Petition to expand Medicare to be the Single Payer Healthcare System for the USA

[vertical_doug]

The republicans on reforming Obamacare are like the dog that caught the car.

But just to keep up the drug prices....
Massive Price Hike for Lifesaving Opioid Overdose Antidote - Scientific American

Naxolone injector for opiod OD's, prices goes from $690 to $4500 from 2014.

and if that is not enough:
steroid approved in the US for first time which is about $1500 overseas, to be sold at 89,000.
Marathon Pharmaceuticals to Charge $89, for Muscular Dystrophy Drug After 7-Fold Increase - WSJ

[jclay]

The republicans on reforming Obamacare are like the dog that caught the car.

The GOP has been talking a lot of smack over the last 8 years; now they realise they'd better be able to deliver or else....and their toolbox is empty. On the other hand:

More on the Economics of Single Payer Insurance | naked capitalism

Responding to Political Attacks on Single Payer | naked capitalism

[vertical_doug]

You have to wonder how far we have fallen when something as serious as Healthcare reform is named:
H.R. 1275 - World's Greatest Healthcare Plan of 2017.

Thankfully, section one of the bill does provide a short title for the plan:

SECTION 1. SHORT TITLE; PURPOSES; TABLE OF CONTENTS.
(a) Short Title.—This Act may be cited as the “World’s Greatest Healthcare Plan of 2017”.

Text - H.R.1275 - 115th Congress (217-218): World's Greatest Healthcare Plan of 217 | Congress.gov | Library of Congress
(I include the link for those that imagine this is made up fake news, but here it is in black and white on .gov)

For those wishing to follow the debate: kff.org for the Kaiser Family Foundation which is probably the best source of neutral scoring for healthcare and fact based arguments.

ACA Repeal | ACA Repeal | Search Results | The Henry J. Kaiser Family Foundation

[Scott G.]

You have to wonder how far we have fallen when something as serious as Healthcare reform is named:
H.R. 1275 - World's Greatest Healthcare Plan of 2017.

How about calling it the "The Manchurian Insurance Revenue Enhancement Act of 2017" ?

Raymond Shaw is the kindest, bravest, warmest, most wonderful human being I've ever known in my life.

[lumpy]

You have to wonder how far we have fallen when something as serious as Healthcare reform is named:
H.R. 1275 - World's Greatest Healthcare Plan of 2017.

Thankfully, section one of the bill does provide a short title for the plan:

SECTION 1. SHORT TITLE; PURPOSES; TABLE OF CONTENTS.
(a) Short Title.—This Act may be cited as the “World’s Greatest Healthcare Plan of 2017”.

Text - H.R.1275 - 115th Congress (217-218): World's Greatest Healthcare Plan of 217 | Congress.gov | Library of Congress
(I include the link for those that imagine this is made up fake news, but here it is in black and white on .gov)

For those wishing to follow the debate: kff.org for the Kaiser Family Foundation which is probably the best source of neutral scoring for healthcare and fact based arguments.

ACA Repeal | ACA Repeal | Search Results | The Henry J. Kaiser Family Foundation

Nadir.

[defspace]

Short Title.—This Act may be cited as the “World’s Greatest Healthcare Plan of 2017”.

I feel like I'm being trolled.

[Dallas Tex]

It may be better to see what the actual tangible performance of the new healthcare is rather than mock the name ?

[robin3mj]

It may be better to see what the actual tangible performance of the new healthcare is rather than mock the name ?

I think most discerning adults can do both. The point regarding the name is that the drafters either have a slightly humorous sense of self awareness, or a 20m-person sized blind spot and distinct lack of said awareness.

[EricKeller]

the most intelligent thing I have seen about the AHCA is that the republicans have made two major mistakes:
They kept the basic premise of the ACA, and now they own all the problems with healthcare. I am sure their approach will be to blame Obamacare and say this is the best they can do, but everything people hated about Obamacare is a lot worse with this plan. And it seems designed to immiserate (or worse) Trump voters.

[lumpy]

Apparently The World's Greatest Healthcare Plan is not the mainstream Republican bill.

[lumpy]

It may be better to see what the actual tangible performance of the new healthcare is rather than mock the name ?

Better to oppose it and try to make sure it doesn't get passed, since every reputable analysis shows it can't work and the effect on the healthcare system would be catastrophic.

[jclay]

Seven years of HC vitriol, not to mention death panels and Obama gonna take our guns away et al., and THIS is the best they can come up with? Basically a revision of the ACA that makes it worse for the poorest? And then I have to endure listening to Paul Ryan's health care economics horse shit that will only lead back to more uncovered people, 'cause we're 'Mericans and nobody gonna tell us that we have to contribute, as a people, to health care, 'cept when we want to.

We have effective, cost efficient examples in Medicare, Tricare, Canada and other countries, yet we keep insisting on Balkenized systems that have enormous flaws.

Still, a small personal victory in a fairly conservative location: Guest Column: America needs the single-payer system | Jacksonville News, Sports and Entertainment | jacksonville.com

[vertical_doug]

John Oliver on the new healthcare bill. John at his best.

[Saab2000]

I know next to nothing about health care policy or law or insurance law. Can someone who knows something give a word on the state lines thing? Aren't large insurance providers national companies? I think so. What do state borders have to do with this? This is an honest question and not something to argue about.

What would be pros and cons about larger, interstate competition?

Honest, naive question here....

[Dallas Tex]

I know next to nothing about health care policy or law or insurance law. Can someone who knows something give a word on the state lines thing? Aren't large insurance providers national companies? I think so. What do state borders have to do with this? This is an honest question and not something to argue about.

What would be pros and cons about larger, interstate competition?

Honest, naive question here....

Great question. I certainly don't know. Maybe this conversation will turn into something more than the equivalent of the fans from two opposing high schools cheering against each other.

[Scott G.]

Each State has insurance regulator setting rules for the State.
Insurance companies adjust their policies per State,
meaning lovely IT projects to figure the costs & content of each policy given per State variations.
When Insurance companies merge/acquire others companies it is a years long process to regularize policies.
Anyone know how Hospital groups and provider groups would work across State lines ?

[guido]

My understanding about the state lines thing is that if individual states could set their own regulations as to minimum coverage, pre-existing condition coverage and the like, which would let companies in those states offer lower prices for policies worth a lot less to normal folks.

The concern with this is generally, it creates a race to the bottom where states/companies try to undercut each other to the extent that the market crashes and the few players left standing can then jack up rates in the unregulated and newly less congested market that remains. Folks in rural areas have enough trouble with lack of competition even with standards. Imagine what that would be like all over.

[Dallas Tex]

My understanding about the state lines thing is that if individual states could set their own regulations as to minimum coverage, pre-existing condition coverage and the like, which would let companies in those states offer lower prices for policies worth a lot less to normal folks.

The concern with this is generally, it creates a race to the bottom where states/companies try to undercut each other to the extent that the market crashes and the few players left standing can then jack up rates in the unregulated and newly less congested market that remains. Folks in rural areas have enough trouble with lack of competition even with standards. Imagine what that would be like all over.

It seems to already be a race to the bottom. What are the pros/cons of companies racing to the bottom within a single state versus all the states?

[jlyon]

I certainly can see the day we get a single payer system.

Then the harder questions begin.
Do we need a national Helmet law? Would Head injuries for motorcyclist be covered if the had no helmet?
Do we cover opiate or other drug related ODs? Will Pot need to be made illegal everywhere again? What about Alcohol? Liver disease covered?
Is there any coverage you could opt out of for lower premiums?
These issues could be debated for years even after a single payer goes live.

[guido]

It seems to already be a race to the bottom. What are the pros/cons of companies racing to the bottom within a single state versus all the states?

With minimum standards to what a policy includes, there is a built in gating factor on how low companies can go and still make a reasonable profit. Remove the standard they race to be bottom of which ever market you look at, instate or cross state.

With the ACA as it currently stands, the biggest problem is that with the penalties of the mandate being so low, many folks decided to incur the penalty and so the numbers required by the insurance companies to stay in a market just were not there in many (most?) rural places. If they had made the penalty as high (or higher) than a policy (and insuring fair income based subsidies for those in need) nearly no-one would sit on the sidelines and there would have been far less pressure to push prices up and everyone would have benefited by having more healthy markets in the rural areas.

Instead of making this adjustment, the current House bill goes the other way by eliminating the mandate, guaranteeing that rural areas will face worse pricing issues than they do now.