not, we can continue the present “system”.

      • LeePefley

        Medicare for all is not economically feasible. Medicare for the old will not be feasible for much longer.

        • Andrew Allison

          Nonsense.

          • LeePefley

            Then I must apologize.

    • rpabate

      I agree. If you are too bloody stupid and undisciplined to lead a healthy lifestyle, you don’t deserve other people’s hard earned income to take care of you when you get sick. I am all in on health insurance that covers genetic conditions, contagious diseases, and accidents, but we know enough today about the causes of degenerative conditions to deny coverage when people are the cause of their own illness.

    • FriendlyGoat

      Are you making a sort of Randian case that 15% might be good people, or worthy, or valuable and 85% are not? Or are you suggesting that 15% have significant assets to spend on their own care and 85% do not? This matters, because if it’s the former, you need a way to sort out who to care for in a manner that is not defined merely by the latter in the marketplace.

      • LeePefley

        “…15% might be good people, or worthy, or valuable and 85% are not…”

        15% might be the sort I’m willing to assist. Most people have little value, and some have negative value only.
        http://www.titoperdue.com

        • FriendlyGoat

          Did author, Tito Perdue, leave you in this condition, or did you become hardened against humanity all by yourself?

          • LeePefley

            I am Tito Perdue, and harder than you know.

          • FriendlyGoat

            And so what? Your message, as expressed here, is so objectionable that the more you publicize it, the more likely you are to sway the country in the exact opposite direction of your sentiments.

          • LeePefley

            You believe this is a country I wish to sway?

          • FriendlyGoat

            I believe you’re in a comment section saying very anti-social things which should be condemned for their evil. I have no idea who or what you want to sway, but the tone HERE stinks.

  • Andrew Allison

    TAI continues to conflate health insurance with health care. There’s already a perfectly good model for providing low-cost health INSURANCE for all; it’s called Medicare. In order to preempt all the usual irrelevant replies, let me emphasize that single-payer insurance DOES NOT imply single-provider health care. In simple terms, insurance underwriting does not involve the individual but ALL the insured. The reason that the Obaminable Care Act is doomed is that the risk pool is heavily skewed toward the sick. The only solution is to throw everybody into the pool. The same, incidentally, is true of Medicare which is suffering the same problem as Social Security, namely that people are enjoying the benefits for longer than the funding can support. The solution for Social Security is to increase the retirement age.

    • M Snow

      I wonder how old you are? I ask because most of my friends as well as myself are currently over 65. Some of us worked in jobs that were more strenuous than others, but all of us are beginning to develop the illnesses of our age group that would make work somewhat problematic. Just how high would you like to raise the retirement age? On the issue at hand, I would support single payer insurance as long as it wasn’t single provider as you suggest.

      • Andrew Allison

        I’m 77 and, despite being (as you might guess from my profile) quite healthy I’m deeply appreciative of Medicare. I’m also grateful to have at least one other participant in this blog who gets that the issue is insurance, not care.
        Social Security is a completely different topic, which I should probably not have brought up. That said, in answer to your question it seems pretty clear that in order for Social Security to remain viable, retirement age must track (not necessarily linearly) longevity. Such a change would, of course, need to be phased in gradually, just as the current increase from 65 was.

        • M Snow

          Congrats on being in good health at 77. I was a junior high math teacher (among other things) and I can honestly say I could not do that job with the same energy now that I brought to it during my late fifties or early sixties. I agree with a gradual phase in but I can’t see going beyond 66. And yes, the inability to separate “care” and “insurance” drives me nuts too.

          • Andrew Allison

            Let’s start a movement to call out any post or comment which conflates them.

          • M Snow

            OK, I’m on board.

  • Jacksonian_Libertarian

    Socialism can NEVER WORK, for the simple reason that it’s by definition a Monopoly. The Government Monopoly like all Monopolies, suffers from the same disease, the lack of the “Feedback of Competition”. It’s the “Feedback of Competition” that provides both the Information and Motivation which forces continuous improvements in Quality, Service, and Price in free markets.

    As one of Obamacare’s critics, I can say that I saw the failure of Obamacare long before it ever became law, it was obvious to anyone not a stupid leftist.

  • bobro

    The Dems know that Obamacare is in a fatal spiral. Their plan now is to lie and obfuscate enough to get by the election so that they can implement the even more disastrous single payer.They don’t give a rat’s behind about the law or the people that it kills. They only want to maintain their corrupt hold on power.

  • LeePefley

    Imagine we’d had no federal government at all since 1950. The country would be infinitely richer, we could have colonized the galaxy by now, and the catastrophe of racial integration would have been strangled in the crib.

    • M Snow

      No, no, and no.

© The American Interest LLC 2005-2016 About Us Masthead Submissions Advertise Customer Service