Are we headed toward Medicare For All??

[kentuck]

At the moment, our only choices seem to be to accept "Obamacare" or go back to whatever the insurance companies want to charge or want to cover? The Republicans offer no other choice.

Health costs have been going up at an unbelievable rate for the last 20 years or so. It now sucks up about 17% of our GDP! That's a lot of money to take care of sick people. And the insurance companies take a big share of that money. The Republicans want to put your healthcare back in their hands entirely, without any controls or regulations.

But Obamacare also wants your healthcare in the hands of insurance companies. However, they want some controls on how much they can charge and who they can cover. Obviously, it is better than the "nothing" that the Republicans offer.

So, both Parties support the insurance companies. Neither is preferable to the American people. Why pay insurance companies hundreds of billions of dollars for something we can do on our own, thru our government? Medicare for all, is the solution. Put everyone to work and take out a small percentage of their pay for health coverage and give them a Medicare card if they need to go to the doctor. Isn't it time we stopped the big rip-off ?

[NYC_SKP]

1. My COBRA for an individual just went up to $1,432.49

That's more than my mortgage AND my electric bill combined.

I could buy a second home, or three or four cars with that kind of money.

I expect it to be half of that under ACA.

I would support Medicare over ACA, but I think ACA is a step in that direction.

[WCGreen]

53. Ours runs about $1,100.00

I can opt to Medicare and get a gap policy and Mrs. WCGreen can then grab coverage more in tune to her needs...

I'm hoping we can get that down to about $500.00 or so with deductible.

[canoeist52]

2. "Lord, hear our prayer!" as republican were heard (forced) to say at Ted Kennedy's funeral mass.

[Harmony Blue]

3. The insurance companies are trying to rake in the money while they can

Medicare for all is a given based on population demographics in the United States alone.

[MrsKirkley]

4. Any political party responsible for expanding Medicare

would have a strong voter base for many years to come. Yet no party will do it. Sad.

[Fantastic Anarchist]

19. Money speaks volumes.

Money in politics and money for propaganda will keep single-payer at bay for some time, I'm afraid.

[Hoyt]

5. I'm for Medicare for all. But, 28% of beneficiaries are covered by private Medicare Advantage Plans,

which are private insurers. Those beneficiaries voluntarily chose those plans because they felt they offered more than traditional Medicare. And Medicare is administered at local level, by private insurance company subsidiaries, that pay every health care providers' claims, make coverage determinations, etc., under federal guidelines -- sort of like what we'll have with ACA.

Good or bad, we are stuck with them for the time being.

[PoliticAverse]

30. Which is why Medicare is actualy far from a 'single payer' system. n/t

[subterranean]

31. Private insurers exist even in countries with UHC.

In countries such as France, Australia, Germany and even Canada, it is common for people to carry supplemental private health insurance to cover what the public system doesn't. That would likely be the case if we were ever to get Medicare-for-All in this country. The insurance companies would still exist and make money, just not as much as they do now.

[Scuba]

6. With dental, optical and hearing aids.

We can afford it, the question is if we have the will.

[RebelOne]

54. Basic Medicare does not cover dental, optical and hearing aid costs.

The Advantage plan covers those, but it is more expensive. I pay $105 a month now for basic Medicare now and cannot afford the Advantage plan. My social security is $1400 a month with $105 deducted for Medicare, so that does not give me much to live on.

[1-Old-Man]

7. I think that the ACA will certainly delay if not entirely kill any chance of Medicare for all.

Unless the power of the medical complex is greatly diminished or the Republican Party is emasculated the passage of the Affordable Care Act represents a line drawn in the sand past which our movement toward national health care will be blocked for years and years to come. Considering the political turmoil attendant to the ACA no future Congress will be willing to take up the issue again. What we have now is what we will have to live with - there will be no further progress.

There was a dam good reason to accept nothing less than a fully taxpayer funded national health care right from the start, it was because what we were going to end up getting was all that we were ever going to get.

[jeff47]

12. I believe the opposite

The ACA and it's exchanges provide the mechanism to get single-payer.

Blue states will implement "government options" in their exchanges. These options don't have to make a profit, so they will be less expensive than the commercial options. That'll get people started on them. And when those people don't die, it disarms the anti-"government healthcare" arguments, leading to more people joining the government plan for the cost savings.

Success in the blue states will be noticed by the purple states, and they will follow that path. As the insurance companies lose customers, they will lose cost sharing. That will make them even more expensive and accelerate the transition.

And then you end up with de-facto single-payer.

Why do I think this will work? It's how Canada got single-payer. One province started it. The others followed when it worked so well.

what we were going to end up getting was all that we were ever going to get.

It took decades for Social Security to cover as many people as are covered today. Medicare and Medicaid have been expanded many times since they were created. There's no reason to believe the ACA is set in stone. And even if it is set in stone, it still provides the mechanism for single-payer to emerge.

[1-Old-Man]

14. Jeff, you make very good points and I sincerely hope you are right and I am wrong

I honestly hope you are right about everything except how long it might take I hope you're right and it happens almost overnight.

But there's a fundamental problem with our discussion. We aren't talking about the same thing. The overall subject is the same, national health care, but were we differ is you are relying on the good sense of the people whereas my argument rests on the timidity of the Congress, both the current one and those to follow. You're saying the people will demand it and it will come or that the economics will drive us in that direction, but what I'm saying is the Congress will look to our current experience and will refuse to touch the continuing problem with a ten foot pole.

Maybe I'm wrong to be the congressional pessimist, but to be honest about it I have no faith in the institution to chose the welfare of the people over the outright bribery from the medical/insurance/pharmaceutical complex.

[jeff47]

28. Actually, no. I'm saying Congress is irrelevant.

It's the states that are going to make single-payer happen. Congress doesn't have to do squat.

Public options in individual states will give us de-facto single payer. Congress may decide to recognize and nationalize that sometime in the future, but it isn't necessary.

[1-Old-Man]

34. Well, on that one I'd have to disagree with you.

I think that puts you back into a situation similar to the pre-ACA days in which for health insurance there were 50 different systems with 50 different requirements and for some reason I have never understood the inability of the consumer to pick from a state other than their own. If we go to the 50 state model I'm certain that there will be horrible coverage in Alabama and great coverage in Maryland or New York, and possibly no real coverage at all in Utah.

If we are going to have National Health Care, just one system with just one payer, which is what Medicare for everyone would have to be, then the Congress will have to make it happen, and I maintain that simply is not going to be in the cards.

But once again, I hope for future generations that you are right and I am wrong.

By the way, I've been being treated for cancer for two and a half years now. I incur medical expenses that have averaged $15,000 per month over that time; one medication I take daily cost $6,000 per month all by itself. My total outlay during that time has been $60 in co-pay. I have very good insurance. So my wishes are for generations that will long survive me; I've got no dog in this fight myself.

[jeff47]

35. Because then it's a race-to-the-bottom.

I have never understood the inability of the consumer to pick from a state other than their own.

Because each state regulates its own health insurance market. California has different requirements on its books than Alabama.

And if we could buy out-of-state, the health insurance companies would all race to the bottom. Just like every credit card is issued by banks in Delaware or South Dakota - those states give massive blowjobs to the credit card industry by fucking consumers.

We don't want to repeat that mistake with health insurance.

If we go to the 50 state model I'm certain that there will be horrible coverage in Alabama and great coverage in Maryland or New York, and possibly no real coverage at all in Utah.

For a while, yes. But that's still better than the status-quo, because the ACA added regulations to those terrible Alabama and Utah plans to make them a little better.

But as time goes on, the difference between the plans in Alabama and California will become a political issue even in Alabama. Kinda like the lack of paved roads in some states became a political issue.

If we are going to have National Health Care, just one system with just one payer, which is what Medicare for everyone would have to be, then the Congress will have to make it happen, and I maintain that simply is not going to be in the cards.

An instant leap to Medicare-for-all was never going to happen. Too much FUD from the insurance companies, and too many Democrats like Lieberman. The leap is just too far.

But when a whole bunch of blue states have already made state-size leaps, the federal leap is far easier to make. The FUD runs smack into reality when there aren't piles of dead bodies in the blue states.

And again, this isn't me just being wishful. This is exactly how Canada ended up with single-payer. They tried to implement a national system, and FUD killed it. A single province started their own single-payer, and its success dragged along the other provinces.

So my wishes are for generations that will long survive me; I've got no dog in this fight myself.

I'm a just-under-40-year-old who is paying for insurance via my employer. It's great insurance, and somewhat reasonably priced. But single-payer is still better for all of us. My dog in this fight is I don't want my kids to have to choose between work they want to do and health insurance, as I have.

[1-Old-Man]

43. Your argument is powerful and good. I hope like hell I am wrong and you are right.

I'm not too sure that the Canadian experience will translate to us, they seem to handle a number of things better than we do. I am not expecting to see any great improvement in my lifetime (which has been long, I have no complaints) but I hope you do.

[LWolf]

40. I agree.

The foundation of the ACA is private, for-profit insurance.

That's not the foundation that leads to a fully taxpayer funded national health care system, and THAT'S the goal.

Still too expensive insurance that I can't afford to use for care because of the deductibles and copays, that continues to make a profit for insurance companies while I continue not to get care...that's no solution to the health care crisis.

[tridim]

8. Insurance companies HATE the 20% profit cap.

No company enjoys sending rebate checks to their customers every month. BCBS has sent me three big rebate checks so far.

Obama is smart, and he understands that he doesn't have the power to shut down the Insurance industry directly (which is what the far-left wanted him to do, major DERP). He would have been impeached had he tried. Honestly, I don't want any president shutting down legal businesses.

There are better ways to do this, and the ACA is a perfect example of that better way. Yes, we are headed toward single payer HC, thanks to Obamacare.

[bvar22]

29. Insurance companies HATE the 20% profit cap ?

That is not what the Smart Money says.
The Smart Money says they LOVE guaranteed PROFITS
funded by the US Treasury!


Please don't throw me into that Guaranteed 20% Profits Briar Patch!!!

[tridim]

32. It's a cap, not a guarantee.

You suck at spin dude.

[bvar22]

36. The customers ARE Guaranteed, forced to buy.

..and the Cap (rate) IS Cost Plus.
There is absolutely NO incentive for the Insurance Companies to
pressure Health providers to Keep Costs Down.
In fact, if the Insurance Cartel makes even MORE money if prices by the Providers INCREASE, because the Cartel is now on a Cost Plus basis,
guaranteed by the US Treasury.
(as Wendell Potter exposed years ago.)


Please don't throw me in the Briar patch!!!


BTW: You suck at defending your position.
Your failed attempt to change the subject is noted.


for EVERYBODY else, once again,
THIS is How Much the Insurance Cartel HATES ObamaCare!

They're hatin on ObamaCare all the way to the Wall Street Banks.

[Hoyt]

38. Plenty of incentives when consumers can switch and use the exchanges to determine best deals.

[bvar22]

48. Only if you believe the Insurance Cartel is going to cut their own throats.

I predict that the "competing plans" on The Exchange will be remarkably similar, like they got together and set prices and floors, but, of course, they would NEVER do THAT because THAT would be illegal...wink..wink

Like today, the States Exchanges will be divided among the conquerors,
and their new mandatory "customers" will be herded into the Exchange Pens for their mandatory yearly shearing with the IRS serving as their herd dogs, nipping at the heels of reluctant "customers".

BTW, since the invention of the Internet, there have been numerous sites for Comparison Shopping & One Stop Shopping among the Health Insurance Corporations. The Exchange doesn't offer anything "new" in that area.


http://www.ehealthinsurance.com/

http://www.fortmilltimes.com/2013/09/19/2968043/healthaviator-to-offer-one-stop.html

http://finder.healthcare.gov/

[Hoyt]

50. I think there will be at least on "renegade" -- perhaps a non-profit -- that keeps them honest.

Besides, if they make too much money, the feds will make them pay it back.

There are a number of safeguards built into the ACA.

[bvar22]

55. You have much more faith in the Health Insurance Industry...

..than I do.
They aren't going to give up a damned penny unless forced to do so,
and there is no enforcement agency or penalties written into the ACA.

As far as I can tell at this point, if a "consumer" has a complaint,
he/she will have to hire a lawyer and take the Insurance Cartel to court,
just like now.

But we're wasting time here with predictions.
2014 and The MANDATE fast approaches.
The majority of non-insured Americans (40 Million - 70 Million) have NO Idea what is going to be expected of them.

Tick...tock...Tick...tock

We will see.

[Demo_Chris]

47. exactly. nt

[NoOneMan]

9. No.

That's just a truthy political slogan to sell an conservative 1960s policy to American liberals who don't know better.

[MrsKirkley]

10. I'd love to see Medicare or Medicaid for all.

I'm for single-payer health care. Health insurance companies treat approving claims for medical care the same way auto insurance companies treat claims for auto repairs and I hate them for it. Nobody dies if the insurance company refuses to pay for auto body repair. When health insurance companies refuse to pay for health care, people die. That's why I believe for profit health insurance, except for cosmetic procedures, should be illegal. Unfortunately, they are a necessary evil and need to be regulated to keep from killing even more people.

[leftstreet]

11. Medicare is heading toward privatization

If you look at the legislative changes since 1997...

It could be argued that the ACA will actually help Americans adjust to that

[MrsKirkley]

13. Perhaps we should make health insurance for medically necessary health care illegal.

[1StrongBlackMan]

37. Wow …

I would ask for substantiation for that leap; but you know …that Chicken Little, Crying Boy speculation doesn’t merit it. The ACA is nowhere near a step towards medicare privatization. While that is a major goal for the gop, it hasn’t gone, and will not go, anywhere.

[Hoyt]

46. I'm for the ACA, but it does include incentives for hospitals, physicians and others to form

something they call Accountable Care Organizations which act essentially like local insurance companies in that they take federal money and keep any "savings" they produce from providing care to Medicare beneficiaries. Thus, they are essentially a newer form of Medicare Advantage Plans (which are private insurers who currently get paid by the feds to handle administering Medicare for 28% of Medicare beneficiaries). The current Medicare Advantage Plans continue under the ACA.

Thus, Medicare really is becoming privatized to an extent. I'm not sure that is a bad thing as long as the feds tightly monitor what is going on.

[1StrongBlackMan]

56. I have not heard of Accountable Care Organizations ...

I'll have to research them.

Care to provide a link to get me started.

I'd appreciate a link to the "private insurers who currently get paid by the feds to handle administering Medicare for 28% of Medicare beneficiaries" ... I don't doubt it; but I need to see how this is different and/or problematic. I confess not knowing a lot about Medicare Advantage Plans, but I guess I should bone up since I'm headed that way.

[Hoyt]

57. I'm on a pad thst is hard to do links. Google Medicare Advantage Plans.

Insurers like United Healthcare, Humana, Kaiser, Cigna offer the plans. They often couple the drug coverage, traditional Medicare coverage, and offer some things that traditional Medicare does not like some vision care. I'm closing in on Medicare, and may go that route. I checked CMS site for percentage of beneficiaries currently enrolled.

You should be able to find some stuff by searching "ACO under ACA." Over last 10 years government had some demonstration projects that showed some cost savings and quality improvement through better coordinated care. I'm a little skeptical, but we need to try some new things to change the way care is delivered.

[Bonhomme Richard]

16. Both parties support business.

End of story.
One party simply doesn't even bother trying to hide it.

[Fantastic Anarchist]

20. ^^^This^^^

[Bonhomme Richard]

23. It will not end until they are afraid of the people.

Until then....Nada, only more for the wealthy. It has always been that way. In the 30's the only reason Roosevelt was able to make the changes he did was due to the growth and popularity of the communist and socialist parties here. Hell, Joesph Kennedy thanked him for saving capitalism.
Sometimes I think the working class in this country must be the dumbest motherfuckers on the planet.

[woo me with science]

25. +1 I was just about to write that

if we are given something called "Medicare for All" from this bunch in Washington now, it will be a cruel perversion of "Medicare" that further enriches the wealthy at the expense of the rest of us.

[Fantastic Anarchist]

17. I can only wish ...

... but like you said, both parties won't interfere with Big Insurance and their method of treating health as a commodity.

[Cryptoad]

18. Sorry ,,,,

but that is all we could get passed... and we barely did that..... I predict ACA and Medicare will morph into a single payer in time...that is ..If we can keep voting more Democrats into office!

Have you looked at any of the ACA exchanges that are coming online?

Looks Better than I expected!

[Hoyt]

39. +1

[Ron Obvious]

21. I wish

We're not addressing the real problem: runaway medical costs. When the same treatment costs about $10,000 in Europe and $350,000 here in the US (personal experience), than even paying the entire medical bill in Europe is way cheaper than paying the porting the insurance doesn't cover here in the US. And that's without over $10,000 in insurance premiums annually.

Regulation of medical costs is what's most needed. Subsidising insanely high insurance premiums will help some people, but will ultimately drive premiums up even more.

ETA: grammar

[bvar22]

22. The Health Insurance Industry:

*Manufactures NO product

*Provides NO Useful Service

*Creates NO Value Added Wealth

*Keeps NO Inventory

..but NOW we have opened the doors to the Public Treasury to these parasites
by paying them our Tax Dollars to "cover" Americans.
They NOW have a guaranteed PROFIT,
and the 15% - 20% paid to these parasites for NO Useful Service
WILL be 15% - 20% of OUR money that does NOT go to Health Care,
but into the private pockets of Corporate Owners & their "investors".

The Smart Money says that the ACA is going to be a Gold Mine for the Insurance Cartel, as the price of "investing" in these parasitic industries has more than DOUBLED since the passing of the ACA.


Establishing the private Health Insurance Industry as the only Gateway to Health Care in America, and MANDATING their "customers" & GUARANTEEING their PROFITS from our Public Treasury ,
is NOT a step toward an efficient & fair Publicly Owned, Government Administered, National Health Care Plan.

It IS a BIG step in the opposite direction,
toward the Privatization of Health Care Delivery.
The Mandate & The State Exchanges will have to be undone before we can move toward a plan like Medicare for All.

FDR & LBJ would NOT approve of the Corporatization of Health Care in America.

They believed that Health Care was a Basic Human Right to be protected and administered by our Government OF The People,
and NOT as a Commodity to be SOLD to Americans at a profit by Private Corporations.



You will know them by their [font size=3]WORKS.[/font]

[woo me with science]

26. Thank you. They are nothing but middlemen who profit from illness.

It is as evil to profit from the need for health care as it is to profit from imprisoning human beings.

[SammyWinstonJack]

44. Parasites, now with a guaranteed customer base..........NICE!

[Spitfire of ATJ]

24. People already know the answer to that question....

We can't have nice things because,....all together now!

[Romulox]

27. Nope. Our politicians will be bribed with the very premiums Obamacare mandates.

Government-forced purchase empowers private insurers. It doesn't weaken them.

[BKH70041]

33. At some point down the road, yes.

But it won't be like single payer in Europe, Canada, etc... I think the insurance companies will still be in the loop as third party administrators. Why? Because we're Americans and we'll do it our own way.

I do have a friend who works at a corporate office of one of the insurance giants and his line to me is "We don't want to keep all the money in the world, we just want all of it to run through our books, and for us to make 2% from it."

Now there's your thought for the moment.

[MNBrewer]

41. probably not

[eridani]

42. Only state by state n/t

[Sheepshank]

45. We also seem to forget that profit vs health care spending % ages are also managed

under ACA.

I think the curbing the bloated, unchecked proft making insurance machines, will help with the rising costs. I also think, and I really believe we will eventually end up with health care not being offered by employers, but will be a line item tax deduction from our paychecks like Social Security. It will be a win for employers as well as for the public....and will be fully socialized.

[DirkGently]

49. Disempowering private health insurance is like dislodging a tick

... just have to keep pulling.

I do think the ACA / "Obamacare" is an improvement in that it regulates private insurers to the benefit of everyone. The fact that this will occur is doubtless why Republicans are so frantic to torpedo a plan so close to their own 1990s proposal.

But we can't afford not have national healthcare any more. It's a gift to private insurers. Had they behaved, and managed care in good faith, they could have continued to be paid for doing that. But instead they've decided they have Americans by the throat and are going to squeeze both patients and providers until something gives.

Something will. We need to make Medicare for All a big priority, with or without the ACA. It's the next stepp.

[Laelth]

51. Hear, hear! k&r n/t

-Laelth

[Trillo]

52. Is HR676 still on the table?

The American dream was independence. That is no longer the case, now corporations and the NSA are in the middle of every damn transaction.

I'm thinking that while something like Medicare-for-all it may be preferable, it may be more practical to bring back over-the-counter laudanum, like we had in the 1800s.

[RagAss]

58. Where do you think you live ? In a country ?

"This is not a country. It's a fucking business."