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#316938 - 10/19/19 01:25 PM Public option vs Medicare for All
logtroll Offline
veteran

Registered: 04/26/10
Posts: 9590
Loc: One of the Mexicos
I confess I hadnít paid enough attention to catch the difference.

Public option = choice of government provided healthcare or private insurance

Medicare for All = no choice but government provided healthcare

I suppose the MFA strategy is that for it to work there needs to be the entire population paying into it. I expect that given enough time the public option would easily become preferred by enough to be viable.

The bugaboo would be in the transition.
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#316969 - 10/20/19 12:28 AM Re: Public option vs Medicare for All [Re: logtroll]
logtroll Offline
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Registered: 04/26/10
Posts: 9590
Loc: One of the Mexicos
Ultimately, I favor "Medicare for All" with the option of private purchase of supplemental insurance.
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#316970 - 10/20/19 12:33 AM Re: Public option vs Medicare for All [Re: logtroll]
logtroll Offline
veteran

Registered: 04/26/10
Posts: 9590
Loc: One of the Mexicos
E pluribus unum = "Out of many, one"

Sounds like the principle behind the concept of insurance. The key to cheapest coverage is having the biggest possible risk pool.

It's also the motto of the U. S. of A.
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#316975 - 10/20/19 01:24 AM Re: Public option vs Medicare for All [Re: logtroll]
NW Ponderer Offline
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Carpal Tunnel

Registered: 09/09/11
Posts: 17185
I am a very strong proponent of "public option" for very obvious and philosophical reasons. I agree that eventually it will lead to "Medicare for All". The Public Option was part of the ACA at the outset. We all know that it was killed by Joe Lieberman. Had it been enacted, we would be discussing other issues today, and the ACA would have been a boon for millions more than it was.

The concept of the ACA was to allow people to have a choice of coverage. I strongly support that position. The removal of the public option essentially eliminated most of the choice and much of the benefits of the ACA. It was a poison-pill move by a faux Democrat (I thoroughly detest the man as a traitor to principle). But even more ironically, most consumers got more choice as a result of the ACA. I have heard endless whinging about how "Obama lied" about being able to keep your doctor, but in almost every such circumstance it had nothing directly to do with the ACA. People were losing their doctor choice, paying more deductibles and co-pays and getting lousier coverage long before the ACA - because the health-insurance industry and corporations were taking away coverage, moving to new "plans" and jacking up deductibles and co-pays at an alarming pace. It was just that after passage all of it was blamed on the ACA.

The public option will be the first choice of two starkly different populations around the United States - rural and inner-city denizens. These are the demographics that are least served by the "market". In less populated States, choice is an illusion.
Quote:
The average number of companies per state in 2018 was 3.5, ranging from one company in eight states (Alaska, Delaware, Iowa, Mississippi, Nebraska, Oklahoma, South Carolina, and Wyoming) to more than 10 insurers in three states (Wisconsin, California, and New York). In 2018, 48% of enrollees (living in about 18% of counties) had a choice of three or more insurers. Despite concerns earlier in the year, there were no counties without at least one insurer in 2018.
Insurer Participation on ACA Marketplaces, 2014-2019 (Kaiser Family Foundation) [I would love to link the map which will illustrate the point perfectly.] In the inner-city, too many simply don't qualify for the support they need to get coverage. In those areas, the public option will take off like gangbusters.

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#316983 - 10/20/19 03:39 AM Re: Public option vs Medicare for All [Re: NW Ponderer]
Greger Offline


Carpal Tunnel

Registered: 11/24/06
Posts: 15783
Loc: Florida
I'm okay either way, but it seems to me that the easiest route is to re-package Obamacare as it was originally intended to work, states are now more inclined to expand Medicaid as per the original ACA.

At the same time I'd drop the enrollment age for Medicare from 65 to 55 which would improve the Medicare pool. Prices would be pegged to income or wealth, with everyone's out of pocket expenses generally lower than they are currently.

Then I'd just let it evolve. Wherever weaknesses appear in the system they get funded and fixed, prices might go up occasionally to cover shartfalls...er, shortfalls that is...they would also go down when the system is overfunded.

Business and government would work together. There's a huge amount of administrative work in insurance, a huge amount of paperwork and data processing. Private insurers have the infrastructure in place to handle it, why shut them down? It's not a super high moneymaker for insurance companies because healthcare is f***ing Expensive! They'd package slightly different policies for slightly different copays or services blah blah blah business would go on as usual but much more simplified and with a written in profit. I might meld Medicare and the VA then allocate funds to build many more facilities/Hospitals to handle geriatrics and veterans as well as serving as local emergency clinics. These hospitals would be spread out where hospital beds are most needed. As we boomers age there's gonna be a lot of geriatric beds needed and there are millions of veterans.

Anyway...if I was the King of the World that's what I'd do. Everybody would pitch in to the best of their ability to make this thing work and roll with the punches where it didn't.
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#317000 - 10/20/19 06:21 PM Re: Public option vs Medicare for All [Re: Greger]
Jeffery J. Haas Offline

It's the Despair Quotient!
Pooh-Bah

Registered: 08/03/04
Posts: 14617
Loc: Whittier, California
Originally Posted By: Greger
I'm okay either way, but it seems to me that the easiest route is to re-package Obamacare as it was originally intended to work, states are now more inclined to expand Medicaid as per the original ACA.

At the same time I'd drop the enrollment age for Medicare from 65 to 55 which would improve the Medicare pool. Prices would be pegged to income or wealth, with everyone's out of pocket expenses generally lower than they are currently.

Then I'd just let it evolve.
Wherever weaknesses appear in the system they get funded and fixed, prices might go up occasionally to cover shartfalls...er, shortfalls that is...they would also go down when the system is overfunded.

Business and government would work together. There's a huge amount of administrative work in insurance, a huge amount of paperwork and data processing. Private insurers have the infrastructure in place to handle it, why shut them down? It's not a super high moneymaker for insurance companies because healthcare is f***ing Expensive! They'd package slightly different policies for slightly different copays or services blah blah blah business would go on as usual but much more simplified and with a written in profit. I might meld Medicare and the VA then allocate funds to build many more facilities/Hospitals to handle geriatrics and veterans as well as serving as local emergency clinics. These hospitals would be spread out where hospital beds are most needed. As we boomers age there's gonna be a lot of geriatric beds needed and there are millions of veterans.

Anyway...if I was the King of the World that's what I'd do. Everybody would pitch in to the best of their ability to make this thing work and roll with the punches where it didn't.


I have almost nothing to add, but I wanted to clap.
Very well put. I think that is how it will all pan out, even WITH a so called "far Left" administration like Warren's, or Bernie's.

Because a Bernie or a Warren STILL HAS to work with others.
That means they probably won't get 100% of their idea to sell to everyone else in Congress.

We will have to hammer out some kind of reasonable compromise, and this time without the nonsense that plagued the last attempt.
We are not trying to "unplug Grandma", okay?

And I think that even Warren or Bernie recognizes the realities.
They are going to try their best to push their whole agenda but just as with other administrations, they will eventually reach the stage where they will have to be willing to make adjustments.
That IS "just letting it evolve" and I think that is a rather natural process IF we all agree that we are all attempting to make life better for as many as possible.
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#317002 - 10/20/19 09:39 PM Re: Public option vs Medicare for All [Re: logtroll]
chunkstyle Online   content
member

Registered: 10/02/07
Posts: 1941
Medicare for all. Offshore those insurance jobs like they were 80ís steel workers. I fail to understand the logic of slow walking taking care of people and defending some for profit business model Thatís delivering the least while costing the most.
Get rid of insurance companies. What value do they add? The old arguments of adding efficiency to the Ďmarketí have never appeared. Opposite in fact.
Why would you preserve it or slow walk from it?

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#317004 - 10/20/19 10:55 PM Re: Public option vs Medicare for All [Re: chunkstyle]
Greger Offline


Carpal Tunnel

Registered: 11/24/06
Posts: 15783
Loc: Florida
Quote:
Why would you preserve it or slow walk from it?

Simple, I see it as the path of the least resistance. Start at the beginning and work your way towards a completed project. A lot of people are going to be against it, so you implement it in a way that they never even know it's happening.
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"Be yourself; everyone else is already taken."ó Oscar Wilde

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#317008 - 10/21/19 12:53 AM Re: Public option vs Medicare for All [Re: Greger]
chunkstyle Online   content
member

Registered: 10/02/07
Posts: 1941
Democrats passed a republican health care package. It didnít matter, they still railed against it,
Why not pass something most are in favor for? I donít recall FDR or Johnson slow walking their major accomplishment. Come to think of it, Iíve heard nothing but slow walking on anything to do with healthcare from either political party for decades so really arenít you just advocating for the status quo?


Edited by chunkstyle (10/21/19 12:54 AM)

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#317010 - 10/21/19 02:23 AM Re: Public option vs Medicare for All [Re: chunkstyle]
Greger Offline


Carpal Tunnel

Registered: 11/24/06
Posts: 15783
Loc: Florida
Status quo doesn't have a public option, expanded medicaid, or expanded medicare. Status quo doesn't cover every American.

I'd be perfectly happy if they can find a way to offer Medicare to everyone. But I'm skeptical that it can happen. Republicans are not going to all go away when Trump does so I see a better chance that ACA can salvaged for the interim to ease us into real affordable healthcare.

And I'll point out once again that Medicare is not free and it doesn't cover a lot of things, Eyeglasses and hearing aids aren't covered, nor the exams for them. There's no dental at all. There's no long term care. You pay 20% of the cost of some procedures, 100% of others, many are free. Flu shots are covered, hepatitis shots aren't. I'm likely going to be liable for several thousand dollars worth of odds and ends for my recent hospital stay. Medicare isn't exactly a magic bullet and I don't know that it can be turned into one. There isn't a co-pay that I know of but pretty much every time I visit a doctor I've gotta fork over $35 bucks or so.

As I understand it Medicare for all is about a $3 Trillion dollar program. Warren plans to release her plan to pay for it soon.
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