carcajou

Well, maybe because the two responses to my original post in this thread segment were character attacks on me for historical disagreements with those two posters about single-payer, rather than on the substance of my post. At that point, I got "rude."

I do, frankly, have to disagree with you about the number of people who are knowledgable about the massive cost with single-payer - which was actually the intent of my original post in this thread segment. I think people who have migrated to the US from Europe may have a better handle but certainly most of it (though that is not universal). But, for instance, many university students I've worked with the last 10 years - and many in that age bracket - are not, and have very unrealistic expectations about what it is going to deliver and what it will actually cost . . . both that and a misunderstanding of the European social net model, which often trades wider access for deeper benefits in contrast to the American system. There are a lot of people walking around who think "single payer" means they can rip up their insurance cards, take a $200 a year tax increase and have "free" health care that covers everything under the sun etc . . . and yes, that is partly because they are sometimes lied to, and partly because they are misled by people who don't actually fully understand the system they've lived under in Europe.

Some of that is the consequence of the continual labeling of it as "free health care" to people who have never lived in Europe. That goes both ways - labeling anything as "free" draws automatic (and justified) suspicion in the US public and context and immediately raises the question, what's the catch. Should it ever come to pass - and I don't believe it will, for a large number of reasons, including that the beneficiary pool is actually a lot smaller than commonly believed - there will be rabid protests about the tax increase, continued existence of insurance, division of private and public hospitals, you name it. All from the left. You can also bet the medical profession as a whole will become a lot less supportive than they are now, once wage caps are put in place.

The Democratic President who implements this, will be shredded to pieces by the left before the right even gets to feast on him or her . . . and will do so without any political cover from the groups that pushed him/her there to begin with.

The other lesson from 1994 and 2010 was that both Clinton and Obama were smart enough to make sure their attempts were tried before a mid-term and not a Presidential election. It gave them both time to recover and both knew they might need it.

scrubbedexpat099

Excellent points I seriously dislike the US system but in any change, especially of substance there will be winners, there will be losers. People who are losers tend to pay more attention.

civilservant

I work in the US healthcare sector, and am wholly opposed to M4A.

From a business perspective, the reimbursement provided by Medicare is a pittance compared to that offered from insurance companies. If every hospital were only a Medicare/Medicaid hospital, many would close - especially rural ones like mine.

From a personal perspective, I am one of the middle, making less than $100k, that would be taken to the cleaners by the policy as proposed. My taxes would increase far beyond the $100 a month that I currently pay in insurance premiums for my wife and I. I agree that US healthcare should be better, but I don’t see why I should be forced to subsidize others when at present I barely use what healthcare I do have.

Thats not a popular opinion here, but it is what it is

Steerpike

For what it's worth, I view the President is something of a figurehead. I expect the president to be presidential, to lead, to inspire. I expect them to surround themselves with smart people and to listen to them. I expect them to hold broad policy positions, then allow others to implement them. The biggest complaint I have of our current President is that he lacks all these characteristics, and it has a serious negative effect on the country. Kamala Harris, like Obama, would likely be an inspirational leader.

Steerpike

I'm with you in that I don't think M4A will be the big cure-all that many people seem to think. I would like to see the ACA strengthened and then attention paid to reduction in costs. Your point is important that currently, the 'for profit' side of the industry essentially subsidizes Medicare, and if it became 'all Medicare' then there would be big financial issues.

What I don't quite understand is your statement "My taxes would increase far beyond the $100 a month that I currently pay in insurance premiums for my wife and I". If you are only paying $100/mo for employer-provided health insurance, for both yourself and wife, then you are exceedingly lucky and that is not representative at all of most modern employer-provided packages. Most packages heavily subsidize the employee, but not the family of the employee. So a single person may pay, say, $100/mo, but if they want to add their spouse then it can go up to $700, or more. Add a whole family and it can go well over $1,000/mo. I worked for a company (basically an insurance broker) briefly that actually provided insurance packages to employers, so I got to see a lot of 'typical' packages. The costs of the recent ACA packages (without subsidy) were fairly representative of the actual cost of the insurance packages, to the employer. The employer then decides how much they want to subsidize it to sweeten the deal if they want to offer an attractive benefit to the employee. 35+ years ago when I started working here, it was common for the whole family package to get subsidized heavily, but over time, it has become common practice to not subsidize spouse and family.

civilservant

Agreed, this package is very generous for staff + spouse. Adding a child though 5x's the cost, so that's where the hurt comes. We don't have children.

Giantaxe

Attorney General of the largest state in the union. Very competent senator for said state.

Giantaxe

Exactly. What most people seem to overlook is that the employer's contribution is essentially being paid in lieu of more salary.There really is no such thing as a free lunch, especially when 18% of GDP is going to healthcare.

Giantaxe

The ACA actually passed after the midterm but before the Democrats lost their 60 person (59+Lieberman) supermajority in the Senate. But your point is generally correct. And if Obama hadn't wasted so much time trying to get Republicans on board, it would have happened earlier.

dave_j

Quite so, it's an attitude that's as valid as any other and I understand why social healthcare is so fiercely resisted in the US.
At the moment, one way or another you'll be subsidizing hedge fund bonuses and the multi million payments to health company CEOs. I note from your monica that you're probably a civil servant. If so you'll be aware that taxpayers actually pay your wages and presumably some of those who pay taxes cannot afford or are denied health care and these people are subsidising your lifestyle, they don't have the choice that you have.
But as you say, it is what it is.

Cape Blue

Paying wages isn't a "subsidy" - it's an exchange of labour for money.

Giantaxe

The person who "barely uses healthcare today" often becomes the opposite down the road. That's the nature of growing older. Also,we've seen from this pandemic that the idea of tying healthcare access to employment is an exceedingly poor idea. The sceanrio of lose employment, lose health insurance has played out for millions in the last few months.

civilservant

Former civil servant back in the UK, and my time as a civil servant was for a Trading Fund, which is a QANGO that takes no money from the public purse.

Indeed. I understand the need for the many to outweigh the few, but that doesn't mean I as a turkey have to vote for christmas.

Giantaxe

It doesn't. However, unlike turkeys, some day you could benefit from such a vote.

johnwoo

As far as I know, no one has described "Universal" or "Healthcare for all" as free healthcare.
Aren't those that get their healthcare from their employer getting free healthcare, payed for either by taxes or the price payed for products. The quality of free healthcare by way of employment decreases on a sliding scale. from the best for highest paid to zero to those at the bottom of the pay scale.
I've never met anyone from the UK that would like to see American.healthcare adopted in the UK.

I'd be interested to know if you think it's OK for millions of our fellow citizen to to have virtually no or little access to healthcare. I'll say again, I presume you have good healthcare yourself. Feel free ti insult or belittle me all you like. I really don't care.
Just so you know my wife and I have excellent healthcare, Medicare + medicare supplement, and part D. That costs $800/mo, which fortunately I'm in a position to be able to afford.
I'd willingly be happy to contribute that to a healthcare for all system.