DNC platfirm committee voted down #Medicareforall

[Antiganon]

I dont which is a worse hell:

1) Listening to people trying to explain the passage of the ACA when they were 14 years old in 2009. They were very apolitical, and mostly into Ron Paul and Pokemon.

2) Listening to those same people trying to explain Medicare For All, at age 25. Now they're mostly into Bernie, Joe Rogan, and anime girls.

I mean, I was 22 in 2009, I voted for Obama twice, I voted for Democrats up and down the ticket in every election since I've been eligible, and I've been passionate about politics since an early age, owing to my family's strong involvement in local politics when I was growing up.

I understood then and understand now how it passed, what the process was like at the time, the rationale behind Reid and Pelosi attempting to compromise with Republicans, like I get it. At the time it seemed like a great stepping stone to eventual better things, we would get Obamacare now, and once the country recognized that being able to get healthcare without going bankrupt was a good thing, we'd be one step closer to single payer.

Looking back, since the only reasoning for weakening the ACA was in an effort to get Republican buy in and show the American people at large that there was a broad mandate, and every Republican still opposed the weakened bill, there was no reason NOT to use the Democratic supermajorities at the time to bring back the original non-compromised bill.

[Gestopft]

there was no reason NOT to use the Democratic supermajorities at the time to bring back the original non-compromised bill.

There was a reason- his name was Joe Lieberman.

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You have to pretty damn daft to think that the ACA is doing a good job. Especially when you compare it to other nation's healthcare system.

I think the best thing you can say about the ACA is that it's awful as a healthcare system, but still better than what we had before.

[Antiganon]

There was a reason- his name was Joe Lieberman.

Man, fuck that guy.

I voted against him in the primaries, he lost, and then the motherfucker swapped parties and won anyway.

I thought we had enough votes for cloture even without him though?

For those uninitated, Joe Lieberman (yes, the same Joe Lieberman that Trump floated for AG that one time) used to be a "Democratic" Senator from Connecticut, then when he lost a primary for being a DINO, he ran as an independent and won anyway (over Ned Lamont, currently CT governor, who is doing very well right now). He's apparently a Republican now, because reasons.

I'm far, FAR happier with my current delegation to Congress. Murphy and Blumenthal are both class acts with outstanding records that speak for themselves.

[Shadowferal]

Man, fuck that guy..

Lol
Those were the same words I was thinking.

[Milchshake]

Man, fuck that guy.

I voted against him in the primaries, he lost, and then the motherfucker swapped parties and won anyway.

I thought we had enough votes for cloture even without him though?

For those uninitated, Joe Lieberman (yes, the same Joe Lieberman that Trump floated for AG that one time) used to be a "Democratic" Senator from Connecticut, then when he lost a primary for being a DINO, he ran as an independent and won anyway (over Ned Lamont, currently CT governor, who is doing very well right now). He's apparently a Republican now, because reasons.

I'm far, FAR happier with my current delegation to Congress. Murphy and Blumenthal are both class acts with outstanding records that speak for themselves.

Funny that you cant remember Lieberman spiking the public option ... proves my point. I mean thousands of miles away had this seared into their memory

Lieberman also spiked the option to have a Medicare buy-in at 55.

The legislation also had to get over other hurdles, like Ben Nelson of Nebraska who demanded a lot of concessions.
Nebraska voters still punished him and the rest of the nation by replacing him with Ben Sassee.


Yep, this is definitely some level of hell.

[Ivanstone]

Looking back, since the only reasoning for weakening the ACA was in an effort to get Republican buy in and show the American people at large that there was a broad mandate, and every Republican still opposed the weakened bill, there was no reason NOT to use the Democratic supermajorities at the time to bring back the original non-compromised bill.

There's a little more to it than that. They also had to appease a lot of party members as well. Ben Nelson being the most infamous. The Dems had exactly 60 senate votes and couldn't afford any dissent.

[Antiganon]

Funny that you cant remember Lieberman spiking the public option ... proves my point. I mean thousands of miles away had this seared into their memory

Lieberman also spiked the option to have a Medicare buy-in at 55.

The legislation also had to get over other hurdles, like Ben Nelson of Nebraska who demanded a lot of concessions.
Nebraska voters still punished him and the rest of the nation by replacing him with Ben Sassee.


Yep, this is definitely some level of hell.

I remembered him spiking the 55+ buy-in, but I thought the Republicans had spiked the no-age-restriction public option before that point.

Sorry I'm fuzzy on the details of the process by which legislation was passed over 10 years ago. Mea culpa.

[Gestopft]

Lieberman also spiked the option to have a Medicare buy-in at 55.

Quoting Sherrod Brown on that:

Lieberman killed it, saying it was a matter of conscience when it was clearly a matter of insurance industry interests in Hartford. And I’m speaking on the record.

[Zan15]

I mean, they could have. We had supermajorities in both houses of Congress and the White House.

The only, and I do mean only, reason the public option was dropped was as an appeasement to Republicans in an effort to encourage some bipartisanship. Instead, after weakening the initial proposed bill with hundreds of Republican amendments, all the Republicans voted no anyway.

Honestly, in hindsight, Obama should have vetoed the ACA when it hit his desk with all the no votes from Republicans, and sent it back to Nancy Pelosi and Harry Reid to get the original plan passed, with the public option and everything else included. If we aren't going to even get political capital or bipartisan compromise by watering down key policy items, [b]why water them down in the first place[b]?

Very simplistic view of it. Sure they tried to appease the republicans in order to push bipartisanship and use it as a vault to push other projects along with republican support but there was a lot more to the whole process than just passing it because you had a majority.

They knew long term the aspects of ACA that were on shakey ground and a public option that would be challenged for decades in the court even worse than ACA has been.

that and the public option back then was a lot less popular of an idea than it is today.

[Antiganon]

Very simplistic view of it. Sure they tried to appease the republicans in order to push bipartisanship and use it as a vault to push other projects along with republican support but there was a lot more to the whole process than just passing it because you had a majority.

They knew long term the aspects of ACA that were on shakey ground and a public option that would be challenged for decades in the court even worse than ACA has been.

that and the public option back then was a lot less popular of an idea than it is today.

Which is why I said in hindsight.

[Zan15]

Here I thought you knew how this all worked. Guess you're just making stuff up when you said; "I know way more than you ever will about the topic and healthcare/insurance."

There was no twist in my statement when I said the ACA left millions uninsured. *Affordable*
https://fivethirtyeight.com/features...lth-insurance/

.

Sigh. Again with the twist. You point out how many do not have insurance and leave out the part of the huge gains of the ACA.
Why hide the full picture to support your obvious bias towards the ACA??
Why? Would you rather have nothing as we spend a decade trying to pass a public option?
You think its a horrible thing 20 million people got covered through the ACA?

2019 the number of uninsured dropped to 28 million from 46.5 million, mostly due to ACA and employment gains.

https://www.kff.org/uninsured/issue-...ed-population/

Lack of health coverage has been a persistent problem in the U.S. The Affordable Care Act (ACA) sought to address gaps in the health coverage system and led to historic gains in health insurance coverage by extending Medicaid coverage to many low-income individuals and providing Marketplace subsidies for individuals below 400% of poverty. The number of uninsured nonelderly Americans decreased from over 46.5 million in 2010 (the year the ACA was enacted) to just below 27 million in 2016.

More praise for such a great system of the ACA. It's perfect!!!
https://www.cnbc.com/2020/07/14/one-...o-do-next.html

https://www.nytimes.com/2020/07/13/u...nce-trump.html

https://www.npr.org/2020/05/13/85509...ployment-soars

https://www.healthcaredive.com/news/...9-down/577852/


.

No one said it was a great system stop being a D.
Did you even read your links? None of the said it was perfect or called it a great system.
Every one of them pointed out that the vast vast majority of losses of insurance was from job losses and now people qualified for subsidized insurance through the ACA. Without the ACA these numbers would be a blood bath, especially now that the 600 officially ended. Not enough money for COBRA now for most people.


Among the newly uninsured, almost half, or 12.7 million, are eligible for Medicaid, and another 8.4 million are eligible for subsidies in the marketplace, KFF found. An estimated 19 million people who would otherwise lose employer-sponsored coverage could retain job-based insurance by switching to a family member's plan, while a very small portion — 1.6 million — had another source of insurance, like Medicare, they can keep.

About 5.7 million people who lose coverage through their job are not eligible for any sort of subsidized coverage: 3.7 million whose family income is above eligibility limits, 1.3 million with insurance through another working family member, 530,000 who don't meet citizenship or immigration requirements and 150,000 who fall into the coverage gap.

The horror of the ACA!! making sure 21.1 million people have options to get lower cost health insurance than with COBRA!!!!!

You're literally praising a system who made it mandatory to buy health care from huge private health care companies. Companies whose only jobs is to act as a middleman between patients and doctors and to extract as much money as possible. They are a business and they will do all they can to maximize profit. Even screwing over their customers. Not that it matters, because most insurance companies are acting in a Oligarchy fashion with no real competition. Just because it's better than nothing, doesn't make it good.

https://www.commonwealthfund.org/pub...-lack-coverage

https://www.commonwealthfund.org/pub...ears-after-aca

[/URL]

HAHAHAHAHA
You are sitting here talking about a public option and M4A, which under almost every proposal would tax everyone and force everyone to buy/pay for healthcare that would be managed by huge private health care companies. You know just like Medicare does now. Forces your participation. Forces you to pay for it. Is administered and run by huge private health care companies. Odd, being forced to buy health insurance since 1966 and the kicker is you can't even use it for 65 years while paying for it, at least the ACA lets you use it right away. But now its a problem.

I am praising the good parts of it while pushing for expansion and enhancements of the program to get to the "public option". A different route and a more realistic route then yours of jumping right into a huge public option heads first. We both support the same end goal so i don't understand your vitriol.


Its better than nothing, and its good. Not great, not awesome full of holes, problems, unaffordability and waste but still good for 20 million people whom other wise would be fucked.

You have to pretty damn daft to think that the ACA is doing a good job. Especially when you compare it to other nation's healthcare system.

Relative to pre ACA its doing a good job. You have to be daft to think the ACA has not done good by helping 20 million people afford coverage.

Comparing to other nation's healthcare systems its failing Bigly never said it wasn't but we know which party is responsible for this problem. Its not an ACA problem, its a republican problem.

[Zan15]

Did it control cost? Nope.

Control cost?
Whelp that is subjective on what your definition of "control cost" is.
Under mine and the HHS/CBO the answer is Yes.


https://www.statnews.com/2019/03/22/...ontrols-costs/

One month after the ACA had passed, the Office of the Actuary of the Department of Health and Human Services projected its financial impact in a report entitled “Estimated Financial Effects of the ‘Patient Protections and Affordable Care Act’, as Amended.” The government’s official record-keeper estimated that health care costs under the ACA would reach $4.14 trillion per year in 2017 and constitute 20.2 percent of the gross domestic product (GDP).

Fast forward to December 2018, when that same office released the official tabulation of health care spending in 2017. The bottom line: cumulatively from 2010 to 2017 the ACA reduced health care spending a total of $2.3 trillion.

In 2017 alone, health expenditures were $650 billion lower than projected, and kept health care spending under 18 percent of GDP — basically a tad over where it was in 2010 when the ACA was passed. It did all of this while expanding health coverage to more than 20 million previously uninsured Americans.



https://www.thebalance.com/cbo-report-obamacare-3305627
The other official govt agency that analyzes programs

The CBO report said the ACA reduced the budget deficit by $143 billion between 2010 and 2019
On top of that the ACA has saved hundreds of billions of dollars over several different programs under the ACA

\

Did it insure everyone? Nope.

Did it break up large insurance companies making a more diverse market? Nope.

\

Wasn't designed to do either of these in the first version.
Take a look at Massachusetts version of the ACA.
You know the forced health insurance plan by republicans for which the ACA was based on and was the goal of the next round of ACA improvements. Been around for over a decade or so and people are taxed for not having insurance. Gee i wonder where the republicans were in for abolishing this plan???

Sub 3% uninsured population.

Imagine republicans let ACA get to the same point as the plan in MA.

If you knew about health insurance markets you would understand that no plan would make most markets more diverse. Most markets have only a handful of large employers and if they choose the same insurance company they basically own the market. No other company would come into the market since they all would be fighting over the scraps that were left.
Any insurance company can participate and compete in every market in this country, but good luck making back the cost of building a provider network that is competitive in both coverage and cost.


That is more of a private employer problem then anything the govt can fix.

Is it robust enough to keep from underfunded from an hostile executive branch? Nope.

Does it prevent people from Medical Bankruptcy, the thing that is the largest Number of Bankruptcies in the US? Nope.

Was it able to keep it's individual mandate? Nope.

nope nope and nope. But that was not the fault of ACA but of the republican party.
You keep blaming the ACA when you should be blaming that faction for not expanding and improving the ACA.

But you unrealistically want single payer instantly.

Something is better than nothing, but it was a corporate handout. Yes I don't want a FOR-PROFIT Middleman whose whole business model is to get as much money as possible and then provide the least amount of coverage. *Shocked Face*

Yes corporations made money, just like they do with Medicare.
Just like they will do with M4A/Universal coverage/etc.
Whom do you think is going to administer all this coverage if we convert to m4a or UC??

Full on Canadian system? whelp all that saved money would have to be offset by the impact on the economy and jobs loss. I would love that kind of system, but realistically its fantastical on one end of the coin and devastating to 15+% of our GDP.

[Shadowferal]

Pfft...the ACA was the reason why I lost my HMO and now have no insurance beyond dental.

[Gestopft]

Control cost?
Whelp that is subjective on what your definition of "control cost" is.
Under mine and the HHS/CBO the answer is Yes.

I think the best way to describe it is that while it didn't make our healthcare system any cheaper, it did stop it from getting even more expensive so quickly. "Control costs" in this context can be kind of nebulous, kind of like parsing whether or not nixing COLA for Social Security counts as "cutting" or not.

Sub 3% uninsured population.

A better number than before obviously, but I think it's important to point out that high deductibles are also keeping people from seeking healthcare as well. And Congress is still unable to act on surprise medial billing. 3% uninsured is almost a misleading number when you remember that a staggering number of people avoid or delay treatment due to costs.

If you knew about health insurance markets you would understand that no plan would make most markets more diverse. Most markets have only a handful of large employers and if they choose the same insurance company they basically own the market. No other company would come into the market since they all would be fighting over the scraps that were left.

Bingo. And this is one of the reasons that I would yell at the TV every time one of the Democratic candidates would talk about "choice" in healthcare. Most people don't really have much choice of insurer, and as long as we maintain employee-sponsored insurance, this will continue to be the case.

Any insurance company can participate and compete in every market in this country, but good luck making back the cost of building a provider network that is competitive in both coverage and cost.

Bingo here too. Which is one of the reasons the ACA is particularly ineffective in rural areas (which tend to be more Medicare/Medicaid-dependent anyway iirc).

Full on Canadian system? whelp all that saved money would have to be offset by the impact on the economy and jobs loss. I would love that kind of system, but realistically its fantastical on one end of the coin and devastating to 15+% of our GDP.

I have seen this surmised, but I'm not sure why it would be such a blow, except locally to places that have large health insurance employment. It's not like that cost savings just disappears- theoretically, if you take say 5% of GDP out of the healthcare system, that 5% that people save in taxes compared to premiums is going to find other venues in the economy- which will grow jobs in those sectors, and as long as the bill has robust unemployment insurance for the displaced workers, there won't be a massive hit in aggregate demand or GDP, right?

(As an aside, I think the scenario you've laid out wherein private companies manage a universal system is more likely- and major systemic changes will theoretically happen when the pressure on insurance companies is such that they BEG to run M4A rather than be completely dismantled.)

[Zan15]

Pfft...the ACA was the reason why I lost my HMO and now have no insurance beyond dental.

How so?
Your company refused to update their plan to meet the requirements so they instead cancelled it?

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A better number than before obviously, but I think it's important to point out that high deductibles are also keeping people from seeking healthcare as well. And Congress is still unable to act on surprise medial billing. 3% uninsured is almost a misleading number when you remember that a staggering number of people avoid or delay treatment due to costs.

I partially agree. But if 20% had no insurance, then a much larger % would be delaying treatment due to cost and inability to pay.

Any type of public plan would still require taxes to pay and based on all the plans in circulation, most of them would still hit these same people in the lower middle to middle class with taxes that are relative to their yearly out of pocket cost.


Surprise medical billing is not just an ACA/Insurance problem. Doctors, labs, ambulance companies, etc conspire not to contract with insurance companies in order to jack up reimbursements. Most of this happens in the hospital or services related to hospital procedures.

Hospitals could easily fix this problem by requiring all residents and those with privileges also participate in the insurance plans they do or set their reimbursement to a max % of standard prevailing rates for the market. If they don't, then let them try to find a place they can administer anesthesia outside of a hospital.

[Shadowferal]

How so?
Your company refused to update their plan to meet the requirements so they instead cancelled it?

Replaced my HMO with a PPO or something like it. The rep tried claiming that a "targeted" approach would be more cost effective. I never saw a person blush so fast as I enumerated the problems I had with that statement. And at a glance my monthly bill would have been 6x the cost for simply having the plan. Factoring in the deductible (something everyone should do) made it less than worthless, a money sink that made the penalty a cheap price to pay for having no health insurance. (From my perspective)

[Zan15]

Replaced my HMO with a PPO or something like it. The rep tried claiming that a "targeted" approach would be more cost effective. I never saw a person blush so fast as I enumerated the problems I had with that statement. And at a glance my monthly bill would have been 6x the cost for simply having the plan. Factoring in the deductible (something everyone should do) made it less than worthless, a money sink that made the penalty a cheap price to pay for having no health insurance. (From my perspective)

so i don't see the link so much to the ACA as your employer passing on huge increases to their workers???
Sure there would have been some cost increase relative to the ACA regulations and forced minimum insurance requirements but no where would it have been 6x increase without them passing on a huge % of the premium to you from them.

Factoring in the deductible (something everyone should do) made it less than worthless, a money sink that made the penalty a cheap price to pay for having no health insurance. (From my perspective)

Factoring in the deductible is not exactly the way to go since you can go a dozen years with no cost sharing at all. You factor in a cost that might not materialize?

I've seen so many people in my life go from 120% to 0% real fast that i could never suggest anyone ever have no insurance unless they are very rich. Even then it would be silly relative to the cost not to buy it when you have that much money

Insurance is priced for a long term return on your investment. Waiting to get insurance when you finally get older or sick just puts the cost burden on everyone else who now has to pay for your illness, accident or care.
They should be able to charge people more based on their insurance history.

imagine if every pregnant woman waited till they decided to get pregnant to get insurance then dump it after the birth. They would pay 6-8 thousand in premiums for 25k 50k-100k-1m in cost. Everyone else's rates would have to go up to compensate for the huge loss.

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So your company is the asshole, not the ACA?

well the ACA did mandate some things that cost more money, but nothing relative to his increase or even close

[Gaexion Ramza Beoulve]

When people show you who they really are

believe them.

[Cthulhu 2020]

There are no fascists in USA in power.

"There are no fascists in power in the USA" has a different meaning from "The US government isn't wholly fascist". Just because people can protest, just because there are enough non-fascists in power to afford people rights and liberties, doesn't mean there are no fascists in power in the USA. There are factions within the US government, who if they had their way, the US government would suppress all dissent and be full fascist.