Posted by: jgw

Healthcare - 02/05/19 06:07 PM

The current talk about healthcare seems more a wish list than a genuine discussion of facts and costs. I believe, for instance, that medicare for all is a really terrible idea. I also believe that our system, healthcare for profit, is not only poor healthcare but incredibly expensive. Its really time that we take some hard looks at the single payer systems around the world. There is no question about their costs -they are, on average, half of what we spend! If you ask a Canadian, for instance, if they would prefer to have the American system, they just laugh and move on. The same holds for all others I have talked to. The difference is waaaay different than all the systems on political healthcare. Not once, for instance, have I heard anybody take our healthcare for profit to task. Instead costs seem to not even be a subject. When somebody suggested the end of health insurance companies our clever politicians immediately came up with a number of solutions to save the insurance companies. Its also rare to hear the simple fact that the United States is the ONLY nation in witch expected life expectency is going down. This is also one of the most dangerous to have children (and not dying).

The facts are pretty plain. To make a single payer system costs must be contained. This is done in a number of ways. Drug companies can exist but they are rigorously controlled as to profit and pricing. The same is true of every other facet of healthcare. Those against will go nuts and threaten everybody that if such happens everybody will simply die. The rebuttal, of course, is to refer to the existing, cost effective, single payer system. The simple fact is that they seem to not only providing healthcare for all but also doing it for half of what we are currently paying. That would mean that we would actually save something over a trillion dollars a year. What may be even more important is that those single payer systems are consistently providing better healthcare than our own for-profit system which seems more interested in profits than anything else.

These are, incidentally, known facts and easily researched. I could offer any number of studies and sites but, I betcha, you get the picture. Political healthcare is is an exercise in wishful thinking, its really time this thing gets examined with facts, science, and reality instead of all the obvious concern with our current healthcare for profit which is beginning to kill us!
Posted by: chunkstyle

Re: Healthcare - 02/05/19 07:25 PM

Originally Posted By: jgw
I believe, for instance, that medicare for all is a really terrible idea.

Posted by: Greger

Re: Healthcare - 02/05/19 09:09 PM

Yeah, why? We've basically got everything in place to crank up a national healthcare system by tweaking what's already in place.
Posted by: pondering_it_all

Re: Healthcare - 02/05/19 09:13 PM

We obviously desperately need some drug price reforms. The real problem is the patent system. Patents are supposed to make new inventions available for everyone, with reasonable royalties for companies making generics. But our current system is just a legal extortion racket. Drug companies with exclusivity can charge ANYTHING they want and insurance companies and Medicare are required to pay it. I just read about a drug for cystic fibrosis that has a price tag of $350,000 a year! I take a drug for MS that costs them about $100 a year to make and they charge $75,000 a year! And all the other drug companies who make an MS drug charge about the same. Talk about price fixing! How's this for an example: Levitra $30 a pill. Generic levitra from Canada $0.23 a pill.

Insurance companies and the VA can negotiate a slightly lower cost, but Medicare is prohibited from negotiating by law. That is pure legal extortion and draining Medicare. Medicare-for-all retaining this non-negotiation requirement would be a windfall for drug companies who could send drug prices soaring.

There is a lot of confusion over these plans. The biggest point is do we charge everybody zero, and pay for it all in taxes. (Good luck with that.) Or do we let people over 65 get it for the $120 per month we now charge for Medicare Part B, and let younger people buy into it every year for 20% less than their ACA policy would cost.
Posted by: chunkstyle

Re: Healthcare - 02/06/19 12:24 AM

Healthcare or Healthco.
This issue should reveal the ideological fault lines within the democratic party.
Ideology matters. No more than with this issue. Most democrats will side with the insurance corporations. A handful will side with their constituents and make the arguments.
The Neoliberal market world Dems are on record with the Insurance Co.'s
Market World Pelosi backs the industry
Posted by: rporter314

Re: Healthcare - 02/06/19 01:34 AM

The free market does not care about consumer cost. It is a money making machine and if it can get away with overcharging, well ... then ... it makes more money.

My contractual agreement with the federal government is that it will provide for the general welfare. Now, whatever "general welfare" means, the federal government has an obligation based on my contract to make provisions. Healthcare for all citizens sounds like precisely what the Founders may have meant by general welfare.

Federal government ... do your job!!!!!
Posted by: Greger

Re: Healthcare - 02/06/19 03:38 AM

Hopefully there are qualified people somewhere being paid to formulate an orderly transition from healthco to healthcare....?
Posted by: chunkstyle

Re: Healthcare - 02/06/19 03:57 AM

Hope in one hand......
There is a case being made on the left that ties it together with the economy and Green New Deal and is getting scored for cost and savings.
My guess will be to kill the messenger by the 'market oriented' democrats and scare the public over costs and raised taxes. Doing the soft sell of the industry.
Access and affordability ahead! Enhanced tax deferred health savings accounts off the starboard... And more means testing. Lordy how they like them some means testing.

Well see what the democratic political concensus cooks up keep their donors happy while tamping down expectations. It's what they're paid for.
Posted by: pondering_it_all

Re: Healthcare - 02/06/19 08:52 AM

They can go radical with it and make it all tax paid, if they get enough Democrats elected in 2020. But the problem with aggressive partisan legislation is that it tends to get killed when the opponents get back in power. You want something to last? Get enough bipartisan support for it so when the pendulum swings, there are still people on both side of the aisle that supported it. Then it's tough to kill.

That's exactly what the Democrats were trying for with ACA. They kept adding things and subtracting things to get some Republican buy-in. They also needed Blue Dog Democrat's votes to get it passed, so it was nobody's idea of ideal. The idea was just to get something passed, and then to enhance it later. Of course, later never came. Just continued Republican attempts to kill or cripple it because there was no buy in.

So I think an approach that has staying power is to gradually lower the age at which people can buy in to Medicare. That slowly boils the insurance companies' frog, so they don't have a sudden shock. They are already in the Medicare Advantage business and make money processing Medicare claims. This would just gradually shift their business toward the Medicare side.
Posted by: NW Ponderer

Re: Healthcare - 02/06/19 02:10 PM

There are a number of Medicare-for-all plans out there. I think the 2020 race is going to be the public debate over them. The two that I think make the most sense are the "public option" ones and the "Medicare at 55" plans, because they do a good job of boiling the frog. But we shouldn't mistake Medicare for a universal healthcare plan, any more than the ACA. The ACA has gotten a bad rap because it is actually too close to Medicare, in reality.

Medicare really isn't "single-payer," since there are many costs to the recipient: premiums, co-payments, cost-shares, deductibles. (I just paid $346 yesterday for one medication for my wife.) Medicare costs for 2019 and, according to Kaiser family health, 34 percent of enrollees are in a "Medicare advantage" plan: Medicare vs. Medicare Advantage. There are also Medicare supplement, or "Medigap", insurance plans. So, private insurance is a big part of "Medicare" as it exists in the real world, and Medicare is far from "free health care". It is subsidized healthcare. Medicaid-for-all is closer to what many advocates want, but that doesn't have the same good reputation.
Posted by: Jeffery J. Haas

Re: Healthcare - 02/06/19 04:33 PM

Originally Posted By: NW Ponderer
There are a number of Medicare-for-all plans out there. I think the 2020 race is going to be the public debate over them. The two that I think make the most sense are the "public option" ones and the "Medicare at 55" plans, because they do a good job of boiling the frog. But we shouldn't mistake Medicare for a universal healthcare plan, any more than the ACA. The ACA has gotten a bad rap because it is actually too close to Medicare, in reality.

Medicare really isn't "single-payer," since there are many costs to the recipient: premiums, co-payments, cost-shares, deductibles. (I just paid $346 yesterday for one medication for my wife.) Medicare costs for 2019 and, according to Kaiser family health, 34 percent of enrollees are in a "Medicare advantage" plan: Medicare vs. Medicare Advantage. There are also Medicare supplement, or "Medigap", insurance plans. So, private insurance is a big part of "Medicare" as it exists in the real world, and Medicare is far from "free health care". It is subsidized healthcare. Medicaid-for-all is closer to what many advocates want, but that doesn't have the same good reputation.

Imagine how much you could save if Medicare was allowed to negotiate prescription drug prices.
Look, I've priced medigap plans because I know they're in my future, a lot of people have. On the whole, it boils down to a much more affordable arrangement than what I would have if I had to be in the marketplace right now. I know what my older brother paid prior to his 65th birthday, which was in 2016.
Posted by: jgw

Re: Healthcare - 02/06/19 07:25 PM

Because its a cop out. Medicare for all would bankrupt the country in no time. Drugs can't be negotiated, everybody couldn't afford the co-pays,etc.

A VA for all would make more sense as they actually have already cut the costs of healthcare by something between 25% and 50% (the figures move depending on who is offering them and has much to do with the ongoing, and kind of disasterous, efforts to privatize).

I should probably also add that a lot of the VA problems stemmed from the inability of managers to fire (congress did that one I think). Anyway, that is fixed. They also had lousy oversite which, I think, has got better. The simple fact is that single payer is the really fair way to do this. Gov CAN run stuff well, if they get the oversite they also need (not unlike most agencies and congress is the oversite, when it works)
Posted by: jgw

Re: Healthcare - 02/06/19 07:40 PM

Continuing with any part of a for profit healthcare system is just nuts. Its not working now and its not going to work in the future as good old fashioned American greed just gets in the way. Same with Medicare which has a pretty bad history of controlling things. The nation needs a better deal. Our for profit healthcare system is also waaaay too expensive! All this talk of socialism is just wrong. The Dems did that one all on their own and some of the newly elected don't even understand what real socialism is (gov own ALL production sources).

All we will hear, from the Right, is "Socialism". The left has to change its vocabulary instead of waving red flags. "for profit healthcare is BAD" (and too expensive, and failing, and needs serious oversite) might help. "Socially responsible gov actions" followed by others that are in place and work, ie. police, firemen, public schools, libraries, food stamps, etc. Some work better than others or could work better but that is an ongoing thing with them all! The trick, of course, is to set it up, make the rules, watch it like a hawk, and seriously resist any rules and/or regulations that are political. I firmly believe that we, and gov, can do better.

When we see the rest of the developed world providing better healthcare at, at least, half of our cost the it just makes sense to study what they are doing, cherry pick and build one of our own. This is not socialism, its just a social responsibility that we all need to understand.

I feel the same way about the war on drugs - The nation of Portugal solved that one almost 20 years ago!!!
Posted by: NW Ponderer

Re: Healthcare - 02/06/19 07:50 PM

I do imagine that. I do that a lot.

On a separate, but important, line, I have been following an exchange/debate that arose from a congressional hearing:

AOC on Pharma & Public Funding
Posted by Lisa Ouellette
Congresswoman Alexandria Ocasio-Cortez has already gotten Americans to start teaching each other about marginal taxation, and now she has started a dialog about the role of public funding in public sector research:
here's how it started:

This week I conducted my first-ever line of questioning at an Oversight committee hearing, which focused on the skyrocketing costs of pharmaceuticals.

Here’s what happened
AOC Twitter post

And here's where it went:

how it really works;

Ocasio-Cortez fires back;

Written Description (blog).

If you have the time, this is an important discussion to deal with.
Posted by: pondering_it_all

Re: Healthcare - 02/07/19 10:26 AM

That's how it works on state-of-art cancer drugs sometimes. The drug companies have to try lots of things to get a good one. But think about Tecfidera instead:

Dimethyl Fumerate had been used for psoriasis treatment for decades and was generic. A drug company thought "Why don't we see if it works for other autoimmune diseases?" They didn't have to try lots of variations, because they could just buy it right off pharmacy shelves. It's toxicity was known already. They could just run some trials where they gave it to patients with Rheumatoid Arthritus, Sjogren's Syndrome, Multiple Sclerosis, and so on. Did they pay those patients a lot of money? Probably not. In fact, I bet they paid them nothing. Also, I assume they made their own Dimethyl Fumerate since it is easy and costs about $5.00 to make one patient's for one year. So then they just sat back and collected data. After a few years, they looked at the data, and low and behold it seemed to work pretty well for MS.

So then they expanded their trial and gave it to a lot more MS patients. A few more years and it proved to work pretty well and just a couple of people died of a brain virus. (It is an immune system suppressant.) Then they got FDA approval for prescribing for MS and voila: A drug that they can charge $65,000.00 a year for. It works as well as the other MS drugs and unlike most of them it's just a cheap twice a day capsule. So they make millions of dollars (billions?) because the insurance companies have to pay something near the full price and Medicare has to pay full price. They get exclusivity for some number of years, and even better for some reason they get to sell it to all the psoriasis patients at full price, even though they were getting it dirt cheap for decades before!

There are lots of drugs that are NOT brand new magic cancer bullets. Like EpiPens: Two dollars worth of epinephrine in an autoinjector. Let's jack up the price to $300! We'll make some real dough, even though it costs us nothing in new development costs. And even though syringes suitable for epinephrine injection cost about 35 cents.

BTW, I actually worked in medical research at a major university medical center for 11 years. Those "huge costs" to do the work? I never made more than $35K per year. I see people with my last job level are now making about $47K per year.
Posted by: chunkstyle

Re: Healthcare - 02/07/19 12:08 PM

Originally Posted By: jgw
some of the newly elected don't even understand what real socialism is (gov own ALL production sources).

You keep equating state capitalism with socialism. A common mistake.
Posted by: chunkstyle

Re: Healthcare - 02/07/19 12:11 PM

Originally Posted By: jgw
Because its a cop out. Medicare for all would bankrupt the country in no time. Drugs can't be negotiated, everybody couldn't afford the co-pays,etc.

So allow Medicare to negotiate drug prices
Posted by: chunkstyle

Re: Healthcare - 02/07/19 12:15 PM

Anyone notice that healthcare debate has focused on drug pricing, much like Pelosi wants it.......
That's odd
Posted by: rporter314

Re: Healthcare - 02/07/19 03:18 PM

it is only one aspect of the cost driven industry. Here area couple of stats ... drugs account for 18% of HC costs and more specifically account for 12% in cancer treatments. The reader can find their own stats, as I use these as a relative indicator. Like wise one can find stats on other cost drivers like hospitals, doctors, and possibly one overlooked variable, over-utilization. Questions of newer high tech treatments versus traditional outcomes, is the cost worth it? or to look at it another way, don't compare costs if you want the enhanced outcomes despite the higher costs.

This is far more complicated than simply thinking we should have affordable HC.
Posted by: NW Ponderer

Re: Healthcare - 02/07/19 04:25 PM

I do think the considerations need to be holistic. Whenever there are major changes to a "system" there are lots of unintended consequences, or "second- and third-order effects" as we would call them in military planning. For example: More people going to doctors means demands for doctors goes up, they're busier so demand more pay, wait times get longer, med schools have to recruit more, etc., etc., and down the chain. The job of legislators is to consider as many of these possibilities as possible, and adjust to real world conditions.

When the ACA was set up, many of these effects were anticipated. Others were not. But, over all, they did pretty well. Ideology got in the way, though, and A LOT of disingenuous arguments were made, countereffective strategies were enlisted, and adjustments were thwarted. The result was a godawful mess.

We can anticipate a similar pattern for any future plans, especially in this ideology-driven, fact-phobic environment. The question put to Kamala Harris about private health insurance is a good example. It wasn't just putting the cart before the horse, it was jumping the shark. There isn't even a concept on the table, yet!

That's why I prefer the "public option" approach. We can expand the availability of a known process (e.g., Medicare) to a discrete population and observe the result. Based on observations, we can expand the population affected (e.g., 55-64 year olds). By these steps, we can make adjustments as needed, with the clear goal of eventual universal coverage, sooner than later.
Posted by: jgw

Re: Healthcare - 02/07/19 06:56 PM

Negotiating for drug prices should have been done long ago. If nothing else it tells us all where congress stands and it sure as hell is not standing with the nation.

The nations that have single payer understands. For profit healthcare is simply not in the interest of citizens. So, those single payer nations firmly regulate ANYTHING to do with healthcare. Drug companies are allows a small profit, for instance. Manufacturers of medical devices are also controlled (Obama made a run at that but Jackass dropped it).

My view is that when other nations have solved their healthcare and its working for them (France, for instance, is considered the gold standard when it comes to healthcare). Remember, whilst we are told we have the finest healthcare in the world our life expectancy continues to fall and childbirth deaths continue to climb. Basically we are now considered to be on the low end of heathcare for developed countries.

Its really kinda insane. Everybody agrees that if we continue down the current path we will be bankrupt because of our for profit healthcare system. This is a simple fact. We spend two times what other nations for less services. If nothing else one would think the financial savings alone would mandate a single payer system. I know, its socialism (plain baloney)
Posted by: pondering_it_all

Re: Healthcare - 02/08/19 03:25 AM

There are certainly many other health care ripoffs going on. I just detailed drug pricing because I know it pretty well and I see some outrageous loopholes that drug companies use to drain money out of Medicare, Medicaid, and insurance companies. A big part of our expensive health care is precisely this.
Posted by: rporter314

Re: Healthcare - 02/08/19 05:51 AM

I think it is inappropriate to use the phrase "we have the best HC" unless everyone has access to said best HC.
Posted by: pondering_it_all

Re: Healthcare - 02/08/19 08:33 AM

unless everyone has access to said best HC.

I think you are proposing an impossibility, like saying everybody is above average. There is luxury healthcare, like private rooms in the hospital, suites so your caregiver can stay with you, gourmet meals, private nurses, etc. All things that don't necessarily contribute to the quality of healthcare delivered.

Then there is something called "standard of care" meaning the patient gets everything they need for the best outcome, but maybe not everything they want when they want it. I think in this case "better" is the enemy of "good enough". Everyone needs access to "good enough" health care.
Posted by: chunkstyle

Re: Healthcare - 02/08/19 03:04 PM

Access, Affordability Ho!
Posted by: NW Ponderer

Re: Healthcare - 02/08/19 04:03 PM

Originally Posted By: pondering_it_all
Everyone needs access to "good enough" health care.
That is the perfect encapsulation. Some are shooting for the gold standard (and we should get there eventually) but I don't think that should be the initial goal. The ACA set a baseline for coverage. Medicare does. Medicaid does. Then the questions become: how do we enforce it?; How do we pay for it?

Eventually, for-profit companies need to be eliminated from the primary market, but they can still have a role in secondary markets, the way Medicare Advantage and Medigap plans do. Social Security provides a baseline of support in retirement, but it's subsistence-level. Most people need to supplement their retirement for a decent standard of living, but survival on SSA alone is possible. Similarly, Medicare provides a baseline of coverage for all enrollees, but over a third of them supplement that coverage with other plans. A significant difference between Medicare and the ACA, though, is coverage. Medicare doesn't need to cover things like pregnancy and birth control, for example, so it doesn't. Coverage is an issue that would HAVE to be addressed.

Another significant issue to resolve is taxation and cost sharing. One of the reasons American healthcare is so expensive is because the users pick up so much of the costs. But that is true in Medicare, too. Each doctor visit is $20-40, each prescription might be $20 to 20, 30, 50%. I recently paid over $300 for a single prescription, and that was only 20% of the "cost". Last year the same prescription was $72. A negotiated price would have brought that back to earth.

An ancillary, but directly related, issue is profit. Most universal healthcare systems do not contend with this directly, they just set compensating rates. Others do directly limit "administrative costs" including profit margins. Medications and medical supplies may be the first area to get scrutiny in the "marketplace", but eventually excessive executive compensation will have to be. Then it might get scrutiny in other markets beyond medical and insurance.
Posted by: rporter314

Re: Healthcare - 02/08/19 04:14 PM

I think we are saying the same thing only using different words.

luxury healthcare

Yes we have this, which is not available to ordinary folk with the bare minimum of resources. I should note that in one source commented a stat worth mentioning. Hospital costs are high here. One cause is over-ultilization to which you mention ie most countries have average of 6 day stays and here we have 10 day stays.

standard of care
Yes and you mention "good enough". Again it should be clear the results from other countries compares most favorably with the results here. So we should conclude there probably exists an equation which finds the "proper" equilibrium between adequate care and luxury care. The point being, high end care is available although not necessary.

ACA attempted to address this as a way to reduce costs i.e. cost effective care with the option to access high end care.
Posted by: pondering_it_all

Re: Healthcare - 02/09/19 07:22 AM

ACA has one weird twist this year: Insurance companies have to base their costs on the second cheapest silver plan in the area. So they have jacked up the cost of silver plans, so in some cases the gold plan (IE. lower deductibles, etc) is cheaper than the silver, once you take into account the benefits.

Last year we filled in the ACA qualification form for my wife and checked the wrong box by accident. It took months to get free of Medicaid even though we have WAY too much in assets to qualify. The ACA website had no way to fix it. It took dozens of phone calls and ACA kept cancelling my wive's policy every other month even though they cashed the checks. Thank God she turns 65 in September. You could die from the aggravation of dealing with ACA.
Posted by: jgw

Re: Healthcare - 02/09/19 11:36 PM

How about a little test of where the congress is. They have made 2 decisions, in the past and they are both i n the books right now - neither side has even suggested changing, or getting rid of them. The first is now allowing medicare to even discuss drug prices with the drug companies. The second is that they have made it illegal for an American citizen to buy their drugs in Canada (either by mail or going up there). My own feelings about these two is that they boldly define who congress is working and they obviously would have taken care of these two if the institution of the congress they actually gave a damn.

So, when the congress gets rid of these two, without legislating any new, and even more offensive laws, I will have more kindly thoughts about the congress. Both of these, incidentally, have survived under both sides.

Even if they do take care of these there are lots more where citizens lose. One of the more egregious are the ongoing efforts to destroy the institutions of the post office and the va. Nobody seems to give a damn about those either.

Just saying..........
Posted by: chunkstyle

Re: Healthcare - 02/10/19 06:01 PM

Couldn't agree more JGW.

This will hopefully be a crack in the centrist's armor going into the 2020 election and I hope the tip gets buried deep.
A very good analysis of the growing schism within the democratic party between the corporatists and the progressives and lef...

"While a spokesperson for Pelosi has (rather unconvincingly) insisted it was merely intended to be “a broad look at the healthcare environment and some of House Democrats’ legislative priorities over the next two years in a period of GOP control,” the presentation is a remarkable illustration of the contradictions inherent in the political practices of the so-called “Third Way”: institutionalized secrecy; excessive deference to markets and corporate (sorry, “stakeholder”) interests; crippling ideological conservatism; intellectual default to the logic of austerity; a pathological aversion to conflict with powerful private actors; right down to the sheer, naked, hypocrisy of assuming one posture in public then signaling quietly to these same actors that it’s essentially for show — in both form and content, it’s pretty much all here."

Full article
Posted by: jgw

Re: Healthcare - 02/10/19 09:35 PM

I should add one more to my thought - the so-called tax cut. I have noticed that NOBODY is bothering to mention the tax cut is, right now, taking 100 million a year out of medicare and slight less out of medicaid. `One would think this might be important but, as far as I can tell, the Dems seem to be onboard about this. If not then one can only wonder why they are so silent. I am also sure that this may be occasionally mentioned but, in passing.

The apparent plan is to just fix EVERYTHING! No discussion, no facts, now hows - its just, apparently, gonna happen. I will remain skeptical until they can, at least, fix this egregious stuff, that, I think the voters on both sides, agree are not exactly their favorite things.
Posted by: pondering_it_all

Re: Healthcare - 02/11/19 09:01 PM

They can fix it, but not until we have Democrats running things. Pretty much what they always do: Fixing things Republicans broke. Republicans break things to prove "government doesn't work." Certainly not Republican government! They are right about that. Trump actually fits that model very well: An arsonist who claims credit for putting out his own fires.
Posted by: jgw

Re: Healthcare - 02/12/19 08:13 PM

You are, again, spot on. Remember, however, when the Dems are in power they do not exactly march in lock step so they also don't really accomplish much more than 'fixing' what the Republicans left for them. ADA was almost not passed (and the republicans actually wrote half of it! (they just didn't vote for it)) They had lots of other things (I have mentioned several in other posts) that they could have fixed but choose to ignore in favor of battles over whatever.

Now they are starting to run as Socialists! One can only wonder just how serious they really are. Perhaps they too have bases that are ignorant, completely seduced, and willing to support because they can (right or wrong). <sigh> If they keep it up I suspect that the next election will have low turnout, on the part of the left.
Posted by: Greger

Re: Healthcare - 02/12/19 09:59 PM

If they keep it up I suspect that the next election will have low turnout, on the part of the left.

And I suspect the turnout will be very high. Especially if they "keep it up".

Alexandia Ocasio-Cortez continues to kick ass and take names. Republicans are running scared. Moderate Dems are seeing the future and jumping on the Green New Deal bandwagon.

Are you worried that dems are standing up and taking a path that Republicans don't like? Or do you honestly believe that Democrats should defer to the more conservative wing of the party and present themselves in such a way as not to offend the right?

I say stand up. Be bold and unafraid to usher in a new and better future.
Posted by: jgw

Re: Healthcare - 02/13/19 06:43 PM

I tend to believe that some of the stuff in the green thing is going to get a lot of support from everybody. Mitch is going to get a vote on it which will be interesting too. I am not sure about what the "more conservative wing" actually means. I do know that most, for instance, are for a single payer system but that many just don't think that the American Electorate will buy it. It would mean, for instance, no more insurance companies, no more co-pays, no more a whole bunch of things. The there is the healthcare industry itself. Between that industry, and the Republicans demonization will kick into high gear too. On the other hand, if then Dems don't change their ways its doubtful that they will even vaguely fight back. I am talking about stuff that is fact, right now. By the time that crew are through the majority of Americans are going to be quaking in fear for their lives.

Huge changes are unlikely to happen quickly and some groundwork needs to be done. Right now, however, stuff like "Medicare for All" seem to be holding the banner and I don't have a real good opinion of that one.

By the way, did you know that half of the American auto industry moved to Canada, years ago, because they had a single payer system which means that auto industry was not forced to pay for healthcare? I always liked that one. There are some very real benefits of single payer but, again, nobody is talking about that. As far as the green thing it gets even stranger. In Washington state they just had a vote on things green and it lost. The state didn't want to put too much of a burden on big polluters so the plan was to slam everybody else with little things like 15 cent gas price tax, etc. (not sure about specifics but it was somewhere in that range). The biggest polluter in the state, also got to skate. There was a few other things that didn't seem right too, like where the money taken is was actually going to be spent (with any real detail).

all in all the problem is pesky. Big changes need big support. As far as I can tell that big support is simply not there. There needs to be some serious education about this stuff to get it done and that isn't happening either.