The Republicans and Single Payer

The next time the Republicans try to repeal/replace Obamacare they should abandon the idea of fitting "Phase One" through the Senate's reconciliation loophole and, instead, put their whole plan in the bill. Then the House should pass it and put the onus on Senate Democrats to act in the nation's interest. The larger issue, however, is that Obamacare has created a political consensus in favor of universal coverage. That points to single payer someday, somehow, unless the Republicans are successful.





The road to single-payer health care

By Charles Krauthammer

Repeal-and-replace (for Obamacare) is not quite dead. It has been declared so, but what that means is that, for now, the president has (apparently) washed his hands of it and the House Republicans appear unable to reconcile their differences.
Neither condition need be permanent. There are ideological differences among the various GOP factions, but what’s overlooked is the role that procedure played in producing the deadlock. And procedure can easily be changed.
House leadership crafted a bill that would meet the delicate requirements of “reconciliation” in order to create a (more achievable) threshold of 51 rather than 60 votes in the Senate. But this meant that some of the more attractive, market-oriented reforms had to be left out, relegated to a future measure (a so-called phase-three bill) that might never actually arrive.
Yet the more stripped-down proposal died anyway. So why not go for the gold next time? Pass a bill that incorporates phase-three reforms and send it on to the Senate. . . .
A broad national consensus is developing that health care is indeed a right. This is historically new. And it carries immense implications for the future. It suggests that we may be heading inexorably to a government-run, single-payer system. It’s what Barack Obama once admitted he would have preferred but didn’t think the country was ready for. It may be ready now.
As Obamacare continues to unravel, it won’t take much for Democrats to abandon that Rube Goldberg wreckage and go for the simplicity and the universality of Medicare-for-all. Republicans will have one last chance to try to persuade the country to remain with a market-based system, preferably one encompassing all the provisions that, for procedural reasons, had been left out of their latest proposal.

Jack Hays said:

The next time the Republicans try to repeal/replace Obamacare they should abandon the idea of fitting "Phase One" through the Senate's reconciliation loophole and, instead, put their whole plan in the bill. Then the House should pass it and put the onus on Senate Democrats to act in the nation's interest. The larger issue, however, is that Obamacare has created a political consensus in favor of universal coverage. That points to single payer someday, somehow, unless the Republicans are successful.





The road to single-payer health care

By Charles Krauthammer

Repeal-and-replace (for Obamacare) is not quite dead. It has been declared so, but what that means is that, for now, the president has (apparently) washed his hands of it and the House Republicans appear unable to reconcile their differences.
Neither condition need be permanent. There are ideological differences among the various GOP factions, but what’s overlooked is the role that procedure played in producing the deadlock. And procedure can easily be changed.
House leadership crafted a bill that would meet the delicate requirements of “reconciliation” in order to create a (more achievable) threshold of 51 rather than 60 votes in the Senate. But this meant that some of the more attractive, market-oriented reforms had to be left out, relegated to a future measure (a so-called phase-three bill) that might never actually arrive.
Yet the more stripped-down proposal died anyway. So why not go for the gold next time? Pass a bill that incorporates phase-three reforms and send it on to the Senate. . . .
A broad national consensus is developing that health care is indeed a right. This is historically new. And it carries immense implications for the future. It suggests that we may be heading inexorably to a government-run, single-payer system. It’s what Barack Obama once admitted he would have preferred but didn’t think the country was ready for. It may be ready now.
As Obamacare continues to unravel, it won’t take much for Democrats to abandon that Rube Goldberg wreckage and go for the simplicity and the universality of Medicare-for-all. Republicans will have one last chance to try to persuade the country to remain with a market-based system, preferably one encompassing all the provisions that, for procedural reasons, had been left out of their latest proposal.

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Yeah.
I get a kick out of Schumer claiming he'd love to work with Trump on healthcare. Meaning prop up Obamacare with more money and add more elements to make it closer to Single Payer, which was the original goal anyway.
I hope Trump doesn't fall for that nonsense.

Jack Hays said:

The next time the Republicans try to repeal/replace Obamacare they should abandon the idea of fitting "Phase One" through the Senate's reconciliation loophole and, instead, put their whole plan in the bill. Then the House should pass it and put the onus on Senate Democrats to act in the nation's interest. The larger issue, however, is that Obamacare has created a political consensus in favor of universal coverage. That points to single payer someday, somehow, unless the Republicans are successful.





The road to single-payer health care

By Charles Krauthammer

Repeal-and-replace (for Obamacare) is not quite dead. It has been declared so, but what that means is that, for now, the president has (apparently) washed his hands of it and the House Republicans appear unable to reconcile their differences.
Neither condition need be permanent. There are ideological differences among the various GOP factions, but what’s overlooked is the role that procedure played in producing the deadlock. And procedure can easily be changed.

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There was no "phase 2" or "phase 3", all that talk was just politicians engaging in spin to save an unpopular bill. The Freedom Caucus wanted even more for their rich donors and less for the poor and old not yet on Medicare. The moderates were concerned about angering the seniors and the people who enjoyed Medicaid in their districts.

I see no Republican solution to healthcare. I see single-payer as an inevitable outcome, even if it takes a slow, painstaking journey to get there. There is no free market answer to the health care crisis. Sick people and the elderly are not profitable. A man with preexisting conditions gets turned down for coverage routinely, then finds a high deductible, high premium plan, that doesn't include RX, but hey, that's his problem, and the free market functioning as it should. Eventually, it will hit an inflection point, especially if the Democrats and the media can carry the message out there.

Jack Hays said:

The next time the Republicans try to repeal/replace Obamacare they should abandon the idea of fitting "Phase One" through the Senate's reconciliation loophole and, instead, put their whole plan in the bill. Then the House should pass it and put the onus on Senate Democrats to act in the nation's interest. The larger issue, however, is that Obamacare has created a political consensus in favor of universal coverage. That points to single payer someday, somehow, unless the Republicans are successful.





The road to single-payer health care

By Charles Krauthammer

Repeal-and-replace (for Obamacare) is not quite dead. It has been declared so, but what that means is that, for now, the president has (apparently) washed his hands of it and the House Republicans appear unable to reconcile their differences.
Neither condition need be permanent. There are ideological differences among the various GOP factions, but what’s overlooked is the role that procedure played in producing the deadlock. And procedure can easily be changed.
House leadership crafted a bill that would meet the delicate requirements of “reconciliation” in order to create a (more achievable) threshold of 51 rather than 60 votes in the Senate. But this meant that some of the more attractive, market-oriented reforms had to be left out, relegated to a future measure (a so-called phase-three bill) that might never actually arrive.
Yet the more stripped-down proposal died anyway. So why not go for the gold next time? Pass a bill that incorporates phase-three reforms and send it on to the Senate. . . .
A broad national consensus is developing that health care is indeed a right. This is historically .........

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There seems indeed to have been a certain shift in attitude. And it is quite true that in a simple economic model a single payer system covered by taxes with a strict and transparent cap on coverage might lead to welfare optimization, if accompanied by privately available insurance and sensible regulations governing contracts.

The most problematic point I see for a democracy like our's is coverage creep. This would unvariably lead to a slow lifting of the cap till we would again be spending far more of taxes per beneficiary than most social democracies do now. It would mean that we would not be better off and probably much worse off than today.

Why not simply have (expanded?) Medicaid as a "public option" with premiums at 10% of gross income? Messing with "private" medical care insurance via federal mandates and/or tax penalties is a bad idea no matter which party tries it. I would much prefer to have a public option than to have no private options and higher mandatory taxes to support some UHC (single payer?) system.

Jack Hays said:

As Obamacare continues to unravel, it won’t take much for Democrats to abandon that Rube Goldberg wreckage and go for the simplicity and the universality of Medicare-for-all. Republicans will have one last chance to try to persuade the country to remain with a market-based system, preferably one encompassing all the provisions that, for procedural reasons, had been left out of their latest proposal.

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What nonsense is this? "One last chance to persuade the country"? These are the people who've been actively working to sabotage and discredit a market-based approach for seven years. If we end up going to some variant of single-payer, it'll be because the GOP worked overtime to try and prove that the alternative doesn't work.

I have said this before on here and I will say it again, The Republicans need to get this through their thick heads: Any plan that is built upon our current system where old people are on Medicare, very poor people are on Medicaid, and most everyone else with insurance is covered by their employer group plan, and that insures about the same number of people that are insured now, will look just like the ACA does. The ACA looks and works the way it does because it is the only way of increasing coverage with our current system. That is it. Get used to it. So what they should do, which they won't, is fix the problems with the ACA rather than trying to repeal and replace it. Because there is nothing you can replace it with that builds on our system that won't look and work just like it. The ACA looks and works just like RomneyCare did in Massachusetts. The reason for that is that unless you throw everything out and go single payer (which is politically impossible), there is only one way of doing it.

Healthcare is different than any other sector of the economy. Every conservative party on the face of the earth has realized that other than the Republicans.

Winston said:

There was no "phase 2" or "phase 3", all that talk was just politicians engaging in spin to save an unpopular bill. The Freedom Caucus wanted even more for their rich donors and less for the poor and old not yet on Medicare. The moderates were concerned about angering the seniors and the people who enjoyed Medicaid in their districts.

I see no Republican solution to healthcare. I see single-payer as an inevitable outcome, even if it takes a slow, painstaking journey to get there. There is no free market answer to the health care crisis. Sick people and the elderly are not profitable. A man with preexisting conditions gets turned down for coverage routinely, then finds a high deductible, high premium plan, that doesn't include RX, but hey, that's his problem, and the free market functioning as it should. Eventually, it will hit an inflection point, especially if the Democrats and the media can carry the message out there.

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Please do not parade your ignorance. Phase Two and Phase Three were briefed many times. They were held back because Phase One was designed to fit through Senate reconciliation.

ttwtt78640 said:

Why not simply have (expanded?) Medicaid as a "public option" with premiums at 10% of gross income? Messing with "private" medical care insurance via federal mandates and/or tax penalties is a bad idea no matter which party tries it. I would much prefer to have a public option than to have no private options and higher mandatory taxes to support some UHC (single payer?) system.

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The problem is that Medicaid requires significant subsidies to work.

Jack Hays said:

Please do not parade your ignorance. Phase Two and Phase Three were briefed many times. They were held back because Phase One was designed to fit through Senate reconciliation.

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http://www.cnbc.com/2017/03/14/repu...s-3-phase-health-care-plan-its-just-spin.html

Senator Cotton says there is no 3 phase plan. It is a political talking point to sell a bogus health care plan to the American people. It's coverup of a bad CBO score when attacking the CBO's credibility wasn't enough.

Winston said:

http://www.cnbc.com/2017/03/14/repu...s-3-phase-health-care-plan-its-just-spin.html

Senator Cotton says there is no 3 phase plan. It is a political talking point to sell a bogus health care plan to the American people. It's coverup of a bad CBO score when attacking the CBO's credibility wasn't enough.

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Cotton was opposed to the plan from the beginning. He's not credible.

Jack Hays said:

Cotton was opposed to the plan from the beginning. He's not credible.

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From my POV Tom Price isn't credible.

Winston said:

From my POV Tom Price isn't credible.

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That's fine. Good for you.

Greenbeard said:

What nonsense is this? "One last chance to persuade the country"? These are the people who've been actively working to sabotage and discredit a market-based approach for seven years. If we end up going to some variant of single-payer, it'll be because the GOP worked overtime to try and prove that the alternative doesn't work.

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No one had to work much to discredit Obamacare; it did that all by itself.

Jack Hays said:

The problem is that Medicaid requires significant subsidies to work.

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So does any program that covers many below actual cost like PPACA. The point was that we already have a public option that many pay no premiums for in states that opted for Medicaid expansion - I merely suggested that we allow folks to join but my version of Medicaid expansion causes those that opt for it to pay 10% of their gross income as a public option premium.

ttwtt78640 said:

So does any program that covers many below actual cost like PPACA. The point was that we already have a public option that many pay no premiums for in states that opted for Medicaid expansion - I merely suggested that we allow folks to join but my version of Medicaid expansion causes those that opt for it to pay 10% of their gross income as a public option premium.

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Fair enough.

bubbabgone said:

Yeah.
I get a kick out of Schumer claiming he'd love to work with Trump on healthcare. Meaning prop up Obamacare with more money and add more elements to make it closer to Single Payer, which was the original goal anyway.
I hope Trump doesn't fall for that nonsense.

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Oh Bubba, as long as you cling to false conservative narratives, you will never be able to understand reality. If you truly believe Obamacare is a path to single payer then explain why it has mandates? Mandates are required to eliminate the "pre-existing condition" exclusion. Hence mandates make it a viable alternative to single payer. I don't see that as a "secret path to single payer". Oh and you need to explain why if Obamacare is "secret path to single payer" that republicans are the ones trying to sabotage it. Republicans sabotaged the Risk Corridor program, didn't expand Medicaid in 19 states and encouraged people to not sign up. These actions were specifically intended to cause a death spiral. and don't forget Trump's EO. He's making it easier for people to not pay the penalty.

And if there was ever a "secret path to single payer" it was Trumpcare. 24 million people losing coverage would only encourage people to wanting single payer. The majority of people get insurance from their employer and Obamacare made it the law. These are simply not the actions of a "secret path to single payer". Now do everybody a favor, skip the chat room-esque responses about me that ignore my points and go straight to the eventual "cutting and running" part.

Greenbeard said:

What nonsense is this? "One last chance to persuade the country"? These are the people who've been actively working to sabotage and discredit a market-based approach for seven years. If we end up going to some variant of single-payer, it'll be because the GOP worked overtime to try and prove that the alternative doesn't work.

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The degree to which the GOP is boxing itself into a future commitment to single-payer is absurd. See their latest "fix" this week to the zombie AHCA legislation they're still pushing.

A Republican health-care plan to lower insurance premiums would need to cut payments to hospitals and doctors to the same level as federally-set Medicare rates and would require billions of dollars in extra government spending to meet its goals, according to an independent analysis of the policy.

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David Anderson, a health policy researcher at Duke University, said that the policy looked like a price-control program.

“It is structurally single-payer for the chronically ill and expensive, with a private sector front-end sorting system,” said Anderson.

Republicans have typically opposed that sort of policy, and there were signs of immediate skepticism on Thursday. Representative Louie Gohmert, a Texas Republican and member of the conservative Freedom Caucus, said he was worried the program would just “give the federal government more power and more money.”

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