- Joined
- Aug 10, 2013
- Messages
- 20,231
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- Location
- Cambridge, MA
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- Political Leaning
- Slightly Liberal
I'm sure it would have done what it needed in order to remain competitive. The bottom line is that the public option would have almost certainly been a competitive or better alternative to most or all private providers,.
Have you learned nothing from the co-ops? Cut off access to the guaranteed start-up capital and defund the risk corridors assumed in premium-setting and you will more likely than not kill the payer if it has no other lines of business to fall back on. The public option would've been subject to the same political sabotage that its successors, the co-ops, faced. If you have any affection for the concept (and I do), you are lucky it was not around for the past few years.
Don't you dare try and equivocate your ethically bankrupt position to mine; our stances could not be more different and we are not on the same team whatsoever.
It probably makes you sad to hear it (you might have to share some of your smug!) but our stances are not very different. You apparently also want payment methodologies that support new business models for care delivery, even while bizarrely dismissing the concept as hopeless. You say you want universal coverage; so do I. You claim to be worried about quality; so am I.
The real difference between you and me is that I don't believe policy should made out of anger, frustration, wishful thinking, envy, self-righteousness, malice, vanity, ignorance, or cult-like devotion to any man. I think it should made out of rational analysis, careful study, and a clear-eyed accounting of the likely outcomes. I'm not looking for a ticker tape parade in my honor like some, I just want to design and implement good policy that works here and now and into the future.
This is why the hand-waving and magical thinking you use to fill in the gaps annoys me. Rhetorical BS is not policy. But this is a discussion board and if your rhetorical flights of fancy let you feel morally superior so be it.
If tackling perverse incentives and realizing these goals has been the project of you and yours over the past couple of decades, you have been miserable, abject failures.
I didn't say "decades," I said the better part of the past decade. Since the ACA passed seven years ago.
And yes a lot of meaningful progress has made during that period, on coverage and access, on clinical quality, on sustainability and delivery system reform.
Perhaps its news to you, but in states all across the country millions of man-hours have been poured into improving our health system by people of good will who I guarantee care a lot more about improving our health system than the keyboard zealots who sneer at them. If only they'd known to use the magic button, they could've avoided all that hard work! In reality, if single-payer ever happens it will be built on the infrastructure they constructed.
I used to wonder why folks like you are so contemptuous of your allies. But then I realized they're not really your allies. They're engaged in the project that for you is more of a rhetorical device. Their efforts are outward; yours are inward, stoking those raging fires of smug self-righteousness. You bolster those holier-than-thou purist bona fides by opining from your soapbox about "concrete actions" to make the system and people's lives and care better, they're actually engaged in them without fanfare. They have to tackle the realities and challenges that you can just hand-wave away. No wonder you despise them so!
Personally I can't help but feel you have some personal investment in/exposure to the current health system to be such an ardent defender of the indefensible.
Pointing out the challenges casual single-payer supporters refuse to acknowledge, much less grapple with, is not "defending the indefensible." Wariness of the magical thinking of the SP crowd is not an argument for the status quo.
Because people like Bernie exist, and he's created a vital movement of people with integrity who refuse to be bought in defiance of all the odds and pressure to do otherwise, while so many have become emboldened to champion and advocate truly progressive ideas in mainstream discourse. For the first time in well over a decade, barring a very brief and disappointing anomaly in Obama's case (the outcome of which was unfortunately unsurprising) back in 2008, I feel there's actually hope, however difficult to realize or remote, and it's largely thanks to him.
So let me get this straight. Our politics are corrupt, the interests control all, and most everyone is bought and sold. But turning decision-making for our health sector over to that cabal is going to work out great because BERNIE.
Wonderful.