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Paracaidas
Sep 24, 2016
Consistently Tedious!
I look forward to the next round of The List of Alternatives to PP being released. Two times ago had a substantial number of dentists' offices. Last time featured women's prisons. What dark humor will we get this time?

the exact same list as the last two times because nobody trying to defund PP gives the slightest gently caress about women's healthcare if it doesn't impact their mistress, and maybe their daughter

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Paracaidas
Sep 24, 2016
Consistently Tedious!
It's a tremendously poo poo bill, but read with caution any source that tells you it's taking insurance away from 24 million.

Those losses come at 3 stages.

2018: 14 million total fewer insured Americans. The majority of these are voluntary and attributed to the repeal of the individual mandate.
2020: An additional 7 million Americans lose health care due to the Medicaid cuts.
2026: An additional 3 million Americans lose health care due to the Medicaid cuts.

e: Saw the McConnell quote. The "three-prong" approach relies on 8 Democrats hopping the aisle in order to make the other two prongs work... or a wildly different definition of reconciliation, requiring massive overstep by Pence.

Paracaidas fucked around with this message at 00:59 on Mar 14, 2017

Paracaidas
Sep 24, 2016
Consistently Tedious!

Badger of Basra posted:

I'm not sure why we should be worried about twisting numbers or lying after 8 years of being shown that it's a winning formula.

Because D&D is left-leaning enough I assume the bulk of readers are of a like mind and are looking to be informed? Wasn't aware this was the "Anti-Trumpcare" Strategy Thread. Message and spin all you'd like, but poo poo like this bill is what happens when you get high on your own supply.

Arglebargle III posted:

Just like I voluntarily don't have a retirement account.

The only thing that will have changed in 2018 for (most of) those first 14 million people is that they are no longer required to purchase insurance. It may be a desperately stupid decision to not do so, but the CBO says few in that group are people who wish to continue purchasing insurance and are now unable to.

Paracaidas
Sep 24, 2016
Consistently Tedious!

awesmoe posted:

yes this. If i want propoganda I'll go somewhere else (cspam probably)
:tipshat:

Arglebargle III posted:

AHCA would save $33 bln a year -- less than the $54 bln DoD spending increase Trump wants. More money for bombs, no money for health care. #hashtag
Are we failing to properly message the anti-war deficit hawks who are ambivalent about Trumpcare?

Also, it's TigerBeat, but...

http://www.politico.com/story/2017/03/obamacare-uninsured-white-house-236019 posted:

The White House's own internal analysis of the GOP plan to repeal and replace Obamacare show even steeper coverage losses than the projections by the Congressional Budget Office, according to a document viewed by POLITICO on Monday.

The executive branch analysis forecast that 26 million people would lose coverage over the next decade, versus the 24 million CBO estimate — a finding that undermines White House efforts to discredit the forecasts from the nonpartisan CBO.

The analysis found that under the American Health Care Act the coverage losses would include 17 million for Medicaid, six million in the individual market and three million in employer-based plans.

Paracaidas
Sep 24, 2016
Consistently Tedious!
It's me. I'm the segment of the voting population preemptively getting pissed off over Dem failure to justify why I don't show up to vote in the midterm which proves my theories about Dem failure.

The GOP can still escape this by following the Cruz path and having Pence overrule the parliamentarian about whether or not their other prongs can be passed via reconciliation. That broadens what they can put in to appease both wings in the house, but risks a pretty epic revolt in the Senate. There's also the chance that the parliamentarian rolls over if this becomes a real threat, to avoid the destruction of the office.

Past that, it's playing hot potato to see who gets the blame. There's zero chance Manchin or Heitkamp move on the bill, so Ryan is trying to force it into the Senate and make it Mitch's problem. Senators who'd rather not vote for it are talking tough right now to hopefully avoid having a vote on record that will be used against them in either the primary or the general. It's unclear that the GOP has sticks or carrots necessary to get to 50 in the Senate, without reconciliation trickery.

Biggest risk is collective action-the individual cost of killing a bill that would decimate the GOP is too high, so everyone passes it through.

Paracaidas
Sep 24, 2016
Consistently Tedious!

call to action posted:

"Sure, we have literal MSF-style medical encampments in the poorest areas of the US where people don't have access to even basic medical or dental services, and people break down crying when they get a $100 treatment for free, but in reality ICD10 and MRIs means this doesn't happen"

liberal propaganda:



loving MRIs killing our children! liberal CDC is agenda 21!!!
In all seriousness: Lurk More. You are clearly passionate about our healthcare system being a steaming pile of poo poo for many who must rely on it, but you seem to have bought the line that literally any other (first - world system) would be better and the only thing preventing that is politicians are too dumb/corrupt/selfish to propose it.

Many Americans believe we need to make changes to better handle healthcare for others in the country. What literally every effort at reform runs into, though, is that somewhere north of 60% of insured Americans rate their coverage as "good" or "excellent". Many of these people are eager for reforms, even if it means paying more, for those who are currently underserved. A sort of regulatory NIMBYism takes over when you ask these (if my math is right) 100m+ people to change the health care they and their family rely on.

You've stumbled into a rare d&d thread featuring people who know what the gently caress they're talking about (and also people who fantasybook the legislative process). You can read the thread to become more educated about a topic you clearly care about... or you can continue angrily flailing your way into a fuckbarreling.


Twerk from Home posted:

I've got one big savings immediately: allow providers to bulk-import drugs from Canada and align our FDA requirements so that if it's fine in Canada it's fine here.

If you're referring to the Sanders/Klobuchar amendment from January, I'll note that Paul, Lee, and Cruz all crossed the aisle to support it. Generally, any time that trio is together on a bill/amendment with bipartisan opposition - especially as it relates to government regulation and consumer protection - Americans are about to get hosed for the benefit of "overregulated" corporations.

Paracaidas
Sep 24, 2016
Consistently Tedious!

tekz posted:

This isn't an unfair criticism at all, and the lovely incrementalism the Democrats tried that coincidentally happened to enrich a bunch of their donors has still left a lot of a people screwed and suffering for the foreseeable future, and is likely to be eroded anyway?

I'd be curious to read about how the UK/Canada/whatever went from laissez-faire healthcare to the NHS/province provided healthcare/etc. ?

Fun fact: Literally any policy enacted by the Democrats will enrich a bunch of their donors, thanks to how campaign finance works in the US. May as well complain about them groveling at the demands of their oxygen breathing base. :argh:Big O2:argh:

You blame lovely incrementalism, I blame the specific portion of the base who stayed home in 2010 and the Supreme Court. I've also yet to see a credible proposal for reorganizing 20% of the economy and the majority of well-regarded current coverage into a single payer system: The AHSA (2013 model) was riddled with showstopping problems, Green Mountain Care was a nice idea (and not Single Payer) that proved unworkable in the best of circumstances, and Colorado saw their single payer plan lose 80-20 despite seeing Clinton and Bennett victories and majorities for the expansion of marijuana and hiking the minimum wage.

In the meantime, Republicans control both chambers and the White House and are struggling mightily to replace Obamacare despite it being the keystone of their platform for the last 6 years. Right now the smart money is still that they're unable to make substantial changes. The changes they do make will continue to screw people over. Generally, though, I'd chalk up survival under Endured rather than Eroded.

There remain flaws in the ACA that screw segments of the population and allow them to fall through the cracks. A public option gets part of the way to resolving that. Funding the risk corridors, (despite *enriching donors*) gets part of the way there. Rewriting the language of the Medicaid Expansion to survive Roberts gets part of the way there. If you have any content to contribute about how we can convince people to risk the coverage they currently enjoy and enact Single Payer or about ways to move towards UHC under the ACA, I'm all ears. If you'd prefer to whinge about the self-evident corruption of Democrats, I'll direct you to either of our subforums (depending on the flavor of your complaint) or nearly any other thread in this forum.

skull mask mcgee posted:

I'm pretty sure the NHS was created almost immediately after the U.K. was bombed to poo poo during WW2.

They were well down the road during the war, though it wasn't implemented until after. The Brits also "enriched their donors" (or rather, bribed the opposition) to help get it through, but I'll tap out here since I'm far from an expert on the topic. His legacy among the current Left (to the extent that we count Corbyn voters in Labour as the Left) has suffered a bit though-despite building much of what Thatcher aimed to destroy, only 43% named him one of their favorite Labour leaders (choosing up to 3), compared to 65% for Jeremy.

Paracaidas
Sep 24, 2016
Consistently Tedious!

daydrinking is fun posted:

When Democrats retake the Senate and house (whenever that happens) I'm sure they'll try to enact reforms like this, resulting in healthcare costs only growing by a few percentage points for a few years, and then it'll all be torn away by the next Republican administration. Meanwhile, millions of Americans will still be without healthcare, American healthcare costs will still be the highest in the world, and people will continue to wear bracelets with poo poo like "i'm too poor, don't call an ambulance" written on them. Liberal incrementalism has failed, you might as well go for broke and push for single payer.

I look forward to your proposal to convince ~100m Americans, across the ideological spectrum, to ditch the plans they and their families are quite happy with in favor of an unknown government plan that'll totally work and also not be subject to the whims of the next Republican administration.

It'd be a tidy story if Single Payer in the US was a popular concept blocked only by the monied interest of the corrupt. Sadly, that's not the case, as demonstrated in the post you quoted. But it's not all bad news! Single Payer is not the only form of UHC. Other forms are very possible here, and will be very good.

"Liberal incrementalism", such a dirty word, has failed by providing coverage to tens of millions who did not have it before and would have done substantially more were it not for an... idiosyncratic.... ruling by the Roberts court and the newfound Republican Congressional Majority blocking the mechanisms by which the bill worked. ACA, though imperfect, is still a solid foundation from which to build to UHC and to do so as soon as Democrats retake congress. It currently appears ready to survive the full force of a GOP onslaught.

Why do you seek to scrap it and start over?

Paracaidas
Sep 24, 2016
Consistently Tedious!

daydrinking is fun posted:

America is a country of more than 300 million people so having a hundred million or so people happy with their plan is actually a huge failure, FYI.

Liberal incrementalism failed to stop the climbing healthcare prices. The AHCA provided people with health insurance (through an unpopular mandate), which isn't the same thing as actually providing them healthcare in a great deal of instances. Of course it's better than nothing, and better than anything the GOP can come up with, but that doesn't mean it's a success, and the main reason to scrap it is that it fails to confront the main reason healthcare is expensive, which is the parasitic middlemen in the form of the insurance providers.

First off: ACA

Secondly, it absolutely is a failure that so few people are happy with it! Unfortunately, having 100m people who feel as if your plan is likely to lead to worse outcomes for them and/or their family is....not a great starting place. It'd be one thing if they were all GOP and thus against your plan to begin with, but they're not. It's the poisoned starting point from which all American Healthcare Reform conversations must begin. Don't get me wrong, I'd love Single Payer and I'm a big fan of decoupling insurance from employment. But I don't see a way to get over that barrier.

Luckily, again, Single Payer is not the only form of UHC. There are a wealth of other options, many of which enjoy wide support among Dems and are only inferior to Single Payer if you'd rather rage against insurance providers than provide healthcare.

Paracaidas
Sep 24, 2016
Consistently Tedious!

LeeMajors posted:

True.

Standing on the edge of a cliff makes you grip onto whatever you can to keep from going over.

It's all part of the plan.

America actually has tremendous healthcare if you're lucky enough to have one of the good plans. Many of the 100m or so do. They're not being tricked by the system. This does not excuse the abhorrent suffering that our current system causes (that ACA only partially mitigated), but contributes to the political reality of reform.

tekz posted:

*said against the steady background noise of people dying and going destitute* Slow and steady wins the race my friends.

:jerkbag: nuD&D is the best.

Paracaidas
Sep 24, 2016
Consistently Tedious!

Annual Prophet posted:

in late january, CMS posted is first annual report on maryland's hospital all-payer implementation

linking it here in case it's of interest to anyone and hasn't yet been linked in this thread

summary background is here

Thank you for posting this! It's a bit early, to me, to categorize the impacts found (-1.08% reduction in medicare per capita hospital cost vs 1.07% increase nationwide) as much more than noise but I especially appreciate the use of the waiver process to force hospitals into measuring against metrics that are more beneficial to the general population than what they'd been using since the 70s.

Look forward to reading more through it.

Ytlaya posted:

Just as a random note that applies to this sort of thing, but "not enough people want to do X thing" is not a rebuttal to "I think it would be good to do X thing."

For a somewhat exaggerated analogy (though honestly I'm not sure if it's really that exaggerated), it's like if you kept telling abolitionists in 1820 that they were wrong to continue advocating for the end of the slavery because not enough people supported it and X% of the economy was connected with the slavery industry.

It's the job of politicians and advocacy organizations/think tanks to tackle the issues of getting policy written and passed. A citizen only has the responsibility to express their views of what they want. It's obviously impossible to ever get a majority in support of something if there isn't first a minority who is willing to express their support. If every single citizen was a ~serious person~ who was only willing to support things that were currently politically viable, literally nothing would ever get done because you'd basically have a giant political game of chicken where no one is willing to advocate for anything until it has enough support.

I get where you're coming from and generally agree with you, but "not enough people want to do X thing" is a pretty healthy rebuttal to "Y thing was bad and the only course of action is to do X". I don't mind the exaggeration (and yes, comparing insufficient healthcare with the literal rape, murder, torture, and dehumanization of slavery is that exaggerated) of your analogy, the bigger problem to me is abolitionists were arguing on a binary level while healthcare exists on more of a spectrum. To torture the analogy a bit further, given the context of the conversation, it's an intra-abolitionist disagreement on if there's merit to trying to free slaves in a given state or if anything that fails to emancipate the entire nation immediately is a failure and hurts the cause. A less inflammatory analogy might be telling people who Fight for 15 to shut the gently caress up because all they're doing is propping up the capitalist system and the only solution worth working on is UBI.

Everyone should feel fine to advocate for whatever they'd like. With that said, if people insist on demonizing or making GBS threads on the work others are doing (or proposing) to accomplish similar objectives it changes the conversation a bit. When meaningful structural impediments are pointed out, I expect those making GBS threads on the solutions of others to grapple with them. Assuming spherical elephants in a frictionless vacuum, I'd love Single Payer. Contra the poster I was quoting, spinelessness and corruption of the Dems don't rank on the list of reasons why it's not currently feasible and "accept the reality of the situation" doesn't strike me as an unreasonable barrier to entry in a conversation if you're already making GBS threads on the participants.

blackmet posted:

RE: ColoradoCare
[...]
I support universal, nationwide health care. I'm open to discussion about different ways of doing it, as long as it gets done.

I appreciate the local detail! My point in bringing up the landslide against CC in this election was as a demonstration that even in a blue state (and yes, weed+Hillary+DemSenator+minimum wage increase is Blue), Democrats abstained or voted against it en masse. I think UHC is a moral imperative and I'm open to nearly any way of achieving it, including and especially Singe Payer if it were feasible. Working within a framework that has successfully expanded coverage and saved lives to accomplish UHC and help reduce the structural barrier to Single Payer seems to me like the best way to do so.

It is amazing how the tables of turned on Healthcare-If you'd told me after the Tea Party takeover in 2010 that "Vote for me, I'll save (restore?) Obamacare" looks like a winning message for 2018, I'd have been more skeptical about that than President Trump. If Obamacare survives the next 3 years, nobody should survive Super Tuesday without having a specific and scored plan for expanding the ACA (or a single payer replacement that can be evaluated on its merits... the last 3 months have demonstrated what goes wrong with "elect us and find out!"). As a progressive, I'll be beyond excited if "re-expand Medicaid and reestablish risk corridors to encourage exchange reentry" is the centrist Dem position in 2020 given the teeth we had to pull to get even something as relatively milquetoast as the ACA through 8 years ago.

Paracaidas
Sep 24, 2016
Consistently Tedious!
:getin:

https://twitter.com/elianayjohnson/status/844892819085021186

Paracaidas
Sep 24, 2016
Consistently Tedious!

evilweasel posted:

https://twitter.com/rachaelmbade/status/844901101233147904

That'll be the big inflection point of today, I guess.

Freedom Caucus should hold out for the password to @RealDonaldTrump

Paracaidas
Sep 24, 2016
Consistently Tedious!

Rhesus Pieces posted:

The Market! The Market as far as the eye can see!

Paracaidas
Sep 24, 2016
Consistently Tedious!

evilweasel posted:

this bill has 17% support and the Freedom Caucus hasn't yet gotten coverage for pre-existing conditions and lifetime caps removed

imagine what it would poll at with that added in

Nah, you know better than this. Mirroring Obamacare favorability before the GOP made America go all Big Yellow Taxi on it, a chunk of ACHA unfavorability is certainly from the right. It's what Ryan is fighting (and losing) as we speak. I'm guessing that 17% would climb slightly after HFC removes preexisting, staying on your parents plan, and lifetime caps.

Paracaidas
Sep 24, 2016
Consistently Tedious!

Typo posted:

sorry guys i think the lovely trumpcare bill passes either tmr or next week: the suicide caucus is suicidal but not that suicidal, they want to get re-elected and trump is playing the "I don't care if I win re-election" madman theory chess move.

the HFC will bend and the moderates will go along because it's more politically suicidal not to pass a repeal than to pass a repeal

Trump played this pretty well except for signing up for it in the first place thing, the senate OTOH is gonna be much bigger challenge

HFC districts are among the safest in the House, and they won't be facing primaries from the right over this. In addition to the Koch war chest that's been pledged.

Paracaidas
Sep 24, 2016
Consistently Tedious!

oldswitcheroo posted:

"Take Alabama, Mississippi, and West Virginia out of the statistics because..... gently caress those people"

-an actual user in this thread

I thought relitigating the primary was verboten?

Paracaidas
Sep 24, 2016
Consistently Tedious!

EugeneJ posted:

If Dems hype it enough and say "we're the party that can bring you single-payer" before the mid-terms, that's good

Helps Dem chances for regaining congressional seats next year

Whether or not Trump would veto a single-payer bill if it got to his desk is another thing. Maybe they can get him on record saying yes or no?

It's difficult (impossible) to hype a bill that is killed in committee, as evidenced by the fact that this is considered a big deal and not just Sanders coming 2 months late to the party that Conyers kicked off.

The only way I could see this getting a vote in the senate is if it's in exchange for not filibustering Gorsuch.

Paracaidas
Sep 24, 2016
Consistently Tedious!

EugeneJ posted:

They have no other strategy

What if they ran on reinforcing and expanding the Affordable Care Act, taking advantage of its popularity and the already demonstrated grassroots passion for the bill, building it towards a multipayer flavor of UHC... as opposed to scrapping it to start from scratch with a Single Payer idea that would require all three branches of government to implement and isn't possible in even the wildest fever dreams of the 116th congress?


empty whippet box posted:

Supporting any healthcare plan at all seems likely to hurt anyone who does so politically, may as well support the right one.

Anything other than fullthroated support of Medicare is political suicide. Neither chamber holds a large enough majority to gently caress up a Medicaid expansion for only a portion of the country, that's been around for less than a decade. Red State Dems like Heitkamp and Manchin felt zero pressure to cross the aisle for bills that reduced Obamacare's subsidies.

It turns out that only healthcare plans that radically alter the status quo are political suicide. This is either due to regulatory capture and general corruption, or because most people believe they are receiving good-to-great care & coverage and are skeptical about any plans to change that.

Paracaidas
Sep 24, 2016
Consistently Tedious!

Hollismason posted:

So is the plan to repeal dead because of in fighting because that would be great.

The path forward is murky, but yes it seems that the mixture of infighting and Dem unity has killed the current bill and will make any other changes far more challenging.

A bill can't pass the house without dunking on Planned Parenthood, reducing subsidies and rolling back the expanded Medicaid entitlements. That same bill can't pass the senate while defunding Planned Parenthood, increasing rural healthcare costs, and loving over medicaid-expanded states.


awesmoe posted:

*the majority* of republicans aren't that dumb. About 10, 15% are!

Those same 20ish congressmen and halfdozen senators stopped Obama from GrandBargaining away Social Security and Medicaid, so there's an argument that they've done more for the progressive movement than the conservative one!

Paracaidas
Sep 24, 2016
Consistently Tedious!
Honestly, I haven't seen someone aggressively misinterpret Evilweasel like this while emphatically missing the point since.... holy poo poo...

Welcome back Willa.

Paracaidas
Sep 24, 2016
Consistently Tedious!

Fulchrum posted:

Honestly, on balance, Pelosi is probably the most effective speaker of the house of the 21st century.

Well, successful at things other than molesting underage boys.

Ambivalent GOP moderates got Steve Bannon impotently threatening them. Back when the ACA went through, moderate Democrats were receiving calls from childhood classmates and coworkers from a decade ago asking why they weren't going to protect children with preexisting conditions. She's a goddamn titan.

Paracaidas
Sep 24, 2016
Consistently Tedious!
https://twitter.com/ASlavitt/status/859933959244963840

Slavitt has been a bit hyperbolic in the last month or so, but also knows his poo poo.

If he's correct, the premise of the thread is that Upton's $8b for those with preexisting conditions is only available to states who cut essential benefits requirements AND doesn't actually have to go towards the coverage of those who have preexisting conditions.

Paracaidas
Sep 24, 2016
Consistently Tedious!
From the WSJ, no less:
https://twitter.com/ASlavitt/status/860085668403441665

They better have gotten their whip count confirmed with blood oaths, because yiiiikes.

Paracaidas
Sep 24, 2016
Consistently Tedious!

parallelodad posted:

The AARP has long been considered a liberal organization thanks to Fox News. Conservative boomers don't give a gently caress.

http://www.ipsos-na.com/download/pr.aspx?id=11545

As of 2012, Favorability is 81/19 with the overall population and 68/32 for conservatives.

Nothing Facts matter.

Paracaidas
Sep 24, 2016
Consistently Tedious!

Arkane posted:

I have a super expensive and super lovely Obamacare plan that I am obligated to buy. Will that part become fixed by this bill?

Weren't you supposed to be getting named Ambassador to Russia soon?

Good news: It'll be less expensive. Or you won't be obligated to buy it but gently caress you're screwed next time you do need to buy insurance.
Bad news: It's very likely to be extremely high deductible with a low cap on lifetime benefit.

Paracaidas
Sep 24, 2016
Consistently Tedious!

BarbarianElephant posted:

To do that, you'd need to lower tuition fees at universities. No-ones gonna go $400k in debt for a $75k salary. Specifically not clever doctor folks. There's other stuff they could do.

gently caress this, break up the cartel.

Paracaidas
Sep 24, 2016
Consistently Tedious!

Mr. Nice! posted:

These are 'merican ideals, though. I should get to choose my own plan! Why do I, a single white male, need maternity coverage?!

Democrats think that you should have more control over your cable TV networks than your healthcare. Just another example of the twisted priorities of these rootless cosmopolitans coastal elites.

Paracaidas
Sep 24, 2016
Consistently Tedious!

evilweasel posted:

One thing that's not often realized is that doctor salaries have an inverse scale to geography that most professions do. Typically, the salary for a job goes up the more expensive your region is - a programmer/lawyer/whatever in Manhattan gets paid way more than one in Bumblefuck, Texas. That is not actually true of doctors: doctors in Bumblefuck, Texas get paid much more than doctors in Manhattan because you've got to bribe the doctors to go out to the middle of loving nowhere. So you're not actually going to be able to cut doctor pay all the way to where it is in the most efficient European countries because it's an outgrowth of the US's geography problem. There's no need to pay a doctor in Manhattan more than one in London - but you've gotta pay the one in Bumblefuck Texas more.

A ludicrous perversion of the labor market caused by the AMA's ability to control the supply at nearly every step of the process. Stop creating artifical shortages (and using tuition cost/length of education to shape the candidate pool), and all of a sudden Bumblefuck will have doctors who will be happy to be employed there (or, indeed, anywhere).

I don't begrudge them their cartel, but let's not pretend that they're not driving up medical costs to line their pockets.

Paracaidas
Sep 24, 2016
Consistently Tedious!

evilweasel posted:

No, I'd rather have a high barrier to entry for doctors than to have doctors desperate to find a job because they're not actually that qualified.

This one time, the truth may actually be in the middle. If we're serious about cutting costs, this is one of the (many) drivers and one that can be adjusted without major structural change or reorientation.

This isn't saying throw open the doors (or combine med school/undergrad as was suggested upthread). I am saying that I believe our current supply (of med school spots, of internships, of residencies, of speciality spots) is more motivated by the economic concerns of the AMA and its membership than by concern for public safety.

Paracaidas
Sep 24, 2016
Consistently Tedious!

evilweasel posted:

We can certainly do more medical schools and lower the barrier to entry with the massive debt, I just don't want something like where law schools are that churn out hundreds of "lawyers" where only half may even pass the bar and those that do, maybe one is a competent lawyer. It should be a high-paying job and we should want a good chunk of our best and brightest going into medicine. We can afford to pay for it as a nation, the costs should just be shared more equally through UHC.
Anyone who wants to copy the lawschool model is a damned idiot, so I certainly hope I didn't come across that way. I agree that we can afford to pay for it as a nation, but I'm skeptical we're getting our money's worth at this rate. I suspect that (mildly) weakening the talent pool to increase supply will actually improve outcomes as doctors work fewer hours, but I also recognize that making this change is condemning many nameless, faceless patients to die via errors of doctors who would have otherwise been rejected.

silence_kit posted:

It's not really an oddball idea. Lots of countries with great healthcare systems do things that way and start medical school after high school. It makes a lot of sense.
I don't believe it's feasible with the American education system. Colleges and universities smooth out (and filter out) so much of the disparity in the quality of education at the HS level in the US. I'm not sure how you can fairly compare candidates across districts, much less states (I get how colleges do it, but this would be markedly higher stakes). To say nothing of sitting your MCAT alongside your SAT and ACT, or locking yourself into an emotionally fraught, tremendously draining, and extremely difficult career choice at 16/17.

xarph posted:

And really when was the last time someone who got in a bad accident and was full of morphine could be expected to make correct, informed financial decisions?
In fairness, with insurance being predominantly tied to employment-we're not given the opportunity to be informed buyers in that situation either. Bill was right, our current system is the craziest thing in the world-but there's tremendous political support to maintain it in addition to the typical inertia.

Paracaidas
Sep 24, 2016
Consistently Tedious!

Gumbel2Gumbel posted:

There's no way this doesn't wreck the GOP and go to Single Payer by 2022. The one way you lose voters is changing their standard of living, and enough people have been ruined by medical bills that it counts.

Genuine question:

How do you intend to convince the 100m+ Americans who are happy/extremely happy with their current (typically employer-sponsored) health coverage to give that up for a hypothetical government-sponsored program?

Paracaidas
Sep 24, 2016
Consistently Tedious!

Hieronymous Alloy posted:

I've thought about this a lot and the best way is to allow opt-in to Medicare + Medicaid. Everyone keeps what they have but natural market churn would gradually transition us to single payer.

I think this makes a lot of sense-it allows the programs to grow and expand into their new roles(rolls? :rimshot:) rather than jumping there immediately while maintaining continuity for the HealthcareNIMBYs on the left. The reason I asked is because I can't imagine it being even a 50/50 split by G2G's 2022 date.

It also could qualify as UHC despite the presence of multiple payers-depending on the details of the plan.

Gumbel2Gumbel posted:

They're happy because it isn't as bad as it will be when the new law goes through the Senate. It covers things now. People get really loving mad when you take stuff away, people have a huge loss aversion instinct. They're already anticipating losing any sort of meaningful coverage, that is why everyone is loving pissed.

If Comcast calls you up and says "We're going to still charge you $125, but you're getting half the channels", you'd be furious. If you bought into that 2nd plan with half the channels that everyone was already getting you'd be like, "well it sucks but whatever."

The polling predates the AHCA push, so that's definitely not it. It does illustrate the problem though-People do get really loving mad when you take stuff away, specifically their stuff (see: 2010 and the GOP lies associated with it). HA's plan covers this by allowing people to maintain their coverage while expanding and demonstrating the Single Payer alternative(s). Single Payer by 2022 wouldn't permit that transitional phase, and even HA's plan is susceptible to a similar backlash as the ACA.

So do you have a mechanism for winning over the majority of American voters who are happy/very happy with their coverage? Because Single Payer, by its definition, means that they're losing that coverage.

Paracaidas
Sep 24, 2016
Consistently Tedious!

Gumbel2Gumbel posted:

My opinion is basically a prediction that American Companies are incredibly short sighted and that the Republican plans will make them slash benefits and provide terrible, bare bones coverage.

I have 0 faith, backed by every development in American history, that American companies will go to bat for their workers voluntarily once they get the option to provide the worst health care coverage ever and call it a benefit. And people are going to be furious.
Fair enough. I'm not convinced it'll be worse than the pre-ACA status quo. Which was unconscionable, but not sufficient to bring about Single Payer.

Mr. Nice! posted:

A lot of americans aren't happy with their employer plan. My dad's plan left him hanging for 20k in hospital bills that weren't covered when he had to stay four days for pneumonia. I know multiple people that have to carry two insurance plans because their employer plan doesn't cover everything.
Yup, polling showed 60% favorable and 40% neutral or negative.

I'm not trying to defend the US health care system, but it's helpful to discuss why Single Payer routinely flames out on the ballot despite the positive polling. Some of it is the inherent difference between federal and state level plans, some of it is that polling tends not to address funding mechanisms, but a significant chunk is that most American voters are happy with their healthcare.

Paracaidas
Sep 24, 2016
Consistently Tedious!

Mr. Nice! posted:

The thing is, those who have an employer plan and are happy with it are dwarfed by those on medicaid/care, an exchange plan they can't afford, or just flat out have no coverage. It's a matter of getting those people off their asses just as much as it is convincing the guy that makes 40k and has to carry secondary insurance because his employer HSA is actually poo poo that he has bad insurance.


I think part of it is shifting compensation that previously went to healthcare to the worker, but :lol: at employers raising someone's wages.

Kaiser still has the majority of Americans covered by private insurance (and the more than 60% of all with any coverage). So the number of happy people are a minority, but "getting off their asses" is an odd way to phrase it for medicaid and medicare enrollees who, based on the demographic makeup, are among the most likely people to vote. And in the case of Medicare enrollees, do not tend to vote for candidates who support UHC-much less single payer. Buncha fygm olds.

The other point also applies to Gumbel2Gumbel: Don't assume that dissatisfaction with the current (or future) system means they'll be open to your alternative. To an extent, it's the mirror of the conservative arguments against ACA, where they ignored that a substantial portion of the dissatisfaction was from the left.

Paracaidas
Sep 24, 2016
Consistently Tedious!
It'd be much more effective to have any Dem doing a TV or Radio hit pivot halfway through the point they were brought on to discuss.

"Thank you, Don. I agree that the situation in Qatar is very unusual, and the President needs to tread carefully with the number of strategic.... pardon me. Speaking of unusual situations, can you believe that Republicans are hiding the bill that their own analysis projects will markedly increase premiums, cause uninsured rates to spike, reduce the coverage for those on employer plans, and kill loads of their constituents?"

It seems like the ask is that Democrats engage in (technically) unprecedented obstruction in order to draw media attention to the horrific bill. Which is a fine strategy, except where it relies on the corporate and right wing media prioritizing the object awfulness of the bill rather than the Democratic obstruction. If y'all want to trust Lucy to hold the football this time, that's fine... but I've seen no indication that the Media has stopped fetishizing BothSides narratives.

Paracaidas
Sep 24, 2016
Consistently Tedious!

Mr. Nice! posted:

I have no doubt whatsoever that if they have 50 votes for the senate AHCA that they cannot pass via reconciliation that they will kill the filibuster over it.

The filibuster is a structural advantage for conservative (big C/little c) politics, and you have enough people in the Senate who remember that.

Democrats, broadly, want to pass new legislation, new programs, new benefits. The GOP, broadly, wants to roll those things back while passing tax reform cuts. They benefit from procedural tricks that delay or smother the legislative process in a way that Democrats do not.

Dems can expand government faster and more thoroughly than Rs can cut it. Same reason the GOP can force shutdowns but the incentives don't align for Dems to retaliate.

Paracaidas
Sep 24, 2016
Consistently Tedious!

evilweasel posted:

quoting this so you can't edit it once you realize who steve daines is

:vince:

Odd of Cornyn to give up the game so early. No reason to do that unless he's getting pressure, right?

Paracaidas
Sep 24, 2016
Consistently Tedious!

VitalSigns posted:

If not for the devastating effects on all the innocent people, it would be hilarious to watch this pass and dick over the insurance companies good and hard.

For eight years they've been cynically blaming every lovely thing they do on Obamacare, even stuff they would do anyway or stuff they were already doing before it passed, figuring they'd get away with it by deflecting customer anger onto Obama. And then those customers went and elected a bunch of idiot true believers who don't understand insurance markets to wreck their business model.

"Please, Brer Turtle, don't throw us into a market where we'll have to have one insanely expensive plan that conforms and a dozen comparatively cheaper empty plans that don't need to cover anything expensive!"

They're literally too big to fail, and they're faced with Dems who are insisting on CSR permanence vs the GOP who are seeking to make them less constrained than Comcast and credit cards. The only bad option is being forced to continue performing under ACA constraints while not receiving any of the ACA's subsidies. Dunno how familar you are with the GOP, but they're not big on making corporations take massive hits to protect the public.

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Paracaidas
Sep 24, 2016
Consistently Tedious!

Rhesus Pieces posted:

I'm glad, but prepare yourselves for reams of insufferable puff pieces and media tug-jobs for the Maverick finally somewhat living up to his nickname.

https://twitter.com/Bro_Pair/status/890809897805164544

I can't wait for the tellall of GOP Leadership for the last 10 minutes of that fiasco. Luckily, given their track record, we should have a leak of every conversation that took place on the floor by morning.

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